不同模式本体感觉神经肌肉促进技术干预对功能性踝关节不稳者平衡能力的影响

关键词：本体感觉神经肌肉促进技术  功能性踝关节不稳  平衡能力

Keywords:proprioceptive neuromuscular facilitation  functional ankle instability  balance ability

摘要：

      摘要 目的：探讨不同模式本体感觉神经肌肉促进技术（PNF）干预对功能性踝关节不稳患者平衡能力的影响。 方法：通过踝关节功能评价量表(ankle joint functional assessment tool， AJFAT)筛选出22位功能性踝关节不稳(functional ankle instability， FAI)的男性在校大学生，随机分成试验组与对照组，分别对两组患者进行4周站立位PNF干预和4周仰卧位PNF干预，两种体位分别采用弹力带施阻和徒手施阻。在干预前后对所有患者的踝关节功能评价问卷评分、闭目单脚站立实验、T型敏捷性测试(agility T-Test)、星状伸展平衡实验(star excursion balance tests， SEBT)进行评定，并于干预结束1个月后对患者进行随访。本实验结果采用意向性治疗分析和符合方案集分析。 结果：干预前两组患者组内健患侧间闭目单脚站立时间和SEBT评定结果存在显著差异(P<0.05)。干预4周后，试验组与对照组的AJFAT评分和Agility T-Test结果较干预前有显著提高(P<0.05)，两组受试者患侧静态平衡能力较干预前有显著提高(P<0.05)，试验组健侧静态平衡能力明显增强(P<0.05)，SEBT中两组患侧间比较，干预后前内(Anteromedial， AMED)方向差异有显著性意义(P<0.05)。随访结果显示，停止干预1个月后，两组受试者闭目单脚站立时间较干预前无明显变化(P>0.05)，AJFAT评分较干预前明显提高(P<0.05)。 结论：FAI患者的患侧下肢平衡能力弱于健侧；4周常规PNF干预与4周站立位PNF干预对于改善FAI患者下肢动态和静态平衡能力都有良好的作用；站立位PNF干预对健侧平衡能力以及患侧动态平衡能力改善的作用优于常规PNF干预。

Abstract:

      Abstract Objective： To investigate the effects of different modes of proprioceptive neuromuscular facilitation interventions（PNF） on balance ability of subjects with functional ankle instability. Method： A total of 22 male college students with functional ankle instability were selected by ankle joint functional assessment tool (AJFAT). All patients were divided into experimental group and control group randomly. The experimental group was given a 4-week standing position proprioceptive neuromuscular facilitation(PNF) treatment and the control group was given a 4 -week conventional PNF treatment. The elastic band or freehand resistance were used in the two positions respectively. Clinical effects of the two groups were evaluated by AJFAT， one-leg standing with eye-closed test， Agility T-Test， stellate extend balance test (SEBT). 12 patients were followed up one month after the intervention. The results of this experiment used intention to treat analysis and per protocol set to analyze. Result： Before treatment， both groups had significant difference in scores of one-leg standing with eye-closed test and SEBT between unaffected side and affected side(P<0.05). After 4-week treatment， the AJFAT score and Agility T-Test results of both groups increased(P<0.05)， the static balance ability of the affected side of the two groups significantly improved compared with that before the treatment(P<0.05)， and the static balance ability of unaffected side in the experimental group was significantly enhanced (P<0.05). Compared with the affected side of both groups in SEBT， the difference in AMED direction after treatment had statistically significant (P<0.05). The follow-up results showed that one month after the treatment， compared with before treatment， the score of one-leg standing with eye-closed test in both groups had no statistical significant difference(P>0.05)，while AJFAT score had obvious increase (P<0.05). Conclusion： Functional ankle instability(FAI) patients’ affected side balance ability were weaker than unaffected side. Both treatment methods can improve the dynamic and static balance of the lower limbs of FAI patients. The effect of standing position PNF in improving unaffected side balance ability and affected side dynamic balance ability is better than the conventional PNF treatment.