Weight-Bearing Dorsiflexion Range of Motion and Landing Biomechanics in Individuals With Chronic Ankle Instability
Weight-Bearing Dorsiflexion Range of Motion and Landing Biomechanics in Individuals With Chronic Ankle Instability
复制标题
DOI：
10.4085/1062-6050-50.5.07
复制
发表时间：
2015-08-01
影响因子：
3.3
通讯作者：
Weinhandl, Joshua T.
中科院分区：
文献类型：
--
作者：
Hoch, Matthew C.;Farwell, Kelley E.;Weinhandl, Joshua T.
背景：与稳定性踝关节患者相比，慢性踝关节不稳定患者在着陆时背屈活动范围(ROM)和膝关节屈曲的负重程度较低。研究背屈关节活动度和着陆生物力学之间的关系可以确定一个与着陆任务中运动学和动力学改变相关的可修改因素。目的：研究CAI患者的负重背屈关节活动度和单腿着陆生物力学之间的关系。设计：横断面研究。地点：实验室。患者或其他参与者：15名患有CAI的体力活动者(男性5人，女性10人；年龄21.9+/-2.1岁，身高168.7+/-9.0 cm，体重69.4+/-13.3 kg)。干预(S)：参与者从40 cm高度进行背屈活动和单腿着地。在着陆过程中记录下肢体的矢状面运动学和地面反作用力(GRF)。主要结果指标(S)：采用负重-弓步试验测量静态背屈。在初始接触、最大角度和矢状位移时观察踝关节、膝关节和髋关节的运动学。计算踝关节、膝关节和髋关节的矢状位移量，以检查总体矢状位移量。动力学变量为最大后部GRFS和垂直GRFS，归一化为体重。我们使用皮尔逊乘积矩相关性来评估背屈关节活动度和着陆生物力学之间的关系。相关系数(R)分别为弱(0.00-0.40)、中等(0.41-0.69)或强(0.70-1.00)。结果：静态背屈活动度与最大背屈(r=0.49，r(2)=0.24)、踝关节移位(r=0.47，r(2)=0.22)、总移位(r=0.67，r(2)=0.45)呈中度相关。静态和着陆时测量的背屈活动度与最大膝关节(r=0.69-0.74，r(2)=0.47-0.55)和髋关节(r=0.50-0.64，r(2)=0.25-0.40)屈曲、髋关节(r=0.53-0.55，r(2)=0.28-0.30)和膝关节(r=0.53-0.70，r(2)=0.28-0.49)移位有中等到高度的相关性。垂直GRF(-0.47~-0.50，r(2)=0.22~0.25)。结论：CAI患者单腿着地时背屈关节活动度与矢状面运动学和最大垂直GRF呈中度至高度相关。背屈活动度较小的人显示出更直立的着陆姿势和更大的GRF。
Context: People with chronic ankle instability (CAI) exhibit less weight-bearing dorsiflexion range of motion (ROM) and less knee flexion during landing than people with stable ankles. Examining the relationship between dorsiflexion ROM and landing biomechanics may identify a modifiable factor associated with altered kinematics and kinetics during landing tasks.Objective: To examine the relationship between weight-bearing dorsiflexion ROM and single-legged landing biomechanics in persons with CAI.Design: Cross-sectional study.Setting: Laboratory.Patients or Other Participants: Fifteen physically active persons with CAI (5 men, 10 women; age = 21.9 +/- 2.1 years, height = 168.7 +/- 9.0 cm, mass = 69.4 +/- 13.3 kg) participated.Intervention(s): Participants performed dorsiflexion ROM and single-legged landings from a 40-cm height. Sagittal-plane kinematics of the lower extremity and ground reaction forces (GRFs) were captured during landing.Main Outcome Measure(s): Static dorsiflexion was measured using the weight-bearing-lunge test. Kinematics of the ankle, knee, and hip were observed at initial contact, maximum angle, and sagittal displacement. Sagittal displacements of the ankle, knee, and hip were summed to examine overall sagittal displacement. Kinetic variables were maximum posterior and vertical GRFs normalized to body weight. We used Pearson product moment correlations to evaluate the relationships between dorsiflexion ROM and landing biomechanics. Correlations (r) were interpreted as weak (0.00-0.40), moderate (0.41-0.69), or strong (0.70-1.00). The coefficient of determination (r(2)) was used to determine the amount of explained variance among variables.Results: Static dorsiflexion ROM was moderately correlated with maximum dorsiflexion (r = 0.49, r(2) = 0.24), ankle displacement (r = 0.47, r(2) = 0.22), and total displacement (r = 0.67, r(2) = 0.45) during landing. Dorsiflexion ROM measured statically and during landing demonstrated moderate to strong correlations with maximum knee (r = 0.69-0.74, r(2) = 0.47-0.55) and hip (r = 0.50-0.64, r(2) = 0.25-0.40) flexion, hip (r = 0.53-0.55, r(2) = 0.28-0.30) and knee (r = 0.53-0.70, r(2) = 0.28-0.49) displacement, and vertical GRF (-0.47--0.50, r(2) = 0.22-0.25).Conclusions: Dorsiflexion ROM was moderately to strongly related to sagittal-plane kinematics and maximum vertical GRF during single-legged landing in persons with CAI. Persons with less dorsiflexion ROM demonstrated a more erect landing posture and greater GRF.