踝关节松动术联合臀肌力量训练治疗慢性足底筋膜炎的疗效分析

关键词：足底筋膜炎  关节松动  臀肌训练

Keywords:plantar fasciitis  joint mobilization  hip strengthening

摘要：

      摘要 目的：观察踝关节松动联合臀肌力量训练对慢性足底筋膜炎的疗效。 方法：选取慢性足底筋膜炎患者50例，随机分为对照组（n=25）和观察组（n=25），两组患者均常规进行小腿肌肉牵伸，在此基础上，对照组给予踝关节松动训练，观察组给予踝关节松动训练联合臀肌力量训练。两组患者均在治疗前、疗程结束时和随访3个月后进行视觉模拟疼痛评分（VAS）和美国矫形外科足踝协会踝-后足评分系统（AOFAS）评分，以及髋关节后伸和外展肌力评估、踝关节背屈活动度评估。 结果：疗程结束时，两组患者的踝关节背屈活动度均较治疗前改善，但两组间对比无显著性意义。随访3个月时，观察组踝关节背屈活动度较对照组大，对比有显著性意义。不同时间对照组的臀肌力量对比无显著性意义。治疗前和疗程结束时观察组的臀肌力量对比无显著性意义，但是随访3个月时的力量大于疗程结束时和治疗前。疗程结束时，两组患者的VAS和AOFAS评分均较治疗前明显改善，但两组间比较差异无显著性意义。随访3个月后，VAS评分观察组降低为（1.52±0.77）分，对照组为（2.68±0.85）分，两组间差异有显著性意义（P=0.003）；AOFAS评分观察组为（89.64±6.52）分，对照组为（81.24±6.11）分，两组间差异有显著性意义（P<0.001）。 结论：踝关节松动联合臀肌力量训练是治疗慢性足底筋膜炎的有效手段。

Abstract:

      Abstract Objective： To evaluate the effectiveness of ankle joint mobilization combined hip strengthening on pain and function of patients with chronic plantar fasciitis （PF）. Method： Fifty patients with PF， aged 23 to 62 years， were randomly assigned to the intervention group (n=25) and the control group (n=25). Both groups of patients were received routinely stretching exercises. Additionally, the control group received ankle joint mobilization and the intervention group received ankle joint mobilization plus hip strengthening. Both groups received total 8 treatments， twice a week. The Visual Analogue pain Score （VAS） and the American Orthopedic Foot and Ankle Society （AOFAS） ankle-hindfoot scale were evaluated before and after treatment and after 3 months of follow-up, along with assessments of hip extension and abduction muscle strength, and ankle dorsiflexion range of motion. Result： After 4 weeks of treatment, both groups showed a significant difference in the VAS and AOFAS compared to before treatment（P<0.001），but no significant difference was found between groups. After 3 months follow-up，the VAS in the intervention group was significantly lower than that in the control group（P=0.003），and the values of AOFAS in the intervention group was significantly higher than that in the control group（P<0.001）. Conclusion： Ankle joint mobilization combined with hip strengthening can effectively alleviate foot pain and improve function to the patients of chronic plantar fasciitis.