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慢性踝關節不穩定者在跳躍落地後的姿勢控制

Postural Control After Drop-Jump Landing in Participants With Chronic Ankle Instability

摘要


本研究目的為探討外側踝關節扭傷後適應良好、慢性踝關節不穩定與健康族群間單腳跳落地後維持姿勢穩定能力的差異。主要招募40名至少有1次外側踝關節扭傷病史的個案,根據扭傷後的自覺關節穩定與功能恢復的程度分成慢性踝關節不穩定組與適應良好組,另招募20名未扭傷過踝關節的健康人為控制組。受試者由30公分的平臺單腳跳落至前方的力板中央,維持平衡至少20秒,以地面反作用力分別計算穩定時間與動態姿勢穩定指標,包括內─外、前─後和垂直方向。研究結果發現慢性踝關節不穩定組的內─外穩定時間與內─外穩定指標均顯著大於適應良好組與控制組,在垂直穩定時間上,慢性踝關節不穩定組也顯著大於控制組;而適應良好組在所有測量參數上均與控制組沒有顯著差異。本研究的結論為慢性踝關節不穩定族群在單腳跳落地後的額狀面與垂直方向的動態姿勢控制能力較差,適應良好族群的動態姿勢控制能力則與未扭傷的健康人無異。踝關節扭傷後期的復健需加強側向干擾的平衡訓練,並反覆練習較柔軟的落地技巧,期望可減少踝關節重複扭傷的機率。

並列摘要


This study aimed to investigate the differences in maintaining the postural stability after a drop-jump landing among copers, individuals with chronic ankle instability, and without chronic ankle instability. Forty participants who had at least one history of lateral ankle sprain were recruited. Based on the joint stability perception and functional recovery level, the participants were divided into the groups of chronic ankle instability and copers. Twenty healthy participants without ankle sprain were recruited to be the control group. All participants were asked to jump and land with one leg from a 30-cm height platform onto the center of force plate and to keep steady for at least 20 seconds. Time to stabilization (TTS) and dynamic postural stability index (DPSI) at the medial-lateral, anterior-posterior, and vertical directions were calculated using ground reaction force. The results showed significantly greater medial-lateral TTS and DPSI for the chronic ankle instability group compared to those for copers and controls. In addition, the vertical TTS was significantly greater in the chronic ankle instability group than the controls. However, the copers did not significantly differ from the controls for all testing parameters. We conclude that the dynamic postural control at the medial-lateral and vertical directions after drop-jump landing was poor for the chronic ankle instability group. However, the dynamic postural control of copers was not different from that of controls. In order to reduce the recurrent ankle sprains, lots of practices of balance training with lateral disturbance and soft landing skills at the late stage of ankle sprain rehabilitation are recommended.

參考文獻


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Fransz, D. P., Huurnink, A., de Boode, V. A., Kingma, I., & van Dieën, J. H. (2016). The effect of the stability threshold on time to stabilization and its reliability following a single leg drop jump landing. Journal of Biomechanics, 49(3), 496-501. doi:10.1016/j.jbiomech.2015.12.048
Fransz, D. P., Huurnink, A., de Boode, V. A., Kingma, I., & van Dieën, J. H. (2017). Corrigendum to “The effect of the stability threshold on time to stabilization and its reliability following a single leg drop jump landing” [J. Biomech. 49(3) (2016) 496-501]. Journal of Biomechanics, 63, 206-209. doi:10.1016/j.jbiomech.2017.07.036

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