佩戴软式支具对慢性踝关节不稳患者足底动力学的效果

doi:10.3969/j.issn.1006-9771.2024.05.017

Abstract

Abstract:

Objective To investigate the effect of daily soft brace wearing on plantar dynamics during walking in patients with chronic ankle instability (CAI).

Methods A total of 52 patients with unilateral chronic ankle instability (CAI) in Beijing Rehabilitation Hospital from February, 2021 to January, 2023 were randomly divided into control group (n= 26) and experimental group (n = 26). Both groups underwent an eight-week exercise training program. The control group wore placebo brace during daily activities, while the experimental group wore soft ankle brace. Plantar dynamic parameters were measured using a pressure plate system during walking, including peak plantar pressure and plantar impulse before and after intervention.

Results Six participants dropped out in the control group and five in the experimental group, resulting in a final inclusion of 41 participants. After intervention, there was no significant difference in peak plantar pressure and impulse on the affected side in the control group among different areas (P > 0.05). In the experimental group, the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas increased (|t| > 4.192, P < 0.001), while the peak pressure and impulse in the midfoot and lateral forefoot areas decreased (t > 2.984, P < 0.05); the peak pressure and impulse in the heel medial, heel lateral and forefoot medial areas were higher in the experimental group than in the control group (|t| > 2.126, P < 0.05), and the peak pressure and impulse were lower in the midfoot and forefoot lateral areas (t > 2.133, P < 0.05).

Conclusion Wearing a soft brace during daily activities may optimize the distribution of peak plantar pressure and plantar impulse on the affected side in patients with CAI, which may prevent recurrence of sprains.

Key words: chronic ankle instability, exercise therapy, soft brace, plantar pressure

CLC Number:

R684.7

MA Yubao, HUANG Zhibin, LI Yige, FAN Zhijiao, ZHANG Lihua, SUN Fenglong. Effect of soft brace wearing on plantar dynamics in patients with chronic ankle instability[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 613-620.

Figures/Tables 4

Figure 1

Table 1

Table 2

Table 3

References 24

[1]	GRIBBLE P A, BLEAKLEY C M, CAULFIELD B M, et al. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains[J]. Br J Sports Med, 2016, 50(24): 1496-1505.
[2]	DONOVAN L, HETZEL S, LAUFENBERG C R, et al. Prevalence and impact of chronic ankle instability in adolescent athletes[J]. Orthop J Sports Med, 2020, 8(2): 2325967119900962.
[3]	HERZOG M M, KERR Z Y, MARSHALL S W, et al. Epidemiology of ankle sprains and chronic ankle instability[J]. J Ath Train, 2019, 54(6): 603-610.
[4]	LIN C I, HOUTENBOS S, LU Y H, et al. The epidemiology of chronic ankle instability with perceived ankle instability: a systematic review[J]. J Foot Ankle Res, 2021, 14(1): 41.
[5]	POWDEN C J, HOCH J M, HOCH M C. Rehabilitation and improvement of health-related quality-of-life detriments in individuals with chronic ankle instability: a meta-analysis[J]. J Athl Train, 2017, 52(8): 753-765.
[6]	HALL E A, DOCHERTY C L, SIMON J, et al. Strength-training protocols to improve deficits in participants with chronic ankle instability: a randomized controlled trial[J]. J Athl Train, 2015, 50(1): 36-44.
[7]	MOLLÀ-CASANOVA S, INGLÉS M, SERRA-AÑÓ P. Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: systematic review and meta-analysis[J]. Clin Rehabil, 2021, 35(12): 1694-1709.
[8]	HALL E A, CHOMISTEK A K, KINGMA J J, et al. Balance-and strength-training protocols to improve chronic ankle instability deficits, part I: assessing clinical outcome measures[J]. J Athl Train, 2018, 53(6): 568-577.
[9]	HALL E A, CHOMISTEK A K, KINGMA J J, et al. Balance- and strength-training protocols to improve chronic ankle instability deficits, part II: assessing patient-reported outcome measures[J]. J Athl Train, 2018, 53(6): 578-583.
[10]	GRIBBLE P A, DELAHUNT E, BLEAKLEY C, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium[J]. J Orthop Sports Phys Ther, 2013, 43(8): 585-591.
[11]	ORLIN M N, MCPOIL T G. Plantar pressure assessment[J]. Phys Ther, 2000, 80(4): 399-409. pmid: 10758524
[12]	RAZAK A H A, ZAYEGH A, BEGG R K, et al. Foot plantar pressure measurement system: a review[J]. Sensors, 2012, 12(7): 9884-9912. doi: 10.3390/s120709884 pmid: 23012576
[13]	朱晨辰, 殷缘, 周迎基, 等. 体质量指数对足底压力的影响[J]. 中国组织工程研究, 2024, 28(18): 2808-2813.
	ZHU C C, YIN Y, ZHOU Y J, et al. Effects of body mass index on plantar pressure[J]. Chin J Tissue Eng Res, 2024, 28(18): 2808-2813.
[14]	侯宗辰, 敖英芳, 胡跃林, 等. 慢性踝关节不稳患者足底压力特征及相关因素分析[J]. 北京大学学报(医学版), 2021, 53(2): 279-285.
	HOU Z C, AO Y F, HU Y L, et al. Characteristics and related factors of plantar pressure in the chronic ankle instability individuals[J]. J Peking Univ (Health Sci), 2021, 53(2): 279-285.
[15]	KOLDENHOVEN R M, FEGER M A, FRASER J J, et al. Surface electromyography and plantar pressure during walking in young adults with chronic ankle instability[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(4): 1060-1070.
[16]	SCHMIDT H, SAUER L D, LEE S Y, et al. Increased in-shoe lateral plantar pressures with chronic ankle instability[J]. Foot Ankle Int, 2011, 32(11): 1075-1080. pmid: 22338958
[17]	WEBSTER K A, VINCENT L, DOCHERTY C A. 56 Peak plantar pressures during walking in chronic ankle instability and healthy patients[J]. Br J Sports Med, 2015, 49(Suppl 1): A22-A23.
[18]	VETTE A H, FUNABASHI M, LEWICKE J, et al. Functional, impulse-based quantification of plantar pressure patterns in typical adult gait[J]. Gait Posture, 2019, 67: 122-127. doi: S0966-6362(18)31656-4 pmid: 30321793
[19]	WILLEMS T, WITVROUW E, DELBAERE K, et al. Relationship between gait biomechanics and inversion sprains: a prospective study of risk factors[J]. Gait Posture, 2005, 21(4): 379-387. doi: 10.1016/j.gaitpost.2004.04.002 pmid: 15886127
[20]	MORRISON K E, HUDSON D J, DAVIS I S, et al. Plantar pressure during running in subjects with chronic ankle instability[J]. Foot Ankle Int, 2010, 31(11): 994-1000. doi: 10.3113/FAI.2010.0994 pmid: 21189193
[21]	MOISAN G, DESCARREAUX M, CANTIN V. Effects of chronic ankle instability on kinetics, kinematics and muscle activity during walking and running: a systematic review[J]. Gait Posture, 2017, 52: 381-399. doi: S0966-6362(16)30675-0 pmid: 28063387
[22]	RAFFALT P C, CHRYSANTHOU M, DUDA G N, et al. Dynamics of postural control in individuals with ankle instability: effect of visual input and orthotic use[J]. Comput Biol Med, 2019, 110: 120-126. doi: S0010-4825(19)30186-6 pmid: 31154256
[23]	HERTEL J, CORBETT R O. An updated model of chronic ankle instability[J]. J Athl Train, 2019, 54(6): 572-588.
[24]	FRANKLIN S, GREY M J, HENEGHAN N, et al. Barefoot vs common footwear: a systematic review of the kinematic, kinetic and muscle activity differences during walking[J]. Gait Posture, 2015, 42(3): 230-239. doi: 10.1016/j.gaitpost.2015.05.019 pmid: 26220400

项目	对照组(n = 20)	试验组(n = 21)	t/χ²值	P值
年龄/岁	29.35±6.75	30.33±7.82
性别(男/女)/n	5/15	9/12
身高/cm	167.95±6.13	168.90±9.21	0.389	0.700
体质量/kg	64.50±13.75	71.81±16.76	1.522	0.316
体质量指数/(kg·m^-2)	22.78±4.09	24.89±3.79	1.714	0.094
患侧(左/右)/n	6/14	9/12	0.730	0.393

分区	组别	n	测试	$\bar{x} \pm s$	t值	P值
HM区	对照组	20	前测	2.91±0.35	-2.086	0.051
			后测	3.03±0.40
	试验组	21	前测	2.78±0.51	-4.841	< 0.001
			后测	3.32±0.46
	干预前均值差			0.13±0.45	0.978	0.334
	干预后均值差			0.29±0.43	-2.126	0.040
HL区	对照组	20	前测	2.72±0.46	-0.509	0.617
			后测	2.76±0.36
	试验组	21	前测	2.70±0.52	-4.192	< 0.001
			后测	3.05±0.51
	干预前均值差			0.02±0.49	0.176	0.861
	干预后均值差			0.29±0.45	-2.140	0.039
MF区	对照组	20	前测	1.83±0.46	0.034	0.973
			后测	1.82±0.50
	试验组	21	前测	1.83±0.50	4.533	< 0.001
			后测	1.45±0.39
	干预前均值差			0.01±0.48	0.007	0.995
	干预后均值差			0.37±0.46	2.724	0.010
FM区	对照组	20	前测	1.48±0.26	-1.033	0.315
			后测	1.56±0.33
	试验组	21	前测	1.38±0.37	-5.661	< 0.001
			后测	1.90±0.47
	干预前均值差			0.10±0.33	1.049	0.301
	干预后均值差			0.34±0.42	-2.608	0.013
FI区	对照组	20	前测	3.80±0.70	-1.909	0.071
			后测	4.04±0.81
	试验组	21	前测	3.71±1.08	-1.335	0.197
			后测	3.98±0.62
	干预前均值差			0.09±0.95	0.270	0.789
	干预后均值差			0.06±0.73	0.291	0.773
FL区	对照组	20	前测	1.37±0.34	0.167	0.869
			后测	1.36±0.28
	试验组	21	前测	1.41±0.33	2.984	0.007
			后测	1.20±0.19
	干预前均值差			0.04±0.34	-0.442	0.661
	干预后均值差			0.16±0.25	2.133	0.039
T区	对照组	20	前测	1.67±0.32	-1.262	0.222
			后测	1.82±0.41
	试验组	21	前测	1.72±0.19	-0.793	0.437
			后测	1.80±0.48
	干预前均值差			0.05±0.28	-0.633	0.530
	干预后均值差			0.02±0.45	0.141	0.888

分区	组别	n	测试	$\bar{x} \pm s$	t值	P值
HM区	对照组	20	前测	17.39±4.33	-1.640	0.117
			后测	18.41±3.48
	试验组	21	前测	17.21±3.53	-8.024	< 0.001
			后测	22.28±2.92
	干预前均值差			0.18±4.01	0.149	0.882
	干预后均值差			3.87±3.23	-3.861	< 0.001
HL区	对照组	20	前测	16.21±3.51	-0.721	0.480
			后测	16.56±3.79
	试验组	21	前测	16.07±3.55	-4.638	< 0.001
			后测	19.45±4.32
	干预前均值差			0.14±3.53	0.122	0.904
	干预后均值差			2.89±4.09	-2.279	0.028
MF区	对照组	20	前测	14.82±3.23	0.625	0.539
			后测	14.38±3.20
	试验组	21	前测	15.31±3.64	9.512	< 0.001
			后测	8.80±1.88
	干预前均值差			0.49±3.45	-0.459	0.649
	干预后均值差			5.58±2.86	6.836	< 0.001
FM区	对照组	20	前测	10.27±2.22	-0.897	0.381
			后测	10.70±2.20
	试验组	21	前测	9.68±2.22	-6.543	< 0.001
			后测	12.45±2.30
	干预前均值差			0.59±2.22	0.854	0.399
	干预后均值差			1.65±2.25	-2.487	0.017
FI区	对照组	20	前测	22.11±5.49	0.405	0.690
			后测	21.84±5.50
	试验组	21	前测	21.97±4.91	1.653	0.114
			后测	0.16±4.60
	干预前均值差			0.14±5.22	0.086	0.932
	干预后均值差			1.68±5.11	1.079	0.287
FL区	对照组	20	前测	9.60±2.11	0.920	0.369
			后测	9.26±2.18
	试验组	21	前测	10.20±1.88	4.617	< 0.001
			后测	7.72±1.77
	干预前均值差			0.60±2.01	-0.944	0.351
	干预后均值差			1.56±2.01	2.497	0.017
T区	对照组	20	前测	9.60±1.92	1.736	0.099
			后测	8.86±2.42
	试验组	21	前测	9.59±2.33	0.859	0.401
			后测	9.19±2.22
	干预前均值差			0.01±2.15	0.020	0.984
	干预后均值差			0.33±2.33	-0.454	0.653

Effect of soft brace wearing on plantar dynamics in patients with chronic ankle instability

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