Lentell G, Baas B, Lopez D, McGuire L, Sarrels M, Snyder P
Physical Therapy Department, California State University, Fresno 93740-0029, USA.
J Orthop Sports Phys Ther. 1995 Apr;21(4):206-15. doi: 10.2519/jospt.1995.21.4.206.
Functional instability is a common complication following an acute ankle sprain. Three potential contributing factors underlying the ankle which chronically gives way are proprioceptive deficits, muscle weakness, and ligamentous laxity. This study's purpose was to document the presence or absence of these concerns in a sample of subjects with unilateral functional ankle instability. Both ankles of 42 subjects were randomly assessed for passive movement sense into inversion and generation of peak torque by the evertors isokinetically. Thirty-four subjects were available for documentation of talar tilt of both ankles through inversion stress radiographs. Analysis found significantly greater mean values for passive movement sense and talar tilt for the involved ankles compared with the uninvolved, while no significant strength differences in peak torque of the evertors were present. Fifty-eight percent of the sample demonstrated clinical impairments in at least one of these three categories. In conclusion, deficits in passive movement sense and anatomic stability are greater concerns than strength deficits when managing the ankle with functional instability.
功能性踝关节不稳是急性踝关节扭伤后的常见并发症。踝关节长期出现不稳的三个潜在因素是本体感觉缺陷、肌肉无力和韧带松弛。本研究的目的是记录单侧功能性踝关节不稳受试者样本中这些问题的存在与否。对42名受试者的双侧踝关节进行随机评估,以检测踝关节内翻时的被动运动感觉以及由外翻肌等速运动产生的峰值扭矩。通过内翻应力X线片,对34名受试者的双侧踝关节距骨倾斜情况进行记录。分析发现,与未受伤的踝关节相比,受伤踝关节的被动运动感觉和距骨倾斜的平均值显著更高,而外翻肌的峰值扭矩没有显著的力量差异。58%的样本在这三个类别中的至少一项中表现出临床损伤。总之,在处理功能性踝关节不稳时,被动运动感觉和解剖稳定性的缺陷比力量缺陷更值得关注。