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1.
ObjectiveTo examine the effects of dynamic tape on balance control in subjects with chronic ankle instability (CAI).MethodsThis two group experimental pre- and post-treatment design included 18 individuals with CAI and 18 controls. The single-limb stance test with eyes open and closed, standing on a force plate (Accusway Plus; AMTI) for 30 s, was conducted before, 10 min (T1) and 24 h (T24) after a dynamic tape application over the gastrocnemius muscle. Outcome measurements were: mean sway velocity, sway area (circular area), and standard deviation of the body center of pressure path length in both mediolateral and anteroposterior directions. Individuals with poor (unable to perform a single leg test for at least 30 s, eyes closed) vs. good postural stability, were also compared.ResultsIn both groups, a repeated analysis of variance demonstrated a significant time main effect on sway velocity (F = 14.95; p < 0.001) and path length (F = 14.95; p < 0.001) during eyes closed. Post-hoc analysis revealed a significant decrease in T1 values compared to baseline. When comparing individuals with poor vs good stability amongst the CAI group, a statistically significant interaction was observed between group, time on sway velocity and path length (F = 3.92; p < 0.05) during eyes closed. In the poor postural group, most T1 values were significantly lower than baseline.ConclusionsDynamic tape when applied to posterior calf muscles, enhanced balance control with no difference between CAI individuals and controls. The contribution of the tape was greater in those with poor postural stability.  相似文献   

2.
BackgroundProprioceptive deficits may attribute to functional Chronic ankle instability (CAI) with impairments in balance and postural control. Physical therapy interventions such as taping, bracing, manual therapy, and balance training play an essential role in managing ankle instabilities. Fascial Manipulation (FM) is a manual therapy technique considered to restore function by improving the joint range of motion and proprioception. However, the effects of FM on Ankle dorsiflexion range of motion (ADROM) and postural sway in athletes with chronic ankle instability are unclear.ObjectiveThis study aims to determine the effect of FM on function, ADROM, and Postural sway in athletes with CAI.DesignSingle group, pretest-posttest design.MethodsIndividuals with a history of recurrent ankle sprains with the Cumberland ankle instability tool (CAIT) score of ≤27 were included. FM was applied to the painful and densified center of coordination points on the lower limb myofascial lines based on Stecco's FM method. The outcomes measures include Foot and ankle disability index (FADI), ADROM during the weight-bearing lunge, and postural sway (excursion of the center of pressure during single limb stance).ResultsThere was a significant improvement in the FADI scores (Z = −3.626, p < 0.05), ADROM [F (2)=38.056, p<0.05], ηp 2 = 0.69 following FM. However, the center of pressure excursion with both opened and closed eyes showed no differences following FM.ConclusionSince fascial manipulation had shown improvement in the function and ankle dorsiflexion range, it can be used as an adjunct treatment strategy in CAI management.  相似文献   

3.

Background

Although it is known that muscle weakness is a major cause of postural instability and leads to an increased incidence of falls in patients with neuromuscular disease, the relative contribution of lower extremity and trunk muscle weakness to postural instability has not been studied well.

Methods

We determined the relationship between muscle fatty infiltration and sagittal-plane balance in ten patients with facioscapulohumeral muscular dystrophy. Sagittal-plane platform translations were imposed in forward and backward directions on patients with facioscapulohumeral muscular dystrophy and healthy controls. Stepping thresholds were determined and kinematic responses and center-of-mass displacements were assessed using 3 dimensional motion analysis. In the patients, magnetic resonance imaging was used to determine the amount of fatty infiltration of trunk and lower extremity muscles.

Findings

Stepping thresholds in both directions were decreased in patients compared to controls. In patients, significant correlations were found for fatty infiltration of ventral muscles with backward stepping threshold and for fatty infiltration of dorsal muscles with forward stepping threshold. Fatty infiltration of the rectus abdominis and the back extensors explained the largest part of the variance in backward and forward stepping thresholds, respectively. Center-of-mass displacements were dependent on intensity and direction of perturbation. Kinematic analysis revealed predominant ankle strategies, except in patients with lumbar hyperlordosis.

Interpretation

These findings indicate that trunk muscle involvement is most critical for loss of sagittal-plane postural balance in patients with facioscapulohumeral muscular dystrophy. This insight may help to develop rehabilitation strategies to prevent these patients from falling.  相似文献   

4.
目的:拟探究新型踝关节平衡装置训练对功能性踝关节不稳(FAI)患者踝关节功能及姿势控制能力的影响。方法:将符合纳入条件的FAI患者45名随机分为常规组(n=21)和平衡组(n=24),2组患者分别接受常规功能训练和新型踝关节平衡训练装置训练,8周干预前后,使用Noraxon表面肌电测试系统和Trap-door踝关节内翻诱发装置进行踝周肌肉潜伏期的测试,使用Biodex Systems IV型等速肌力测试系统进行踝关节位置觉和踝内外翻等速肌力的测试,使用Y型平衡测试(YBT)系统进行姿势控制能力的测试,使用坎伯兰踝关节不稳定工具(CAIT)对FAI患者进行评分。结果:干预8周后,平衡组FAI患者的CAIT评分、踝周肌肉潜伏期(腓肠肌内侧头、腓肠肌外侧头、腓骨长肌、胫骨前肌)、峰值踝外翻力矩和姿势控制能力(内收、外展的最大距离)相比于干预前显著改善(P<0.05),且明显优于对照组(P<0.05)。结论:相比于常规功能训练,踝关节平衡装置训练可以更显著地提高FAI患者的姿势控制能力和踝关节的功能。  相似文献   

5.

Objective

To explore whether carbamazepine impairs postural control in older people with epilepsy.

Design

Measures at 0 hours, before ingesting carbamazepine (baseline), and 2, 4 and 6 hours thereafter.

Setting

Rehabilitation laboratory.

Participants

Patients, aged 55 years or more, taking carbamazepine for epilepsy (n = 4) and age-matched healthy volunteers (n = 2).

Measures

(1) Heel-to-toe walk: walking speed, double support time and hand excursion. (2) Standing still, eyes open/closed: centre of mass excursion. (3) Sit-to-walk: duration of task and component phases.

Results

(1) Heel-to-toe. Three patients completed the task. At baseline, double support time was 150% and hand excursion was 65% of volunteer values. Walking speed did not differ. Patients showed no change over time. (2) Standing. At baseline, patients’ centre of mass excursion was 294% (eyes open) and 288% (eyes closed) of volunteer values. Patients showed no change over time. (3) Sit-to-walk. At baseline, no difference was observed in task duration between patients and volunteers. Patients took 42% longer for flexion momentum, 59% less time for unloading and 219% longer for stance phases. Over time, patients took longer for flexion momentum (208% of volunteer values at 6 hours, 142% of volunteer values at baseline) and extension (190% of volunteer values at 2 hours, 126% of volunteer values at baseline).

Conclusions

Older people with epilepsy taking carbamazepine could have postural control deficits. Further investigation is justified.  相似文献   

6.
7.

Background

Diminished postural stability is a risk factor for ankle sprain occurrence and ankle sprains result in impaired postural stability. To date, ankle sprain history has not been taken into account as a determinant of postural stability, while it could possibly specify subgroups of interest.

Methods

Postural stability was compared between 18 field hockey athletes who had recovered from an ankle sprain (mean (SD); 3.6 (1.5) months post-injury), and 16 uninjured controls. Force plate and kinematics parameters were calculated during single-leg standing: mean center of pressure speed, mean absolute horizontal ground reaction force, mean absolute ankle angular velocity, and mean absolute hip angular velocity. Additionally, cluster analysis was applied to the ‘injured’ participants, and the cluster with diminished postural stability was compared to the other participants with respect to ankle sprain history.

Findings

MANCOVA showed no significant difference between groups in postural stability (P = 0.68). A self-reported history of an (partial) ankle ligament rupture was typically present in the cluster with diminished postural stability. Subsequently, a ‘preceding rupture’ was added as a factor in the MANCOVA, which showed a significant association between diminished postural stability and a ‘preceding rupture’ (P = 0.01), for all four individual parameters (P: 0.001–0.029; Cohen's d: 0.96–2.23).

Interpretation

Diminished postural stability is not apparent in all previously injured athletes. However, our analysis suggests that an (mild) ankle sprain with a preceding severe ankle sprain is associated with impaired balance ability. Therefore, sensorimotor training may be emphasized in this particular group and caution is warranted in return to play decisions.  相似文献   

8.
摘要目的:通过比较功能性踝关节不稳(functional ankle instability,FAI)者和健康人群在疲劳前后静态、动态平衡能力及跳跃落地时踝关节本体感觉的差异,探讨全身性疲劳对FAI者平衡能力和本体感觉的影响。方法:单侧FAI者和健康者各31例被纳入研究,并在疲劳前后分别进行了静态、动态平衡测试及跳跃落地时踝关节的本体感觉测试。足底压力中心动摇径、均方根距离、95%包络面积、标准化伸展距离和AUC值等相关指标用于计算与分析。结果:全身性疲劳前,FAI组的静态、动态平衡能力及踝关节的本体感觉均显著低于健康对照组(P<0.05)。全身性疲劳后,FAI组和健康对照组的静态、动态平衡能力以及踝关节的本体感觉均显著降低(P<0.05),且FAI组的动摇径、均方根距离和95%包络面积增加的幅度均显著大于健康对照组(P<0.05),在后内侧、后外侧的标准化动态伸展距离及AUC值的降低幅度显著大于健康对照组(P<0.05)。结论:FAI及健康者在全身性运动疲劳后静态、动态平衡能力以及跳跃落地时踝关节的本体感觉均下降,且FAI者静态、动态平衡能力及本体感觉功能下降程度更大。因此,全身性疲劳可能通过降低FAI者的姿势控制和本体感觉,增加了踝关节反复扭伤的风险。  相似文献   

9.
It has been demonstrated that Kinesio Tape (KT) application has immediate positive effects on balance in healthy individuals, but its mid-term effects have not yet been investigated.ObjectiveEvaluate the effects of KT on postural control in young women, using four strategies.MethodsForty-eight healthy women aged 18–35 years old were randomly assigned to four groups with different elastic bandages (G1: ankle; G2: hamstrings; G3: lumbar; G4: different taping applications) and their postural control was evaluated using stabilographic parameters obtained on a force platform during right and left unipodal (UNP-R and UNP-L) and semi-tamdem tests at pre-intervention (PRE), immediately after (IME), and 24 and 48 h after the application of bandages.ResultsG1 showed a significantly lower velocity in the antero-posterior direction for the PRE compared to the IME period (p = 0.0204) in the UNP-R task, and the same was observed in the medio-lateral velocity when comparing the results for PRE with IME (p = 0.0340 and p = 0.0244) in the UNP-L task. Regarding the frequency, G2 had a significantly lower mean for the PRE, compared to IME (p < 0.001) in the UNP-R in antero-posterior direction, and in medio-lateral direction in the UNP-R (p = 0.003) and in the UNP-L task (p = 0.020).ConclusionsThe use of KT changed postural control, mainly considering the velocity and frequency of COP oscillations, and especially immediately after its application.  相似文献   

10.
Objective: To compare the effects of vision and cognitive load on static postural control in subjects with and without patellofemoral pain syndrome (PFPS). Methods: Twenty-eight PFPS patients and 28 controls participated in the study. Postural control was assessed in isolation as well as with visual manipulation and cognitive loading on symptomatic limb. The outcome measures of postural control were quantified in terms of area, anterior-posterior (AP), medial-lateral (ML), and mean velocity (MV) of the displacements of center of pressure (COP). In addition, cognitive performance (auditory Stroop task) was measured in the forms of average reaction time and error ratio in baseline (sitting) and different postural conditions. Results: PFPS subjects showed greater increases in area (p = 0.01), AP (p = 0.01), and ML (p = 0.05) displacements of COP in the blindfolded tasks as compared to control group. However, cognitive load did not differently affect postural control in the two groups. Although PFPS and control group had similar reaction times in the sitting position (p = 0.29), PFPS subjects had longer reaction times than healthy subjects in dual task conditions (p = 0.04). Conclusion: Visual inputs seem to be essential for discriminating postural control between PFPS and healthy individuals. PFPS patients biased toward decreasing cognitive performance more than healthy subjects when they perform the single leg stance and cognitive task concurrently.  相似文献   

11.
目的 对治疗性运动对功能性踝关节不稳(FAI)患者姿势控制和踝周肌肉功能的效果进行Meta分析。方法 检索PubMed、Web of Science、Embase、SPORTdiscus、Medline、Science Direct、EBSCO、Springlink、中国知网、维普、万方数据库不同类型运动干预FAI的随机对照试验,时间范围自建库至2021年12月。由2名研究人员对纳入文献进行质量和结果证据等级评估,采用RevMan 5.4进行分析。结果 最终纳入随机对照试验14篇,共434例受试者。与无运动干预相比,治疗性运动明显减少睁闭眼下压力中心偏移(睁眼, SMD=-0.28, 95%CI-0.46~-0.09, P=0.003;闭眼, SMD=-0.24, 95%CI-0.40~-0.09, P=0.001);增强运动任务前腓骨长肌激活(SMD=0.38, 95%CI 0.05~0.71, P=0.03),运动任务后腓骨长肌(SMD=0.53, 95%CI 0.16~0.90, P=0.005)和胫骨前肌(SMD=0.47, 95%CI 0.10~0.84, P=0.01)激活...  相似文献   

12.

Background

Recurrent ankle injury occurs in 70% of individuals experiencing a lateral ankle sprain. The cause of this high level of recurrence is currently unknown. Researchers have begun to investigate sensorimotor deficits as one possible cause with inconclusive and often conflicting results. The purpose of this study was to further the understanding of the role of sensorimotor deficits in the chronically unstable ankle by establishing which specific measures best distinguish between chronically unstable and healthy ankles.

Methods

Twenty-two participants with chronic ankle instability and 21 healthy matched controls volunteered. Twenty-five variables were measured within four sensorimotor constructs: joint kinesthesia (isokinetic dynamometer), static balance (force plate), dynamic balance (Star Excursion Balance Test) and motoneuron pool excitability (electromyography).

Findings

The above variables were evaluated using a discriminant function analysis [Wilks’ Λ = 0.536 χ2(7, N = 43) = 22.118, P = 0.002; canonical correlation = 0.681]. The variables found to be significant were then used to assess group discrimination. This study revealed that seven separate variables from the static balance (anterior/posterior and medial/lateral displacement and velocity) and motoneuron pool excitability constructs (single-legged recurrent inhibition and single- and double-legged paired reflex depression) accurately classified over 86% of participants with unstable ankles.

Interpretation

These results suggest that a multivariate approach may be necessary to understand the role of sensorimotor function in chronic ankle instability, and to the development of appropriate rehabilitation and prevention programs. Out of the four overall constructs, only two were needed to accurately classify the participants into two groups. This indicates that static balance and motoneuron pool excitability may be more clinically important in treatment and rehabilitation of chronic ankle instability than functional balance or joint kinesthesia.  相似文献   

13.
[Purpose] Limited research has been performed in spite of biomechanical evaluation of jump landing with kinesio taping. Therefore, the main objective of this study was to evaluate the effect of kinesio taping applied to athletes. In this study, the authors wished to investigate the effect of kinesio taping during a vertical jump with run-up and countermovement jump on ankle functional instability. [Subjects and Methods] Ten male athletes with ankle functional instability (FI) were recruited in this study from a college volleyball team. Each participant was requested to perform two tasks, the countermovement jump and vertical jump with run-up. Infrared high-speed cameras and force plates were used to assess the effect of ankle taping. [Results] The results showed that the peak ground reaction force in the sagittal plane during a vertical jump with run-up slowed down after kinesio taping and that the peak ankle plantar flexion moment in both types of jump also decreased. [Conclusion] In conclusion, this study proved the effect of kinesio taping on ankle functional instability, which was evaluated by measuring the vertical ground reaction force and peak plantar flexion moment. Its finding may allow us to provide some recommendations for athletes and trainers.Key words: Kinesio taping, Ankle functional instability  相似文献   

14.

Background

Chronic ankle instability is a common occurrence after an ankle sprain. Yet, some people (copers) possess a mechanism that limits recurrent injury and disability. During gait termination, those with chronic ankle instability exhibit altered feed-forward and feedback control but little is known about alterations in copers. Therefore, the purpose of this investigation was to determine the biomechanical control alterations present in controls, copers, and those with chronic ankle instability during planned and unplanned gait termination.

Methods

Twenty subjects with chronic ankle instability, 20 copers, and 20 uninjured controls completed planned and unplanned gait termination tasks. Unplanned gait termination required subjects to stop, when cued, during randomly selected trials. Planned gait termination required intended stopping. A total of 10 trials were recorded for each condition. Normalized propulsive and braking force magnitudes and dynamic postural stability indices were calculated and compared among the groups.

Findings

Normalized maximum braking forces were significantly higher in the chronic ankle instability group (Mean: 2.82 SD: 0.93 N/kg), relative to copers (Mean: 2.59 SD: 0.84 N/kg) and controls (Mean: 2.51 SD: 0.78 N/kg). Similarly, the antero-posterior postural stability index revealed higher scores in the chronic ankle instability group (Mean: 0.15 SD: 0.03) compared to the coper (Mean: 0.14 SD: 0.02) and control group (Mean: 0.14 SD: 0.02). Copers did not differ from controls.

Interpretation

The findings suggest that the ability of copers to terminate gait in a manner similar to uninjured controls may represent part of the underlying mechanism that limits recurrent injury and disability in copers.  相似文献   

15.

Objective

The main objective of the present study was to analyze how supra spinal motor control mechanisms are altered in different directions during anticipatory postural phase of gait initiation in chronic ankle instability patients. It seems that supra spinal pathways modulate anticipatory postural adjustment phase of gait initiation. Yet, there is a dearth of research on the effect of chronic ankle instability on the anticipatory postural adjustment phase of gait initiation in different directions.

Method

A total of 20 chronic ankle instability participants and 20 healthy individuals initiated gait on a force plate in forward, 30° lateral, and 30° medial directions.

Results

According to the results of the present study, the peak lateral center of pressure shift decreased in forward direction compared to that in other directions in both groups. Also, it was found that the peak lateral center of pressure shift and the vertical center of mass velocity decreased significantly in chronic ankle instability patients, as compared with those of the healthy individuals.

Conclusion

According to the results of the present study, it seems that chronic ankle instability patients modulate the anticipatory postural adjustment phase of gait initiation, compared with healthy control group, in order to maintain postural stability. These changes were observed in different directions, too.  相似文献   

16.
IntroductionProprioceptive exercises are performed in physiotherapy with the use of different unstable devices to improve joint stability using the mechanical and sensory properties of the ligaments, joint capsule and muscles surrounding the joint. However, the literature does not clearly show whether the use of foot wear increases or reduces muscle activity on different types of unstable devices.ObjectiveAnalyze the electromyographic activity of the ankle muscles on unstable proprioception devices and a stable surface with and without the use of shoes.MethodsThirty active, healthy men were submitted to warmup and familiarization of the devices prior to data collection. The order of data collection was chosen randomly by lots [on stable ground or unstable platforms (BOSU in the normal and inverted positions and proprioceptive disk) with or without the use of shoes]. The individuals remained balanced on these surfaces for 15 s. Biological signals were captured using surface electromyography for the evaluation of the activity of the tibialis anterior, gastrocnemius and fibularis longus muscles.ResultsNo differences were found in the activation of the muscle in the comparison of the use and non-use of shoes (p > 0.05). The BOSU device in the normal position led to greater muscle activation than in the inverted position (p < 0.05).ConclusionThe use of shoes does not alter muscle activity of the ankle on the proprioceptive devices used in the present study. Moreover, these unstable devices each generate different muscle activities.  相似文献   

17.
IntroductionThe aim of this study was to determine the effects of 8 weeks proprioception training without visual input on the proprioception of the knee and ankle and single standing balance time in deaf students.MethodsTwenty male deaf students participated in this study and were randomly assigned into control (n = 10) and experimental (n = 10) groups. Subjects' proprioception was measured using an electrogoniometer. In addition, balance performance was evaluated through single-limb standing performance test under four sensory conditions (condition 1: eyes open on one leg; condition 2: eyes closed on one leg; condition 3: eyes open on foam; condition 4: eyes closed on foam).ResultsThe findings showed that proprioception training without visual input induced meaningful, significant effects in knee and ankle proprioception (p ≤ 0.001), and single-limb standing time of deaf students at condition 1 (p ≤ 0.03) and 2 (p ≤ 0.001). However, training programs did not have any significant effects on single-limb standing time in conditions 3 (p ≤ 0.41) and 4(p ≤ 0.22).ConclusionsProprioception training without visual input improves proprioception of ankle, knee and single-limb standing balance time in deaf students.  相似文献   

18.
IntroductionPrevious studies have analyzed the effects of manual therapy techniques (MTT) in patients with chronic ankle instability (CAI). Clinicians treat patients according the finding-oriented MTT approach. This approach is seldom pursued in research. The purpose of this study was to evaluate the feasibility and efficacy of finding-oriented MTT applications in patients with CAI.MethodIn this randomized controlled, blinded assessor crossover feasibility trial, participants were randomized to receive nine finding-oriented MTT treatments or no treatment during a three-week period, followed by a six-day washout period after which participants were crossed-over. Criteria under evaluation were adherence and attrition rates, safety (adverse events (AEs)) and acceptability and preliminary effects of finding-oriented MTT on muscular activity (measured by surface Electromyography (sEMG)) and on dynamic balance (measured by time to stabilization (TTS) and the modified Star Excursion Balance Test (modified STBT)).ResultsSeven women and two men (mean age: 26 ± 6.1 years) with CAI enrolled in this feasibility study. Success criteria showed a high adherence (90%) and low attrition rate (10%). All data could be used for analysis. AEs such as tingling in the foot during a short time frame were reported after four finding-oriented MTT interventions. Preliminary effect sizes showed divergence and few statistically significant results for sEMG.ConclusionThe participants were adherent to the finding-oriented MTT intervention. The acceptability of data recording and data analysis was good. In addition, the study protocol should be adapted by adding a 10-min warm up period, a participant familiarization to TTS and modified STBT, and test repetitions.  相似文献   

19.
摘要目的:探讨按压肌筋膜触发点在功能性踝关节不稳(functional ankle instability, FAI)患者中的临床疗效。方法:选取西南大学医院康复医学中心门诊2021年5月—8月就诊的功能性踝关节不稳患者29例,随机分为试验组15例和对照组14例。试验组在踝关节平衡训练基础上增加按压肌筋膜触发点技术,对照组采用BOSU球进行踝关节平衡训练。分别在基线、干预第4周后和干预第8周后对两组患者进行疼痛视觉模拟评分(visual analogue scale, VAS)评估、踝关节功能量表评分(American Orthopedic Foot and Ankle Score,AOFAS)和Y平衡测试(Y-balance test, YBT)评估。结果:治疗前,两组患者在评估的各项指标上无明显差异(P>0.05)。治疗8周后,两组患者在VAS疼痛评分上均有显著降低(P<0.05),Y平衡测试综合数值得到显著改善(P<0.01),AOFAS踝关节功能评分得到显著提高(P<0.05)。治疗后,试验组在上述各项评估指标中均显著优胜于对照组(P<0.05)。结论:为期8周的平衡训练和平衡训练联合按压MTrPs治疗均对FAI患者有显著的临床康复疗效,而平衡训练联合按压MTrPs治疗在缓解FAI患者的疼痛、促进踝关节功能和动态平衡的改善等方面具有更好的康复效益。  相似文献   

20.
SummaryCore stability exercises and exercises that stimulate sensory-motor information are recommended for the prevention of injuries and the maintenance and rehabilitation of deficits related to postural control (PC). However, the comparison of results between core stability and sensory-motor exercises in the literature is limited to sitting and standing positions.ObjectiveTo determine the acute effect of core stability and sensory-motor exercises on PC during sitting and standing in young adults.MethodsA total of 39 participants, with a mean age of 23 years, were randomly divided into three groups (1) Core stability exercises; (2) Sensory-motor exercises; (3) Control. Each group performed a sequence of five specific exercises of core stability and sensory-motor exercises (except controls). PC was evaluated before and after exercise in the seated and the one-legged stance conditions using a force platform.ResultsNo significant difference was found for any variables of postural oscillation (P > 0.05) among the three groups studied. The magnitude of the effect of interventions in general was a small to moderate effect (d = 0.02/-0.48).ConclusionThe findings show that acute intervention with core stability and sensory-motor exercises did not produce any significant effects (reduction of postural oscillation) on PC during sitting and standing positions in young adults.  相似文献   

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