踝關節扭傷對本體感覺與靜態平衡能力的影響研究

踝關節扭傷是最常見與普遍的下肢運動傷害，Freeman指出踝關節扭傷後會降低本體感受能力，並導致身體姿勢穩定性的降低，後續研究(Tropp Ekstrand Gillquist, 1984； Tropp, Odenrick & Gillquist, 1985)亦支持此種觀點，然而最近的研究(Bernier, Perrin & Rijke, 1997; Cornwall & Murrell, 1991)卻顯示似乎並無顯著關係存在。目的：有鑑於相關研究結果的矛盾，本研究利用精密客觀的儀器，來探討有習慣性桌扭傷與正常健康者雙腳本體感覺與站立平衡表現的關係與差異。實驗設計：本研究以16位男性大學生，實驗組共8位有單側習慣性踝扭傷徵兆患者(扭傷組)，而控制組則為8位雙桌健康無扭傷者(正常組)，本研究以BiodexⅢ等速肌力測量儀量測受試者本體感覺功能，以Kisterler測力板搭配Romberg開／閉眼單腳站立測試時，腳底壓力中心的變化作為靜態平衡能力指標。資料收集後以Pearson相關係數考驗各變項間的關係，以獨立樣本t考驗檢定兩組雙腳測試差異情形，以單因子變異數分析考驗各腳本體感覺與平衡測驗的差異。結果：研究顯示：一、個體主動復位表現與開眼或閉眼單腳站立平衡表顯有顯著關係存在；二、扭傷組受傷腳在被動復位、開／閉眼單腳測試上顯著較對側健康腳差，而被動復位與開眼單腳站立平衡表現也顯著較正常組為差。結論：踝關節扭傷的確會降低被動復位本體感覺與開／閉眼站立平衡能力，本研究顯示個體主動復位能力與平衡能力有關，因此為改善站立平衡能力應可加強此方面之復健與訓練，此外扭傷踝關節顯著較差的被動復位能力，似乎驗證個體的被動本體感覺回饋機制可能受損，而運動復健對被動復位能力的影響，與正常組雙腳不同的被動複位能力仍需進一步的研究來加以討探。

關鍵字

踝關節扭傷；本體感覺；靜態平衡

並列摘要

Introduction: Anlke sprains are the most common and frequent injury in sports. Freeman demonstrated that an ankle injury would decreased the propriception sensitivity and result in poor postural steadiness in 1965. Further studies (Tropp, Ekstrand, & Gillquist, 1984; Tropp, Odenrick, & Gillquist,1985) also showed similar results. More recent studies (Bernier, Perrin, & Rijke, 1997; Cornwall & Murrell, 1991) indicated that the injury of the ankle was not connection with the balance performance. Purpose: This study utilized the Kistler force plate and Biodex isokinetic dynamometer to testify the difference between subjects with functional instability and normal subjects. Methods: The ankles of 16 college-aged male subjects were tested in this study: 8 subjects with unilateral ankle sprain symptoms (I) and 8 with bilateral non injured healthy ankles (N). The BioedxⅢisokinetic dynamometer was used to assess ankle proprioception function: active and passive position sense. The static balance ability was assessed by Kistler force plate in the form of mean radius of COP (center of pressure) distribution. Pearson correlation, independent t-test and one-way ANOVA analysis were used to exam the difference between different legs (left & right ankle in N; healthy & injured ankles in I).Results: 1. There was strong correlation between active ankle reposition sense and open/close static balance abilities. 2. The injured ankle had significant poor passive ankle reposition sense and open/close static balance abilities than healthy ankles. Ohterwise, the passive ankle reposition sense and open eyes balance ability while having an injured ankle were also significantly poorer than the left & right ankle in N. Conclusions: This study clearly showed that an ankle sprain impaired the passive reposition sense and the close eyes static balance ability. The active ankle reposition sense has positive correlations with balance control. It was recommended that a rehabilitation program for sprained ankles should include proprioception training, especially in restoring the passive reposition sense. More studies are needed to examine the training or rehabilitation effects on the passive repositioning sense.

並列關鍵字

ankle sprain ； proprioception ； static balance

參考文獻

Amason, A.,Gudmundsson, A.,Dahl, H. A.,Johannsson, E.(1996).Soccer injuries in Iceland.Scandinavian Journal of Medicine and Science in Sport.6

Google Scholar

Bemier, J. N.(1995).Effect of coordination training on proprioception of the functionally unstable ankle.

Google Scholar

Bemier, J. N.,Pen-in, D. H.,Rijke, A.(1997).Effect of unilateral functional instability of the ankle on postural sway and inversion and eversion strength.Journal of Athletic Training.32

Google Scholar

Borsa, P. A.,Lephart, S. M.(1994).Functional assessment and rehabilitation of shoulder proprioception for glenohumeral instability.Journal of Sport Rehabilitation.3