慢性踝关节不稳患者在预期和意外内翻扰动着陆过程中下肢运动学、动力学和肌肉活动的特征：一项系统评价和荟萃分析

Characteristics of Lower Extremity Kinematics, Kinetics, and Muscle Activity in Individuals With Chronic Ankle Instability During Landing With Expected and Unexpected Inversion Perturbations: A Systematic Review and Meta-Analysis.

作者信息

Gong Yixue, Xu Menghan, Chen Peng, Hu Xiaomei, Zhou Wenxing, Wang Lin

机构信息

School of Exercise and Health, Shanghai University of Sport, Shanghai, China.

Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

J Foot Ankle Res. 2025 Sep;18(3):e70082. doi: 10.1002/jfa2.70082.

DOI:10.1002/jfa2.70082

PMID:40922104

Abstract

OBJECTIVE

This study aims to investigate whether alterations in the lower extremity kinematics, kinetics, and muscle activity of individuals with chronic ankle instability (CAI) occur during landing with expected and unexpected inversion perturbations.

METHODOLOGY

PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were searched for relevant studies up to November 30, 2024. Comparative studies investigating the characteristics of lower extremity kinematics, kinetics, and muscle activity in individuals with CAI compared with healthy controls were included. Two independent reviewers extracted the data. Certainty of the evidence was assessed using the Newcastle-Ottawa Scale (NOS) approach.

SYNTHESIS

Thirteen studies involving 207 patients with CAI and 215 healthy controls were included. Individuals with CAI exhibited increased activity of the tibialis anterior muscle before landing (SMD = 0.28 and 95% CI: 0.03-0.54). The delayed activation of the peroneus longus muscle (SMD = 1.35 and 95% CI: 0.90-1.80) and increased co-contraction index in the sagittal plane (SMD = 0.41 and 95% CI: 0.06-0.77), ankle inversion angle (SMD = 0.56 and 95% CI: 0.30-0.81), ankle inversion range of motion (SMD = 0.83 and 95% CI: 0.42-1.24), and knee extension moment (SMD = 0.71 and 95% CI: 0.32-1.11) were observed after landing. Besides, subgroup analysis revealed that the anticipation of perturbations influenced muscle activation patterns, with significant differences in peroneus longus latency and coactivation indices.

CONCLUSION

Patients with CAI may present differences in lower extremity biomechanics during expected and unexpected inversion-perturbed landings compared with healthy controls. The results of this work may have clinical implications in the development of more effective and targeted rehabilitation programs for individuals with CAI.

TRIAL REGISTRATION

PROSPERO registration number: CRD42024615006.

摘要

目的

本研究旨在调查慢性踝关节不稳（CAI）患者在预期和意外内翻扰动着陆过程中下肢运动学、动力学和肌肉活动是否发生改变。

方法

检索了截至2024年11月30日的PubMed、Embase、Cochrane图书馆、Web of Science和Scopus数据库中的相关研究。纳入了比较CAI患者与健康对照者下肢运动学、动力学和肌肉活动特征的比较研究。两名独立评审员提取数据。使用纽卡斯尔-渥太华量表（NOS）方法评估证据的确定性。

综合

纳入了13项研究，涉及207例CAI患者和215名健康对照者。CAI患者在着陆前胫骨前肌活动增加（标准化均数差[SMD]=0.28，95%可信区间[CI]：0.03 - 0.54）。着陆后观察到腓骨长肌延迟激活（SMD = 1.35，95% CI：0.90 - 1.80）、矢状面协同收缩指数增加（SMD = 0.41，95% CI：0.06 - 0.77）、踝关节内翻角度（SMD = 0.56，95% CI：0.30 - 0.81）、踝关节内翻活动范围（SMD = 0.83，95% CI：0.42 - 1.24）和膝关节伸展力矩（SMD = 0.71，95% CI：0.32 - 1.11）。此外，亚组分析显示，对扰动的预期会影响肌肉激活模式，腓骨长肌潜伏期和共同激活指数存在显著差异。