Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability
Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability
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DOI：
10.1177/2325967116653719
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发表时间：
2016-06-01
影响因子：
2.6
通讯作者：
Hertel, Jay
中科院分区：
文献类型：
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作者：
Feger, Mark A.;Snell, Shannon;Hertel, Jay
背景资料：慢性踝关节不稳定（CAI）患者与无踝关节扭伤史的健康对照组相比，神经肌肉功能改变，肌力下降。到目前为止，还没有对CAI患者的肌肉体积进行分析，以确定在复发性扭伤后是否存在肌肉大小的缺陷。目的：分析有和没有CAI的年轻人的内在和外在足和踝关节肌肉体积以及4向踝关节力量。研究设计：横断面研究;证据等级，3。方法：5例CAI患者（平均年龄，23.0 ± 4岁; 1名男性，4名女性）和5名健康对照（平均年龄，23.8 ± 4.5岁; 1名男性，4名女性）自愿参加本研究。使用新型快速采集磁共振成像（MRI）从股骨髁上方扫描至足部和踝关节。在每个轴向切片上勾画每个肌肉的周长，然后将二维面积乘以切片厚度（5 mm）以计算肌肉体积。使用手持式测力计测量跖屈、背屈、内翻和外翻等长肌力。CAI患者与健康对照组进行了肌肉体积和力量的所有测量。通过计算每个CAI受试者每块肌肉的z分数，将CAI患者的外部肌肉体积与健康对照组（n = 24）的标准数据库进行比较。CAI组的总小腿、浅后室、比目鱼肌、拇内收肌、和拇短屈肌体积与健康对照组相比，如组平均值和相关的90%CI所示，不重叠。显著组间差异的Cohen d效应量均较大，范围为1.46 - 3.52，90% CI未过零。CAI组的外翻、背屈和4向复合踝关节强度较低，所有组均数和相关90% CI均不重叠。没有其他显着差异identified.Conclusion：CAI患者表现出萎缩的内在和外在的脚和踝关节肌肉组织伴随着较低的踝关节strength.Clinical Relevance：临床医生应该知道的肌肉萎缩和力量不足时，为患者开处方踝关节扭伤或CAI康复。
Background: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain.Purpose: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI.Study Design: Cross-sectional study; Level of evidence, 3.Methods: Five patients with CAI (mean age, 23.0 4 years; 1 male, 4 females) and 5 healthy controls (mean age, 23.8 4.5 years; 1 male, 4 females) volunteered for this study. Novel fast-acquisition magnetic resonance imaging (MRI) was used to scan from above the femoral condyles through the foot and ankle. The perimeter of each muscle was outlined on each axial slice and then the 2-dimensional area was multiplied by the slice thickness (5 mm) to calculate the muscle volume. Plantar flexion, dorsiflexion, inversion, and eversion isometric strength were measured using a handheld dynamometer. Patients with CAI were compared with healthy controls on all measures of muscle volume and strength. Extrinsic muscle volumes of patients with CAI were also compared with a normative database of healthy controls (n = 24) by calculating z scores for each muscle individually for each CAI subject.Results: The CAI group had smaller total shank, superficial posterior compartment, soleus, adductor hallucis obliqus, and flexor hallucis brevis muscle volumes compared with healthy controls as indicated by group means and associated 90% CIs that did not overlap. Cohen d effect sizes for the significant group differences were all large and ranged from 1.46 to 3.52, with 90% CIs that did not cross zero. The CAI group had lower eversion, dorsiflexion, and 4-way composite ankle strength, all with group means and associated 90% CIs that did not overlap. No other significant differences were identified.Conclusion: Patients with CAI demonstrate atrophy of intrinsic and extrinsic foot and ankle musculature accompanied by lower ankle strength.Clinical Relevance: Clinicians should be aware of the muscle atrophy and strength deficits when prescribing rehabilitation for patients with lateral ankle sprain or CAI.