【論文摘要】Lumbopelvic Control, Dynamic Postural Control and Pelvic Kinematics Associated With Athletes With Chronic Ankle Instability

【論文摘要】腰髂控制、動態姿勢控制及骨盆運動學與慢性踝關節不穩定之運動員之關聯性

黃瀞凱(Ching-Kai Huang) ； 陳文英(Wen-Yin Chen) ； 施怡芬(Yi-Fen Shih) ； 林吟亮(Yin-Liang Lin)

《物理治療》 45卷2期 (2020/06) Pp. 124-125

https://doi.org/10.6215/FJPT.202006.O06

摘要

Background and Purpose: In chronic ankle instability (CAI) population, the deficits of sensorimotor control have been demonstrated in postural control and altered lower extremity kinematics during unipedal landing tasks. Compensatory strategy may also happen at lumbopelvic region. Lumbopelvic control played an important role in transferring energy from larger torso to smaller extremities via lower extremity kinetic chain. However, the ability of lumbopelvic control and pelvic kinematics have not been investigated in athletes with CAI during single leg drop landing. Besides, the relationship between dynamic postural control and lumbopelvic control has not been established. The purpose of the study was to investigate lumbopelvic control, dynamic postural control and pelvic kinematics in athletes with CAI compared to the healthy controls. Besides, to determine if there was a correlation between lumbopelvic control and dynamic postural control. Methods: Eighteen athletes with CAI (age = 24.00 ± 4.67 yr, height = 171.72 ± 8.96 cm, mass = 71.89 ± 14.54 kg) and 18 healthy controls (age = 25.94 ± 3.88 yr, height = 170.03 ± 7.74 cm, mass = 69.64 ± 11.65 kg) were recruited. Lumbopelvic control test was to see if subjects could maintain lumbopelvic region in a neutral position with different exercise level of lower extremity movements. Besides, dynamic postural control (time to stabilization [TTS], total center of pressure excursion [COPE], and mean center of pressure velocity [COPV]) and pelvic kinematics were measured during single leg drop landing. Results: The CAI group had poorer lumbopelvic control than the control group (p = 0.015). However, the CAI group had shorter TTS in anteroposterior direction than the control group (p = 0.02). There was no group difference in TTS in the mediolateral direction. We did not find any significant difference between groups in COPE and COPV. In pelvic kinematics, the CAI group had less pelvic angular excursion (p = 0.031) into posterior tilt than the CAI group. No significant difference was found in lateral bending and internal rotation of the pelvis. Also, there was no correlation between lumbopelvic control and dynamic postural control. Conclusion: The CAI group had poorer lumbopelvic control, better dynamic postural control and less pelvic kinematics changes during single leg drop landing. It suggested that individuals with CAI may have altered lumbopelvic strategy to maintain postural stability. No group difference in COP parameters and no correlation between lumbopelvic control and dynamic postural control. Our study limitations may due to selection bias and other confounding factors. Clinical Relevance: Individuals with CAI have altered lumbopelvic control, which may support the theory of central changes. Further study is needed to establish the relationship between lumbopelvic control and dynamic postural control with more sensitive test to discriminate CAI population.