双重任务和步行速度对慢性踝关节不稳患者步态变异性的影响

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摘要目的探讨双重任务和步行速度对慢性踝关节不稳定(chronic ankle instability，CAI)患者步态变异性的影响。方法选取我院2015年1月至2016年9月间诊治的16例患者，均有慢性踝关节不稳定症状，同时招募了16例年龄、性别相匹配的健康人作为对照组，在跑步机上测量在自定步速行走、双重任务自定步速行走、快速行走和双重任务快速行走四种不同条件下的步频的变异系数(stride time variability，STV)和步长的变异系数(stride length variability，SLV)。结果在自定步速行走(无双重任务)下，CAI和对照组的STV差异无统计学意义(P＝0.346)。在健康对照组中，与自定步速行走模式下的STV相比，健康对照组人群的双重任务自定步速行走、快速行走及双重任务快速行走模式下的STV都降低(P值分别为0.011、0.016和0.001)。在CAI组中，与自定步速行走模式下的STV进行比较，只有双重任务快速行走模式下的STV降低(P＝0.008)。两组受试者在四种不同行走模式下的SLV差异均无统计学意义。结论 CAI和健康受试者在挑战性的行走条件下均减少了步幅时间的可变性，但变化模式不同。与健康受试者相比，CAI患者出现因更高程度的步态障碍(概念混乱，应是“行走条件”)导致其步态模式的改变，表明CIA患者感觉系统的适应性较低。

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	马阳
	董卫东
	丁俊杰
	管英杰

关键词 ：慢性踝关节不稳定, 踝关节扭伤, 步行, 步态变化

Abstract：Objective To evaluate the effects of dual-task and walking speed on gait variability in patients with chronic ankle instability(CAI).Methods 16 cases of patients with CAI in our hospital from January 2015 to September 2016 were selected as study objects.And 16 age-and gender-matched，able-bodied controls participated in this study.Stride time variability and stride length variability were measured on a treadmill under four different conditions：self-paced walking，self-paced walking with dual-task，fast walking，and fast walking with dual-task.Results Under self-paced walking(without dual-task)，there was no difference in stride time variability between CAI and control groups(P＝0.346).In the control group，compared to self-paced walking，stride time variability decreased in all conditions：self-paced walking with dual-task，fast speed，and fast speed with dual-task(P＝0.011，0.016 and 0.001，respectively).However，in the CAI group，compared to self-paced walking，decreased stride time variability was demonstrated only in the fast speed with dual-task condition(P＝0.008).Stride length variability did not change under any condition in either group.Conclusion Subjects with CAI and healthy controls reduced their stride time variability in response to challenging walking conditions；however，the pattern of change was different.A higher level of gait disturbance is required to cause a change in walking in the CAI group compared to healthy individuals，which may indicate lower adaptability of the sensorimotor system.

Key words： chronic ankle instability ankle sprain walking gait varability

作者简介: 马阳(1981－ )，男，主治医师，延安市人民医院骨科四病区，716000。

引用本文:

马阳，董卫东，丁俊杰，管英杰. 双重任务和步行速度对慢性踝关节不稳患者步态变异性的影响[J]. 实用骨科杂志, 2018, 24(4): 332-335.
Ma Yang，Dong Weidong，Ding Junjie，et al. Effects of Dual-task and Walking Speed on Gait Variability in People with Chronic Ankle Instability：a Cross-Sectional Study. sygkzz, 2018, 24(4): 332-335.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2018/V24/I4/332

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