两种平衡测试中功能性踝关节不稳患者的肌肉活化特征
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摘要
背景:研究发现,功能性踝关节不稳定患者足部肌肉活化异常结果并不一致,且对穿鞋与否是否影响足部肌肉表现探讨者不多。目的:分析功能性踝关节不稳定患者在穿鞋与赤脚状况下测量其双脚转至单脚站立及单脚落地2个任务中,下肢承载腿比目鱼肌与腓骨长肌的激活状况。方法:从西部地区某综合性大学招募到功能性踝关节不稳定大学生患者及健康者(控制组)各15名。分别在穿鞋及赤脚2种状况下完成双至单脚站立与单脚落地实验测试,采用表面肌电仪系统监测2个任务中的承载腿比目鱼肌与腓骨长肌表面肌电,并运用适当的统计方法对相关指标进行处理。结果与结论:①双脚转至单脚站立中,功能性踝关节不稳定患者与控制组的比目鱼肌与腓骨长肌的启动时间、预备肌肉活性不受是否穿鞋及组别因素的影响,但两块肌肉的"反应性肌肉活性"表现为功能性踝关节不稳定患者激性明显弱于控制组;②单脚着地测试中,比目鱼肌及腓骨长肌的启动时间不受组别因素的影响,但穿鞋状况下功能性踝关节不稳定组的启动时间明显短于赤脚组;③单脚着地测中,比目鱼肌与腓骨长肌的预备性肌肉活性与组别及是否穿鞋无关,而反应性肌肉活性中,功能性踝关节不稳定组显着弱于控制组,赤脚组显着高于穿鞋组。④结果说明,双脚转至单脚站立及单脚落地双重任务中,功能性踝关节不稳定显著影响患者比目鱼肌及腓骨长肌的活化程度,而穿鞋与否影响着单脚着地肌肉活化的"启动时间"及"反应性肌肉活性",故穿鞋可能对踝关节肌肉神经控制有一定的影响,且这种影响随着测试难度的提升而表现得更为突出。
BACKGROUND: Studies have found that abnormal muscle activation in the feet of functional ankle instability patients is inconsistent, and whether wearing shoes or not affects the performance of the foot muscles is rarely reported.OBJECTIVE: To investigate the activation of the soleus muscle and peroneus longus muscle of the lower extremities in functional ankle instability patients in double-to-single-leg stance test and single-leg landing test under the conditions of wearing shoes and barefoot. METHODS: Fifteen patients with functional ankle instability and 15 healthy individuals(control group) were recruited from a university in the western China. Double-to-single-leg stance test and single-leg landing test were performed under the two conditions of wearing shoes and barefoot. The surface electromyography of peroneus longus muscle and solesus muscles in two tasks were monitored, and appropriate statistical methods were applied to the relevant indicators. RESULTS AND CONCLUSION:(1) In double-to-single-leg stance test, the start-up time and pre-muscle activation of the soleus muscle and peroneus longus muscle of the functional ankle instability patients and the controls were not affected by whether or not wearing shoes. But the responsiveness of muscle activation of the two muscles was obviously affected by group factors, which showed that the functional ankle instability patients were significantly weaker than the controls.(2) In the single-leg landing test, the start-up time of the soleus muscle and the peroneus longus muscle was not affected by the group factor. However, the start-up time of the functional ankle instability patients wearing shoes was significantly shorter than that in the barefoot condition.(3) In the single-leg landing test, the pre-muscle activation of the soleus muscle and the peroneus longus muscles was not related to the group and whether wearing shoes or barefoot. But the reactive muscle activation in the functional ankle instability group was significantly weaker than that in the control group, and the barefoot group was significantly higher than the footwear group.(4) These results suggest that during double-to-single-leg stance test and single-leg landing test, functional ankle instability significantly affects the degree of activation of the soleus muscle and peroneus longus muscle, and whether or not wearing shoes affects the start-up time and responsiveness of muscle activation. Therefore, wearing shoes may influence the control of ankle neuromotor to some extent, and this effect becomes more prominent as the difficulty of testing increases.
BACKGROUND: Studies have found that abnormal muscle activation in the feet of functional ankle instability patients is inconsistent, and whether wearing shoes or not affects the performance of the foot muscles is rarely reported.OBJECTIVE: To investigate the activation of the soleus muscle and peroneus longus muscle of the lower extremities in functional ankle instability patients in double-to-single-leg stance test and single-leg landing test under the conditions of wearing shoes and barefoot. METHODS: Fifteen patients with functional ankle instability and 15 healthy individuals(control group) were recruited from a university in the western China. Double-to-single-leg stance test and single-leg landing test were performed under the two conditions of wearing shoes and barefoot. The surface electromyography of peroneus longus muscle and solesus muscles in two tasks were monitored, and appropriate statistical methods were applied to the relevant indicators. RESULTS AND CONCLUSION:(1) In double-to-single-leg stance test, the start-up time and pre-muscle activation of the soleus muscle and peroneus longus muscle of the functional ankle instability patients and the controls were not affected by whether or not wearing shoes. But the responsiveness of muscle activation of the two muscles was obviously affected by group factors, which showed that the functional ankle instability patients were significantly weaker than the controls.(2) In the single-leg landing test, the start-up time of the soleus muscle and the peroneus longus muscle was not affected by the group factor. However, the start-up time of the functional ankle instability patients wearing shoes was significantly shorter than that in the barefoot condition.(3) In the single-leg landing test, the pre-muscle activation of the soleus muscle and the peroneus longus muscles was not related to the group and whether wearing shoes or barefoot. But the reactive muscle activation in the functional ankle instability group was significantly weaker than that in the control group, and the barefoot group was significantly higher than the footwear group.(4) These results suggest that during double-to-single-leg stance test and single-leg landing test, functional ankle instability significantly affects the degree of activation of the soleus muscle and peroneus longus muscle, and whether or not wearing shoes affects the start-up time and responsiveness of muscle activation. Therefore, wearing shoes may influence the control of ankle neuromotor to some extent, and this effect becomes more prominent as the difficulty of testing increases.
引文
[1]Freeman MA.Instability of the foot after injuries to the lateral ligament of the ankle.J Bone Joint Surg Br.1965;47(4):669-677.
[2]Doherty C,Delahunt E,Caulfield B,et al.The incidence and prevalence of ankle sprain injury:A systemmatic review and meta analysis of prospective epidemiological studies.Sports med.2014;44(1):123-140.
[3]尹彦,罗冬梅,刘卉,于冰.功能性踝关节不稳者姿势稳定性的研究进展[J].体育科学,2016,36(4):61-67.
[4]Santello M,McDonagh MJ.The control of timing and amplitude of EMG activity in landing movements in humans.Exp Physiol.1998;83(6):857-874.
[5]Divya Bhaskaran,Michael Wortley,Qingjian Chen,et al.Effect of a combined inversion and plantarflexion surface on ankle kinematics and EMG activities in landing.Journal of Sport and Health Science.2015;4(4):377-383.
[6]Sanam Tavakoli,Saeed Forghany,Christopher Nester.The effect of dual tasking on foot kinematics in people with functional ankle instability.Gait Posture.2016;49:364-370.
[7]Konradsen L,Magnusson P.Increased inversion angle replication error in functional ankle instability.Knee Surg Sports Traumatol Arthrosc.2000;8(4):246-251.
[8]Yoshida M,Taniguchi K,Katayose M.Analysis of muscle activity and ankle jointmovement during the side-hop test.JStrength Cond Res.2011;25(8):2255-2264.
[9]Byung-Ki Cho,Ji-Kang Park,Seung-Myung Choi and et al.The peroneal strength deficits in patients with chronic ankle instability compared to ankle sprain copers and normal individuals.Foot Ankle Surg.2017;pii:S1268-7731(17)31330-31339.
[10]Munn J,Sullivan SJ,Schneiders AG.Evidence of sensorimotor deficits in functional ankle instability:Asystematic review with metaanalysis.J Sci Med Sport.2010;13:2-12.
[11]Hopkins JT,Brown TN,Christensen L,et al.Deficits in peroneal latency and electromechanical delay in patients with functional ankle instability.J Orthop Res.2009;27:1541-1546.
[12]Lee AJ,Lin WH.Twelve-week biomechanical ankle platform system training on postural stability and ankle proprioception in subjects with unilateral functional ankle instability.Clin Biomech(Bristol,Avon).2008;23(8):1065-1072.
[13]Arnold BL,De La Motte S,Linens S,et al.Ankle instability is associated with balance impairments:A meta-analysis.Med Sci Sports Exerc.2009;41:1048-1062.
[14]Rosen A,Swanik C,Thomas S,et al.Differences in lateral drop jumps from an unknown height among individuals with functional ankle instability.J Athl Train.2013;48:773-781.
[15]Delahunt E,Monaghan K,Caulfield B.Ankle function during hopping in subjects with functional instability of the ankle joint.Scand J Med Sci Sports.2007;17:641-648.
[16]Ross SE,Guskiewicz KM,Gross MT,et al.Balance measures for discriminating between functionally unstable and stable ankles.Med Sci Sports Exerc.2009;41:399-407.
[17]Suda EY,Amorim CF,Sacco Ide C.Influence of ankle functional instability on the ankle electromyography during landing after volleyball blocking.J Electromyogr Kinesiol.2009;19:e84-93.
[18]Van Deun S,Staes FF,Stappaerts KH,et al.Relationship of chronic ankle instability to muscle activation patterns during the transition from double-leg to singleleg stance.Am J Sports Med.2007;35:274-281.
[19]Levin O,Van Nevel A,Malone C,et al.Sway activity and muscle recruitment order during transition from double to single-leg stance in subjects with chronic ankle instability.Gait Posture.2012;36:546-551.
[20]Mitchell A,Dyson R,Hale T,et al.Biomechanics of ankle instability.Part 2:Postural sway-reaction time relationship.Med Sci Sports Exerc.2008;40(15):22-28.
[21]Lin CY,Shih YF.The neuromuscular control of the ankle joint in subjects with functional ankle instability.Formos J Phys Ther.2014,39:191-202.
[22]Wikstrom EA,Tillman MD,Chmielewski TL,et al.Dynamic postural stability deficits in subjects with self-reported ankl e ins t abi l i ty.Med Sc i Sports Exerc.2007;39:397-402.
[23]Lin CF,Chen CY,Lin CW.Dynamic ankle control in athletes with ankle instability during sports maneuvers.Am J Sports Med.2011;39:2007-2015.
[24]Raymond J,Nicholson LL,Hiller CE,et al.The effect of ankle taping or bracing on proprioception in functional ankle instability:A systematic review and meta-analysis.J Sci Med Sport.2012;15:386-392.
[2]Doherty C,Delahunt E,Caulfield B,et al.The incidence and prevalence of ankle sprain injury:A systemmatic review and meta analysis of prospective epidemiological studies.Sports med.2014;44(1):123-140.
[3]尹彦,罗冬梅,刘卉,于冰.功能性踝关节不稳者姿势稳定性的研究进展[J].体育科学,2016,36(4):61-67.
[4]Santello M,McDonagh MJ.The control of timing and amplitude of EMG activity in landing movements in humans.Exp Physiol.1998;83(6):857-874.
[5]Divya Bhaskaran,Michael Wortley,Qingjian Chen,et al.Effect of a combined inversion and plantarflexion surface on ankle kinematics and EMG activities in landing.Journal of Sport and Health Science.2015;4(4):377-383.
[6]Sanam Tavakoli,Saeed Forghany,Christopher Nester.The effect of dual tasking on foot kinematics in people with functional ankle instability.Gait Posture.2016;49:364-370.
[7]Konradsen L,Magnusson P.Increased inversion angle replication error in functional ankle instability.Knee Surg Sports Traumatol Arthrosc.2000;8(4):246-251.
[8]Yoshida M,Taniguchi K,Katayose M.Analysis of muscle activity and ankle jointmovement during the side-hop test.JStrength Cond Res.2011;25(8):2255-2264.
[9]Byung-Ki Cho,Ji-Kang Park,Seung-Myung Choi and et al.The peroneal strength deficits in patients with chronic ankle instability compared to ankle sprain copers and normal individuals.Foot Ankle Surg.2017;pii:S1268-7731(17)31330-31339.
[10]Munn J,Sullivan SJ,Schneiders AG.Evidence of sensorimotor deficits in functional ankle instability:Asystematic review with metaanalysis.J Sci Med Sport.2010;13:2-12.
[11]Hopkins JT,Brown TN,Christensen L,et al.Deficits in peroneal latency and electromechanical delay in patients with functional ankle instability.J Orthop Res.2009;27:1541-1546.
[12]Lee AJ,Lin WH.Twelve-week biomechanical ankle platform system training on postural stability and ankle proprioception in subjects with unilateral functional ankle instability.Clin Biomech(Bristol,Avon).2008;23(8):1065-1072.
[13]Arnold BL,De La Motte S,Linens S,et al.Ankle instability is associated with balance impairments:A meta-analysis.Med Sci Sports Exerc.2009;41:1048-1062.
[14]Rosen A,Swanik C,Thomas S,et al.Differences in lateral drop jumps from an unknown height among individuals with functional ankle instability.J Athl Train.2013;48:773-781.
[15]Delahunt E,Monaghan K,Caulfield B.Ankle function during hopping in subjects with functional instability of the ankle joint.Scand J Med Sci Sports.2007;17:641-648.
[16]Ross SE,Guskiewicz KM,Gross MT,et al.Balance measures for discriminating between functionally unstable and stable ankles.Med Sci Sports Exerc.2009;41:399-407.
[17]Suda EY,Amorim CF,Sacco Ide C.Influence of ankle functional instability on the ankle electromyography during landing after volleyball blocking.J Electromyogr Kinesiol.2009;19:e84-93.
[18]Van Deun S,Staes FF,Stappaerts KH,et al.Relationship of chronic ankle instability to muscle activation patterns during the transition from double-leg to singleleg stance.Am J Sports Med.2007;35:274-281.
[19]Levin O,Van Nevel A,Malone C,et al.Sway activity and muscle recruitment order during transition from double to single-leg stance in subjects with chronic ankle instability.Gait Posture.2012;36:546-551.
[20]Mitchell A,Dyson R,Hale T,et al.Biomechanics of ankle instability.Part 2:Postural sway-reaction time relationship.Med Sci Sports Exerc.2008;40(15):22-28.
[21]Lin CY,Shih YF.The neuromuscular control of the ankle joint in subjects with functional ankle instability.Formos J Phys Ther.2014,39:191-202.
[22]Wikstrom EA,Tillman MD,Chmielewski TL,et al.Dynamic postural stability deficits in subjects with self-reported ankl e ins t abi l i ty.Med Sc i Sports Exerc.2007;39:397-402.
[23]Lin CF,Chen CY,Lin CW.Dynamic ankle control in athletes with ankle instability during sports maneuvers.Am J Sports Med.2011;39:2007-2015.
[24]Raymond J,Nicholson LL,Hiller CE,et al.The effect of ankle taping or bracing on proprioception in functional ankle instability:A systematic review and meta-analysis.J Sci Med Sport.2012;15:386-392.