In Vivo Kinematics of Functional Ankle Instability Patients and Lateral Ankle Sprain Copers During Stair Descent
In Vivo Kinematics of Functional Ankle Instability Patients and Lateral Ankle Sprain Copers During Stair Descent
复制标题
功能性踝关节不稳定患者和外侧踝关节扭伤治疗者下楼梯时的体内运动学
DOI：
10.1002/jor.24303
复制
发表时间：
2019-08-01
影响因子：
2.8
通讯作者：
Wang, Kan
中科院分区：
文献类型：
--
作者：
Cao, Shengxuan;Wang, Chen;Wang, Kan
机械性踝关节不稳定患者的胫距和距下关节松弛增加。然而，功能性踝关节不稳定（FAI）患者和外侧踝关节扭伤（LAS）患者的体内关节运动学，特别是在动态活动期间，人们知之甚少。10例FAI患者、10例LAS患者和10例健康对照者被纳入本研究。双透视成像系统被用来分析下楼梯时胫距和距下关节的运动学。分析了下楼梯的五个关键姿势。利用实体建模软件计算六个自由度的运动学数据。比较3组患者的关节活动度和各自由度关节位置。FAI患者和LAS患者的胫距关节在足部撞击过程中比健康对照者的胫距关节明显更内翻（p = 0.016，ηp2 = 0.264）。FAI患者距下关节明显向前平移（姿势2，p = 0.003，ηp2 = 0.352;姿势3，p < 0.001，ηp2 = 0.454;姿势4，p = 0.004，ηp2 = 0.334），倒置（姿势4，p = 0.027，ηp2 = 0.234;姿势5，p = 0.034，ηp2 = 0.221），外旋（姿势4，p = 0.037，ηp2 = 0.217;姿势5; p = 0.004，ηp2 = 0.331）比健康对照组在站立中期和脚跟离开期间的结果。FAI患者在下楼梯时表现出过度的胫距内翻和距下关节过度活动。同时，LAS患者保持距下关节的稳定性，仅在足部撞击时出现过度的胫距内翻。这些数据提供了深入了解FAI发展背后的机制后，最初的LAS。© 2019骨科研究学会。由威利期刊公司出版J Orthop Res 37：1860-1867，2019
Patients with mechanic ankle instability experience increased tibiotalar and subtalar joint laxity. However, in vivo joint kinematics in functional ankle instability (FAI) patients and lateral ankle sprain (LAS) copers, especially during dynamic activities, are poorly understood. Ten FAI patients, 10 LAS copers, and 10 healthy controls were included in this study. A dual fluoroscopic imaging system was used to analyze the tibiotalar and subtalar joint kinematics during stair descent. Five key poses of stair descent were analyzed. Kinematic data from six degrees of freedom were calculated utilizing a solid modeling software. The range of motion and joint positions in each degree of freedom were compared among the three groups. The tibiotalar joints of FAI patients and LAS copers were significantly more inverted than those of healthy controls during the foot strike (p = 0.016, ηp2 = 0.264). The subtalar joints of FAI patients were significantly more anteriorly translated (pose 2, p = 0.003, ηp2 = 0.352; pose 3, p < 0.001, ηp2 = 0.454; pose 4, p = 0.004, ηp2 = 0.334), inverted (pose 4, p = 0.027, ηp2 = 0.234; pose 5,p = 0.034, ηp2 = 0.221), and externally rotated (pose 4, p = 0.037, ηp2 = 0.217; pose 5; p = 0.004, ηp2 = 0.331) than those of healthy controls during the mid‐stance and the heel off. The FAI patients showed excessive tibiotalar inversion and subtalar joint hypermobility during stair descent. Meanwhile, the LAS copers maintained subtalar joint stability, and only showed excessive tibiotalar inversion in foot strike. These data provide insight into the mechanisms behind the development of FAI after initial LAS. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1860–1867, 2019