目的 观察综合康复治疗对慢性踝关节外侧不稳患者的疗效。方法 对慢性踝关节外侧不稳76例,按就诊顺序随机分成观察组和对照组,每组38例。对照组均予常规的中频、超短波物理治疗。观察组在此基础上,结合手法整复、电针、肌力训练、踝关节平衡训练等。两组治疗均1次/d,10次为1个疗程,2个疗程后统计疗效。于治疗前后,采用足踝症状功能评估(AOFAS)和平衡功能评定疗效。结果 治疗后,两组患者的踝关节AOFAS评分分别为(86.97±6.05)分和(68.63±16.52)分,均较治疗前明显增加(P<0.01),且观察组治疗后的踝关节AOFAS评分优于对照组,差异有统计学意义(P<0.01);治疗后两组患者的踝关节ATE(17.47±7.30,24.71±8.83)%较治疗前明显改善(均P<0.01),但治疗后组间比较无统计学意义(P=0.10);治疗后两组患者的平均力量差(1.36±0.72,2.53±1.20)kg较治疗前明显改善(P<0.01和P=0.02),且观察组治疗后的平均力量差优于对照组,差异有统计学意义(P=0.018)。结论 综合康复治疗能改善慢踝关节外侧不稳的状况,促进踝关节本体感觉(平衡觉)的恢复。

Objective To study the clinical effect of comprehensive rehabilitation on patients with chronic lateral ankle instability.Methods Seventy-six young patients with chronic lateral ankle instability were randomly divided into the observation group(n=38)and control group(n=38). The patients in the control group were given mid frequency and ultrashort wave therapy, while those in the observation group additionally received manipulation、electroacupuncture、muscle strength training and ankle balance training. Patients in both groups were treated once a day, for a total of 2 courses (10 times as a course).The scores of AOFAS and balance function were used to evaluate the therapeutic effect.Results The AOFAS scores in the two groups (86.97±6.05,68.63±16.52)significantly increased after treatment (P<0.01 and P<0.01), especially in the observation group (P<0.01).The average trace error (ATE) (17.47±7.30,24.71±8.83)% in the two groups significantly improved (P<0.01 and P<0.01), but there was no significant difference between the two groups after treatment(P>0.05). The average weight force error(1.36±0.72和2.53±1.20)kg in the two groups also significantly improved (P<0.01和P<0.05),especially in the observation group (P<0.05).Conclusions Comprehensive rehabilitation therapy can improve the chronic lateral ankle instability of young patients, and promote the recovery of ankle proprioception(equilibratory sensation).