下肢运动链协同训练对慢性踝关节外侧不稳患者髋膝肌群肌力及平衡能力的影响价值探讨

Influence value of lower extremity movement chain training on the strength andbalance of hip and knee muscles in patients with chronic lateral ankle instability

目的:探究下肢运动链协同训练对慢性踝关节外侧不稳定患者髋膝肌群肌力及平衡能力的影响。方法:选我科2020年10月至2022年2月收治的87例慢性踝关节外侧不稳患者为研究对象,随机分为两组,对照组43例给予常规训练,观察组44例联合下肢运动链协同训练,在干预前及干预1 m后应用坎伯兰踝关节不稳(Cumberland Ankle instability rating,CAIT)评分、星形偏移平衡测试(Star offset balance test,SEBT)、单腿站立试验(One leg standing test,OLS)检测患者的踝关节稳定性;应用等速肌力检测仪检测患者的髋、膝周围肌力;应用平衡检测仪检测患者睁眼-硬地面、闭眼-硬地面、睁眼-软地面条件下的重心晃动指数;在患者住院期间统计患者出现关节僵硬、关节疼痛及其他不良反应的发生率。结果:干预后,观察组CAIT评分、SEBT高于对照组,OLS低于对照组(P<0.05);观察组髋后伸肌群、髋外展肌群、膝伸直肌群峰力矩高于对照组(P<0.05);观察组睁眼-硬地面、闭眼-硬地面、睁眼-软地面条件下的重心晃动指数低于对照组(P<0.05);两组不良反应发生率无明显差异(P>0.05)。结论:下肢运动链协同训练可提高踝关节稳定性,改善髋膝肌群肌力水平及踝关节平衡能力。

Objective:To explore the effects of lower limb motor chain training on patients with chronic lateral ankle instability.Method:A total of 87 patients with chronic lateral ankle instability from October 2020 to February 2022 in our department were selected as research objects and randomly divided into two groups:43 patients in the control group received routine training,and 44 patients in the observation group received joint training with lower limb motor chain.Cumberland ankle instability rating(CAIT),star offset balance test(SEBT),and one leg standing test(OLS)were performed to measure ankle stability before and 1 m after the intervention.The muscle strength around the hip and knee was measured by the isokinetic muscle strength tester.A balance detector was used to detect the center of gravity shaking index under the conditions of eye-opening-hard floor,eye-closing-hard floor,and eye-opening-soft floor.The incidence of joint stiffness,joint pain,and other adverse reactions was calculated during hospitalization.Results:After the intervention,the CAIT score and SEBT of the observation group were higher than the control group,and OLS was lower than the control group(P<0.05).The peak moment of the hip posterior extensor,hip abductor,and knee extensor in the observation group was higher than that in the control group(P<0.05).The center of gravity shaking index of the observation group under eye-opening-hard ground,eye-closing-hard ground,eye-opening-soft ground conditions was lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The lower extremity kinematic chain training can improve the stability of the ankle joint,improve the strength level of the hip and knee muscle group and ankle joint balance.