血流限制下低强度增强式跳跃训练干预功能性踝关节不稳的效果

doi:10.3969/j.issn.1006-9771.2024.03.014

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (3): 352-361.doi: 10.3969/j.issn.1006-9771.2024.03.014

血流限制下低强度增强式跳跃训练干预功能性踝关节不稳的效果

梁馨文¹, 韩亚兵², 王世林¹, 潘玮敏¹^,³(), 蒋应鹏¹, 魏晓宇¹, 黄艳¹

1.西安体育学院，陕西西安市 710068
2.安康学院医学院，陕西安康市 725000
3.体育智能装备关键技术陕西省高校工程研究中心，陕西西安市 710068

收稿日期:2023-10-13 修回日期:2024-01-25 出版日期:2024-03-25 发布日期:2024-04-01
通讯作者: 潘玮敏 E-mail:panweimin@163.com
作者简介:梁馨文(1999-)，女，汉族，河南洛阳市人，硕士研究生，主要研究方向：运动损伤预防与康复。
潘玮敏(1974-)，女，汉族，陕西咸阳市人，博士，教授，硕士研究生导师，主要研究方向：运动医学与健康。
基金资助:
陕西省自然科学基础研究计划项目(2021JM-530)

Effect of blood flow restriction combined with low-intensity plyometric jump training on functional ankle instability

LIANG Xinwen¹, HAN Yabing², WANG Shilin¹, PAN Weimin¹^,³(), JIANG Yingpeng¹, WEI Xiaoyu¹, HUANG Yan¹

1. Xi'an Physical Education University, Xi'an, Shaanxi 710068, China
2. Medical College of Ankang University, Ankang, Shaanxi 725000, China
3. Engineering Research Center of Innovative Technology of Intelligent Sports Equipment, Universities of Shaanxi Province, Xi'an, Shaanxi 710068, China

Received:2023-10-13 Revised:2024-01-25 Published:2024-03-25 Online:2024-04-01
Contact: PAN Weimin E-mail:panweimin@163.com
Supported by:
Shaanxi Natural Science Basic Research Foundation(2021JM-530)

摘要/Abstract

摘要：

目的探讨血流限制下低强度增强式跳跃训练(LI-PJT+BFR)对功能性踝关节不稳(FAI)大学生的下肢动态姿势控制的影响。

方法 2023年3月至5月，招募西安体育学院FAI大学生40例，随机分为高强度增强式跳跃训练(HI-PJT, n = 14)组、低强度增强式跳跃训练(LI-PJT, n = 13)组和LI-PJT+BFR组(n = 13)，各组完成相应的干预训练，共6周。干预前后，采用无线遥感表面肌电测试仪测量胫骨前肌、腓骨长肌、腓肠肌外侧头、臀大肌、股外侧肌、股二头肌和半腱肌最大自主等长收缩(MVIC)和单腿下落(SLL)时肌电均方根值(RMS)，采用Y平衡和坎伯兰踝关节不稳问卷(CAIT)进行评定。

结果干预后，除LI-PJT组腓骨长肌、臀大肌、股二头肌和半腱肌MVIC和RMS，LI-PJT+BFR组腓骨长肌RMS外，各组其余肌肉MVIC和RMS均较干预前提高(t > 2.218, P < 0.05)；3组中，除腓骨长肌外，LI-PJT组各肌肉MVIC和RMS均最低(F > 3.262, P < 0.05)；各组Y平衡各方向评分和综合分均提高(t > 2.485, P < 0.05)，3组中LI-PJT组最低(F > 5.042, P < 0.05)；各组CAIT评分显著改善(t > 5.227, P < 0.001)，3组中LI-PJT组最低(F = 4.640, P < 0.05)。

结论 LI-PJT+BFR可改善功能恢复期FAI大学生下肢动态姿势控制能力，效果与HI-PJT相似。

关键词: 功能性踝关节不稳, 血流限制训练, 增强式跳跃训练

Abstract:

Objective To investigate the effect of blood flow restriction combined with low-intensity plyometric jump training (LI-PJT+BFR) on lower limb dynamic postural control of functional ankle instability (FAI) in college students.

Methods From March to May, 2023, 40 FAI college students were recruited from Xi'an Physical Education University, and randomly divided into high-intensity plyometric jump training (HI-PJT, n = 14) group, low-intensity plyometric jump training (LI-PJT, n = 13) group and LI-PJT+BFR group (n = 13). All the groups finished the six-week corresponding training. The maximum voluntary isometric contraction (MVIC) of tibialis anterior, peroneus longus, lateral head of gastrocnemius, gluteus maximus, vastus lateralis, biceps femoris and semitendinosus were measured, and the root mean square (RMS) of electromyography of these muscles was measured during the single-leg landing (SLL), using wireless surface electromyography before and after intervention. Moreover, they were assessed with Y-balance test and Cumberland Ankle Instability Tool (CAIT).

Results MVIC and RMS of the target muscles improved after intervention in all the groups (t > 2.218, P < 0.05), except MVIC and RMS of peroneus longus, gluteus maximus, biceps femoris and semitendinosus in LI-PJT group, and RMS of peroneus longus in LI-PJT+BFR group; and MVIC and RMS of the target muscles were the least in LI-PJT group (F > 3.262, P < 0.05), except those of peroneus longus. The extension scores of Y-balance test and the total score improved after intervention (t > 2.485, P < 0.05), and they were the least in LI-PJT group (F > 5.042, P < 0.05). The CAIT score improved after intervention (t > 5.227, P < 0.001), and it was the least in LI-PJT group (F = 4.640, P < 0.05).

Conclusion LI-PJT+BFR could improve lower limb dynamic postural control of FAI college students, which is similar to HI-PJT.

Key words: functional ankle instability, blood flow restriction training, plyometric jump training

中图分类号:

R684.7

梁馨文, 韩亚兵, 王世林, 潘玮敏, 蒋应鹏, 魏晓宇, 黄艳. 血流限制下低强度增强式跳跃训练干预功能性踝关节不稳的效果[J]. 《中国康复理论与实践》, 2024, 30(3): 352-361.

LIANG Xinwen, HAN Yabing, WANG Shilin, PAN Weimin, JIANG Yingpeng, WEI Xiaoyu, HUANG Yan. Effect of blood flow restriction combined with low-intensity plyometric jump training on functional ankle instability[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(3): 352-361.

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组别	n	性别(男/女)/n	年龄/岁	身高/m	体质量/kg	体质量指数/(kg·m^-2)
HI-PJT组	14	9/5	21.82±2.04	1.78±0.07	71.64±10.25	22.41±1.99
LI-PJT组	13	7/6	20.18±1.55	1.75±0.05	69.41±7.06	22.66±3.63
LI-PJT+BFR组	13	8/5	21.27±1.90	1.77±0.05	73.55±6.31	23.27±1.51
χ²F/值		0.950	0.369	0.657	1.199	1.373
P值		0.396	0.694	0.524	0.313	0.266

靶肌肉	电极放置位置	MVIC测试动作
臀大肌	骶椎与大转子连线中点	俯卧位，膝屈曲90°，固定带放置于于大腿后侧远端，另一条带子固定骨盆，受试者尽可能用力后伸髋关节
股外侧肌	髂前上棘与膝外侧间隙中点连线2/3处	坐位，髋膝屈曲90°，固定带放置于于胫骨下部，受试者尽可能用力伸膝关节
股二头肌	坐骨结节与胫骨外髁连线2/5处	俯卧位，膝屈曲45°，固定带放置于小腿远端，另一条带子固定骨盆，受试者尽可能用力屈曲膝关节
半腱肌	坐骨结节与胫骨平台中点连线2/5处	同上
胫骨前肌	腓骨头与内踝连线1/3处	坐位，髋、膝屈曲90°，踝关节中立位，受试者尽可能用力背屈并内翻踝关节
腓骨长肌	腓骨头与外踝连线1/4处	坐位，髋、膝屈曲90°，踝关节中立位，受试者尽可能用力跖屈并外翻踝关节
腓肠肌外侧头	腓肠肌外侧肌腹最膨隆处	坐位，髋、膝屈曲90°，踝关节中立位，固定带位于足底，受试者尽可能用力跖屈踝关节

组别	n	肌肉	干预前	干预后	t值	P值
LI-PJT组	13	胫骨前肌	334.69±25.45	385.23±19.73	2.137	0.047
		腓骨长肌	173.62±17.15	196.77±24.21	1.439	0.176
		腓肠肌外侧头	133.38±18.36	184.77±30.43	2.283	0.041
HI-PJT组	14	胫骨前肌	344.43±29.08	528.86±36.86^a	9.015	< 0.001
		腓骨长肌	179.86±24.46	229.01±21.69	3.946	0.002
		腓肠肌外侧头	140.36±16.81	302.43±24.46^a	8.191	< 0.001
LI-PJT+BFR组	13	胫骨前肌	352.08±47.14	503.23±39.01^a	6.311	< 0.001
		腓骨长肌	174.54±26.78	206.23±23.61	2.002	0.066
		腓肠肌外侧头	139.46±24.97	263.23±39.93^a	4.703	0.001
F_胫骨前肌			0.059	5.279
P_胫骨前肌			0.943	0.010
F_腓骨长肌			0.021	1.594
P_腓骨长肌			0.979	0.217
F_{腓肠肌外侧头}			0.044	3.961
P_{腓肠肌外侧头}			0.957	0.028

组别	n	肌肉	干预前	干预后	t值	P值
LI-PJT组	13	臀大肌	273.46±51.13	316.77±39.78	1.700	0.115
		股外侧肌	196.62±29.79	232.38±26.18	2.218	0.047
		股二头肌	204.29±38.74	222.38±25.93	1.191	0.387
		半腱肌	265.69±30.96	280.85±29.33	0.317	0.757
HI-PJT组	14	臀大肌	260.64±40.42	450.62±53.19^a	5.480	< 0.001
		股外侧肌	180.21±31.23	304.07±27.42^a	4.632	< 0.001
		股二头肌	239.29±35.62	348.79±31.95^a	3.371	0.003
		半腱肌	334.86±36.86	459.43±55.19^a	2.246	0.043
LI-PJT+BFR组	13	臀大肌	299.00±34.79	409.21±33.17^a	4.749	0.001
		股外侧肌	201.62±29.19	445.31±44.59^a	8.485	< 0.001
		股二头肌	223.77±42.93	331.38±49.88^a	2.904	0.013
		半腱肌	321.00±36.24	359.85±41.75	2.285	0.041
F_臀大肌			0.249	4.067
P_臀大肌			0.781	0.025
F_股外侧肌			0.481	10.229
P_股外侧肌			0.622	0.001
F_股二头肌			0.085	3.561
P_股二头肌			0.919	0.029
F_半腱肌			0.784	4.602
P_半腱肌			0.464	0.016

组别	n	肌肉	干预前	干预后	t值	P值
LI-PJT组	13	胫骨前肌	40.88±11.25	47.86±10.41	2.516	0.026
		腓骨长肌	31.95±9.55	36.85±9.58	1.928	0.780
		腓肠肌外侧头	41.91±10.20	55.89±10.93	4.470	0.001
HI-PJT组	14	胫骨前肌	49.93±13.55	64.98±16.36^a	4.136	< 0.001
		腓骨长肌	34.39±9.83	48.69±10.06	2.142	0.047
		腓肠肌外侧头	44.24±11.80	70.96±14.11^a	5.615	< 0.001
LI-PJT+BFR组	13	胫骨前肌	42.54±13.20	60.12±22.85^a	4.919	< 0.001
		腓骨长肌	36.36±7.67	45.74±15.02	1.938	0.078
		腓肠肌外侧头	47.16±17.39	74.58±15.43^a	5.101	< 0.001
F_胫骨前肌			1.919	4.671
P_胫骨前肌			0.161	0.007
F_腓骨长肌			0.262	1.050
P_腓骨长肌			0.771	0.360
F_{腓肠肌外侧头}			0.374	8.693
P_{腓肠肌外侧头}			0.690	0.001

血流限制下低强度增强式跳跃训练干预功能性踝关节不稳的效果

Effect of blood flow restriction combined with low-intensity plyometric jump training on functional ankle instability

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组别	n	肌肉	干预前	干预后	t值	P值
LI-PJT组	13	臀大肌	50.71±21.25	57.00±15.54	1.690	0.117
		股外侧肌	87.82±12.26	101.17±13.45	2.719	0.019
		股二头肌	56.95±11.94	70.97±36.66	1.710	0.113
		半腱肌	41.02±20.73	51.16±13.33	2.124	0.055
HI-PJT组	14	臀大肌	52.45±18.01	76.23±14.26^a	4.837	0.001
		股外侧肌	82.30±17.06	123.40±27.24^a	5.879	< 0.001
		股二头肌	61.44±10.39	92.28±33.47^a	3.704	0.003
		半腱肌	36.86±10.54	66.39±10.55^a	14.70	< 0.001
LI-PJT+BFR组	13	臀大肌	56.86±14.97	83.93±27.38^a	5.843	< 0.001
		股外侧肌	87.92±12.26	137.88±45.17^a	4.573	0.001
		股二头肌	59.45±12.34	94.44±17.56^a	5.599	< 0.001
		半腱肌	43.04±22.08	60.65±27.06^a	5.473	< 0.001
F_臀大肌			0.284	4.140
P_臀大肌			0.755	0.015
F_股外侧肌			0.111	4.419
P_股外侧肌			0.896	0.019
F_股二头肌			0.509	4.254
P_股二头肌			0.605	0.013
F_半腱肌			0.420	3.262
P_半腱肌			0.672	0.037

组别	n	方向	干预前	干预后	t值	P值
LI-PJT组	13	前方	55.56±6.05	59.37±8.20	3.135	0.011
		后外侧	96.83±8.67	102.92±6.90	2.741	0.021
		后内侧	99.56±7.14	105.66±10.75	2.485	0.032
		综合	98.73±11.95	104.55±14.46	2.842	0.017
HI-PJT组	14	前方	58.47±9.62	69.84±6.18^a	9.220	< 0.001
		后外侧	98.40±8.78	114.94±8.96^a	6.036	< 0.001
		后内侧	98.80±15.12	118.78±12.67^a	8.642	< 0.001
		综合	99.52±8.38	118.71±11.38^a	9.943	< 0.001
LI-PJT+BFR组	13	前方	59.35±6.81	68.44±6.68^a	5.466	< 0.001
		后外侧	99.39±9.37	109.58±8.20	5.012	0.001
		后内侧	100.50±11.74	108.44±11.86	3.568	0.004
		综合	99.89±7.17	110.50±9.35	6.031	< 0.001
F_前方			1.269	6.533
P_前方			0.294	0.004
F_后外侧			0.243	6.102
P_后外侧			0.786	0.006
F_后内侧			0.087	5.042
P_后内侧			0.917	0.012
F_综合			0.048	5.920
P_综合			0.953	0.006

组别	n	干预前	干预后	t值	P值
LI-PJT组	13	14.56±3.59	19.25±3.70	5.227	< 0.001
HI-PJT组	14	16.82±3.35	27.14±3.01^a	8.028	< 0.001
LI-PJT+BFR组	13	15.93±3.61	24.07±3.81	7.807	< 0.001
F值		0.130	4.640
P值		0.879	0.016

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