动静态平衡仪评定和治疗慢性踝关节不稳的临床研究
发布时间：2018-08-29 15:29
【摘要】：目的:探讨动静态平衡仪评估和治疗慢性踝关节不稳(CAI)患者踝关节稳定性的临床研究。方法:本研究收集慢性踝关节不稳(Chronic Ankle Instabiliy CAI)患者32例和无踝关节扭伤史的正常人群30例,选择2位已熟练掌握动静态平衡仪操作方法的治疗师A和治疗师B,在同一时间段应用Pro-kin252动静态平衡仪分别对62例受试者(CAI患者患侧踝关节和正常人群的单侧踝关节)进行踝关节的本体感觉预评估、多轴本体感觉评估,于此同时CAI患者根据患侧踝关节近况给予Cumberland不稳定评价问卷评估。治疗师A在1周内(于首次测量间隔3天)再次对62例受试者进行1次踝关节本体感觉评估。对62例受试者的3次评估结果采用等级相关系数(introclass correlation coefficient ICC)检验Pro-kin252动静态平衡仪的信度。对32例CAI患者3次的本体感觉预评估和多轴本体感觉评估指标的均值分别与Cumberland不稳定评价问卷评分进行Pearson相关性分析检验动静态平衡仪的效度。正常组与CAI组3次多轴本体感觉评估结果采用两独立样本t检验来检验Pro-kin252动静态平衡仪的灵敏度。之后将32例CAI患者,按就诊顺序及患者意愿分为对照组和治疗组。对照组16例患者,指导家中踝泵运动;治疗组16例患者,在此基础上增加动静态平衡训练。治疗时间为4周,分别对2组患者治疗前、后的Cumberland踝关节不稳定评价问卷评分、动静态平衡仪测试指标(平均轨迹差、平均负重力量差)进行比较,并比较治疗后2组患者疗效的差异。结果:Pro-kin252动静态平衡仪的重复测量信度ICC为0.831~0.959,95%可信区间集中;测量者间信度ICC为0.798~0.961,95%可信区间集中。动静态平衡仪多轴本体感觉评估指标:平均轨迹差,平均负重力量差与Cumberland踝关节不稳定评价问卷评分呈中度负相关(r=㧟0.421,-0.419 P0.05);Pro-kin252动静态平衡仪本体感觉预评估指标:前后稳定指数、左右稳定指数、A2-A6稳定指数、A4-A8稳定指数、圆周稳定指数与Cumberland踝关节不稳定评价问卷评分相关性弱(r=-0.003—-0.164 P0.05)。正常组与CAI组3次多轴本体感觉评估指标分别进行比较,差异均具有统计学意义(均P0.05)。32例CAI患者经4周治疗后,对照组患者患侧踝关节治疗前的平均轨迹差、平均负重力量差、Cumberland踝关节不稳定评价问卷评分与治疗后比较,差别不具有显著性(P0.05);治疗组患者治疗后平均轨迹差、平均负重力量差较治疗前显著降低,Cumberland踝关节不稳定评价问卷评分显著增高(P0.05)。比较治疗后治疗组与对照组的平均轨迹差、平均负重力量差、Cumberland踝关节不稳定评价问卷评分,差别具有显著性(P0.05)。结论:1.Pro-kin252动静态平衡仪测量踝关节稳定性具有较高的信度。2.Pro-kin252动静态平衡仪多轴本体感觉评估指标平均轨迹差和平均负重力量差可用来评估踝关节的稳定性,且具有较高的灵敏度。3.动静态平衡训练可以明显改善CAI患者踝关节的本体感觉,增强踝关节的稳定性。
[Abstract]:Objective: To evaluate the ankle stability of patients with chronic ankle instability (CAI) by dynamic and static balance instrument. Methods: 32 patients with chronic ankle instability (Chronic Ankle Instability CAI) and 30 normal people without history of ankle sprain were enrolled in this study. Therapist A and therapist B, at the same time, used Pro-kin252 dynamic and static balance instrument to pre-evaluate the proprioception of the ankle joints in 62 subjects (CAI patients'affected ankle joints and unilateral ankle joints in the normal population), and multi-axis proprioception assessment was performed. At the same time, CAI patients were assessed for Cumberland instability according to the recent status of the affected ankle joints. Price Questionnaire Assessment. Therapist A repeated ankle proprioceptive assessment in 62 subjects within one week (three days after the first measurement). The reliability of Pro-kin252 dynamic and static balancer was tested by introclass correlation coefficient (ICC) in the three assessments of 62 subjects. The proprioceptive assessment was performed in 32 CAI patients three times. Pearson correlation analysis was used to test the validity of the dynamic and static balancer by the mean values of sensory pre-assessment and multiaxial proprioceptive assessment indices, respectively. The sensitivity of Pro-kin252 dynamic and static balancer was tested by two independent sample t-tests in the normal group and CAI group. Thirty-two patients with CAI were divided into control group and treatment group according to the order of visiting and patients'wishes. Sixteen patients in control group were instructed to exercise the ankle pump at home. Sixteen patients in treatment group were given dynamic and static balance training on the basis of this. The treatment time was 4 weeks. The Cumberland ankle instability evaluation questionnaire scores before and after the treatment in the two groups were evaluated. Results: The ICC of Pro-kin252 dynamic and static balancer ranged from 0.831 to 0.959,95% confidence interval concentration, and the ICC of inter-tester reliability ranged from 0.798 to 0.961,95% confidence interval concentration. Pro-Kin 252 Dynamic and Static Balancer Pro-Sensory Pre-assessment Indicators: Pre-and Post-Pro Stability Index, Left and Right Stability Index, A2-A6 Stability Index, A4-A8 Stability Index, Circumferential Stability Index There was a weak correlation between the number of CAI patients and the score of the Cumberland Ankle Instability Assessment Questionnaire (r = - 0.003 -- 0.164 P Cumberland Ankle Joint Instability Assessment Questionnaire score after treatment, the difference was not significant (P 0.05); treatment group patients after treatment, the average trajectory difference, the average weight difference significantly lower than before treatment, Cumberland Ankle Joint Instability Assessment Questionnaire score significantly increased (P 0.05). There were significant differences in mean trajectory difference, mean negative weight difference and Cumberland ankle instability evaluation questionnaire score between the two groups (P 0.05). Conclusion: 1. Pro-kin252 dynamic and static balance instrument has high reliability in measuring ankle stability. 2. Pro-kin252 dynamic and static balance instrument has high reliability in evaluating the average trajectory difference and mean negative weight of multi-axis proprioceptive evaluation index. Poor can be used to assess the stability of the ankle, and has a high sensitivity. 3. Dynamic and static balance training can significantly improve the proprioception of the ankle in CAI patients, and enhance the stability of the ankle.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684
本文编号：2211627
[Abstract]:Objective: To evaluate the ankle stability of patients with chronic ankle instability (CAI) by dynamic and static balance instrument. Methods: 32 patients with chronic ankle instability (Chronic Ankle Instability CAI) and 30 normal people without history of ankle sprain were enrolled in this study. Therapist A and therapist B, at the same time, used Pro-kin252 dynamic and static balance instrument to pre-evaluate the proprioception of the ankle joints in 62 subjects (CAI patients'affected ankle joints and unilateral ankle joints in the normal population), and multi-axis proprioception assessment was performed. At the same time, CAI patients were assessed for Cumberland instability according to the recent status of the affected ankle joints. Price Questionnaire Assessment. Therapist A repeated ankle proprioceptive assessment in 62 subjects within one week (three days after the first measurement). The reliability of Pro-kin252 dynamic and static balancer was tested by introclass correlation coefficient (ICC) in the three assessments of 62 subjects. The proprioceptive assessment was performed in 32 CAI patients three times. Pearson correlation analysis was used to test the validity of the dynamic and static balancer by the mean values of sensory pre-assessment and multiaxial proprioceptive assessment indices, respectively. The sensitivity of Pro-kin252 dynamic and static balancer was tested by two independent sample t-tests in the normal group and CAI group. Thirty-two patients with CAI were divided into control group and treatment group according to the order of visiting and patients'wishes. Sixteen patients in control group were instructed to exercise the ankle pump at home. Sixteen patients in treatment group were given dynamic and static balance training on the basis of this. The treatment time was 4 weeks. The Cumberland ankle instability evaluation questionnaire scores before and after the treatment in the two groups were evaluated. Results: The ICC of Pro-kin252 dynamic and static balancer ranged from 0.831 to 0.959,95% confidence interval concentration, and the ICC of inter-tester reliability ranged from 0.798 to 0.961,95% confidence interval concentration. Pro-Kin 252 Dynamic and Static Balancer Pro-Sensory Pre-assessment Indicators: Pre-and Post-Pro Stability Index, Left and Right Stability Index, A2-A6 Stability Index, A4-A8 Stability Index, Circumferential Stability Index There was a weak correlation between the number of CAI patients and the score of the Cumberland Ankle Instability Assessment Questionnaire (r = - 0.003 -- 0.164 P Cumberland Ankle Joint Instability Assessment Questionnaire score after treatment, the difference was not significant (P 0.05); treatment group patients after treatment, the average trajectory difference, the average weight difference significantly lower than before treatment, Cumberland Ankle Joint Instability Assessment Questionnaire score significantly increased (P 0.05). There were significant differences in mean trajectory difference, mean negative weight difference and Cumberland ankle instability evaluation questionnaire score between the two groups (P 0.05). Conclusion: 1. Pro-kin252 dynamic and static balance instrument has high reliability in measuring ankle stability. 2. Pro-kin252 dynamic and static balance instrument has high reliability in evaluating the average trajectory difference and mean negative weight of multi-axis proprioceptive evaluation index. Poor can be used to assess the stability of the ankle, and has a high sensitivity. 3. Dynamic and static balance training can significantly improve the proprioception of the ankle in CAI patients, and enhance the stability of the ankle.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R684
【参考文献】
相关期刊论文 前1条
1 何伟华;李珂;独建库;黄涛;左新成;朱杏莉;;肌肉功能锻炼对慢性外踝关节不稳的治疗效果[J];实用医学杂志;2014年09期
，本文编号：2211627
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