Huang Dunbing, Song Wei, Liu Yang, Ke Xiaohua, Wu Zhenhua
Encephalopathy and Rehabilitation Center, The Second Affiliated Hospital of Zhejiang Chinese Medical University, No. 318 Chaowang Road, Hangzhou, Zhejiang, 310005, China.
Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, 1279 Sanmen Road, Shanghai, 200434, China.
J Orthop Surg Res. 2025 Aug 20;20(1):775. doi: 10.1186/s13018-025-06194-0.
To investigate the effects of a 12-week isokinetic eccentric training program on postural control and ankle muscle strength in individuals with functional ankle instability (FAI).
In this randomized controlled trial, 42 participants with unilateral FAI were randomly assigned to either an experimental group (n = 21), receiving isokinetic eccentric training, or a control group (n = 21), receiving isokinetic concentric training. Both groups trained three times per week for 12 weeks. One participant from each group dropped out during the intervention, resulting in 20 participants per group included in the final analysis. Primary outcomes included static and dynamic postural control assessed using the Pro-Kin 254P platform. Secondary outcomes were ankle dorsiflexion and eversion strength, as well as dorsiflexion/plantarflexion (D/P) and eversion/inversion (E/I) torque ratios measured with a Biodex System 4 Pro dynamometer at 60°/s and 180°/s. Between-group comparisons and effect sizes (Cohen's d) with 95% confidence intervals (CI) were reported.
After 12 weeks, the experimental group demonstrated significantly greater improvements in postural control and ankle strength outcomes compared to the control group (p < 0.01). For dynamic postural control, the total offset index decreased by 23.8% in the eccentric group, showed a significant improvement with a very large effect size (Cohen's d = 2.06, 95% CI [1.29, 2.82], p < 0.001). Static postural control, measured by sway area, was reduced by 17.3% (Cohen's d = 0.81, 95% CI [0.16, 1.45], p = 0.015), while sway length did not reach statistical significance (Cohen's d = 0.55, 95% CI [-0.08, 1.18], p = 0.090). Regarding ankle strength, dorsiflexion relative peak torque (RPT) at 60°/s increased by 30.7% in the eccentric group (Cohen's d = - 0.79, 95% CI [-1.44, - 0.15], p = 0.016), while eversion RPT at 180°/s improved by 75.7% (Cohen's d = - 1.13, 95% CI [-1.79, - 0.46], p = 0.001). The D/P torque ratio at 180°/s exhibited a very large between-group difference (Cohen's d = - 2.18, 95% CI [-2.96, - 1.39], p < 0.001), and the E/I torque ratio at 60°/s demonstrated an extremely large effect size (Cohen's d = - 4.50, 95% CI [-5.67, - 3.34], p < 0.001).
Isokinetic eccentric training significantly enhances postural stability and ankle muscle strength in patients with FAI. These improvements in torque symmetry and balance support the inclusion of eccentric training as an effective rehabilitation strategy to reduce reinjury risk and restore neuromuscular function.
探讨为期12周的等速离心训练计划对功能性踝关节不稳（FAI）个体姿势控制和踝关节肌肉力量的影响。
在这项随机对照试验中，42名单侧FAI参与者被随机分配到实验组（n = 21），接受等速离心训练，或对照组（n = 21），接受等速向心训练。两组均每周训练3次，共12周。干预期间每组各有1名参与者退出，最终分析每组纳入20名参与者。主要结局包括使用Pro-Kin 254P平台评估的静态和动态姿势控制。次要结局为踝关节背屈和外翻力量，以及使用Biodex System 4 Pro测力计在60°/秒和180°/秒时测量的背屈/跖屈（D/P）和外翻/内翻（E/I）扭矩比。报告组间比较和效应量（科恩d值）及95%置信区间（CI）。
12周后，与对照组相比，实验组在姿势控制和踝关节力量结局方面有显著更大的改善（p < 0.01）。对于动态姿势控制，离心组的总偏移指数下降了23.8%，显示出显著改善，效应量非常大（科恩d值 = 2.06，95% CI [1.29, 2.82]，p < 0.001）。以摆动面积衡量的静态姿势控制减少了17.3%（科恩d值 = 0.81，95% CI [0.16, 1.45]，p = 0.015），而摆动长度未达到统计学显著性（科恩d值 = 0.55，95% CI [-0.08, 1.18]，p = 0.090）。关于踝关节力量，离心组在60°/秒时背屈相对峰值扭矩（RPT）增加了30.7%（科恩d值 = -0.79，95% CI [-1.44, -0.15]，p = 0.016），而在180°/秒时外翻RPT提高了75.7%（科恩d值 = -1.13，95% CI [-1.79, -0.46]，p = 0.001）。在180°/秒时的D/P扭矩比显示出非常大的组间差异（科恩d值 = -2.18，95% CI [-2.96, -1.39]，p < 0.001），在60°/秒时的E/I扭矩比显示出极大的效应量（科恩d值 = -4.50，95% CI [-5.67, -3.34]，p < 0.001）。
等速离心训练显著增强了FAI患者的姿势稳定性和踝关节肌肉力量。扭矩对称性和平衡的这些改善支持将离心训练作为一种有效的康复策略，以降低再次受伤风险并恢复神经肌肉功能。
