踝关节骨折患者的等速肌力、平衡能力及步态特征分析

Analysis of isokinetic muscle strength, balance ability and gait characteristics in patients with ankle fractures

  • 摘要:
    目的 探讨踝关节骨折患者的等速肌力、平衡能力和步态特征, 为制订康复计划及疗效评估标准提供参考。
    方法 选取36例踝关节骨折患者纳入实验组,同时招募20例健康人员纳入对照组。检测并比较2组受试者的踝关节与髋关节等速肌力、平衡能力及步态特征。
    结果 角速度为60°/s和120°/s时,实验组髋关节外展、伸展等速肌力相对峰力矩均低于对照组,踝关节跖屈、背伸等速肌力相对峰力矩均低于对照组,差异有统计学意义(P < 0.05)。实验组平衡仪测量指标(重心摆动轨迹长度、重心摆动外周面积)均大于对照组,差异有统计学意义(P < 0.05); 实验组Tinetti平衡与步态量表(POMA)评分低于对照组,差异有统计学意义(P < 0.05); 根据Tinetti POMA评分标准,实验组有跌倒风险(Tinetti POMA评分 < 24分)者占比高于对照组,差异有统计学意义(P < 0.05)。实验组步态周期中的患侧髋关节活动度、步长、步速均小于对照组,且步态周期长于对照组,差异有统计学意义(P < 0.05)。
    结论 经一定时间康复后,踝关节骨折患者的踝关节等速肌力、髋关节等速肌力、平衡能力和步态功能与健康人群相比仍存在差距,这一发现对后续康复计划制订和疗效评估具有重要意义。

     

    Abstract:
    Objective To investigate the isokinetic muscle strength, balance ability and gait characteristics in patients with ankle fractures, providing references for the formulation of rehabilitation plans and the establishment of efficacy evaluation criteria.
    Methods Thirty-six patients with ankle fracture were selected as experimental group, while 20 healthy individuals were recruited as control group. The isokinetic muscle strength of the ankle and hip joints, balance ability, and gait characteristics of the two groups were measured and compared.
    Results At angular velocities of 60°/s and 120°/s, the relative peak torque of isokinetic muscle strength for hip abduction and extension in the experimental group was significantly lower than that in the control group (P < 0.05). Similarly, the relative peak torque of isokinetic muscle strength for ankle plantarflexion and dorsiflexion in the experimental group was also significantly lower than those in the control group (P < 0.05). The balance instrument measurement indicators (length of center of gravity sway trajectory, peripheral area of center of gravity sway) in the experimental group were significantly greater than those in the control group (P < 0.05). The Tinetti Performance-Oriented Mobility Assessment (POMA)score in the experimental group was significantly lower than that in the control group (P < 0.05). According to the Tinetti POMA scoring criteria, the proportion of individuals at risk of falling (Tinetti POMA score < 24) in the experimental group was significantly higher than that in the control group (P < 0.05). The range of motion of the affected hip joint, stride length, and walking speed during the gait cycle in the experimental group were significantly smaller than those in the control group, while the gait cycle duration was significantly longer (P < 0.05).
    Conclusion After a certain period of rehabilitation, there is a certain gap in the isokinetic muscle strength of the ankle and hip joints, balance ability, and gait function between patients with ankle fractures and healthy individuals. Our findings in the study are of great significance for the subsequent formulation of rehabilitation plans and efficacy evaluation.

     

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