Diaphragm Contractility in Individuals with Chronic Ankle Instability.
Diaphragm Contractility in Individuals with Chronic Ankle Instability.
复制标题
慢性踝关节不稳定患者的膈肌收缩力。
DOI：
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发表时间：
2016
影响因子：
4.1
通讯作者：
P. Gribble
中科院分区：
文献类型：
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作者：
M. Terada;Kyle B. Kosik;Ryan S. McCann;P. Gribble
导言/目的
先前的研究已经确定了慢性踝关节不稳定（CAI）患者的躯干和姿势稳定性受损。膈肌通过调节腹腔内压来维持躯干和姿势的稳定性。一个可能有助于解释躯干和姿势稳定性缺陷的潜在机制可能与CAI引起的脊髓上感觉运动变化引起的膈肌功能改变有关。本研究的目的是检查个体与CAI和健康对照的膈肌收缩力。
方法
27名自我报告CAI的参与者和28名健康对照参与者自愿参加。使用便携式超声装置观察和测量仰卧位安静呼吸时静息吸气和呼气结束时的左右半横膈膜厚度。在B型超声检查中对膈肌运动进行成像和记录。从静息吸气和呼气结束时的三个图像的平均值计算膈肌收缩的程度。采用独立t检验比较CAI组和对照组左右两侧膈肌厚度的变化程度。
结果
与对照组相比，CAI组左半侧膈肌收缩力较小（P = 0.03）。其他膈肌变量无组间差异。
结论
CAI患者的膈肌收缩力似乎发生了改变，这可能是CAI人群中膈肌功能障碍和中枢神经系统变化的一个例证。CAI和膈肌收缩力改变之间的关联为临床医生提供了与CAI相关的近端损伤的更全面的认识。未来的研究需要确定是否改变了膈肌的收缩力有助于功能障碍，活动限制，和参与者的限制，通常观察到的CAI患者。
INTRODUCTION/PURPOSE
Previous investigations have identified impaired trunk and postural stability in individuals with chronic ankle instability (CAI). The diaphragm muscle contributes to trunk and postural stability by modulating the intra-abdominal pressure. A potential mechanism that could help to explain trunk and postural stability deficits may be related to altered diaphragm function due to supraspinal sensorimotor changes with CAI. The purpose of this study was to examine the diaphragm contractility in individuals with CAI and healthy controls.
METHODS
Twenty-seven participants with self-reported CAI and 28 healthy control participants volunteered. A portable ultrasound unit was used to visualize and measure the right and left hemidiaphragm thickness at the end of resting inspiration and expiration in supine while breathing quietly. The diaphragm movement was imaged and recorded on B-mode ultrasonography. The degree of diaphragm contractility was calculated from the mean of three images from the end of resting inspiration and expiration. Independent t-tests were used to compare the degree of diaphragm thickness of right and left sides between the CAI and the control groups.
RESULTS
The CAI group had a smaller degree of left hemidiaphragm contractility compared with the control group (P = 0.03). There was no between-group difference in other diaphragm variables.
CONCLUSION
Individuals with CAI appear to have altered diaphragm contractility, which may be an illustration of diaphragm dysfunction and central nervous system changes in CAI population. The association between CAI and altered diaphragm contractility provides clinicians a more comprehensive awareness of proximal impairments associated with CAI. Future investigation is needed to determine whether altered contractility of the diaphragm contributes to functional impairments, activity limitations, and participant restrictions commonly observed in patients with CAI.