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目的对慢性踝关节不稳患者常规康复训练前后进行综合功能评估;采用综合康复治疗方法,观察其治疗效果。方法门诊选取124例单侧踝关节不稳患者,年龄34~56岁,其中男性73例,女性51例。分别进行肌力及关节活动度训练,平衡训练,本体觉训练,疗程为2个月,康复前后分别做即时、行走后疼痛[500 m行走后,视觉模拟评分法(VAS)评定)]、患肢负重时间、星偏移距离平衡检查及动、静态足底压力评估。结果患足负重项康复前平均站立时间与康复后差异有显著统计学意义;即时VAS疼痛评分康复前与康复后差异显著(5.32±0.27,1.07±0.08);500 m步行VAS疼痛评分康复前后差异有显著性(8.79±1.78,4.51±1.78),且显著高于健侧(5.41±0.42,27.31±5.48)(P<0.05);两组足底动、静态峰值压力分布无明显改变(P>0.05),静态压力:健侧前足(1095.30±61.28)gr/cm~2,患侧前足(1670.30±151.22)gr/cm~2负重增加,动态压力:健侧(1654.98±294.27)gr/cm~2,患侧前足(2822.30±312.28)gr/cm~2(P>0.05)。结论经过综合康复治疗后,患者即时疼痛得到明显缓解,平衡能力得到明显提高,但500 m步行后疼痛以及动静态足底压力无明显变化,生物力学未得到纠正,限制了治疗效果。
Objective To evaluate the comprehensive function of patients with chronic ankle instability before and after routine rehabilitation training. The comprehensive rehabilitation treatment was used to observe the therapeutic effect. Methods Outpatient 124 patients with unilateral ankle instability, aged 34 to 56 years, 73 males and 51 females. Muscle and joint activity training, balance training and ontology training were performed respectively for 2 months. Immediate and postoperative walking pains (visual analog scale (VAS) assessment) were performed before and after rehabilitation Limb weight time, star offset distance balance check and dynamic and static plantar pressure assessment. Results The average stand time before rehabilitation was significantly different from that before rehabilitation (P> 0.05). The immediate VAS pain score was significantly different before and after rehabilitation (5.32 ± 0.27, 1.07 ± 0.08). The VAS pain score was significantly different between before and after rehabilitation (8.79 ± 1.78, 4.51 ± 1.78), and significantly higher than that of the healthy side (5.41 ± 0.42, 27.31 ± 5.48) (P <0.05). There was no significant change in the dynamic peak pressure distribution between the two groups (P> 0.05). The static pressure increased with the increase of gr / cm ~ 2 in the anterior forelimb (1095.30 ± 61.28) gr / cm ~ 2 and the anterior forelimb (1670.30 ± 151.22) gr / cm ~ 2, ipsilateral forefoot (2822.30 ± 312.28) gr / cm ~ 2 (P> 0.05). Conclusion After comprehensive rehabilitation, the patients’ immediate pain relief was significantly relieved and their balance ability improved obviously. However, there was no significant change in pain and dynamic and static plantar pressure after walking at 500 m. Biomechanics was not corrected and the therapeutic effect was limited.