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[1]劉輝,劉波,伍薩,等.踝關(guān)節(jié)不穩(wěn)患者踝關(guān)節(jié)等速肌力和動態(tài)平衡能力的臨床研究[J].中醫(yī)正骨,2015,27(02):7-11.
　LIU Hui,LIU Bo,WU Sa,et al.Clinical study on ankle isokinetic muscle strength and dynamic balance ability of patients with ankle joint instability[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):7-11.
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踝關(guān)節(jié)不穩(wěn)患者踝關(guān)節(jié)等速肌力和動態(tài)平衡能力的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年02期
頁碼:
7-11
欄目:
臨床研究
出版日期:
2015-02-10

文章信息/Info

Title:
Clinical study on ankle isokinetic muscle strength and dynamic balance ability of patients with ankle joint instability
作者:
劉輝; 劉波; 伍薩; 林靜
四川省骨科醫(yī)院,四川 成都 610041
Author(s):
LIU Hui; LIU Bo; WU Sa; LIN Jin
Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China
關(guān)鍵詞:
踝關(guān)節(jié);  關(guān)節(jié)不穩(wěn)性;  本體感覺;  等速肌力;  平衡能力;  康復(fù)
Keywords:
ankle joint;  joint instability;  proprioception;  isokinetic muscle strength;  balance ability;  rehabilitation
摘要:
目的:探討踝關(guān)節(jié)不穩(wěn)患者不同角速度下踝關(guān)節(jié)背伸、跖屈等速肌力以及動態(tài)平衡能力。方法:隨機抽取30歲以下單側(cè)踝 關(guān)節(jié)不穩(wěn)患者33例,男16例,女17例; 左踝13例,右踝20例; 年齡15～30歲,中位數(shù)22歲; 病程1個月至10年,中位數(shù)12個月。同時 隨機抽取30歲以下踝關(guān)節(jié)正常的健康志愿者33例,男16例,女17例; 年齡19～29歲,中位數(shù)22歲。采用等速肌力測定儀對踝關(guān)節(jié)不 穩(wěn)患者踝關(guān)節(jié)背伸、跖屈肌群進行測試,并比較角速度為60(°)·s-1和120(°)·s-1時健、患側(cè)踝關(guān) 節(jié)跖屈、背伸的峰值力矩、單位體質(zhì)量峰值力矩、總做功值。采用平衡測定儀對踝關(guān)節(jié)不穩(wěn)患者和健康志愿者進行平衡功能測 試,并對2組受試者的總體穩(wěn)定指數(shù)、前后向穩(wěn)定指數(shù)及左右向穩(wěn)定指數(shù)進行組間比較。結(jié)果:①踝關(guān)節(jié)峰值力矩。在60(°) ·s-1和120(°)·s-1等速肌力測試時,患側(cè)踝關(guān)節(jié)跖屈峰值力矩與健側(cè)比較,差異均無統(tǒng)計學(xué)意義 [(70.85±30.29)Nm,(75.15±33.76)Nm,t=1.482,P=0.148;(57.02±27.14)Nm,(60.81±30.06) Nm,t=1.716,P=0.096]; 患側(cè)踝關(guān)節(jié)背伸峰值力矩與健側(cè)比較,差異均無統(tǒng)計學(xué)意義[(23.65±10.50)Nm, (22.98±9.43)Nm,t=-1.026,P=0.313;(19.59±9.35)Nm,(19.16±9.27)Nm,t=-0.471,P=0.641]。②踝關(guān)節(jié)單位體 質(zhì)量峰值力矩。在60(°)·s-1和120(°)·s-1等速肌力測試時,患側(cè)踝關(guān)節(jié)跖屈單位體質(zhì)量峰值力矩 與健側(cè)比較,差異均無統(tǒng)計學(xué)意義[(113.45±36.20)Nm·kg-1,(119.68±41.21)Nm·kg- 1,t=1.528,P=0.136;(90.88±32.49)Nm·kg-1,(96.54±35.70)Nm·kg- 1,t=1.839,P=0.075]; 患側(cè)踝關(guān)節(jié)背伸單位體質(zhì)量峰值力矩與健側(cè)比較,差異均無統(tǒng)計學(xué)意義[(37.08±10.00) Nm·kg-1,(36.16±9.85)Nm·kg-1,t=-0.909,P=0.370;(30.80±10.43)Nm·kg- 1,(30.49±11.82)Nm·kg-1,t=-0.207,P=0.838]。③踝關(guān)節(jié)總做功值。在60(°)·s-1和 120(°)·s-1等速肌力測試時,患側(cè)踝關(guān)節(jié)跖屈總做功值小于健側(cè)[(160.84±66.31)J,(189.01±78.65) J,t=2.609,P=0.014;(286.22±156.55)J,(318.56±182.50)J,t=2.056,P=0.048]; 患側(cè)踝關(guān)節(jié)背伸總做功值與健側(cè)比 較,差異均無統(tǒng)計學(xué)意義[(59.80±22.17)J,(62.05±24.34)J,t=0.807,P=0.426;(80.18±38.06)J, (80.15±37.52)J,t=-0.009,P=0.993]。④踝關(guān)節(jié)穩(wěn)定指數(shù)。踝關(guān)節(jié)不穩(wěn)組總體穩(wěn)定指數(shù)、前后向穩(wěn)定指數(shù)、左右向穩(wěn)定指 數(shù)與踝關(guān)節(jié)正常組比較,差異均無統(tǒng)計學(xué)意義[0.93±0.51,0.86±0.34,t=0.593,P=0.555; 0.63±0.39,0.56±0.26,t=0.895,P=0.374; 0.54±0.28,0.53±0.21,t=0.169,P=0.845]。結(jié)論:踝關(guān)節(jié)不穩(wěn) 患者患側(cè)踝關(guān)節(jié)的背伸肌力與健側(cè)無明顯差異,但其跖屈總做功值小于健側(cè),在踝關(guān)節(jié)康復(fù)治療中應(yīng)加強踝關(guān)節(jié)跖屈肌群的訓(xùn)練; 踝關(guān)節(jié)不穩(wěn)患者雙腳站立時動態(tài)平衡能力與正常人無明顯差異。
Abstract:
Objective:To investigate the ankle isokinetic muscle strength of dorsal extension and plantar flexion at different angular velocity and dynamic balance ability of patients with ankle joint instability.Methods:Thirty-three patients(<30 yrs)with unilateral ankle instability were randomly selected.The patients consisted of 16 males and 17 females,and ranged in age from 15 to 30 years(Median=22 yrs).The course of disease ranged from 1 month to 10 years(Median=12 months).The joint instability located in left side for 13 patients and right for 20 patients.Meanwhile,33 healthy volunteers with normal ankles were randomly selected.The volunteers consisted of 16 males and 17 females,and ranged in age from 19 to 29 years (Median=22 yrs).The ankle dorsal extension and plantar flexion muscle groups were tested by using isokinetic dynamometer in patients with ankle joint instability; and the peak torque(PkT),peak torque per unit body mass (PkT/BM)and total work(TW)of ankle extensors and flexors were compared between affected side and uninjured side at 60°/sec and 120°/sec.The balance function were evaluated by using balance determinator and compared between patients with ankle joint instability and healthy volunteers; and the total stability index(TSI),forward-backward stability index(FBSI)and left-right stability index(LRSI)were compared between the 2 groups.Results:There was no statistical difference in plantar flexion PkT of ankle joint at 60°/sec and 120°/sec between affected side and uninjured side(70.85+/-30.29 vs 75.15+/-33.76 Nm,t=1.482,P=0.148; 57.02+/-27.14 vs 60.81+/-30.06 Nm,t=1.716,P=0.096).There was no statistical difference in dorsal extension PkT of ankle joint between affected side and uninjured side(23.65+/-10.50 vs 22.98+/-9.43 Nm,t=-1.026,P=0.313; 19.59+/-9.35 vs 19.16+/-9.27 Nm,t=- 0.471,P=0.641).There was no statistical difference in plantar flexion PkT/BM of ankle joint at 60°/sec and 120 °/sec between affected side and uninjured side(113.45+/-36.20 vs 119.68+/-41.21 Nm/kg,t=1.528,P=0.136; 90.88+/-32.49 vs 96.54+/-35.70 Nm/kg,t=1.839,P=0.075).There was no statistical difference in dorsal extension PkT/BM of ankle joint between affected side and uninjured side(37.08+/-10.00 vs 36.16+/-9.85 Nm/kg,t=- 0.909,P=0.370; 30.80+/-10.43 vs 30.49+/-11.82 Nm/kg,t=-0.207,P=0.838).The plantar flexion TW of affected side at 60°/sec and 120°/sec were less compared with that of uninjured side(160.84+/-66.31 vs 189.01+/-78.65 joules(J),t=2.609,P=0.014; 286.22+/-156.55 vs 318.56+/-182.50 J,t=2.056,P=0.048).There was no statistical difference in dorsal extension TW of ankle joint between affected side and uninjured side(59.80+/-22.17 vs 62.05+/-24.34 J,t=0.807,P=0.426; 80.18+/-38.06 vs 80.15+/-37.52 J,t=-0.009,P=0.993).There was no statistical difference in TSI,FBSI and LRSI between ankle instability group and normal ankle group(0.93+/-0.51 vs 0.86+/- 0.34,t=0.593,P=0.555; 0.63+/-0.39 vs 0.56+/-0.26,t=0.895,P=0.374; 0.54+/-0.28 vs 0.53+/- 0.21,t=0.169,P=0.845).Conclusion:There is no significant difference in dorsal extension strength between affected ankle and uninjured ankle in patients with ankle joint instability,while the plantar flexion TW of affected ankle is less than that of uninjured ankle,suggesting that strengthened ankle plantar flexion muscle exercises should be applied to ankle rehabilitation.There is no obvious difference in dynamic balance ability between patients with ankle joint instability and heath person when standing on both foot.

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備注/Memo

備注/Memo:
2014-03-25收稿 2014-06-10修回
基金項目:四川省科學(xué)技術(shù)廳項目(2011SZ0306)
通訊作者:劉波 E-mail:[email protected]
更新日期/Last Update: 2015-02-25