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踝关节骨关节炎的力学及感觉运动影响

Mechanical and sensorimotor implications with ankle osteoarthritis.

作者信息

Hubbard Tricia J, Hicks-Little Charlie, Cordova Mitchell

机构信息

Department of Kinesiology, University of North Carolina Charlotte, Charlotte, NC 28223, USA.

出版信息

Arch Phys Med Rehabil. 2009 Jul;90(7):1136-41. doi: 10.1016/j.apmr.2008.11.020.

Abstract

OBJECTIVE

To understand the mechanical and sensorimotor adaptations that may occur with ankle osteoarthritis (OA).

DESIGN

Case-control.

SETTING

Biodynamics research laboratory.

PARTICIPANTS

Subjects with ankle OA (n=8; 4 males, 4 females) were matched to healthy controls (n=8; 4 males, 4 females).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Mechanical joint stability was assessed with an instrumented ankle arthrometer. Static balance was measured using a force platform during a double-legged stance. Isometric ankle/foot complex strength in the sagittal and frontal plane was assessed with a handheld dynamometer. Last, subjective level of function was assessed using the foot and ankle disability index.

RESULTS

There were significant group x side interactions for anterior displacement, inversion rotation, eversion rotation, ankle isometric strength, and the foot and ankle disability index (P<.05). The affected ankle of the OA group demonstrated significantly more mechanical stiffness, more impairments in ankle/foot isometric strength, and less subjective level of function than the matched controls. Additionally, the ankle OA group exhibited significantly more center of pressure displacement, total velocity, and medial-lateral velocity (P<.05).

CONCLUSIONS

These limitations observed in joint laxity, postural control, muscle strength, and perceived function provide evidence that patients with ankle OA display a number of characteristics that affect joint stability and overall function. These identified impairments necessitate the need for rehabilitation and exercise programs to be developed to help improve joint stability and function in patients with ankle OA.

摘要

目的

了解踝关节骨关节炎(OA)可能出现的力学和感觉运动适应性变化。

设计

病例对照研究。

地点

生物动力学研究实验室。

参与者

踝关节OA患者(n = 8;4名男性,4名女性)与健康对照者(n = 8;4名男性,4名女性)进行匹配。

干预措施

不适用。

主要观察指标

使用仪器化踝关节测角仪评估关节力学稳定性。在双腿站立期间使用测力平台测量静态平衡。使用手持测力计评估矢状面和额状面的等长踝/足复合体力量。最后,使用足踝残疾指数评估主观功能水平。

结果

在前向位移、内翻旋转、外翻旋转、踝关节等长力量以及足踝残疾指数方面存在显著的组×侧交互作用(P <.05)。与匹配的对照组相比,OA组患侧踝关节表现出明显更大的力学僵硬、踝/足等长力量更多受损以及主观功能水平更低。此外,踝关节OA组表现出明显更多的压力中心位移、总速度和内外侧速度(P <.05)。

结论

在关节松弛度、姿势控制、肌肉力量和感知功能方面观察到的这些局限性表明,踝关节OA患者表现出一些影响关节稳定性和整体功能的特征。这些已确定的损伤使得有必要制定康复和运动计划,以帮助改善踝关节OA患者的关节稳定性和功能。

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