Olszewski Maciej, Krężałek Piotr, Golec Joanna
Doctoral School, University of Physical Culture in Kraków, 31-571 Kraków, Poland.
Laboratory of Biophysics and Movement Analysis, Department of Biomechanics, University of Physical Culture in Kraków, 31-571 Kraków, Poland.
J Clin Med. 2025 Aug 24;14(17):5977. doi: 10.3390/jcm14175977.
Although considerable progress has been made in understanding lateral ankle sprains (LAS) and chronic ankle instability (CAI), recurrent injury rates remain high. This highlights the need to explore additional contributors such as comprehensive lower-limb gait analysis, including multisegmented foot models and proximal joint kinematics and strength. This study aimed to assess multisegmented foot and lower-limb kinematics throughout the gait cycle in individuals with CAI compared to healthy controls. Additionally, associations between hip abductor strength and frontal plane ankle kinematics were examined. Fifty males (25 with CAI and 25 healthy controls) participated in this cross-sectional study. Gait analysis was conducted using a BTS SMART 3D motion capture system to assess multisegmented foot and proximal joint kinematics. Isometric hip strength was measured using a Biodex dynamometer. Statistical Parametric Mapping (SPM) was used to assess group differences, and correlations were calculated between hip abductor strength and ankle kinematics. The CAI group demonstrated significantly greater calcaneus abduction relative to the shank in the transverse plane between 88% and 93% of the gait cycle (MD = -3.50°, 95% CI [-5.60, -1.40], = -0.95, = 0.037). No other statistically significant between-group differences in hip, knee, or foot segment kinematics were detected. Furthermore, correlations between hip abductor strength and ankle frontal plane kinematics were not significant. Males with CAI demonstrated altered rearfoot kinematics in the transverse plane during the terminal swing phase. The multisegmented foot model was valuable in detecting subtle deviations and emphasized the importance of including the swing phase. Hip abductor strength was not associated with ankle kinematics, suggesting that its potential role in CAI may involve other mechanisms. These findings may support clinical gait assessment and rehabilitation planning by highlighting the importance of evaluating all foot segments and the entire lower limb, rather than focusing solely on the ankle joint. Segment-specific deviations, particularly those emerging during the swing phase, may help guide targeted interventions aimed at improving foot positioning in males with CAI.
尽管在理解外侧踝关节扭伤（LAS）和慢性踝关节不稳（CAI）方面已经取得了相当大的进展，但复发性损伤率仍然很高。这凸显了探索其他影响因素的必要性，如全面的下肢步态分析，包括多节段足部模型以及近端关节的运动学和力量。本研究旨在评估与健康对照组相比，CAI患者在整个步态周期中的多节段足部和下肢运动学。此外，还研究了髋外展肌力量与踝关节额状面运动学之间的关联。五十名男性（25名CAI患者和25名健康对照者）参与了这项横断面研究。使用BTS SMART 3D运动捕捉系统进行步态分析，以评估多节段足部和近端关节的运动学。使用Biodex测力计测量等长髋部力量。采用统计参数映射（SPM）来评估组间差异，并计算髋外展肌力量与踝关节运动学之间的相关性。CAI组在步态周期的88%至93%期间，相对于小腿，跟骨在横平面上的外展明显更大（平均差值=-3.50°，95%置信区间[-5.60，-1.40]，t=-0.95，p=0.037）。在髋、膝或足部节段的运动学方面，未检测到其他具有统计学意义的组间差异。此外，髋外展肌力量与踝关节额状面运动学之间的相关性不显著。患有CAI的男性在摆动末期阶段，后足在横平面上的运动学发生了改变。多节段足部模型在检测细微偏差方面很有价值，并强调了纳入摆动阶段的重要性。髋外展肌力量与踝关节运动学无关，这表明其在CAI中的潜在作用可能涉及其他机制。这些发现可能通过强调评估所有足部节段和整个下肢的重要性，而不是仅关注踝关节，来支持临床步态评估和康复计划。特定节段的偏差，特别是在摆动阶段出现的偏差，可能有助于指导旨在改善CAI男性足部位置的针对性干预措施。
