Effect of Impairment-Based Rehabilitation on Lower Leg Muscle Volumes and Strength in Patients With Chronic Ankle Instability: A Preliminary Study
Effect of Impairment-Based Rehabilitation on Lower Leg Muscle Volumes and Strength in Patients With Chronic Ankle Instability: A Preliminary Study
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DOI：
10.1123/jsr.2017-0136
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发表时间：
2019-07-01
影响因子：
1.7
通讯作者：
Hertel, Jay
中科院分区：
文献类型：
--
作者：
Feger, Mark A.;Donovan, Luke;Hertel, Jay
背景：患有慢性踝关节不稳（CAI）的患者已表现出足部和踝部肌肉组织萎缩以及踝部力量缺陷。此前尚未在 CAI 患者中研究康复对肌肉形态和踝关节力量的影响。目的：我们的目的是分析基于损伤的康复对 CAI 患者足部和踝部内在和外在肌肉体积和力量的影响。设计：受控实验室研究。环境：实验室。患者：五名患有 CAI 的年轻人。干预：十二次基于损伤的监督康复训练，包括运动范围、力量、平衡和功能练习。主要结果指标：在 4 周监督康复之前和之后测量足部外在和内在的肌肉体积以及踝关节力量。使用新型快速采集磁共振成像从股骨髁上方扫描整个足部。在每个轴向切片上勾勒出每块肌肉的周长，然后将二维面积乘以切片厚度（5毫米）以计算肌肉体积。使用手持式测力计测量跖屈、背屈、内翻和外翻等距力量。结果：康复导致除拇长屈肌和腓骨外的所有足部外在肌肉肥大。康复后内翻、外翻和跖屈力量都有很大改善。康复后显着差异的效应值都很大，范围为 1.54 至 3.35。内在足部肌肉体积没有发现显着差异。结论：初步结果表明，基于损伤的 CAI 康复可引起足部和踝关节外肌组织肥大，相应增加踝关节力量。
Context: Patients with chronic ankle instability (CAI) have demonstrated atrophy of foot and ankle musculature and deficits in ankle strength. The effect of rehabilitation on muscle morphology and ankle strength has not previously been investigated in patients with CAI. Objective: Our objective was to analyze the effect of impairment-based rehabilitation on intrinsic and extrinsic foot and ankle muscle volumes and strength in patients with CAI. Design: Controlled laboratory study. Setting: Laboratory. Patients: Five young adults with CAI. Intervention: Twelve sessions of supervised impairment-based rehabilitation that included range of motion, strength, balance, and functional exercises. Main Outcome Measures: Measures of extrinsic and intrinsic foot muscle volume and ankle strength measured before and after 4 weeks of supervised rehabilitation. Novel fast-acquisition magnetic resonance imaging was used to scan from above the femoral condyles through the entire foot. 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 muscle volume. Plantar flexion, dorsiflexion, inversion, and eversion isometric strength were measured using a hand-held dynamometer. Results: Rehabilitation resulted in hypertrophy of all extrinsic foot muscles except for the flexor hallucis longus and peroneals. Large improvements were seen in inversion, eversion, and plantar flexion strength following rehabilitation. Effect sizes for significant differences following rehabilitation were all large and ranged from 1.54 to 3.35. No significant differences were identified for intrinsic foot muscle volumes. Conclusion: Preliminary results suggest that impairment-based rehabilitation for CAI can induce hypertrophy of extrinsic foot and ankle musculature with corresponding increases in ankle strength.