摘要
目的急性踝关节扭伤是最常见的骨与关节损伤之一,踝关节扭伤后容易造成踝关节不稳,导致反复扭伤,严重影响患者的生活质量。本研究针对急性单侧踝关节扭伤后双下肢平衡功能的变化进行Meta分析,了解受伤前后患者的平衡功能状况。方法采用Cochrane系统评价方法,检索Cochrane图书馆临床对照试验数据库、Medline网上数据库、Science Direct、中国生物医学文献服务系统等数据库,2名评价员独立提取信息并评价文献质量后交叉比对,采用Rev Man 5.3软件进行Meta分析。结果共有4篇文献进入急性单侧踝关节扭伤后双下肢平衡功能比较的Meta分析,研究对象共202例;3篇文献进入急性单侧踝关节扭伤前平衡功能比较的Meta分析,研究对象共220例。利用标准化均数差(SMD)分析显示,急性单侧踝关节扭伤后患侧下肢(SMD=0.73,Z=4.99,P<0.000 01)及健侧下肢(SMD=0.69,Z=4.71,P<0.000 01)与正常对照组相比平衡功能均有下降,生物力学方面表现为单足站立时重心摆动指数增大,重心偏移速度增大等,发生踝关节扭伤的患者,受伤前即存在一些生物力学特征异常(SMD=0.42,Z=2.41,P<0.05),差异有统计学意义。结论急性单侧踝关节扭伤患者双下肢平衡功能均受损,这些异常可能在受伤前就存在。在今后的研究中不适合将这类患者的健侧下肢作为对照组,并且在康复训练时建议进行双下肢平衡功能训练,预防再次扭伤。
Objective Acute ankle sprain is one of the most common injuries in musculoskeletal system.Ankle sprainoften result in chronic ankle instability,which largely decreases patients'life quality.The purpose of this meta-analysis was to assessthe effects of acute lateral ankle sprain on balance of the involved and uninvolved limb,and find the biomechanical characters ofankle sprain subjects.Methods Cochrane systematic evaluation was used to search through Cochrane database for systematicreviews,PubMed,ScienceDirect and SinoMed database.The quality of literatures was independently evaluated and cross-checked bytwo evaluators.The results were analyzed with RevMan5.3software.Results Four articles were involved in the Meta analysis ofbalance change after unilateral ankle sprain,with total202patients,three articles were involved in the Meta analysis of biomechanicalcharacters before ankle sprain,with220patients.We used standardized mean difference analysis to found,balance of both the injured limb(SMD=0.73,Z=4.99,P<0.00001)and uninjured limb(SMD=0.69,Z=4.71,P<0.00001)were impaired after acute ankle sprains,there aresome biomechanical characters before ankle sprian(SMD=0.42,Z=2.41,P<0.05).Biokinetic performances include increasing in centralof pressure velocity,sway index,and so on.Conclusion Bilateral balance deficits were found in patients suffered from acute anklesprains,these deficits may have before ankle sprian.It's inappropriate to use the uninjured limb as normal control in future studies.Wesuggest rehabilitation for acute ankle sprain patients should include bilateral balance trainings to prevent re-sprains.
作者
张冉
于惠贤
胡志伟
陈亚平
ZHANG Ran;YU Hui-xian;HU Zhi-wei;CHEN Ya-ping(Deparment of Rehabilitation, Beijing Tongren Hospital of Capital Medical University, Beijing 100730, China)
出处
《足踝外科电子杂志》
2016年第3期13-18,共6页
Electronic Journal of Foot and Ankle Surgery
