The Neuromuscular Control of the Ankle Joint in Subjects with Functional Ankle Instability

背景與目的：功能性踝關節控制障礙常認為是造成運動員重複性扭傷與不良動作控制的主因。功能性踝關節控制障礙可能與受傷後下肢肌群的反應時間延遲及收縮強度減低有關；然而目前下肢肌群收縮反應時間與強度的相關研究結論並不一致。此外，不同測試參數是否會影響下肢肌群反應時間與收縮強度之測試結果，目前並無研究探討。因此本研究針對健康與踝關節控制障礙受試者，利用不同測試參數進行突然足踝內翻與單腳著地測試，探討測試參數對下肢肌群反應時間與收縮強度的影響，並分析組間測試結果間之差異。方法：本實驗利用體表肌電圖系統，收取踝關節控制障礙患者14名，並依照年齡、身高、體重、慣用側選定配對健康受試者14名進行突然足踝內翻測試（sudden inversion test 15°, 30°, and 45°）與單腳著地測試（single leg landing test 25, 35,and 45 cm）的脛前肌（tibialis anterior）、腓骨長肌（peroneus longus）以及比目魚肌（soleus）之肌群收縮強度與反應時間，比較踝關節穩定障礙組之健側、患側與對照組的差異。統計分析：以二因子重複測量之變異數（ｔwo-way repeated measures analyses of variance, ANOVA）進行統計分析。顯著水平α值定於0.05。結果：研究結果顯示，在不同測試參數條件下，肌肉反應時間（p＜0.001）與收縮強度（p＜0.005）有顯著差異。此外，功能性踝關節穩定障礙組之患側腓骨長肌反應時間較短（p=0.03）且著地前患側腓骨長肌（p=0.03）與比目魚肌（p=0.04）肌肉收縮強度，相較於對照組有顯著減少的情形。結論與臨床意義：本研究顯示不同測試參數的確會造成下肢肌群反應時間與反應強度的不同，且踝關節控制障礙患者之腓骨長肌與比目魚肌之神經肌肉控制產生變化。進一步實驗探討相關肌肉神經控制須考慮各項研究參數之控制。

關鍵字

功能性踝關節控制障礙；踝關節損傷；肌電圖；肌肉反應時間

並列摘要

Background and purpose: Functional ankle instability (FAI) is considered a major cause of recurrent ankle sprains in athletes. Researchers have proposed that altered neuromuscular control in the lower extremities as the major contributor to FAI. However, inconsistent findings were reported regarding muscle activation and reaction time in FAI sufferers, probably due to variations in the testing parameters among studies. The purposes of this study was to investigate the effects of testing parameters on the measurement of muscle reaction time and muscle activation of the peroneus longus, tibialis anterior, and soleus during sudden inversion and single leg landing tests, and to compare the differences in these measurements between subjects with and without functional ankle instability (FAI). Methods: Fourteen subjects with FAI and 14 matched controls were recruited for this study. Three inclination angles: 15°, 30°, and 45° and three landing heights: 25, 35, and 45 cm were used for the sudden inversion test and single leg landing test respectively. Muscle activities and reaction time of tibialis anterior, peroneus longus and soleus in control and FAI groups were recorded bilaterally using a surface electromyography system (Telemyo 900, Noraxon USA Inc., AZ, USA). Statistical Analysis: Two-way repeated measures analyses of variance (ANOVA) was used for statistical analysis. The level of significance was set at α=0.05. Results: Testing inclination angle and landing height had a significant impact on the measured muscle activities (p＜0.005) and muscle reaction time (p＜0.001). Compared to the control group, significantly shorter peroneal reaction time (p=0.03) and decreased peroneal (p=0.03) and soleus (p=0.04) muscle activation were identified on the involved side in subjects with FAI. Conclusion and Clinical Relevance: The testing parameters influenced the results of the muscle performance measurement. The reaction time and activation amplitude of the peroneus longus and soleus muscles were altered in subjects with FAI. Further studies should take into consideration the effect of testing parameters, and investigate the mechanisms behind the changes of the muscle performance in subjects with FAI.

並列關鍵字

Functional ankle instability ； Ankle injuries ； Electromyography ； Reaction time

國際替代計量

The Neuromuscular Control of the Ankle Joint in Subjects with Functional Ankle Instability

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