踝关节松动术联合臀肌力量训练治疗慢性足底筋膜炎的疗效分析  

Combined ankle joint mobilization and hip strengthening in treatment for chronic plantar fasciitis

作　　者：韩秀兰[1] 张珊珊[1] 张桂芳[1] 张振发[1] 鲍珊珊[1] 王楚怀[1] HAN Xiulan;ZHANG Shanshan;ZHANG Guifang(The First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong,510080)

机构地区：[1]中山大学附属第一医院康复医学科,广东省广州市510080

出　　处：《中国康复医学杂志》2024年第12期1804-1809,共6页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金项目(82102677);广东省中医药局资助课题(20221073);广东省医学科学技术研究基金项目(A2022096)。

摘　　要：目的:观察踝关节松动联合臀肌力量训练对慢性足底筋膜炎的疗效。方法:选取慢性足底筋膜炎患者50例,随机分为对照组(n=25)和观察组(n=25),两组患者均常规进行小腿肌肉牵伸,在此基础上,对照组给予踝关节松动训练,观察组给予踝关节松动训练联合臀肌力量训练。两组患者均在治疗前、疗程结束时和随访3个月后进行视觉模拟疼痛评分(VAS)和美国矫形外科足踝协会踝-后足评分系统(AOFAS)评分,以及髋关节后伸和外展肌力评估、踝关节背屈活动度评估。结果:疗程结束时,两组患者的踝关节背屈活动度均较治疗前改善,但两组间对比无显著性意义。随访3个月时,观察组踝关节背屈活动度较对照组大,对比有显著性意义。不同时间对照组的臀肌力量对比无显著性意义。治疗前和疗程结束时观察组的臀肌力量对比无显著性意义,但是随访3个月时的力量大于疗程结束时和治疗前。疗程结束时,两组患者的VAS和AOFAS评分均较治疗前明显改善,但两组间比较差异无显著性意义。随访3个月后,VAS评分观察组降低为(1.52±0.77)分,对照组为(2.68±0.85)分,两组间差异有显著性意义(P=0.003);AOFAS评分观察组为(89.64±6.52)分,对照组为(81.24±6.11)分,两组间差异有显著性意义(P<0.001)。结论:踝关节松动联合臀肌力量训练是治疗慢性足底筋膜炎的有效手段。Objective:To evaluate the effectiveness of ankle joint mobilization combined hip strengthening on pain and function of patients with chronic plantar fasciitis(PF).Method:Fifty patients with PF,aged 23 to 62 years,were randomly assigned to the intervention group(n=25)and the control group(n=25).Both groups of patients were received routinely stretching exercises.Additionally,the control group received ankle joint mobilization and the intervention group received ankle joint mobilization plus hip strengthening.Both groups received total 8 treatments,twice a week.The Visual Analogue pain Score(VAS)and the American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot scale were evaluated before and after treatment and after 3 months of follow-up,along with assessments of hip extension and abduction muscle strength,and ankle dorsiflexion range of motion.Result:After 4 weeks of treatment,both groups showed a significant difference in the VAS and AOFAS compared to before treatment(P<0.001),but no significant difference was found between groups.After 3 months follow-up,the VAS in the intervention group was significantly lower than that in the control group(P=0.003),and the values of AOFAS in the intervention group was significantly higher than that in the control group(P<0.001).Conclusion:Ankle joint mobilization combined with hip strengthening can effectively alleviate foot pain and improve function to the patients of chronic plantar fasciitis.

关 键 词：足底筋膜炎 关节松动 臀肌训练 

分 类 号：R493[医药卫生—康复医学]