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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability
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Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability

机译：患有慢性踝关节不稳的年轻成年人的足部和踝部肌肉量减少

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Background: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain. Purpose: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Five patients with CAI (mean age, 23.0 ± 4 years; 1 male, 4 females) and 5 healthy controls (mean age, 23.8 ± 4.5 years; 1 male, 4 females) volunteered for this study. Novel fast-acquisition magnetic resonance imaging (MRI) was used to scan from above the femoral condyles through the foot and ankle. The perimeter of each muscle was outlined on each axial slice and then the 2-dimensional area was multiplied by the slice thickness (5 mm) to calculate the muscle volume. Plantar flexion, dorsiflexion, inversion, and eversion isometric strength were measured using a handheld dynamometer. Patients with CAI were compared with healthy controls on all measures of muscle volume and strength. Extrinsic muscle volumes of patients with CAI were also compared with a normative database of healthy controls (n = 24) by calculating z scores for each muscle individually for each CAI subject. Results: The CAI group had smaller total shank, superficial posterior compartment, soleus, adductor hallucis obliqus, and flexor hallucis brevis muscle volumes compared with healthy controls as indicated by group means and associated 90% CIs that did not overlap. Cohen d effect sizes for the significant group differences were all large and ranged from 1.46 to 3.52, with 90% CIs that did not cross zero. The CAI group had lower eversion, dorsiflexion, and 4-way composite ankle strength, all with group means and associated 90% CIs that did not overlap. No other significant differences were identified. Conclusion: Patients with CAI demonstrate atrophy of intrinsic and extrinsic foot and ankle musculature accompanied by lower ankle strength. Clinical Relevance: Clinicians should be aware of the muscle atrophy and strength deficits when prescribing rehabilitation for patients with lateral ankle sprain or CAI.
机译：背景：与没有踝关节扭伤史的健康同行者相比，患有慢性踝关节不稳（CAI）的患者表现出神经肌肉功能改变和肌肉力量下降。到目前为止，尚未对CAI患者的肌肉体积进行分析，以判断复发性扭伤后是否存在肌肉尺寸不足。目的：分析患有和不患有CAI的年轻人的内在和外在的脚部和踝部肌肉的体积以及4向脚踝的力量。研究设计：横断面研究;证据等级，3。方法：5名CAI患者（平均年龄，23.0±4岁; 1名男性，4名女性）和5名健康对照（平均年龄，23.8±4.5岁; 1名男性，4名女性）自愿参加了这项研究。新型快速采集磁共振成像（MRI）用于通过脚和脚踝从股骨dy上方进行扫描。在每个轴向切片上勾勒出每个肌肉的周长，然后将二维区域乘以切片厚度（5毫米）以计算肌肉体积。使用手持式测功机测量in屈，背屈，内翻和外翻等距强度。将CAI患者与健康对照组的肌肉体积和力量的所有指标进行了比较。通过计算每个CAI受试者的每条肌肉的z值，还将CAI患者的外在肌肉体积与健康对照组的规范数据库（n = 24）进行比较。结果：与对照组相比，CAI组的小腿，浅表后房，比目鱼肌，斜肌内收肌和短屈屈拇小肌的体积较小，相关的90％CI没有重叠。显着性组差异的Cohen d效应大小都很大，范围从1.46到3.52，其中90％的置信区间不为零。 CAI组的外翻，背屈和四向综合踝关节强度较低，均具有组均值和相关的90％CI且不重叠。没有发现其他显着差异。结论：CAI患者表现出脚和踝肌肉的内在和外在萎缩，同时踝关节强度降低。临床意义：在为踝关节扭伤或CAI的患者开具康复处方时，临床医生应意识到肌肉萎缩和力量不足。

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