中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (32): 6920-6926.doi: 10.12307/2025.974

• 组织构建与生物力学 tissue construction and biomechanics • 上一篇    下一篇

单侧慢性踝关节不稳患者双侧下肢生物力学特征异常

郭  萍1，王  娟2   

  1. 1汉江师范学院体育学院，湖北省十堰市  442000；2武汉体育学院运动医学院，湖北省武汉市  430079


  • 收稿日期:2024-11-06 接受日期:2024-12-25 出版日期:2025-11-18 发布日期:2025-04-26
  • 通讯作者: 王娟，硕士，中级实验师，武汉体育学院运动医学院，湖北省武汉市 430079
  • 作者简介:郭萍，女，1986年生，湖北省十堰市人，汉族，硕士，讲师，主要从事运动损伤康复与体育教学研究。
  • 基金资助:
    湖北省教育厅教学研究项目(2021407)，项目负责人：王娟

Bilateral lower limb biomechanical abnormalities in patients with unilateral chronic ankle instability

Guo Ping1, Wang Juan2   

  1. 1College of Physical Education, Hanjiang Normal University, Shiyan 442000, Hubei Province, China; 2School of Sports Medicine, Wuhan Sports University, Wuhan 430079, Hubei Province, China
  • Received:2024-11-06 Accepted:2024-12-25 Online:2025-11-18 Published:2025-04-26
  • Contact: Wang Juan, Master, Intermediate experimentalist, School of Sports Medicine, Wuhan Sports University, Wuhan 430079, Hubei Province, China
  • About author:Guo Ping, Master, Lecturer, College of Physical Education, Hanjiang Normal University, Shiyan 442000, Hubei Province, China
  • Supported by:
    Teaching and Research Project of Hubei Province Department of Education, No. 2021407 (to WJ)

PDF

70

摘要：


文题释义：
慢性踝关节不稳：是一种以反复扭伤和踝关节“让位”为特征的临床疾病。在初次踝关节外侧扭伤后，近40%的个体出现脊髓兴奋性降低、本体感觉障碍及神经肌肉控制障碍，最终发展为慢性踝关节不稳。
生物力学：运用力学的观点、方法和理论对生物体结构和功能进行研究的生物物理学分支。通过生物力学分析受试者运动质量，可以为识别异常负荷策略、降低损伤风险提供有价值的信息。

背景：研究表明，单侧慢性踝关节不稳患者存在双侧感觉运动障碍。然而，双侧感觉运动障碍会对患侧和健侧的生物力学特征造成怎样的影响目前尚未可知。
目的：探究单侧慢性踝关节不稳患者双侧下肢在进行侧切动作时的运动学和动力学特征。
方法：招募18例男性单侧慢性踝关节不稳患者和18名男性健康受试者，慢性踝关节不稳患者分别用患侧和健侧完成90°侧切动作，健康受试者用优势侧完成90°侧切动作。应用红外高速运动捕捉系统采集侧切过程中下肢运动学参数，应用三维测力台采集下肢动力学参数，比较各生物力学变量的差异。
结果与结论：①与健康受试者相比，慢性踝关节不稳患者患侧表现出更高的踝关节内翻(P=0.047)和内旋角度(P=0.046)，健侧表现出更高的踝关节内翻角度(P=0.049)；与患侧相比，慢性踝关节不稳患者健侧的膝关节外翻(P < 0.001)和髋关节内收角度(P=0.046)显著提高；②与健康受试者相比，慢性踝关节不稳患者患侧表现出更高的膝关节伸直力矩(P=0.029)；与患侧相比，慢性踝关节不稳患者健侧的踝关节跖屈力矩显著提高(P=0.027)，膝关节伸直力矩显著降低(P=0.048)；③结果提示，单侧慢性踝关节不稳患者不仅患侧，健侧也存在下肢生物力学特征异常，两侧均存在“让位”或复发性踝关节扭伤的潜在风险；此外，单侧慢性踝关节不稳患者患侧近端关节冠状面生物力学特征也产生改变。
https://orcid.org/0009-0006-7605-455X(郭萍)；https://orcid.org/0009-0004-6653-5769(王娟)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 慢性踝关节不稳, 侧切, 运动学, 动力学, 生物力学, 交叉训练

Abstract: BACKGROUND: Recent studies have shown that patients with unilateral chronic ankle instability have bilateral sensorimotor impairment. However, it is still unknown how bilateral sensorimotor impairment affects the biomechanical characteristics of the affected and unaffected sides. 
OBJECTIVE: To investigate the kinematic and kinetic characteristics of the bilateral lower limbs in patients with unilateral chronic ankle instability during lateral cutting maneuver.
METHODS: Eighteen patients with unilateral chronic ankle instability and eighteen healthy subjects were recruited. The patients with chronic ankle instability completed 90° cutting on the affected and healthy sides. The healthy subjects completed 90° cutting on the dominant side. The kinematic parameters of the lower limbs during lateral incision were collected using an infrared high-speed motion capture system, and the kinetic parameters of the lower limbs were collected using a three-dimensional force platform. Paired and independent sample t-tests were used to compare differences in various biomechanical variables.
RESULTS AND CONCLUSION: (1) Compared with healthy subjects, patients with chronic ankle instability showed higher ankle inversion (P=0.047) and internal rotation (P=0.046) angles on the affected side, and higher ankle inversion angles (P=0.049) on the unaffected side. Compared with the affected side, the knee valgus (P < 0.001) and hip adduction (P=0.046) angles of patients with chronic ankle instability were significantly increased on the unaffected side. (2) Compared with healthy subjects, patients with chronic ankle instability showed higher knee extension moment on the affected side (P=0.029). Compared with the affected side, the plantar flexion moment of the ankle on the unaffected side of patients with chronic ankle instability was significantly increased (P=0.027), and the extension moment of the knee was significantly reduced (P=0.048). To conclude, patients with unilateral chronic ankle instability have abnormal biomechanical characteristics of the lower limbs not only on the affected side but also on the unaffected side, and there are potential risks of “giving way” or recurrence ankle sprains on both sides. Furthermore, patients with unilateral chronic ankle instability also exhibit changes in the biomechanical characteristics of the proximal joints in the coronal plane on the affected side.

Key words: chronic ankle instability, cutting, kinematics, kinetics, biomechanics, cross-training

中图分类号: