慢性踝关节不稳定患者的下肢运动学、动力学和肌肉活动特征在预期和意外的反转扰动下着陆:系统回顾和荟萃分析。

IF 2.2 3区 医学 Q1 ORTHOPEDICS
Yixue Gong, Menghan Xu, Peng Chen, Xiaomei Hu, Wenxing Zhou, Lin Wang
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引用次数: 0

摘要

目的:本研究旨在探讨慢性踝关节不稳定(CAI)患者在着陆过程中是否会发生预期和意外的反转扰动,从而改变其下肢运动学、动力学和肌肉活动。方法:检索PubMed、Embase、Cochrane Library、Web of Science和Scopus数据库,检索截止到2024年11月30日的相关研究。比较研究调查了CAI患者与健康对照者的下肢运动学、动力学和肌肉活动的特征。两名独立的审稿人提取了数据。使用纽卡斯尔-渥太华量表(NOS)方法评估证据的确定性。综合:纳入13项研究,涉及207例CAI患者和215名健康对照。CAI患者在着陆前表现出胫前肌活动增加(SMD = 0.28, 95% CI: 0.03-0.54)。着地后腓骨长肌激活延迟(SMD = 1.35, 95% CI: 0.90 ~ 1.80),矢状面共收缩指数(SMD = 0.41, 95% CI: 0.06 ~ 0.77)、踝关节内翻角(SMD = 0.56, 95% CI: 0.30 ~ 0.81)、踝关节内翻运动范围(SMD = 0.83, 95% CI: 0.42 ~ 1.24)、膝关节伸力矩(SMD = 0.71, 95% CI: 0.32 ~ 1.11)增加。此外,亚组分析显示,对扰动的预期会影响肌肉的激活模式,腓长肌潜伏期和协同激活指数存在显著差异。结论:与健康对照组相比,CAI患者在预期和非预期的倒立干扰着陆时下肢生物力学可能存在差异。这项工作的结果可能具有临床意义,为CAI患者制定更有效和有针对性的康复计划。试验注册:普洛斯彼罗注册号:CRD42024615006。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Characteristics of Lower Extremity Kinematics, Kinetics, and Muscle Activity in Individuals With Chronic Ankle Instability During Landing With Expected and Unexpected Inversion Perturbations: A Systematic Review and Meta-Analysis.

Characteristics of Lower Extremity Kinematics, Kinetics, and Muscle Activity in Individuals With Chronic Ankle Instability During Landing With Expected and Unexpected Inversion Perturbations: A Systematic Review and Meta-Analysis.

Characteristics of Lower Extremity Kinematics, Kinetics, and Muscle Activity in Individuals With Chronic Ankle Instability During Landing With Expected and Unexpected Inversion Perturbations: A Systematic Review and Meta-Analysis.

Characteristics of Lower Extremity Kinematics, Kinetics, and Muscle Activity in Individuals With Chronic Ankle Instability During Landing With Expected and Unexpected Inversion Perturbations: A Systematic Review and Meta-Analysis.

Objective: This study aims to investigate whether alterations in the lower extremity kinematics, kinetics, and muscle activity of individuals with chronic ankle instability (CAI) occur during landing with expected and unexpected inversion perturbations.

Methodology: PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were searched for relevant studies up to November 30, 2024. Comparative studies investigating the characteristics of lower extremity kinematics, kinetics, and muscle activity in individuals with CAI compared with healthy controls were included. Two independent reviewers extracted the data. Certainty of the evidence was assessed using the Newcastle-Ottawa Scale (NOS) approach.

Synthesis: Thirteen studies involving 207 patients with CAI and 215 healthy controls were included. Individuals with CAI exhibited increased activity of the tibialis anterior muscle before landing (SMD = 0.28 and 95% CI: 0.03-0.54). The delayed activation of the peroneus longus muscle (SMD = 1.35 and 95% CI: 0.90-1.80) and increased co-contraction index in the sagittal plane (SMD = 0.41 and 95% CI: 0.06-0.77), ankle inversion angle (SMD = 0.56 and 95% CI: 0.30-0.81), ankle inversion range of motion (SMD = 0.83 and 95% CI: 0.42-1.24), and knee extension moment (SMD = 0.71 and 95% CI: 0.32-1.11) were observed after landing. Besides, subgroup analysis revealed that the anticipation of perturbations influenced muscle activation patterns, with significant differences in peroneus longus latency and coactivation indices.

Conclusion: Patients with CAI may present differences in lower extremity biomechanics during expected and unexpected inversion-perturbed landings compared with healthy controls. The results of this work may have clinical implications in the development of more effective and targeted rehabilitation programs for individuals with CAI.

Trial registration: PROSPERO registration number: CRD42024615006.

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来源期刊
CiteScore
4.50
自引率
10.30%
发文量
83
审稿时长
>12 weeks
期刊介绍: Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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