佩戴软式支具对慢性踝关节不稳患者足底动力学的效果

Effect of soft brace wearing on plantar dynamics in patients with chronic ankle instability

目的探讨日常佩戴软式支具对慢性踝关节不稳(CAI)患者步行时足底动力学的影响。方法纳入2021年2月至2023年1月在北京康复医院就诊的单侧CAI患者52例,随机分为对照组(n=26)和试验组(n=26),两组均进行为期8周的运动训练方案,在日常活动中对照组佩戴安慰支具,试验组佩戴踝关节软式支具。采用压力平板系统测量患者步行时的足底峰值压力和足底冲量。结果对照组脱落6例,试验组脱落5例,最终纳入41例。干预后,对照组各区域足底峰值压力和冲量均无显著性差异(P>0.05),试验组足跟内侧、外侧和前足内侧区的峰值压力和冲量显著增加(|t|>4.192,P<0.001),而中足和前足外侧峰值压力和冲量减小(t>2.984,P<0.05);干预后,试验组患侧足跟内侧、外侧和前足内侧区的峰值压力和冲量高于对照组(|t|>2.126,P<0.05),中足和前足外侧区峰值压力和冲量低于对照组(t>2.133,P<0.05)。结论日常活动中佩戴软式支具可优化CAI患者患侧的足底峰值压力及足底冲量分布,预防再次发生扭伤。

Objective To investigate the effect of daily soft brace wearing on plantar dynamics during walking in patients with chronic ankle instability(CAI).Methods A total of 52 patients with unilateral chronic ankle instability(CAI)in Beijing Rehabilitation Hospital from February,2021 to January,2023 were randomly divided into control group(n=26)and experimental group(n=26).Both groups underwent an eight-week exercise training program.The control group wore placebo brace during daily activities,while the experimental group wore soft ankle brace.Plantar dynamic parameters were measured using a pressure plate system during walking,including peak plantar pressure and plantar impulse before and after intervention.Results Six participants dropped out in the control group and five in the experimental group,resulting in a final inclusion of 41 participants.After intervention,there was no significant difference in peak plantar pressure and impulse on the affected side in the control group among different areas(P>0.05).In the experimental group,the peak pressure and impulse in the heel medial,heel lateral and forefoot medial areas increased(|t|>4.192,P<0.001),while the peak pressure and impulse in the midfoot and lateral forefoot areas decreased(t>2.984,P<0.05);the peak pressure and impulse in the heel medial,heel lateral and forefoot medial areas were higher in the experimental group than in the control group(|t|>2.126,P<0.05),and the peak pressure and impulse were lower in the midfoot and forefoot lateral areas(t>2.133,P<0.05).Conclusion Wearing a soft brace during daily activities may optimize the distribution of peak plantar pressure and plantar impulse on the affected side in patients with CAI,which may prevent recurrence of sprains.