6周动态神经肌肉训练计划对踝关节功能的影响:1例报告。

Jeremiah O'Driscoll, Fearghal Kerin, Eamonn Delahunt
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引用次数: 58

摘要

背景:踝关节扭伤和随后的慢性踝关节不稳定(CAI)是临床医生参与肌肉骨骼损伤的治疗和康复时经常遇到的问题。最近有人提倡踝关节扭伤后康复方案应纳入动态神经肌肉训练,以提高踝关节感觉运动能力。目前还没有关于动态神经肌肉训练对起跳落地时踝关节定位的影响的研究报道,这是踝关节扭伤的主要损伤机制之一。本病例报告详细介绍了6周动态神经肌肉训练计划对CAI运动员踝关节功能的影响。方法:运动员参加了为期6周的渐进式动态神经肌肉训练计划,包括姿势稳定性、强化、增强式和速度/敏捷性训练。评估干预效果的指标为:1 Cumberland Ankle Instability Tool (CAIT)评分,2 Star偏移平衡测试(SEBT)到达距离,3 drop landing and drop vertical jumping时踝关节跖屈曲,4 ground reaction forces (GRFs) walking时。结果:参加项目后,CAIT和SEBT分数有所提高。在落体落地和落体垂直跳跃任务中,踝关节的足底屈曲角度在初次接触时减小,这表明在参与项目后,踝关节在落体时处于一个不那么脆弱的位置。此外,干预后行走时GRFs降低。结论:6周动态神经肌肉训练方案改善了CAI运动员的踝关节感觉运动控制参数。为了确定神经肌肉训练对踝关节损伤危险因素的影响,现在需要在更大的受试者队列中进行进一步的研究。
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Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report.

Background: Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI.

Methods: The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking.

Results: CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention.

Conclusions: The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

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