足踝平衡训练治疗创伤性踝关节不稳的疗效

Curative effect of normative ankle balance training in treatment of chronic ankle instability

目的探讨足踝平衡训练对创伤性慢性踝关节不稳（CAI）的疗效。方法回顾性分析2014年1月-2015年6月收治的CAI患者90例，并按随机数字表法分为对照组和试验组。对照组男17例，女28例；年龄13～26岁，平均19．6岁。左足23例，右足22例。试验组男18例，女27例；年龄14～27岁，平均20．3岁。左足19例，右足26例。对照组仅完成基础肌力训练，试验组完成基础肌力训练的基础上加平衡训练（橡皮筋、运动海绵垫、平衡踏板、橡皮平衡球、运动跳球）。比较两组足踝残疾指数（FADI），正前方向、正后方向、后外侧45。星状伸展平衡试验（SEBT）达到的距离，以及视觉模拟评分（VAS）情况。结果训练后，试验组和对照组FAD1分别为35．16±3．23，22．33±1．36，正前方向SEBT分别为74．17±8．35、68．32±8．11，正后方向SEBT分别为78．59±7．22、71．89±7．11，后外侧45°SEBT分别为75．79±8．27、68．95±8．03，差异均有统计学意义（P〈0．05）。试验组与对照组训练后VAS分别为（3．01±0．91）分和（3．42±1．02）分，差异有统计学意义（P〈0．05）。组内比较，训练前后试验组FADI、SEBT和VAS差异均有统计学意义（P〈0．05）；对照组FADI训练前后差异有统计学意义（P〈0．05），而VAS及SEBT训练前后差异均无统计学意义（P〉0．05）。结论平衡训练可改善CAI患者的动态平衡和失稳的自我感觉，治疗效果满意，值得临床推广。

Objective To investigate the efficacy of normative ankle balance training on chronic ankle instability （CAI）. Methods Ninety patients were randomized into control group （17 males, 28 females; 13-26 years, mean 19.6 years） and experiment group （18 males, 27 females; 14-27 years, mean 20.3 years） according to the random number table. There were 19 left ankles and 26 fight ankles injured in control group, and 19 left ankles and 26 right ankles injured in experiment group. Patients in control group only completed routine muscle strength training. Besides the routine muscle strength training, balance training （rubber band, spongy cushion, balance pedal, rubber balance ball and jump ball） were added in experiment group. The two groups were compared with respect to foot and ankle disability index （FADI）, anterior, posterior-median and 45° to posterolateral direction reach distance of star excursion balance test （SEBT） and visual analogue score （ VAS ）. Results After training, comparison of experiment and control groups showed significant differences in FADI （ 35. 16 ± 3.23 and 22.33 ± 1.36 ）, SEBT distance in posterior median direction [ （ 78.59 ± 7.22 ） % and （ 71.89 ±7.11）%], SEBT distance in 45 ° to posterolateral direction [（75.79 ± 8.27）% and （68.95 ±8.03） % ] and VAS [ （3.01 ±＋ 0.91 ） scores and （ 3.42 ± 1.02 ） scores ] （ P 〈 0.05 ）. For intragroup comparison, FADI, SEBT and VAS in experimental group showed significant differences before and after training （ P 〈 0.05 ）, but only FADI in control group differed significantly before and after training （P 〈 0.05 ）. Conclusion Normative balance training can improve CAI patients＇ self-feelings of dynamic balance and instability with satisfactory therapeutic efficacy, and is worthy to be popularized.