Immediate effect of walking with talus-stabilizing taping on ankle kinematics in subjects with limited ankle dorsiflexion

ObjectiveTo determine the effects of walking with talus-stabilizing taping (TST) on ankle dorsiflexion (DF) and heel-off time in the stance phase of gait and ankle DF passive range of motion (PROM).DesignPre- and post-intervention study.SettingUniversity motion analysis laboratory.ParticipantsTen subjects participated in this study. Sixteen ankles with limited ankle DF PROM were tested.Main outcome measuresAnkle DF PROM was measured using a goniometer, and maximum ankle DF before heel-off and time to heel-off in the stance phase of gait were measured using a 3D motion analysis system before and after walking with TST. Data were analyzed using a paired t-test.ResultsAnkle maximum DF before heel-off (p = 0.001), time to heel-off during the stance phase of gait (p = 0.005), and ankle DF PROM (p < 0.001) were significantly increased post-intervention compared with pre-intervention.ConclusionsWalking with TST is an effective self-exercise for improving ankle kinematics during gait and increasing ankle DF PROM in individuals with limited ankle DF PROM.     

肌内效贴对慢性踝关节不稳运动神经肌肉控制的影响

文题释义： 慢性踝关节不稳：定义为“外侧踝关节不稳定反复发作,外踝扭伤多次发生”,主要症状为疼痛、肿胀、打软腿及自觉踝关节功能下降。 运动神经肌肉控制：人体在运动过程中,对于自身和外界环境信息进行感觉传入,中枢整合后发出的运动反馈,是神经和肌肉骨骼系统之间相互作用的下意识行为,主要包括以下表现：本体感觉、肌肉活动、平衡功能以及运动生物力学。 背景：慢性踝关节不稳患者踝关节运动神经肌肉控制能力降低,影响其运动表现。肌内效贴在慢性踝关节不稳的防护治疗中已被广泛应用,然而目前肌内效贴对慢性踝关节不稳患者运动神经肌肉控制能力的相关研究有限,且异质性大,研究结果存在较大争议。 目的：阐述目前肌内效贴对慢性踝关节不稳患者运动神经肌肉控制影响的研究现状,为实际应用提供参考依据。 方法：检索2009年1 月至2019年7月期间在PubMed、Cochrane、WOS、CNKI数据库检索肌内效贴应用于慢性踝关节不稳的研究。中文检索词为“慢性踝关节不稳;慢性踝不稳;踝关节”和“肌内效贴;肌贴;贴扎”,英文检索词分别为“chronic ankle instability;ankle instability;ankle”AND“kinesio tap*; kinesiology tap*;kinaesthetic tap*;tap*”。 结果与结论：肌内效贴可能改善慢性踝关节不稳患者的踝关节本体感觉和跳跃类运动生物力学表现,但需要更多高质量研究进行深入探讨。当前并无足够证据支持肌内效贴可以改善慢性踝关节不稳患者的肌肉力量,肌肉激活特征及平衡功能。现有研究选取受试者异质性大,难以对不同运动种类和水平的慢性踝关节不稳患者进行综合归纳;不同研究纳入标准中的量表不同,研究在进行肌内效贴贴扎时选用的贴法、拉力、方向、持续时间等都存在明显差异,无统一标准;缺少高质量的Meta分析对其进行循证论证。 ORCID: 0000-0003-0738-2833(尹璐璐) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

CLINICAL EFFECTIVENESS OF KINESIOLOGICAL TAPING ON PAIN AND PAIN‐FREE SHOULDER RANGE OF MOTION IN PATIENTS WITH SHOULDER IMPINGEMENT SYNDROME: A RANDOMIZED,DOUBLE BLINDED,PLACEBO‐CONTROLLED TRIAL

Background:

Kinesiological taping (KT) is commonly used to improve symptoms associated with musculoskeletal disorders. However, review of the literature revealed minimal evidence to support the use of KT in treatment of shoulder disorders and controversy exists regarding the effect of KT in patients with shoulder impingement syndrome (SIS).

Objective:

The purpose of this study was to investigate the effect of KT on pain intensity during movement, pain experienced during the night (nocturnal pain), and pain‐free shoulder range of motion (ROM) immediately after taping, after three days and after one week, in patients with SIS.

Design:

Randomized, Double blinded, Placebo‐controlled design.

Participants:

A total of 30 patients with SIS participated in this study. Patients were assigned randomly to a control (N = 15) and an experimental group (N = 15).

Methods:

The patients in the experimental group received a standardized therapeutic KT. The standardized, placebo neutral KT was applied for control group. KT was applied two times with a three day interval, remaining on during the 3 day interval. Both groups followed the same procedures. Pain‐free active ROM during shoulder abduction, flexion, and elevation in the scapular plane was measured. Visual analogue scale (VAS) for pain intensity during movement or nocturnal pain and was assessed at baseline, immediately after KT, after three days, and one week after KT.

Results:

The result of repeated measures ANOVA showed a significant change in pain level during movement, nocturnal pain, and pain‐free ROM (p = 0.000) after KT in the experimental group. In the ANCOVA, controlling for pre‐test scores, change in pain level at movement (p = 0.009) and nocturnal pain (p = 0.04) immediately after KT was significantly greater in the experimental group than in control group. There was no significant difference in ROM measures (p > 0.05) between groups immediately after KT. No significant differences were found between the two groups in the after one week measurements of pain intensity and shoulder ROM.

Conclusion:

The KT produces an immediate improvement in the pain intensity at movement and nocturnal pain in patients with SIS.

Level of Evidence:

1     

正常腕骨三维运动学的在体研究

目的探讨正常腕关节在屈伸、桡尺偏运动时各腕骨的三维运动学。方法选健康志愿者10名,在各种体位下行腕关节CT扫描后,在自行开发的外科手术模拟系统内三维重建,计算出各腕骨的质心、转动惯量轴,在桡骨建立参照坐标系,用有限螺旋轴表达各腕骨相对于桡骨远端的旋转及平移运动。结果腕关节在冠状面运动时各腕骨有较大的非平面运动,腕关节在矢状面运动时各腕骨运动主要为屈伸运动,非平面运动较小。远排腕骨运动学相近,可视为一个整体;近排腕骨运动相差较大。结论腕关节在屈-伸和桡-尺偏时各腕骨的运动是三维的,并不是传统的横排和纵列的单一运动模式。该研究的结果与过去文献资料报道相似,为在体研究腕骨三维运动学分析提供了一定的理论及技术参考。     

肌内效贴疗法在儿童康复中的应用研究进展

肌内效贴疗法是近年来在康复领域新兴的一种治疗方法,因其操作简单、方便,效果即刻而明显,使病人易于接受,而得到了广泛的应用。该文通过查阅大量文献,从肌内效贴的出现、发展、特征、作用、在儿童中的贴扎方法与取下方法等方面,综述了肌内效贴疗法在小儿脑瘫、肌性斜颈、臂丛神经损伤及其他疾病中的应用进展情况,并提出肌内效贴今后在儿童康复领域的研究方向。     

不同肌内效贴贴扎方式治疗脑卒中后肩手综合征的疗效观察

目的 观察不同肌内效贴贴扎方式对脑卒中后肩手综合征患者手肿胀程度、肩痛、上肢功能和日常生活活动能力的影响。 方法 采用随机数字表法将60例脑卒中后肩手综合征患者分为对照组、A组、B组、C组,每组15例。4组患者均予以康复训练和常规药物治疗,A组在对照组基础上进行手部爪形+腕部I形+肩部I形贴扎,B组在对照组基础上进行手部爪形+腕部I形+肩部Y形贴扎,C组在对照组基础上进行手部爪形+腕部I形+肩部Y形+肩部I形贴扎。治疗前和治疗4周后（治疗后）,采用排水法计算患者双手体积差,用远红外热成像仪测量患者双手温度差,用视觉模拟评分法（VAS）、Fugl-Meyer量表（FMA）、改良Barthel指数（MBI）评定患者的肩痛、上肢运动功能、日常生活活动能力。 结果 治疗前,4组患者双手体积差、双手温度差、VAS、FMA、MBI评分比较,差异无统计学意义（P＞0.05）。与组内治疗前比较,4组患者治疗后双手体积差、双手温度差、VAS、FMA、MBI评分均有所改善（P＜0.05）。与对照组治疗后比较,A组、B组、C组双手体积差、双手温度差、VAS评分减少、FMA评分增加（P＜0.05）。C组治疗后FMA评分［(27.69±6.91)分］高于对照组［(12.87±3.04)分］、A组［(20.57±6.16)分］、B组［(18.64±5.73)分］（P＜0.05）。4组治疗后MBI评分比较,差异无统计学意义（P＞0.05）。 结论 康复训练和肌内效贴均可有效减小脑卒中后肩手综合征患者的双手体积差和双手温度差,减轻患肩痛,提高日常生活活动能力。在康复训练基础上,进行手部爪形+腕部I形+肩部Y形+肩部I形贴扎还可提高患者患侧的上肢运动功能。