慢性踝關節不穩定對下肢關節在跳躍著地過程動作策略的影響

The Impact of Chronic Ankle Instability to the Joint Motion Strategy of the Lower Limbs in Jump-Landing Task

10.6194/SCS.202009_(59).0002

鄭世忠(Shih-Chung Cheng)；施智恒(Jyh-Herng Shih)；林琬鈞(Won-Jean Lin)

關節活動度 ； 踝策略 ； 髖策略 ； 對稱一致性 ； range of motion ； ankle strategy ； hip strategy ； symmetric pattern

運動教練科學

59期（2020 / 09 / 01）

17 - 28

繁體中文

目的：慢性踝關節不穩定（chronic ankle instability, CAI）是運動員常見的運動傷害，並且會長期地影響運動員的表現。過去的研究中發現在行走以及單腳站著地時，CAI患者相較於健康人的髖和踝策略有不一樣的動作模式。本研究的目的是探討單側CAI運動愛好者在跳耀著地過程，動作策略是否有發生改變以及CAI患者的雙側動作模式是否會趨向相同有對稱一致性。方法：本研究招募60名18-23歲的運動愛好者作為受試者，受試者皆每週固定接受至少三次運動訓練。研究採單盲設計，利用坎伯蘭踝關節不穩定問卷（Cumberland Ankle Instability Tool, CAIT）在受試者不知情的情況下分為CAI組和健康組兩組，評估踝關節活動度、肌力、本體感覺、最大垂直跳躍測試和跳躍落地測試。跳躍落地測試結果將會以Dartfish軟體來分析落地時下肢髖膝踝關節角度變化。結果：分組結果CAI組有33人、健康組有27人，兩組的年齡、身高、體重和垂直跳高度均沒有顯著差異。CAI組跳躍著地的髖屈曲為153.79 ± 14.28度和健康組159.58 ± 9.62度達到顯著差異（p = .04）。CAI組的患側和健側則是都沒有達到顯著差異。結論：本研究發現單側CAI患者在著地時可能會使用比健康人更多的髖策略，而且動作策略的變化並非只有患側，而是兩側皆有的，這些發現對於臨床與復健訓練時針對運動員回到運動場的決策是有幫助的。

Purpose: Chronic ankle instability (CAI) is a common injury in athletes, which brings long term negative impact to performance. Past studies showed that people with chronic ankle instability use different motor pattern comparing with the healthy ones in heel-strike phase and toe-off phase during gait cycle and one leg standing. The purpose of this study was to identify the changes in movement strategy in landing in amateur athletes with CAI, and to identify whether the movement strategy at both sides tends to be consistent. Methods: Sixty participants (18-23 years old) who do at least 3 training sessions per week were recruited in this study. Participants were divided into CAI and healthy groups by Cumberland Ankle Instability Tool (CAIT) with a single blind design. Range of motion (ROM), muscle strength, proprioception, maximal vertical jump test, and jump-land test were used as outcome measurements. Variables of ROM in hip, knee, and ankle joints when landing from jump-land test were analysed by Dartfish 2D software. Independent t test was used to analyse the different data in ROM of hip, knee and ankle between ankle instability group and healthy group. Variables of ROM between involved limb, and non-involved limb of CAI group were analysed by independent t test. A significance level of p ＜ .05 was adopted. Results: No significant difference was found in age, height, weight, and height of maximal vertical jump between CAI group (33 subjects) and healthy group (27 subjects). Significant difference was found between CAI group (153.79 ± 14.28 degrees) and healthy group (159.58 ± 9.62 degrees) in hip flexion ROM at jump-land test (p = .04). No significant difference was found when comparing all involved limb and uninvolved limb of CAI group. Conclusion: People with unilateral CAI may use more hip strategy in landing at both sides. These findings are valuable for decision making in clinics and rehabilitation training for helping athletes return to sport earlier.

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