筋膜手法治疗慢性踝关节不稳的疗效分析  

Analysis of the effect of fascia manipulation on chronic ankle instability

作　　者：李文茂[1] 曲福玲[1] 易江[1] 张红[2] 徐琳 刘忠良[1] LI Wenmao;QU Fuling;YI Jiang;ZHANG Hong;XU Lin;LIU Zhongliang(Department of Rehabilitation Medicine,Second Hospital of Jilin University,Changchun,Jilin 130041,P.R.China;Department of Rehabilitation Medicine,First Hospital of Jilin University,Changchun,Jilin 130021,P.R.China)

机构地区：[1]吉林大学第二医院康复医学科,长春130041 [2]吉林大学第一医院康复医学科,长春130021

出　　处：《华西医学》2021年第5期632-637,共6页West China Medical Journal

基　　金：吉林省卫生健康委技术推广项目(3D5205594429)。

摘　　要：目的探讨筋膜手法治疗对慢性踝关节不稳(chronic ankle instability,CAI)患者的临床疗效。方法回顾性收集吉林大学第二医院康复医学科2018年10月—2020年12月期间,接受康复治疗的CAI患者临床资料。根据治疗方案不同将患者分为平衡训练组和筋膜手法组。平衡训练组接受平衡训练4周,筋膜手法组在筋膜手法治疗后进行平衡训练4周。通过倾向性评分匹配进行1∶1匹配,比较匹配后不同治疗方案对CAI患者功能障碍的影响。采用足踝关节功能量表(Foot and Ankle Ability Measure,FAAM)[包括FAAM-日常生活能力(FAAM-activity of daily living,FAAM-ADL)、日常生活能力(activity of daily living,ADL)自我评分、FAAM-运动(FAAM-sports,FAAM-S)和运动自我评分]、压力中心变化(center of pressure,COP)、足抬离次数(foot lift test,FLT)评估患者干预前后平衡功能及症状的变化。结果共纳入患者52例,其中筋膜手法组24例,平衡训练组28例。采用倾向性评分匹配后,最终纳入患者34例,每组各17例。干预前,两组组间比较,FAAM、COP、FLT差异无统计学意义(P>0.05)。干预前,两组组间比较,FAAM、COP、FLT差异无统计学意义(P>0.05)。干预后,两组组间比较,筋膜手法组FAAM-ADL、ADL自我评分、COP、FLT优于平衡训练组(P<0.05);FAAM-S与运动自我评分比较,差异无统计学意义(P>0.05)。干预前后,两组组内比较,FAAM、COP、FLT较干预前均有改善(P<0.05)。筋膜手法组FAAM-ADL、ADL自我评分改善值、COP下降值均大于平衡训练组,差异均有统计学意义(P<0.05);两组FAAM-S、运动自我评分、FLT干预前后差值的组间比较,差异均无统计学意义(P>0.05)。结论平衡训练可改善CAI患者的功能,结合筋膜手法更能有效提高日常生活能力和静平衡能力。Objective To explore the clinical efficacy of fascial manipulation(FM) treatment in patients with chronic ankle instability(CAI). Methods The clinical data of CAI patients who received rehabilitation treatment in the Department of Rehabilitation Medicine of the Second Hospital of Jilin University from October 2018 to December 2020 were retrospectively collected. According to different treatment methods, patients were divided into balance training(BT)group and FM group. The BT group received BT for 4 weeks, while the FM group received BT for 4 weeks after FM treatment. Propensity score matching(PSM) was used for 1∶1 matching to compare the effects of different treatment options on the dysfunction of CAI patients. Foot and Ankle Ability Measure(FAAM) [including FAAM-activity of daily living(FAAM-ADL), activity of daily living(ADL) self-scoring, FAAM-sports(FAAM-S), and sports self-scoring], center of pressure(COP), foot lift test(FLT) were used to evaluate the changes in balance function and symptoms pre-treatment and post-treatment. Results A total of 52 patients were included, including 24 cases in FM group and 28 cases in BT group. Finally, after PSM method, 34 patients were included, 17 cases in each group. Before intervention, there was no significant difference in FAAM, COP and FLT between the two groups(P>0.05). After the intervention, FAAM-ADL,ADL self score, COP and FLT in the FM group were better than those in the BT group(P<0.05);there was no significant difference between FAAM-S and exercise self score(P>0.05). Before and after the intervention, FAAM, COP and FLT were improved in both groups(P<0.05). The improvement of FAAM ADL, ADL self-score and the decrease of COP in FM group were higher than that of the BT group(P<0.05). Comparison of FAAM-S, exercise self score and FLT before and after intervention, there was no significant difference between the two groups(P>0.05). Conclusion BT can improve the function of patients with CAI, and the combination of FM is more effective in improving the ability of

关 键 词：慢性踝关节不稳 筋膜手法 倾向性评分匹配 

分 类 号：R684[医药卫生—骨科学]