急性踝关节扭伤和慢性踝关节不稳的康复对功能和神经肌肉的影响。

IF 1.3 4区 医学 Q2 Medicine
Andrea De Fazio, Giorgio Fravolini, Elena Gabrielli, Matteo Turchetta, Marianna Citro, Fabrizio Forconi, Giulio Maccauro, Raffaele Vitiello
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引用次数: 0

摘要

背景:外侧踝关节扭伤(LAS)是一种常见的损伤,可发展为慢性踝关节不稳定(CAI),其特征是反复扭伤、本体感觉缺陷和神经肌肉损伤。目的:本研究评估康复对急性LAS和CAI患者功能结局和肌电图(EMG)参数的影响。研究设计:前瞻性观察队列研究方法:在2022年8月至2023年9月期间,对119例患者(73例急性LAS, 46例CAI)在基线(T0)和三个月康复计划(T1)后进行评估。评估包括活动范围(ROM)、肌肉力量、表面肌电图、平衡测试(Y-Balance、足举、侧跳、6米跳)和FAAM问卷。康复包括个体化方案,包括基于健身房的锻炼和水疗,目标是ROM恢复,本体感觉训练和肌肉强化。结果:LAS患者表现出明显的跖屈ROM基线损伤(49.32 ± 13.37 vs. 61.76 ± 17.67;p = 0.01)和足举试验性能(168 ± 191.28 vs. 18.52 ± 58.38; = 0.01页)。康复后,两组的ROM、力量和功能评分均有改善。CAI患者获得了更大的本体感觉(Y-Balance, Side Hop),而LAS患者在跖屈曲强度方面表现出更好的恢复。然而,肌电图分析显示两组患者均存在持续的神经肌肉缺陷。结论:尽管临床有所改善,但持续的肌电图缺损,特别是CAI,表明神经肌肉恢复不完全。这些发现强调了标准康复方案的局限性,并强调了个性化神经肌肉干预和客观回归运动标准的必要性。未来的研究应致力于完善诊断工具,规范治疗方案,并结合技术辅助康复来改善长期疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Functional and neuromuscular effects of rehabilitation in acute ankle sprain and chronic ankle instability.

Background: Lateral ankle sprains (LAS) are common injuries that may progress to chronic ankle instability (CAI), characterized by recurrent sprains, proprioceptive deficits, and neuromuscular impairments.

Purpose: This study evaluated the impact of rehabilitation on functional outcomes and electromyographic (EMG) parameters in patients with acute LAS and CAI.

Study design: Prospective observational cohort study.

Methods: Between August 2022 and September 2023, 119 patients (73 with acute LAS, 46 with CAI) were assessed at baseline (T0) and after a three-months rehabilitation program (T1). Assessments included range of motion (ROM), muscle strength, surface EMG, balance tests (Y-Balance, Foot Lift, Side Hop, 6-m Hop), and the FAAM questionnaire. Rehabilitation consisted of individualized protocols integrating gym-based exercises and hydrotherapy, targeting ROM restoration, proprioceptive training, and muscle strengthening.

Results: LAS patients demonstrated significant baseline impairments in plantarflexion ROM (49.32 ± 13.37 vs. 61.76 ± 17.67; p = 0.01) and Foot Lift Test performance (168 ± 191.28 vs. 18.52 ± 58.38; p = 0.01). Post-rehabilitation, both groups showed improvements in ROM, strength, and functional scores. CAI patients achieved greater proprioceptive gains (Y-Balance, Side Hop), while LAS patients exhibited superior recovery in plantarflexion strength. However, EMG analysis revealed persistent neuromuscular deficits in both groups.

Conclusion: Despite clinical improvements, persistent EMG deficits, especially in CAI, indicate incomplete neuromuscular recovery. These findings highlight the limitations of standard rehabilitation protocols and underscore the need for personalized neuromuscular interventions and objective return-to-sport criteria. Future research should aim to refine diagnostic tools, standardize protocols, and incorporate technology-assisted rehabilitation to improve long-term outcomes.

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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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