《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (7): 783-788.doi: 10.3969/j.issn.1006-9771.2022.07.007

• 专题 骨关节康复 • 上一篇    下一篇

软式支具对慢性踝关节不稳患者的即时疗效

高维广1,刘淑惠1,马玉宝2a(),娄亚兵2b   

  1. 1.沈阳体育学院研究生工作部,辽宁沈阳市 110102
    2.首都医科大学附属北京康复医院,a. 肌骨康复中心;b. 中医康复中心,北京市 100144
  • 收稿日期:2022-03-05 修回日期:2022-05-30 出版日期:2022-07-25 发布日期:2022-08-08
  • 通讯作者: 马玉宝 E-mail:myb-sreha@ccmu.edu.cn
  • 作者简介:高维广(1995-),男,汉族,山东临沂市人,硕士,康复治疗师,主要研究方向:运动损伤的预防与康复。|马玉宝,男,博士,主管治疗师,主要研究方向:运动损伤的预防与康复。
  • 基金资助:
    国家自然科学基金面上项目(61773042);首都医科大学附属北京康复医院博士科研基金专项课题(2020-066)

Immediate effect of soft brace on chronic ankle instability

GAO Weiguang1,LIU Shuhui1,MA Yubao2a(),LOU Yabing2b   

  1. 1. Graduate Department, Shenyang Sport University, Shenyang, Liaoning 110102, China
    2. a. Musculoskeletal Rehabilitation Center; b. Chinese Medicine Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
  • Received:2022-03-05 Revised:2022-05-30 Published:2022-07-25 Online:2022-08-08
  • Contact: MA Yubao E-mail:myb-sreha@ccmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China (General)(61773042);Beijing Rehabilitation Hospital, Capital Medical University Scientific Research Outlays for Doctoral Program(2020-066)

摘要:

目的 探讨佩戴踝关节软式支具对慢性踝关节不稳(CAI)患者动、静态平衡功能及步行模式下患侧下肢生物力学的即时疗效。

方法 2021年1月至8月,首都医科大学附属北京康复医院肌骨康复中心门诊CAI患者40例,采用平板式足底压力测试系统、Y平衡测试于患者佩戴支具前后进行评定,表面肌电图同步采集步行模式下患侧足底动力学指标和下肢主要肌群表面肌电信号。

结果 佩戴支具后,睁、闭眼模式下压力中心椭圆面积和移动速度均明显减小(|t| > 2.876, P < 0.01);Y平衡测试各方向评分均显著增大(|t| > 21.212, P < 0.001);步行模式下患侧中足区和前足内侧区峰值压力和冲量增大(|t| > 2.057, P < 0.05),足跟外侧区、前足外侧区、足趾区峰值压力和冲量减少(|t| > 2.464, P < 0.05);患侧下肢胫前肌、腓肠肌外侧头振幅均方根增大(|t| > 2.159, P < 0.05)。

结论 佩戴软式支具后可以即刻显著改善CAI患者动、静态平衡功能,优化步行模式下患侧足底动力学分布,增强胫前肌、腓肠肌外侧头激活程度,从而改善运动控制能力。

关键词: 慢性踝关节不稳, 软式支具, 平衡, 足底动力学

Abstract:

Objective To investigate the immediate effect of wearing a soft ankle brace on dynamic and static balance function and biomechanics of affected lower limbs during walking in chronic ankle instability (CAI) patients.

Methods From January to August, 2021, 40 CAI patients from Musculoskeletal Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University were measured dynamic and static balance indexes with Zebris FDM-System and Y balance test, before and after wearing a soft ankle brace; while the kinetics indexes and surface electromyography of the affected lower extremities during walking were collected with Zebris FDM-System and a surface electromyography telemeter simultaneously.

Results The velocity and area of center of pressure reduced in both open and closed eye modes (|t| > 2.876, P < 0.01), the Y-balance scores increased in all the directions (|t| > 21.212, P< 0.001) after wearing brace; while the peak pressures and impulses increased in the midfoot and medial forefoot regions (|t| > 2.057, P < 0.05), and decreased in the lateral heel, lateral forefoot and toe regions (|t| > 2.464, P < 0.05), and the root mean square of surface electromyography increased in the tibialis anterior and lateral gastrocnemius (|t| > 2.159, P < 0.05) during walking.

Conclusion Wearing soft brace can immediately improve dynamic and static balance of CAI patients, and optimize plantar kinetic distribution and enhance activation of the anterior tibial and the lateral head of gastrocnemius of the affected limb during walking, to improve motor control of CAI patients.

Key words: chronic ankle instability, soft brace, balance, plantar kinetics

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