تغییرپذیری الگوی حرکتی مفصل مچ پا حین راه رفتن در افراد دارای بی ثباتی عملکردی مچ پا: مقاله مروری

نوع مقاله: مقاله مروری

نویسندگان

1 دانشجوی دکتری بیومکانیک ورزشی، دانشکده تربیت بدنی و علوم ورزشی ، دانشگاه خوارزمی تهران

2 استاد تمام بیومکانیک ورزشی، دانشکده تربیت بدنی و علوم ورزشی ، دانشگاه خوارزمی تهران

چکیده

مقدمه و اهداف
مستند است که یکی از مهمترین یافته­ها در افراد دارای بی­ثباتی عملکردی مچ­پا، تغییر کینماتیک مفصل مچ پا قبل از برخورد پاشنه در راه رفتن است، بنابراین پذیرفتنی است که تغییر در کینماتیک مفصلی را یکی از دلایل احتمالی بازگشت مجدد اسپرین مچ پا در نظر گرفت. اگرچه مکانیک پا و مچ پا نقش مهمی در رخداد این آسیب ایفا می­کند، اما به طور کامل قادر به بروز دادن مکانیزم­های نهفته در بی­ثباتی عملکردی مچ پا نمی­باشد. به همین علت امروزه محققین پیشنهاد کرده­اند تغییرات نامناسب در کنترل عصبی-عضلانی در بروز بی­ثباتی عملکردی مچ پا نقش مهم­تری ایفا می­کنند. هدف مقاله حاضر، مروری بر مطالعات موجود بر تغییرپذیری الگوی حرکتی مفصل مچ پا و استراتژی­های کنترل عصبی- عضلانی در افراد دارای بی ثباتی عملکردی مچ پا است.
مواد و روش­ها
جستجوی مقالات در پایگاه­های اطلاعاتی معتبر نظیرProQuest, Pub Med, Science Direct با جستجوی کلمات، بی­ثباتی عملکردی مچ پا، تغییرپذیری، راه رفتن و کنترل عصبی-عضلانی، در بازه زمانی 1960 میلادی تا 2016 میلادی انجام و بررسی نهایی بر روی 65 مقاله با ارتباط مستقیم انجام شد.
نتیجه­گیری
نتایج ارائه شده در مطالعاتی که تاکنون در خصوص شناسایی مکانیزم­های نهفته در بی­ثباتی عملکردی مچ­پا انجام شده بیانگر تفاوت نگاه دینامیک غیرخطی و خطی است، مطالعات انجام شده بیانگر این واقعیت هستند که بررسی کینماتیکی این پدیده به دلیل پیچیدگی پدیده­ی کنترل عصبی-عضلانی و نقش ترکیبی مکانیزم­های باز در رخداد بی­ثباتی عملکردی مچ پا به تنهایی نمی­تواند پاسخگو باشد. بنابراین تحقیقات بیشتری مورد نیاز است تا استراتژ­ی­های کنترل عصبی- عضلانی در افراد با بی ثباتی مچ پا را مورد بررسی قرار دهند.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Ankle Movement Pattern Variation during Walking in People with Functional Ankle Instability: A Review Article

نویسندگان [English]

  • Mohammad Yousefi 1
  • Hiedar Sadeghi 2
1 PhD Student of Sport Biomechanics, School of Physical Education, Kharazmi University of Tehran, Tehran, Iran
2 Full Professor of Sport Biomechanics, School of Physical Education, Kharazmi University of Tehran, Tehran, Iran
چکیده [English]

Background and Aim: It is known that one of the most important findings in people with functional ankle instability is change of joint kinematic before ankle's contact during walking, thus it is acceptable that change in joint kinematic can be considered as one of the probable reasons of sprained ankle relapse. Although the mechanic of foot and ankle play a significant role in the occurrence of this injury, it fails to completely expose mechanisms hidden in functional ankle instability. For this reason, today, researchers have suggested that improper variation in neuromuscular control plays a more important role in the occurrence of ankle functional instability. The present article was carried out to review the literature on variation of ankle joint movement pattern and neuromuscular control strategies in individuals with functional ankle instability.
Materials and methods: The survey was performed on articles in credible databases such as ProQuest, ScienceDirect, and Pubmed Medline, searching for the terms functional ankle instability, variability, walking gait, neuromuscular control, during 1960 to 2016. A total of 65 articles with direct relevance were selected for the analysis.
Conclusion: Results reported in the studies conducted regarding identification of mechanisms hidden in functional ankle instability suggest disparity between dynamic nonlinear view and linear view. These studies showed that kinematic consideration of this phenomenon cannot, per se, be practical in the occurrence of functional ankle instability due to complexity of neuromuscular control phenomenon and combinatory role of open and close mechanisms. Thus, further investigation is required to study neuromuscular control strategies in people with functional ankle instability.

کلیدواژه‌ها [English]

  • Functional ankle instability
  • variation
  • Walking
  • neuromuscular control
  1. Waterman BR. Epidemiology of ankle sprain at the United States Military Academy. The American Journal of Sports Medicine. 2010; 38(4):797-803.##
  2.  Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ, Jr. The epidemiology of ankle sprains in the United States. Journal of Bone and Joint Surgery American. 2010; 92(13):2279-2284. ##
  3. Fong DT-P. A systematic review on ankle injury and ankle sprain in sports. Sports medicine (Auckland). 2007; 37(l):73-94. ##
  4. McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. British Journal of Sports Medicine. 2001; 35(2): 103-108. ##
  5. Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. The American Journal of Sports Medicine. 1977; 5:241-242. ##
  6. Gerber JP, Williams GN, Scoville CR, Arciero RA, Taylor DC. Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle International. 1998; 19:653-660. ##
  7. Hertel J. Functional instability following lateral ankle sprain. Sports Medicine 2000; 29:361-371. ##
  8. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. Journal of Athletic Training 2002; 37:364-375. ##
  9. Freeman MA, Dean MR, Hanham IW. The etiology and prevention of functional instability of the foot. Journal of Bone and Joint Surgery. 1965; 47:678-685. ##
  10. Hubbard TJ, Kramer LC, Denegar CR, Hertel J. Correlations among multiple measures of functional and mec
  11. Hiller CE, Nightingale E, Lin C, Coughlan G, Caulfield B, Delahunt E. Characteristics of people with recurrent ankle sprains: a systematic review with meta-analysis. British Journal of Sports Medicine. 2011; 45(8):660-672. ##
  12. Brown C. Foot clearance in walking and running in individuals with ankle instability. The American Journal of Sports Medicine. 2011; 39(8): 1769-1776. ##
  13.  Brown C, Padua D, Marshall SW, Guskiewicz K. Individuals with mechanical ankle instability exhibit different motion patterns than those with functional ankle instability and ankle sprain copers. Clinical Biomechanics. 2008; 23(6):822-831. ##
  14. Brown CN. Variability of motion in individuals with mechanical or functional ankle instability during a stop jump maneuver. Clinical Biomechanics (Bristol). 2009; 24(9):762-768. ##
  15. Drewes LK. Dorsiflexion deficit during jogging with chronic ankle instability. Journal of Science and Medicine in Sport. 2009; 12(6):685-687. ##
  16. Drewes LK, Lee SY, McKeon PO, Paolini G, Kerrigan DC, Hertel J. Side-to-side Comparisons of Ankle Kinematics During Gait Among Individuals with Unilateral Chronic Ankle Instability. Medicine & Science in Sports & Exercise. 2008; 40(5):
  17. Drewes LK, McKeon PO, Paolini G, et al. Altered Ankle Kinemati##cs and Shank- Rear-Foot Coupling in Those With Chronic Ankle Instability. Journal of Sport Rehabilitation. 2009; 18(3):375-388. ##
  18. Hertel, J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clinics in Sports Medicine. 2008; 27, 353–370. ##
  19.  Wikstrom E. A, Hubbard-Turner T, & McKeon, P. O. Understanding and treating lateral ankle sprains and their consequences: A constraints-based approach. Sports Medicine. 2013##
  20.  Dugan SA, Bhat KP. Biomechanics and analysis of running gait. Physical Medicine and Rehabilitation Clinics of North America. 2005; 16(3):603-621. ##
  21. Hamel AJ. Relative motions of the tibia, talus, and calcaneus during the stance phase of gait: a cadaver study. Gait and Posture. 2004; 20(2): 147-153. ##
  22. Scott SH. Talocrural and talocalcaneal joint kinematics and kinetics during the stance phase of walking. Journal of Biomechanics. 1991; 24(8):743-752. ##
  23. Arndt A. Ankle and subtalar kinematics measured with intra cortical pins during the stance phase of walking. Fool & Ankle International. 2004; 25(5):357-364. ##
  24. Cornwall MW. Classification of frontal plane rear foot motion patterns during the stance phase of walking. Journal of the American Podiatric Medical Association. 2009; 99(5):399-405. ##
  25. Carson MC. Kinematic analysis of a multi-segment foot model for research and clinical applications: a repeatability analysis. Journal of Biomechanics. 2001; 34(10): 1299-1307. ##
  26.  Sadeghi H, Sadeghi S, Prince, F, Allard, P, Labelle, H, Vaughan L. CFunctional roles of ankle and hip sagittal muscle moments in able-bodied gait. Journal of Clinical Biomechanics.. 2001; 16(8):688-695. ##
 

  1. Eslami M, Begone M, Hinse S, Sadeghi H, Popov P, Allard P. Effect of Foot Orthoses on Magnitude and Timing of Rearfoot and Tibial Motions, Ground Reaction Force and Knee Moment During Running. Journal of Science and Medicine in Sport. 2008; 12(6): 679-684. ##
  2. Stormont DM, Morrey B, An KN, Cass J. Stability of the loaded ankle. Relation between articular restraint and primary and secondary static restraints. The American Journal of Sports Medicine. 1985; 13(5):295-300. ##
  3.  Nigg BM. Elongation and forces of ankle ligaments in a physiological range of motion. Foot & ankle. 1990; 11(1):30-40. ##
  4. Konradsen L, Voigt M. Inversion injury biomechanics in functional ankle instability: a cadaver study of simulated gait. Scandinavian Journal of Medicine &Science in Sports. 2002; 12(6):329. ##
  5. Giza E. Mechanisms of foot and ankle injuries in soccer.The American Journal of Sports Medicine. 2003; 31(4):550-554. ##
  6. Monaghan K, Delahunt E, Caul Held B. Ankle function during gait in patients with chronic ankle instability compared to controls. Clinical Biomechanics (Bristol. Avon). 2006; 21 (2): 168-174. ##
  7.  Fong DT-P, Hong Y, Shima Y, Krosshaug T, Yung P, Chan KM. Biomechanics of supination ankle sprain: a case report of an accidental injury event in the laboratory. The American Journal of Sports Medicine.2009; 37(4):822-827. ##
  8. Doherty C., Bleakley Ch., Hertel J., Caulfield B., Ryan J., Delahunt E. Lower extremity function during gait in participants with first time acute lateral ankle sprain compared to controls. Journal of Electromyography and Kinesiology. Journal of Electromyography and Kinesiology. 2015; 25:182–192. ##
  9.  Hamacher D, Hollander K, Zech A. Effects of ankle instability on running gait ankle angles and its  variability in young adults. Clinical Biomechanics.2016; 33:73-78. ##
  10. Terada M., Bowker S., Abbey C. T., Pietrosimone B., Hiller E. C., Rice S. M., Gribble A. Ph. Alterations in stride – to – stride variability during walking in individuals with chronic ankle instability. Human Movement Science 2015; 40:154-162. ##
  11.  Moore BD, Drouin J, Gansneder BM, Shultz SJ. The differential effects of fatigue on reflex response timing and amplitude in males and females. Journal of Electromyography and Kinesiology. 2002; 12:351-360. ##
  12. Santello M. Review of motor control mechanisms underlying impact absorption from falls. Gait and Posture 2005; 21:85-94. ##
  13. Johansson H, Sjolander P, Sojka P. A sensory role for the cruciate ligaments. Clinical Orthopedic and Related Research. 1991; 268:161-178.
  14. Konradsen L, Ravn JB. Ankle instability caused by prolonged peroneal reaction time. Acta Orthopedica Scandinavica. 1990; 61:388-390. ##
  15. Lynch SA., Eklund U., Gottlieb D., Renstrom PAFH., Beynnon B. Electromyographic latency changes in the ankle musculature during inversion moments. The American Journal of Sports Medicine.1996; 24(3): 362-369. ##
  16.  Sheth p., Bing Y., Laskowski ER., Kai-Nan A. Ankle disk training influences reaction times of selected muscles in simulated ankle sprain. The American Journal of Sports Medicine.1997; 25(4): 538-543. ##
  17. Konradsen L., Voigt M., Hojsgaard C. Ankle inversion injuries. The role of the dynamic defense mechanism. The American Journal of Sports Medicine.1997; 25:54-58. ##
  18. Konradsen L, Olesen S, Hansen HM. Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. The American Journal of Sports Medicine. 1998; 26(1):72–7. ##
  19.  Hoch MC, McKeon PO. Peroneal reaction time is not a risk factor for ankle sprain in healthy adults. Journal of Sport Rehabilitation. 2011; 20(4), 505–511. ##
  20. Hoch C. M., Mckeon O. P. Peroneal Reaction Time after Ankle Sprain: A Systematic Review and Meta-analysis. Medicine and Science in Sports and Exercise. 2013; 46(3): 546-556. ##
  21. Karlsson J, Andreasson GO. The effect of external ankle support in chronic lateral ankle joint instability. An electromyographic study. The American Journal of Sports Medicine. 1992; 20:257-261. ##
  22. Lofvenberg R, Karrholm J, Sundelin G, Ahlgren O. Prolonged reaction time in patients with chronic lateral instability of the ankle. The American Journal of Sports Medicine. 1995; 23:414-417. ##
  23. Ebig M, Lephart SM, Burdett RG, Miller MC, Pincivero DM. The effect of sudden inversion stress on EMG activity of the peroneal and tibialis anterior muscles in the chronically unstable ankle. The Journal of Orthopedic and Sports Physical Therapy. 1997; 26:73-77. ##
  24.  Fernandes N, Allison GT, Hopper D. Peroneal latency in normal and injured ankles at varying angles of perturbation. Clinical Orthopedic and Related Research. 2000; 375:193-201. ##
 

  1. Vaes P, Van Gheluwe B, Duquet W. Control of acceleration during sudden ankle supination in people with unstable ankles. The Journal of Orthopedic and Sports Physical Therapy. 2001; 31:741-752. ##
  2. Vaes P, Duquet W, Van Gheluwe B. Peroneal reaction times and eversion motor response in healthy and unstable ankles. Journal of Athletic Training. 2002; 37:475-480. ##
  3. Munn J, Sullivan SJ, Schneiders AG. Evidence of sensorimotor deficits in functional ankle instability: a systematic review with meta-analysis. Journal of Science and Medicine in Sport. 2010; 13(1):2–12. ##
  4. Benesch S, Putz W, Rosenbaum D, Becker H. Reliability of peroneal reaction time measurements. Clinical Biomechanics. 2000; 15:21-28. ##
  5. Hopkins JT, Palmieri R. Effects of ankle joint effusion on lower leg function. Clinical Journal of Sport Medicine. 2004; 14:1-7. ##
  6. Gruneberg C, Nieuwenhuijzen PH, Duysens J. Reflex responses in the lower leg following landing impact on an inverting and non-inverting platform. The Journal of Physiology. 2003; 550:985-993. ##
  7. Duncan A, McDonagh MJ. Stretch reflex distinguished from pre-programmed muscle activations following landing impacts in man. The Journal of Physiology. 2000; 526 Pt 2:457-468. ##
  8. Santello M. Review of motor control mechanisms underlying impact absorption from falls. Gait and Posture 2005; 21:85-94. ##
  9. Richardson, CA, Paul Hodges, and JA Hides, Therapeutic exercise for lumbopelvic stabilization: a motor control approach for the treatment and prevention of low back pain2004: Churchill Livingstone. ##
  10. Delahunt E, Monaghan K, Caulfield B. Changes in lower limb kinematics, kinetics, and muscle activity in  subjects with functional instability of the ankle joint during a single leg drop jump. Journal of Orthopedic Research. 2006; 24:1991-2000. ##
  11. Caulfield B, Garrett M. Changes in ground reaction force during jump landing in subjects with functional instability of the ankle joint. Clinical Biomechanics (Bristol, Avon). 2004; 19:617-621. ##
  12. Rein, S., Fabian, T., Weindel, S., Schneiders, W., & Zwipp, H. The influence of playing level on functional ankle stability in soccer players. Archives Orthopaedic and Trauma Surgery, 2011; 131: 1043-1052. ##
  13. M_endez-Rebolledo, G., et al., Longer reaction time of the fibularis longus muscle and reduced postural control in basketball players with functional ankle instability: A pilot study, Physical Therapy in Sport (2014): 1-6. ##
  14. Witchalls, J., Waddington, G., Adams, R., & Blanch, P. Chronic ankle instability affects learning rate during repeated proprioception testing. Physical Therapy in Sport, 2014; 15: 106-111. ##
  15. Hopkins JT, Coglianese M, Glasgow P, Reese S, Seeley MK. Alterations in evertor/invertor muscle activation and center of pressure trajectory in participants with functional ankle instability. J Electromyogr Kinesiol. 2012; 22(2):280-285. ##