马联杰,傅建明,李岩,等.动态失稳训练对慢性踝关节不稳患者平衡功能和姿势控制能力的影响[J].中华物理医学与康复杂志,2025,47(8):715-720
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| 动态失稳训练对慢性踝关节不稳患者平衡功能和姿势控制能力的影响 |
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| DOI：10.3760/cma.j.cn421666-20240827-00692 |
| 中文关键词: 慢性踝关节不稳 平衡功能 姿势控制 表面肌电图 |
| 英文关键词: Ankle instability Balance Posture control Surface electromyography Dynamic instability training |
| 基金项目:嘉兴市科技计划项目（2022AY30007）；浙江省科技计划项目(2022C03177) |
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| 中文摘要: |
| 目的 观察动态失稳训练对慢性踝关节不稳(CAI)患者平衡功能和姿势控制能力的影响。 方法 募集符合标准的CAI患者30例，采用随机数字表法将其分为对照组和观察组，每组患者15例。2组患者均接受常规康复训练，包括踝周肌力训练、肌内效贴、振动训练等。观察组额外进行动态失稳训练，每日1次，每次20 min，每周训练5 d，连续训练4周，对照组则增加相同时间的常规康复训练。于治疗前和治疗4周后（治疗后）采用Berg平衡量表(BBS)、星形移动平衡测试(SEBT)评估2组患者的平衡功能，并通过表面肌电图(sEMG)采集2组患者患侧腓骨长肌、胫骨前肌、股直肌、股内侧肌在跳跃-落地测试中的落地前100 ms和落地后100 ms内的表面肌电信号，分析其肌肉激活强度，同时对所得数据进行统计学分析。 结果 治疗后，2组患者BBS、前内侧SEBT(SEBT-AM)、内侧SEBT(SEBT-M)、后内侧SEBT (SEBT-PM)较组内治疗前均显著改善，差异均有统计学意义(P<0.05)，且观察组治疗后的SEBT-AM、SEBT-M、SEBT-PM分别为(80.27±4.06)cm、(90.27±4.06)cm、(97.73±3.47)cm，较对照组治疗后均显著改善，差异均有统计学意义(P<0.05)。治疗后，2组患者落地前100 ms和落地后100 ms患侧腓骨长肌、胫骨前肌、股直肌、股内侧肌的标准化积分肌电值(iEMG)较组内治疗前均显著提高，差异均有统计学意义(P<0.05)。治疗后，观察组落地前100 ms患侧腓骨长肌、胫骨前肌、股直肌、股内侧肌的标准化iEMG较对照组落地前100 ms均显著增高，差异均有统计学意义(P<0.05)。治疗后，观察组落地后100 ms患侧胫骨前肌、股直肌、股内侧肌的标准化iEMG较对照组落地后100 ms亦显著增高，差异均有统计学意义(P<0.05)。 结论 动态失稳训练联合常规康复训练可进一步改善CAI患者的平衡功能和姿势控制能力。 |
| 英文摘要: |
| Objective To observe any effect of dynamic instability training on the balance and posture control of persons with chronic ankle instability (CAI). Methods Thirty persons with CAI were divided at random into a control group and an observation group, each of 15. Both groups received routine rehabilitation interventions (including ankle strength training, kinesio taping, and vibration training), while the observation group additionally underwent 20 minutes of dynamic instability training daily, 5 days a week for 4 consecutive weeks. Before and after the treatment, everyone′s balance was evaluated using the Berg balance scale (BBS) and the star moving balance test (SEBT). Surface electromyography (sEMG) was used to collect electromyograms of the affected peroneus longus, tibialis anterior, rectus femoris and medialis femoris muscles of both groups within 100ms before and after landing in the jump-landing test. The intensity of muscle activation was thus analyzed. Results After the treatment there was significant improvement in the average BBS scores, anterior medial SEBT, medial SEBT and posterior medial SEBT results of both groups. On average, all three SEBT results ［(80.27±4.06)cm, (90.27±4.06)cm and (97.73±3.47)cm respectively］ were significantly better in the observation group than in the control group. The standardized integrated electromyographs of the peroneus longus, tibialis anterior, rectus femoris and medialis femoris muscles on the affected sides showed significant improvement compared with before the treatment, but there too the observation group′s results were significantly better than those of the control group. Conclusions Combining dynamic instability training with conventional rehabilitation can further improve the balance and postural control of persons with chronic ankle instability. |
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