软式支具对慢性踝关节不稳患者的即时疗效  

Immediate effect of soft brace on chronic ankle instability

作　　者：高维广 刘淑惠 马玉宝 娄亚兵 GAO Weiguang;LIU Shuhui;MA Yubao;LOU Yabing(Graduate Department,Shenyang Sport University,Shenyang,Liaoning 110102,China;Musculoskeletal Rehabilitation Center,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China;Chinese Medicine Rehabilitation Center,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)

机构地区：[1]沈阳体育学院研究生工作部,辽宁沈阳市110102 [2]首都医科大学附属北京康复医院肌骨康复中心,北京市100144 [3]首都医科大学附属北京康复医院中医康复中心,北京市100144

出　　处：《中国康复理论与实践》2022年第7期783-788,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家自然科学基金面上项目(No.61773042);首都医科大学附属北京康复医院博士科研基金专项课题(No.2020-066)。

摘　　要：目的探讨佩戴踝关节软式支具对慢性踝关节不稳(CAI)患者动、静态平衡功能及步行模式下患侧下肢生物力学的即时疗效。方法2021年1月至8月,首都医科大学附属北京康复医院肌骨康复中心门诊CAI患者40例,采用平板式足底压力测试系统、Y平衡测试于患者佩戴支具前后进行评定,表面肌电图同步采集步行模式下患侧足底动力学指标和下肢主要肌群表面肌电信号。结果佩戴支具后,睁、闭眼模式下压力中心椭圆面积和移动速度均明显减小(|t|>2.876,P<0.01);Y平衡测试各方向评分均显著增大(|t|>21.212,P<0.001);步行模式下患侧中足区和前足内侧区峰值压力和冲量增大(|t|>2.057,P<0.05),足跟外侧区、前足外侧区、足趾区峰值压力和冲量减少(|t|>2.464,P<0.05);患侧下肢胫前肌、腓肠肌外侧头振幅均方根增大(|t|>2.159,P<0.05)。结论佩戴软式支具后可以即刻显著改善CAI患者动、静态平衡功能,优化步行模式下患侧足底动力学分布,增强胫前肌、腓肠肌外侧头激活程度,从而改善运动控制能力。Objective To investigate the immediate effect of wearing a soft ankle brace on dynamic and static balance function and biomechanics of affected lower limbs during walking in chronic ankle instability(CAI)patients.Methods From January to August,2021,40 CAI patients from Musculoskeletal Rehabilitation Center,Beijing Rehabilitation Hospital,Capital Medical University were measured dynamic and static balance indexes with Zebris FDMSystem and Y balance test,before and after wearing a soft ankle brace;while the kinetics indexes and surface electromyography of the affected lower extremities during walking were collected with Zebris FDM-System and a surface electromyography telemeter simultaneously.Results The velocity and area of center of pressure reduced in both open and closed eye modes(|t|>2.876,P<0.01),the Y-balance scores increased in all the directions(|t|>21.212,P<0.001)after wearing brace;while the peak pressures and impulses increased in the midfoot and medial forefoot regions(|t|>2.057,P<0.05),and decreased in the lateral heel,lateral forefoot and toe regions(|t|>2.464,P<0.05),and the root mean square of surface electromyography increased in the tibialis anterior and lateral gastrocnemius(|t|>2.159,P<0.05)during walking.Conclusion Wearing soft brace can immediately improve dynamic and static balance of CAI patients,and optimize plantar kinetic distribution and enhance activation of the anterior tibial and the lateral head of gastrocnemius of the affected limb during walking,to improve motor control of CAI patients.

关 键 词：慢性踝关节不稳 软式支具 平衡 足底动力学 

分 类 号：R684.7[医药卫生—骨科学]