解剖学报

解剖学报 ›› 2017, Vol. 48 ›› Issue (2): 165-169.doi: 10.16098/j.issn.0529-1356.2017.02.008

• 解剖学 • 上一篇    下一篇

完善慢性功能性关节不稳定康复疗效评估体系

于惠贤1 杨纯生2 张冉1 胡志伟1 何蕾1 陈亚平1*   

  1. 1.首都医科大学附属北京同仁医院康复医学科，北京 100730; 2. 新乡医学院第三附属医院康复科，河南 新乡 453003
  • 收稿日期:2016-08-22 修回日期:2016-09-04 出版日期:2017-04-06 发布日期:2017-04-06
  • 通讯作者: 陈亚平 E-mail:huixianyu@126.com
  • 基金资助:

    北京市医院管理局“青苗”计划专项经费资助;首都医科大学附属北京同仁医院科研种子基金资助项目

Validation of a system to evaluate chronic functional joint instability rehabilitation therapy

YU Hui-xian1 YANG Chun-sheng2 ZHANG Ran1 HU Zhi-wei1 HE Lei1 CHEN Ya-ping 1*   

  1. 1. Rehabilitation Department, Beijing Tongren Hospital ,Capital Medical University ,Beijing 100730,China; 2. Rehabilitation Department,,the Third Affiliated Hospital, Xinxiang Medical College, He’nan Xinxiang 453003, China

  • Received:2016-08-22 Revised:2016-09-04 Online:2017-04-06 Published:2017-04-06
  • Contact: CHEN Ya-ping E-mail:huixianyu@126.com

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摘要：

目的 对慢性踝关节不稳患者常规康复训练前后进行综合功能评估；采用综合康复治疗方法，观察其治疗效果。 方法 门诊选取124例单侧踝关节不稳患者，年龄34～56岁，其中男性73例，女性51例。分别进行肌力及关节活动度训练，平衡训练，本体觉训练，疗程为2个月，康复前后分别做即时、行走后疼痛［500 m走后，视觉模拟评分法(VAS)评定）］、患肢负重时间、星偏移距离平衡检查及动、静态足底压力评估。 结果 患足负重项康复前平均站立时间与康复后差异有显著统计学意义；即时VAS疼痛评分康复前与康复后差异显著 (5.32±0.27，1.07±0.08)；500 m步行VAS疼痛评分康复前后差异有显著性 (8.79±1.78，4.51±1.78)，且显著高于健侧(5.41±0.42，27.31±5.48)(P<0.05)；两组足底动、静态峰值压力分布无明显改变(P>0.05)，静态压力：健侧前足（1095.30±61.28）gr/cm2，患侧前足（1670.30±151.22）gr/cm2负重增加，动态压力：健侧（1654.98±294.27）gr/cm2，患侧前足（2822.30±312.28）gr/cm2 (P>0.05)。 结论 经过综合康复治疗后，患者即时疼痛得到明显缓解，平衡能力得到明显提高，但500 m步行后疼痛以及动静态足底压力无明显变化，生物力学未得到纠正，限制了治疗效果。

关键词: 慢性功能性踝关节不稳, 康复治疗, 足底压力, 动态平衡, 视觉模拟评分法, 人

Abstract:

Objective To investigate the assessment of patients with functional ankle instability prior to and post of regular rehabilitation therapies. Methods One hundred and twenty-four patients with unilateral chronic ankle instability (51 females and 73 males, age 34-56) were received conventional rehabilitation for two month, including muscle strength, range of joint motion, balance, proprioception, etc. The visual analogue scale（VAS）scores (instant pain and pain after 500-meter walk ) were recorded. Standing time of affected limb, the star excursion balance test, static and dynamic plantar pressure were performed. Results There were significant differences in VAS pain score of instant pain(5.32±0.27 vs 1.07±0.08) and after 500 meter walk (8.79±1.78 vs 4.51±1.78) (P<0.05), and standing time of affected limb and the star excursion balance test between the data after and before training. In contrast, no significant difference was observed in the groups of static and dynamic plantar pressure. Static: normal anterior foot（1095.30±61.28）gr/cm2 vs（1670.30±151.22）gr/cm2; Dynamic: normal anterior foot（1654.98±294.27）gr/cm2 vs affected limb（2822.30±312.28）gr/cm2 (P > 0.05). Conclusion Rehabilitation therapy can significantly improve the pain-release, the balance, etc. However, the effect on the dynamic response is not accurate. Thus, the abnormal of walking posture, the biomechanics of the foot and ankle, and biomechanics of functional ankle instability should be considered during the rehabilitation treatment. 

Key words: Functional ankle instability, Rehabilitation, Plantar pressure, Dynamic balance, Visual analogue scale pain scoring, Human