Do individuals with ankle instability show altered lower extremity kinematics and kinetics during walking? A systematic review and meta-analysis

IF 3.1 3区医学 Q1 REHABILITATION

Physiotherapy Pub Date : 2024-08-08 DOI:10.1016/j.physio.2024.101420

Lijiang Luan , Dominic Orth , Phillip Newman , Roger Adams , Doa El-Ansary , Jia Han

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引用次数: 0

Abstract

Objective

To determine if individuals with chronic ankle instability (CAI) demonstrate altered lower extremity kinematics and kinetics during walking.

Data sources

Relevant studies were sourced from PubMed, Embase, Cochrane Library, Web of Science, EBSCO and PEDro.

Study selection

Kinematic and kinetic studies involving joint angle and/or joint moment measured in individuals with CAI were included.

Study appraisal and synthesis methods

The Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tool was used to assess literature quality. Weighted mean differences (WMDs) in joint angles and moments between CAI and controls were analyzed as continuous variables.

Results

1261 articles were screened, with a final selection of 13 studies involving 729 participants. Compared to non-CAI controls, CAI participants showed significantly greater ankle inversion angle (degree) (WMD: 3.71, 95% CI: 3.15 to 4.27, p < 0.001), hip adduction angle (degree) (WMD: 1.60, 95% CI: 0.09 to 3.11, p = 0.04), and knee valgus moment (N m/kg) (WMD: 0.07, 95% CI: 0.01 to 0.13, p = 0.02) during walking. Additionally, there were no consistent findings or specific altered patterns in other lower extremity joint angles, or moment changes, regardless of the motion plane (sagittal, coronal, horizontal), for CAI compared with controls.

Conclusions

This review provides further evidence of altered lower limb kinematics and kinetics in the frontal plane in CAI participants during certain walking phases, which may partially explain the high level of recurrent ankle sprains observed in the CAI population, and support hip abduction and ankle eversion motor control exercises for CAI rehabilitation.

Systematic Review Registration Number

Systematic Review Registration Number PROSPERO CRD42023420418.

Contribution of the Paper

•
Individuals with CAI exhibit greater ankle inversion and hip adduction angles during certain phases of walking compared to non-CAI controls.
•
There may be an increase in the knee valgus moment of individuals with CAI.
•
Altered lower extremity kinematics and kinetics may be associated with the occurrence of recurrent ankle sprains in CAI.

查看原文本刊更多论文

踝关节不稳定患者在行走过程中是否会出现下肢运动学和动力学改变？系统回顾和荟萃分析

数据来源相关研究来自 PubMed、Embase、Cochrane 图书馆、Web of Science、EBSCO 和 PEDro。研究选择纳入涉及 CAI 患者关节角度和/或关节力矩测量的运动学和动力学研究。结果筛选了1261篇文章，最终选出了13项研究，涉及729名参与者。与非 CAI 对照组相比，CAI 参与者在行走过程中的踝关节内翻角（度）（WMD：3.71，95% CI：3.15 至 4.27，p <0.001）、髋关节内收角（度）（WMD：1.60，95% CI：0.09 至 3.11，p = 0.04）和膝关节外翻力矩（N m/kg）（WMD：0.07，95% CI：0.01 至 0.13，p = 0.02）均明显增大。此外，与对照组相比，无论在哪个运动平面（矢状面、冠状面、水平面），CAI 患者的其他下肢关节角度或力矩变化都没有一致的发现或特定的改变模式。结论本综述进一步证明，CAI 参与者在某些步行阶段的前方平面上的下肢运动学和动力学发生了改变，这可能部分解释了在 CAI 群体中观察到的高复发性踝关节扭伤，并支持在 CAI 康复中进行髋关节外展和踝关节外翻运动控制练习。系统综述注册号系统综述注册号PROSPERO CRD42023420418.论文贡献-与非CAI对照组相比，CAI患者在行走的某些阶段表现出更大的踝关节内翻和髋关节外展角度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy 医学-康复医学

CiteScore

6.40

自引率

3.00%

发文量

377

审稿时长

82 days

期刊介绍： Physiotherapy aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions worldwide. Dedicated to the advancement of physiotherapy through publication of research and scholarly work concerned with, but not limited to, its scientific basis and clinical application, education of practitioners, management of services and policy. We are pleased to receive articles reporting original scientific research, systematic reviews or meta-analyses, theoretical or debate articles, brief reports and technical reports. All papers should demonstrate methodological rigour.