【摘要】：目的:探討動靜態(tài)平衡儀評估和治療慢性踝關(guān)節(jié)不穩(wěn)(CAI)患者踝關(guān)節(jié)穩(wěn)定性的臨床研究。方法:本研究收集慢性踝關(guān)節(jié)不穩(wěn)(Chronic Ankle Instabiliy CAI)患者32例和無踝關(guān)節(jié)扭傷史的正常人群30例,選擇2位已熟練掌握動靜態(tài)平衡儀操作方法的治療師A和治療師B,在同一時間段應(yīng)用Pro-kin252動靜態(tài)平衡儀分別對62例受試者(CAI患者患側(cè)踝關(guān)節(jié)和正常人群的單側(cè)踝關(guān)節(jié))進行踝關(guān)節(jié)的本體感覺預(yù)評估、多軸本體感覺評估,于此同時CAI患者根據(jù)患側(cè)踝關(guān)節(jié)近況給予Cumberland不穩(wěn)定評價問卷評估。治療師A在1周內(nèi)(于首次測量間隔3天)再次對62例受試者進行1次踝關(guān)節(jié)本體感覺評估。對62例受試者的3次評估結(jié)果采用等級相關(guān)系數(shù)(introclass correlation coefficient ICC)檢驗Pro-kin252動靜態(tài)平衡儀的信度。對32例CAI患者3次的本體感覺預(yù)評估和多軸本體感覺評估指標的均值分別與Cumberland不穩(wěn)定評價問卷評分進行Pearson相關(guān)性分析檢驗動靜態(tài)平衡儀的效度。正常組與CAI組3次多軸本體感覺評估結(jié)果采用兩獨立樣本t檢驗來檢驗Pro-kin252動靜態(tài)平衡儀的靈敏度。之后將32例CAI患者,按就診順序及患者意愿分為對照組和治療組。對照組16例患者,指導(dǎo)家中踝泵運動;治療組16例患者,在此基礎(chǔ)上增加動靜態(tài)平衡訓(xùn)練。治療時間為4周,分別對2組患者治療前、后的Cumberland踝關(guān)節(jié)不穩(wěn)定評價問卷評分、動靜態(tài)平衡儀測試指標(平均軌跡差、平均負重力量差)進行比較,并比較治療后2組患者療效的差異。結(jié)果:Pro-kin252動靜態(tài)平衡儀的重復(fù)測量信度ICC為0.831~0.959,95%可信區(qū)間集中;測量者間信度ICC為0.798~0.961,95%可信區(qū)間集中。動靜態(tài)平衡儀多軸本體感覺評估指標:平均軌跡差,平均負重力量差與Cumberland踝關(guān)節(jié)不穩(wěn)定評價問卷評分呈中度負相關(guān)(r=㧟0.421,-0.419 P0.05);Pro-kin252動靜態(tài)平衡儀本體感覺預(yù)評估指標:前后穩(wěn)定指數(shù)、左右穩(wěn)定指數(shù)、A2-A6穩(wěn)定指數(shù)、A4-A8穩(wěn)定指數(shù)、圓周穩(wěn)定指數(shù)與Cumberland踝關(guān)節(jié)不穩(wěn)定評價問卷評分相關(guān)性弱(r=-0.003—-0.164 P0.05)。正常組與CAI組3次多軸本體感覺評估指標分別進行比較,差異均具有統(tǒng)計學(xué)意義(均P0.05)。32例CAI患者經(jīng)4周治療后,對照組患者患側(cè)踝關(guān)節(jié)治療前的平均軌跡差、平均負重力量差、Cumberland踝關(guān)節(jié)不穩(wěn)定評價問卷評分與治療后比較,差別不具有顯著性(P0.05);治療組患者治療后平均軌跡差、平均負重力量差較治療前顯著降低,Cumberland踝關(guān)節(jié)不穩(wěn)定評價問卷評分顯著增高(P0.05)。比較治療后治療組與對照組的平均軌跡差、平均負重力量差、Cumberland踝關(guān)節(jié)不穩(wěn)定評價問卷評分,差別具有顯著性(P0.05)。結(jié)論:1.Pro-kin252動靜態(tài)平衡儀測量踝關(guān)節(jié)穩(wěn)定性具有較高的信度。2.Pro-kin252動靜態(tài)平衡儀多軸本體感覺評估指標平均軌跡差和平均負重力量差可用來評估踝關(guān)節(jié)的穩(wěn)定性,且具有較高的靈敏度。3.動靜態(tài)平衡訓(xùn)練可以明顯改善CAI患者踝關(guān)節(jié)的本體感覺,增強踝關(guān)節(jié)的穩(wěn)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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R684

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相關(guān)期刊論文 前1條

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本文編號：2211627