利用不同的力板參數偵測單側腳踝扭傷患者的姿勢控制

Postural Control Deficits Examined by Different Components of Stabilometry in Subjects with Unilateral Ankle Sprain

成戎珠(Rong-Ju Cherng) ； 蘇芳慶(Fong-Chin Su) ； 林純彬(Chun-Pin Lin) ； 何金山(Jin-San Her)

《中華民國物理治療學會雜誌》 22卷4期 (1997/10) Pp. 251-259

https://doi.org/10.29616/JPTAROC.199710.0003

摘要

本篇研究旨在探討腳踝內翻扭傷對患者單腳站立身體擺動的影響，並比較不同的力板測量參數對偵測單腳站立姿勢擺動的敏感度。共有12位曾患腳踝翻扭傷的受試者參與本研究，每位受試者皆接受30秒鐘四種情境的測試：1)張眼、健側肢站立；2)閉眼、健側肢站立；3)張眼、患側肢站立；4)閉眼、患側肢站立。測試的順序乃以實驗設計對抗平衡的方式決定。身體擺動的大小以測力板量取的反作用力經過處理後的參數表示之，這包括，壓力中心的擺動面積、壓力中心的擺動軌跡長度、壓力中心在兩軸的平約擺動速度、壓力中心在兩軸的平均擺動幅度、壓力中心在兩軸的擺動幅度的變異性、反作用力在兩軸的平均擺動幅度、反作用力在兩軸擺動幅度的變異性。以張、閉眼及健、患側肢為獨變項的變異數分析，結果顯示除了「壓力中心的擺動面積」以外，所有的參數都可區辨受試者張眼與閉眼的差異，受試者的身體擺動在閉眼時均比張眼大：但只有「反作用力在兩軸擺動的變異性」可區別健側肢與患側肢單刀卻站立的差異，亦即身體擺動在單脾站立在患側肢時比在健側肢時大，而且其間的差異在閉眼時比張眼時還明顯；顯示受試者患側肢體的本體感覺可能受損，以致影響維持身體穩定時所需的感覺整合。本研究的結論是：「反作用力在兩軸擺動的變異性」在偵測腳踝內翻扭傷患者單腳站立時的身體擺動具有較高的敏感度。

關鍵字

姿勢控制 ； 測力板 ； 腳踝扭傷

並列摘要

The purposes of this study were to investigate the effect of ankle inversion sprain on the postural sway during one-legged stance and to compare the sensitivity of different parameters derived from the force platform in measuring the postural sway. Twelve subjects with unilateral ankle inversion sprain were tested barefooted in one-legged stance for 30 seconds under four conditions: 1) stood with injured leg, eyes open; 2) stood with non-injured leg, eyes open; 3) stood with injured leg, eyes close; and 4) stood with non-injured leg, eyes close. The order of the conditions was counterbalanced to control the series effect. Postural sway was measured by seven parameters derived from a force platform (kistler-9281). The seven parameters were: 1) CP (center of pressure) sway area; 2) CP total excursion; 3) mean velocity of CP sway in the mediolateral and anterioposterior directions; 4) mean value of CP sway amplitude in the mediolateral and anterioposterior directions; 5) variability of CP sway amplitude in the mediolateral and anterioposterior directions; 6) mean value of the force signal in the mediolateral and anterioposterior directions; 7) variability of force signal in the mediolateral and anterioposterior directions; Repeated measures ANOVA procedures were used to analyze the effect of vision condition and ankle sprain. The results indicated that all of the above seven parameters, except for CP sway area, satisfactorily detected a significant vision effect. However, the effect of ankle sprain was only significantly detected by the parameter of variability of force signals. In addition, the effect of injury was significantly greater when subjects' eyes were closed than when their eyes were open with the parameter of force signal variability. The results of this study suggest that the variability of force signal is the most sensitive one among these parameters in detecting the postural sway of subjects with ankle inversion sprain. In addition, the postural stability of subjects with unilateral ankle inversion sprain were impaired by the injury and the impairment of the postural stability may come from the somatosensory impairment.

並列關鍵字

Postural control ； Force platform ； Ankle sprain