慢性踝关节不稳患者从不同高度着地的不同策略

IF 2.2 3区医学 Q3 NEUROSCIENCES Gait & posture Pub Date : 2024-09-15 DOI:10.1016/j.gaitpost.2024.09.008

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引用次数: 0

摘要

背景慢性踝关节不稳定（CAI）患者通常在从高处着地时发生外踝扭伤（LAS）。虽然已有关于在平地上着陆时的运动学研究报道，但尚未有研究探讨不同高度对 CAI 患者使用活门装置着陆策略的影响。研究问题CAI患者在使用活板门装置从三个高度落下时，是否会采取不同的着地策略？方法招募了31名CAI患者（男性24人，女性7人，年龄=21.1±1.8岁，身高=176.9±7.4厘米，体重=71.9±9.2公斤，受伤侧=18 R&13升）。他们从三个不同的高度（低高度（16 厘米）、中高度（23 厘米）、高高度（30 厘米））落下，患足落在活门装置的活动表面上，活门装置向内倾斜 24°，向前倾斜 15°，以模拟 LAS。运动数据由十二摄像头运动捕捉系统收集。结果在踝关节内翻角峰值（p=0.009，η2p=0.280）和角速度（p<0.001，η2p=0.444）以及踝关节内翻峰值时的踝关节跖屈（p=0.002，η2p=0.360）、膝关节屈曲（p<0.001，η2p=0.555）和髋关节屈曲（p=0.030，η2p=0.215）角度均存在显著的高度效应。事后检验表明，低高度时所有角度和速度均高于中高度（p：0.001-0.045，d：0.14-0.44）和高高度（p：0.001-0.023，d：0.28-0.除了踝关节跖屈角，低高度时的踝关节跖屈角低于中高度（p<0.001，d=0.44）和高高度（p=0.021，d=0.38）时的踝关节跖屈角。该策略包括增加踝关节背屈角度以及膝关节和髋关节屈曲角度。

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Different strategies for landing from different heights among people with chronic ankle instability

Background

Lateral ankle sprain (LAS) usually occurs during landing from heights among people with chronic ankle instability (CAI). Although the kinematics when landing on the flat surface has been reported, no studies have explored the effect of different heights on the landing strategies using a trapdoor device among people with CAI.

Research question

Do people with CAI adopt different landing strategies when drop-landing on the trapdoor device from three heights?

Methods

Thirty-one participants with CAI (24 males and 7 females, age=21.1±1.8 years, height=176.9±7.4 cm, body mass=71.9±9.2 kg, injured side=18 R&13 L) were recruited. They dropped from three different heights (low height (16 cm), medium height (23 cm), high height (30 cm)) with their affected foot landing on a movable surface of a trapdoor device, which was tilted 24° inward and 15° forward to simulate LAS. Kinematic data was collected using a twelve-camera motion capture system. One-way analysis of variance with repeated measures was used to compare the differences between the three heights.

Results

Significant height effects were detected in the peak ankle inversion angle (p=0.009, η²_p=0.280) and angular velocity (p<0.001, η²_p=0.444), and the peak ankle plantarflexion (p=0.002, η²_p=0.360), knee flexion (p<0.001, η²_p=0.555), and hip flexion (p=0.030, η²_p=0.215) angles at the time of peak ankle inversion. Post-hoc tests showed that all the angles and velocities were higher at a low height than at medium (p: 0.001–0.045, d: 0.14–0.44) and high heights (p: 0.001–0.023, d: 0.28–0.66), except for the ankle plantarflexion angle, which was lower at a low height than at medium (p<0.001, d=0.44) and high (p=0.021, d=0.38) heights.

Significance

People with CAI adopt a protective strategy during drop-landing at medium and high heights compared to a low height. This strategy involves increased ankle dorsiflexion angle as well as knee and hip flexion angles.

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.