护踝对功能性踝关节不稳患者下肢运动生物力学特征的影响

目的 探究护踝对功能性踝关节不稳(functional ankle instability,FAI)患者的保护作用,为其护踝的选择提供依据。 方法 15 名 FAI 患者随机佩戴半刚性、弹性护踝及无护踝以自选速度步行和跑步,运用红外光点运动捕捉系统和三维测力台采集其下肢运动生物力学参数。 通过 3×2 重复设计的双因素方差分析检验护踝和运动模式对下肢运动学、动力学和能量吸收的影响。 结果 护踝与运动模式对本研究中所有指标均无交互作用(P>0. 05)。不论运动模式,与无护踝相比,弹性护踝显著减少了 FAI 患者踝关节内翻角峰值、内翻角速度和踝关节能量吸收(P<0. 05),同时增加了踝关节外翻力矩( P < 0. 001);而半刚性护踝增加了踝关节内翻角峰值和内翻角速度(P<0. 05)。 此外,弹性护踝可降低着地时刻的膝关节内旋力矩和外旋力矩峰值(P<0. 05)。 结论 与无护踝相比,弹性护踝通过减小踝关节内翻角、内翻角速度和能量吸收,增大踝关节外翻力矩,继而起到预防踝关节扭伤的作用。 FAI 患者佩戴半刚性护踝后需定时关注踝关节慢性损伤风险。 整体来看,弹性护踝的防护效果可能更有效,且未引起膝关节功能补偿,可作为预防 FAI 患者踝关节扭伤的有效措施。

Effects of Ankle Braces on Lower Extremity Biomechanics of Patients with Functional Ankle Instability

Objective To explore the protective mechanism of ankle braces in patients with functional ankle instability (FAI), so as to provide references for the selection of ankle braces. Methods Fifteen FAI patients randomly wore semi-rigid and elastic ankle braces or wore without braces for walking and running at the selfselected speed. The lower extremity biomechanical parameters were collected by infrared motion capture and three-dimensional (3D) force plate. The 3 × 2 repeated two-way ANOVA was used to test the effects of anklebrace and movement patterns on biomechanical parameters of the lower extremity. Results There was no interaction between ankle braces and movement patterns on all indexes in the study (P>0. 05). Regardless of movement patterns, compared with no ankle brace support, the elastic ankle brace significantly reduced peak ankle inversion angle, inversion angular velocity and energy absorption (P<0. 05) for ankle joint, and increased ankle eversion moment ( P < 0. 001). The semi-rigid ankle brace increased peak ankle inversion angle and inversion angular velocity ( P < 0. 05). In addition, the elastic ankle brace reduced the knee internal rotation moment at the landing moment and the peak knee external rotation moment (P<0. 05). Conclusions Compared with no ankle brace support, the elastic ankle brace reduced the ankle inversion angle, inversion angular velocity and energy absorption, increased the ankle eversion moment and played a role in preventing ankle sprain. For FAI patients wearing semi-rigid ankle brace, regular attention should be paid to the risk of chronic ankle injury.Overall, the protective effect of elastic ankle brace may be more prominent and does not cause knee joint function compensation, which can be used as an effective measure to prevent ankle sprain in FAI patients.