功能性踝关节不稳疼痛与功能关系分析

关键词：功能性踝关节不稳  疼痛  功能

Keywords:functional ankle instability  pain  function

摘要：

      摘要 目的：探究功能性踝关节不稳（functional ankle instability， FAI）患者的疼痛程度、部位及疼痛与足踝功能的关系。 方法：2022年9月至2023年7月，对北京同仁医院163例FAI患者进行评估，记录其足踝疼痛部位，疼痛程度（visual analogue scale， VAS）及足踝功能（American orthopedic foot and ankle society ankle and hindfoot score， AOFAS）评分。对相同疼痛部位数下不同疼痛部位及不同疼痛部位数的VAS及AOFAS进行组间比较。采用多元线性回归分析疼痛部位数及VAS与AOFAS的关系。 结果：163例FAI患者中有150例存在疼痛，其中单一部位疼痛占37.33%，2部位疼痛占34%，多部位疼痛（＞2部位）占28.67%。所有疼痛部位中，跗骨窦和距腓前韧带占比较大，分别为32%和31%。相同疼痛部位数的FAI患者的VAS及AOFAS在不同部位间无显著差异（P＞0.05）。多部位疼痛（＞2部位）FAI患者的VAS高于单部位及2部位疼痛患者（P＜0.01），AOFAS低于单部位及2部位疼痛患者（P＜0.05）。疼痛部位数及VAS与AOFAS评分均呈负相关（P＜0.05），VAS和疼痛部位数能够预测AOFAS评分的20.9%。 结论：大部分FAI患者存在疼痛，疼痛程度及疼痛部位数影响FAI患者的足踝功能。在为FAI患者制定和实施康复计划时应该考虑减轻患者疼痛程度及减少患者的疼痛部位数，对于高发的特定部位（如跗骨窦、距腓前韧带）的疼痛，未来研究应探求有效的疼痛管理措施，来提高FAI患者的足踝功能。

Abstract:

      Abstract Objective： To investigate the pain intensity, location and relationship between pain and foot-ankle function in patients with functional ankle instability （FAI）. Method： From September 2022 to July 2023， 163 FAI patients were assessed at Beijing Tongren Hospital， with ankle pain location， pain intensity （visual analogue scale， VAS）， and foot-ankle function （American orthopedic foot and ankle society ankle and hindfoot score， AOFAS） scores recorded. The VAS and AOFAS of various pain locations and the number of pain locations was compared across groups. Multiple linear regression was used to examine the association between the number of pain locations， VAS， and AOFAS. Result： Out of 163 FAI patients， 150 reported the pain. Among them, 37.33% had pain in a single location, 34% in two locations, and 28.67% in multiple locations (>2). The most common pain locations were the sinus tarsi (32%) and the anterior talofibular ligament (31%). There were no significant differences in VAS and AOFAS among different pain locations in FAI patients with the same number of pain locations （P>0.05）. The VAS of FAI patients with multi-location pain （> 2 regions） was higher than that of patients with single-location pain and 2-location pain （P<0.01）， whereas the AOFAS was lower （P<0.05）. The number of pain locations and VAS were negatively correlated with AOFAS score （P<0.05）， which could predict 20.9% of the AOFAS score. Conclusion： The majority of FAI patients experience pain， and the pain intensity and number of pain locations impact foot and ankle function. When establishing and implementing rehabilitation strategies for FAI patients， pain relief and minimizing the number of pain locations should be emphasized. Future research should investigate effective pain management measures to improve ankle function in patients with FAI at specific locations with a high incidence （e.g.， tarsal sinus， anterior talofibular ligament）.