全身性疲劳对功能性踝关节不稳者平衡能力和跳跃落地时踝关节本体感觉的影响

Effects of whole-body fatigue on balance and ankle proprioception during drop landing among individuals with and without functional ankle instability

目的:通过比较功能性踝关节不稳(functional ankle instability,FAI)者和健康人群在疲劳前后静态、动态平衡能力及跳跃落地时踝关节本体感觉的差异,探讨全身性疲劳对FAI者平衡能力和本体感觉的影响。方法:单侧FAI者和健康者各31例被纳入研究,并在疲劳前后分别进行了静态、动态平衡测试及跳跃落地时踝关节的本体感觉测试。足底压力中心动摇径、均方根距离、95%包络面积、标准化伸展距离和AUC值等相关指标用于计算与分析。结果:全身性疲劳前,FAI组的静态、动态平衡能力及踝关节的本体感觉均显著低于健康对照组(P<0.05)。全身性疲劳后,FAI组和健康对照组的静态、动态平衡能力以及踝关节的本体感觉均显著降低(P<0.05),且FAI组的动摇径、均方根距离和95%包络面积增加的幅度均显著大于健康对照组(P<0.05),在后内侧、后外侧的标准化动态伸展距离及AUC值的降低幅度显著大于健康对照组(P<0.05)。结论:FAI及健康者在全身性运动疲劳后静态、动态平衡能力以及跳跃落地时踝关节的本体感觉均下降,且FAI者静态、动态平衡能力及本体感觉功能下降程度更大。因此,全身性疲劳可能通过降低FAI者的姿势控制和本体感觉,增加了踝关节反复扭伤的风险。

Objective:To explore the effects of whole-body fatigue on the balance and ankle proprioception during drop landing of individuals with functional ankle instability(FAI) by comparing the differences in balance and proprioception between the FAI group and the control group before and after fatigue.Method:A total of 31 participants with unilateral FAI and 31 healthy participants were included in this study.A static balance test,dynamic balance test,and ankle proprioception test were conducted before and after fatigue.Sway distance(D) of the center of pressure(COP),root mean square of the COP(RMS),95% confidence ellipse area of the COP movements(95% AREA),normalized reach distance,and the area under the curve(AUC) were calculated and analyzed.Result:Before whole-body fatigue,the static balance,dynamic balance,and ankle proprioception during drop landing in FAI group were significantly lower than those in control group.After whole-body fatigue,the static balance,dynamic balance,and ankle proprioception during drop landing in the FAI group and control group decreased significantly(P<0.05),and the increase of D,RMS and 95% AREA in FAI group were significantly larger than those in control group(P<0.05),and the decrease of normalized reach distance in the posteromedial and posterolateral directions and AUC were significantly larger than those in control group(P<0.05).Conclusion:Whole-body fatigue reduced the static balance,dynamic balance,and ankle proprioception,and the reduction was larger in FAI individuals than in healthy individuals.Therefore,whole-body fatigue may increase the risk of recurrent ankle sprain by reducing posture control and proprioception in FAI individuals.