髋周肌群力量训练对功能性踝关节不稳的疗效及表面肌电评价

doi:10.3969/j.issn.1006-9771.2021.08.008

Abstract

Abstract:

Objective To investigate the effect of strength training of hip muscles on functional ankle instability (FAI), and be evaluated with surface electromyography (sEMG). Methods From January, 2019 to June, 2020, 60 FAI patients were recruited in Qingdao Municipal Hospital. They were divided into control group (n = 30) and observation group (n = 30) randomly. The control group received conventional therapy, including ankle joint mobilization training, strength training and balance training for six weeks, while the observation group received strength training of hip muscles in addition. Cumberland Ankle Instability Tool (CAIT), Star Excursion Balance Test (SEBT) and sEMG were used to assess the function before and after intervention, and integrated electromyography (iEMG) was measured with sEMG. The correlation of CAIT and SEBT to iEMG was analyzed with Pearson coefficient. Results No one dropped out. Before intervention, there was no significant difference between CAIT, SEBT and iEMG between two groups (P > 0.05). CAIT and SEBT improved significantly in both groups (t > 3.657, P < 0.001) after six-week intervention; the iEMG increased significantly in the observation group (t > 22.038, P < 0.001), while no significance was found in the control group (t < 1.916, P > 0.05); all the indexes were better in the observation group than in the control group (t > 2.125, P < 0.05). iEMG of gluteus medius and gluteus maximum correlated to CAIT and SEBT in the observation group (r = 0.712 to 0.866, P < 0.05). Conclusion The strength training of the hip muscles could improve the ankle function of FAI patients. iEMG of gluteus medius and gluteus maximum could be a valid measure to assess the effect of strength training on FAI.

Key words: functional ankle instability, hip muscles, surface electromyography, integrated electromyography, ankle joint, gluteus medius, gluteus maximus

ZHANG Mei-ying,ZHAO Lei,LI Hui,WANG Ying-ying,DAI Shi-you. Effect of Strength Training of Hip Muscles on Functional Ankle Instability: Evaluated with Surface Electromyography[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(8): 936-942.

Figures/Tables 6

References 37

[1]	牛皓, 姜斌, 张杰, 等. 下肢整体康复训练治疗功能性踝关节不稳的疗效观察[J]. 中国康复, 2021, 36(1):12-16.
	NIU H, JIANG B, ZHANG J, et al. Efficacy of overall rehabilitation training of lower extremity for functional ankle instability[J]. Chin J Rehabil, 2021, 36(1):12-16.
[2]	刘宝林, 张阳. 运动干预对功能性踝关节不稳者康复治疗的研究进展[J]. 中国康复医学杂志, 2020, 35(6):758-763.
	LIU B L, ZHANG Y. Research of progress of exercise intervention on rehabilitation treatment of Patients with functional ankle joint instability[J]. Chin J Rehabil Med, 2020, 35(6):758-763.
[3]	宋桂芸, 赵建宇, 恽晓平, 等. 踝关节等速肌力测试在下肢关节损伤中的应用进展[J]. 中国康复理论与实践, 2019, 25(12):1384-1388.
	SONG G Y, ZHAO J Y, YUN X P, et al. Advance in ankle isokinetic test for lower limb joint injuries (review)[J]. Chin J Rehabil Theory Pract, 2019, 25(12):1384-1388.
[4]	张阳, 王强, 宋旭, 等. 功能性踝关节不稳者的动态平衡能力研究[J]. 体育科学, 2016, 36(9):54-58, 83.
	ZHANG Y, WANG Q, SONG X, et al. Research of dynamic balance ability in individuals with functional ankle instability[J]. Chin Sport Sci, 2016, 36(9):54-58, 83.
[5]	于越, 刘冬森, 阮槟, 等. 平衡训练对慢性踝关节不稳疗效的研究进展[J]. 中国康复理论与实践, 2019, 25(12):1374-1383.
	YU Y, LIU D S, RUAN B, et al. Advance in balance training for chronic ankle instability: a systematic review[J]. Chin J Rehabil Theory Pract, 2019, 25(12):1374-1383.
[6]	陈彦, 吴霜, 王志涛, 等. 表面肌电联合等速肌力测试用于不完全腰髓损伤患者的精准评估研究[J]. 中国康复, 2018, 33(1):15-18.
	CHEN Y, WU S, WANG Z T, et al. Surface electromyography combined with isokinetic muscle test for accurate evaluation of patients with incomplete lumbar spinal cord injury[J]. Chin J Rehabil, 2018, 33(1):15-18.
[7]	YAVUZ U S, NEGRO F, SEBIK O, et al. Estimating reflex responses in large populations of motor units by decomposition of the high-density surface electromyogram[J]. J Physiol, 2015, 593(19):4305-4318. doi: 10.1113/JP270635
[8]	钱菁华. 功能性踝关节不稳的神经肌肉控制机制及PNF干预效果研究[D]. 北京:北京体育大学, 2016.
	QIAN J H. The neuromuscular control mechanism of functional ankle instability and the effectiveness of proprioceptive neuromuscular facilitation[D]. Beijing: Beijing Sport University, 2016.
[9]	张晓辉, 刘书芳, 廖八根. 不同训练方法对运动员功能性踝关节不稳康复的影响[J]. 中国运动医学杂志, 2014, 33(6):514-518.
	ZHANG X H, LIU S F, LIAO B G. Effects of different training methods on rehabilitating functional ankle instability in athletes[J]. Chin J Sports Med, 2014, 33(6):514-518.
[10]	萨晨琛, 王剑飞. 慢性踝关节不稳定诊断与治疗的最新进展[J]. 实用医学杂志, 2017, 33(15):2456-2458.
	SA C C, WANG J F. Recent progress in diagnosis and treatment of chronic ankle instability[J]. J Pract Med, 2017, 33(15):2456-2458.
[11]	施晓剑, 韩甲, 刘宇, 等. 慢性踝关节不稳的病理机制和评估诊断研究进展[J]. 中国运动医学杂志, 2019, 38(9):816-824.
	SHI X J, HAN J, LIU Y, et al. Research progress on pathological mechanism and evaluation diagnosis of chronic ankle instability[J]. Chin J Sports Med, 2019, 38(9):816-824.
[12]	GOLDITZ T, WELSCH G H, PACHOWSKY M, et al. A multimodal approach to ankle instability: interrelations between subjective and objective assessments of ankle status in athletes[J]. J Orthop Res, 2016, 34(3):525-532. doi: 10.1002/jor.23039
[13]	KOFOD L M, DØSSING M, STEENTOFT J, et al. Resistance training with ankle weight cuffs is feasible in patients with acute exacerbation of COPD[J]. J Cardiopulm Rehabil Prev, 2017, 37(1):49-56. doi: 10.1097/HCR.0000000000000230
[14]	CUĞ M. Stance foot alignment and hand positioning alter star excursion balance test scores in those with chronic ankle instability: what are we really assessing[J]. Physiother Theory Pract, 2017, 33(4):316-322. doi: 10.1080/09593985.2017.1302028
[15]	BĄCZKOWICZ D, FALKOWSKI K, MAJORCZYK E. Assessment of relationships between joint motion quality and postural control in patients with chronic ankle joint instability[J]. J Orthop Sports Phys Ther, 2017, 47(8):570-577. doi: 10.2519/jospt.2017.6836
[16]	GRIBBLE P A, TERADA M, BEARD M Q, et al. Prediction of lateral ankle sprains in football players based on clinical tests and body mass index[J]. Am J Sports Med, 2016, 44(2):460-467. doi: 10.1177/0363546515614585
[17]	LUCAS-CUEVAS A G, BALTICH J, ENDERS H, et al. Ankle muscle strength influence on muscle activation during dynamic and static ankle training modalities[J]. J Sports Sci, 2016, 34(9):803-810. doi: 10.1080/02640414.2015.1072640
[18]	董伊隆, 钱约男, 林凌志, 等. 多模式功能训练治疗功能性踝关节不稳的疗效观察[J]. 中华物理医学与康复杂志, 2019, 41(4):296-298.
	DONG Y L, QIAN Y N, LIN L Z, et al. Observation on the therapeutic effect of multi-mode functional training on functional ankle instability[J]. Chin J Phys Med Rehabil, 2019, 41(4):296-298.
[19]	马茜茜, 孟伟, 朱毅, 等. 运动疗法应用于功能性踝关节不稳的研究进展[J]. 中国临床保健杂志, 2018, 21(4):563-565.
	MA Q Q, MENG W, ZHU Y, et al. Research progress of functional ankle instability using exercise therapy[J]. Chin J Clin Healthc, 2018, 21(4):563-565.
[20]	孙孟凡, 扈盛. 本体感觉神经促进技术联合核心稳定性训练对功能性踝关节不稳患者下肢功能康复的影响[J]. 中华物理医学与康复杂志, 2017, 39(11):834-838.
	KONG M F, HU S. Proprioceptive neuromuscular facilitation combined with core stability training can help relieve functional ankle instability[J]. Chin J Phys Med Rehabil, 2017, 39(11):834-838.
[21]	AMBEGAONKAR J P, METTINGER L M, CASWELL S V, et al. Relationships between core endurance, hip strength, and balance in collegiate female athletes[J]. Int J Sports Phys Ther, 2014, 9(5):604-616.
[22]	MENDIGUCHIA J, MARTINEZ-RUIZ E, MORIN J B, et al. Effects of hamstring-emphasized neuromuscular training on strength and sprinting mechanics in football players[J]. Scand J Med Sci Sports, 2015, 25(6):e621-e629. doi: 10.1111/sms.12388
[23]	赵响, 詹建国, 许滨. 整合性神经肌肉训练预防青少年女性运动性膝关节损伤[J]. 中国组织工程研究, 2017, 21(32):5108-5114.
	ZHAO X, ZHAN J G, XU B. Integrative neuromuscular training protects juvenile female athletes from knee injury[J]. Chin J Tiss Engin Res, 2017, 21(32):5108-5114.
[24]	骆丽, 孙武东, 赵祥虎, 等. 强化髋周肌群力量训练对功能性踝关节不稳的效果[J]. 中国康复理论与实践, 2017, 23(10):1195-1199.
	LUO L, SUN W D, ZHAO X H, et al. Effect of strengthening training of hip muscles on functional ankle instability[J]. Chin J Rehabil Theory Pract, 2017, 23(10):1195-1199.
[25]	苏来提·肖合热提, 盛加根. 步态研究及其在踝关节不稳中的应用进展[J]. 中华骨与关节外科杂志, 2016, 9(3):255-260.
	XIAOHERETI S, SHENG J G. Gait analysis and its developing application in ankle instability[J]. Chin J Bone Joint Surg, 2016, 9(3):255-260.
[26]	WARD S, PEARCE A J, PIETROSIMONE B, et al. Neuromuscular deficits following peripheral joint injury: a neurophysiological hypojournal[J]. Muscle Nerve, 2015, 51(3):327-332. doi: 10.1002/mus.24463
[27]	尹彦, 罗冬梅, 刘卉, 等. 功能性踝关节不稳的机制与自评量表的研究进展[J]. 中国康复理论与实践, 2018, 24(6):671-677.
	YIN Y, LUO D M, LIU H, et al. Advance in mechanism and self-reported measures of functional ankle instability relationships between core endurance, hip strength, and balance in collegiate female athletes (review)[J]. Chin J Rehabil Theory Pract, 2018, 24(6):671-677.
[28]	HUBBARD-TURNER T, TURNER M J. Physical activity levels in college students with chronic ankle instability[J]. J Athl Train, 2015, 50(7):742-747. doi: 10.4085/1062-6050-50.3.05
[29]	鲁君兰, 蔡斌, 范帅. 慢性踝关节不稳患者的髋关节功能研究进展[J]. 中国康复, 2019, 34(6):328-332.
	LU J L, CAI B, FAN S. Research of progress of hip function in patients with chronic ankle instability[J]. Chin J Rehabil, 2019, 34(6):328-332.
[30]	MCCANN R S, CROSSETT I D, TERADA M, et al. Hip strength and star excursion balance test deficits of patients with chronic ankle instability[J]. J Sci Med Sport, 2017, 20(11):992-996. doi: 10.1016/j.jsams.2017.05.005
[31]	YEN S C, CHUI K K, CORKERY M B, et al. Hip-ankle coordination during gait in individuals with chronic ankle instability[J]. Gait Posture, 2017, 53:193-200. doi: 10.1016/j.gaitpost.2017.02.001
[32]	KOSHINO Y, ISHIDA T, YAMANAKA M, et al. Kinematics and muscle activities of the lower limb during a side-cutting task in subjects with chronic ankle instability[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(4):1071-1080. doi: 10.1007/s00167-015-3745-y
[33]	FEGER M A, DONOVAN L, HART J M, et al. Lower extremity muscle activation during functional exercises in patients with and without chronic ankle instability[J]. PM R, 2014, 6(7):602-611. doi: 10.1016/j.pmrj.2013.12.013
[34]	MITCHELL J, KIM H, SON S J, et al. Altered locomotive hip joint patterns in patients with chronic ankle instability[J]. Med Sci Sports Exerc, 2017, 49(5):740-741.
[35]	KOSHINO Y, YAMANAKA M, EZAWA Y, et al. Lower limb joint motion during a cross cutting movement differs in individuals with and without chronic ankle instability[J]. Phys Ther Sport, 2014, 15(4):242-248. doi: 10.1016/j.ptsp.2013.12.001
[36]	SMITH B I, CURTIS D, DOCHERTY C L. Effects of hip strengthening on neuromuscular control, hip strength, and self-reported functional deficits in individuals with chronic ankle instability[J]. J Sport Rehabil, 2018, 27(4):364-370. doi: 10.1123/jsr.2016-0143
[37]	FEGER M A, HART J M, SALIBA S, et al. Gait training for chronic ankle instability improves neuromechanics during walking[J]. J Orthop Res, 2017, 36(1):515-524.

组别	n	性别(n)		年龄(岁)	病程(d)	侧别(n)
组别	n	男	女	年龄(岁)	病程(d)	左	右
对照组	30	13	17	18.4±4.0	38.7±16.1	17	13
观察组	30	11	19	20.3±3.8	36.6±16.2	14	16
χ²/t值		0.278		1.887	0.504	0.601
P值		0.598		0.064	0.616	0.438

组别	n	治疗前	治疗后	t值	P值
对照组	30	23.3±2.4	25.4±1.1	4.357	< 0.001
观察组	30	22.9±2.6	26.9±1.8	6.928	< 0.001
t值		0.619	3.895
P值		0.538	< 0.001

组别	n	方向	治疗前	治疗后	t值	P值
对照组	30	前	68.6±5.5	73.7±5.3	3.657	< 0.001
		外前	63.9±4.9	69.6±3.3	5.285	< 0.001
		外方	56.1±5.9	65.7±5.4	6.574	< 0.001
		外后	69.1±6.2	78.7±5.5	6.344	< 0.001
		后	77.2±6.8	85.7±3.5	6.088	< 0.001
		后内	73.7±7.0	80.7±3.3	4.954	< 0.001
		内	68.1±7.2	77.9±3.8	6.593	< 0.001
		内前	72.4±6.2	84.7±5.7	8.000	< 0.001
观察组	30	前	69.7±4.6^a	76.3±4.1ⁱ	5.867	< 0.001
		外前	64.4±5.6^b	74.1±4.0^j	7.720	< 0.001
		外方	57.3±7.3^c	69.0±5.2^k	7.150	< 0.001
		外后	70.3±5.6^d	88.0±6.7^l	11.102	< 0.001
		后	78.3±5.7^e	90.6±6.1^m	8.070	< 0.001
		后内	72.2±6.3^f	85.0±4.6ⁿ	8.988	< 0.001
		内	69.3±7.3^g	83.1±4.9^o	8.597	< 0.001
		内前	71.5±5.5^h	88.0±6.3^p	10.806	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	30	194.1±25.7	204.4±26.3	1.532	0.130
观察组	30	201.3±23.5	385.2±28.4	27.325	< 0.001
t值		1.132	25.584
P值		0.262	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	30	230.8±20.3	243.1±28.7	1.916	0.060
观察组	30	238.6±25.5	389.2±27.4	22.038	< 0.001
t值		1.311	20.167
P值		0.195	< 0.001

Effect of Strength Training of Hip Muscles on Functional Ankle Instability: Evaluated with Surface Electromyography

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变量	臀中肌iEMG		臀大肌iEMG
变量	r值	P值	r值	P值
CAIT	0.731	0.046	0.778	0.029
SEBT前	0.808	0.037	0.841	0.020
SEBT外前	0.860	0.042	0.792	0.028
SEBT外	0.866	0.028	0.735	0.037
SEBT外后	0.774	0.050	0.824	0.041
SEBT后	0.712	0.018	0.803	0.033
SEBT后内	0.794	0.009	0.782	0.046
SEBT内	0.813	0.035	0.758	0.034
SEBT内前	0.756	0.004	0.811	0.013

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