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Quantitative assessment of instability of the ankle joint complex by evaluating the viscoelastic properties
Ankle sprain,Anterior drawer test,Viscoelastic properties,Stress relaxation,
|Publication Year :||2013|
結果：我們發展的技術呈現良好的可靠度(r > 0.9)。受傷踝關節的黏性指數明顯比未受傷的大(6,351 ± 5,003比上1,163 ± 778; p < 0.001)，表示受傷踝關節的黏性明顯較低。另外受傷踝關節的CAIT分數明顯比未受傷的低(13.3±4.3比上24.9 ± 4.1; p < 0.001)，表示受傷踝關節的功能穩定性明顯較差。我們也發現，黏性指數和CAIT分數呈現中度的負相關性，相關係數為-0.655 (p < 0.001)。在剛性的部分，受傷和未受傷踝關節之間沒有顯著的差異。
Background: Inversion ankle sprain is an important healthy problem. For medical and economic reasons, it is important to correctly evaluate the initial injury to better ensure for the proper diagnosis and treatment, and to help prevent further complications. The anterior drawer test is a common clinical examination to evaluate lateral ankle ligament injures following inversion ankle sprain. However its value is still controversial. Biological tissues such as ligaments exhibit viscoelastic behaviors. Injury to the ligament may induce changes of these viscoelastic properties. We hypothesize that to evaluate the viscoelastic properties of the ankle by the anterior drawer test may raise another way of assessing lateral ankle ligament injuries objectively.
Purposes: The purposes of this study are to: (1) develop an instrument to perform the anterior drawer test for noninvasive evaluation of the viscoelastic properties of the ankle quantitatively in vivo; (2) investigate the reliability of the instrument; (3) compare the viscoelastic properties of the ankle between patients suffering from inversion ankle sprain and controls; (4) investigate the relationship between the viscoelastic properties of the ankle and the subjective feelings of the patient.
Methods: 15 patients with unilateral inversion ankle sprain and 15 controls participated in this study. The reliability test was performed on three randomly chosen subjects. In patient and control test, both ankles of each subject were tested. The viscoelastic properties of the ankle were measured by the instrument. The viscosity index was defined to evaluate the ankle viscosity; larger the viscosity index was associated with lower ankle viscosity. The stiffness was used to evaluate the ankle elasticity; larger the stiffness was associated with stronger ankle elasticity. The severity of functional ankle instability (FAI) was evaluated by the Cumberland Ankle Instability Tool (CAIT) questionnaire; less the CAIT score was associated with more severe instability. Injured ankles of patients and uninjured ankles of both groups were compared by the Wilcoxon signed-rank test and the Mann-Whitney U test. The spearman’s rank correlation coefficient was applied to determine the relationship between the viscoelastic properties of the ankle and the severity of FAI.
Results: The instrument was shown to be reliable (r > 0.9). Injured ankles of patients had significantly larger viscosity index (6,351 ± 5,003 versus 1,163 ± 778; p < 0.001) and less CAIT score (13.3±4.3 versus 24.9 ± 4.1; p < 0.001) compared with uninjured ankles of both groups. There was a moderate relationship between the viscosity index and the CAIT score with a correlation coefficient -0.655 (p < 0.001). No significant difference in the stiffness could be found among all ankles of both groups.
Conclusion: In this study, injured ankles were successfully differentiated from uninjured ankles by analyzing the viscoelastic properties of the ankle quantitatively. Specifically, injured ankles exhibited significantly less viscous than uninjured ankles. We believed that the viscoelastic properties of the ankle can serve as sensitive and useful clinical biosignatures to differentiate between injured and uninjured ankles. In addition, injured ankles of patients with less viscosity exhibited significantly more severe FAI than uninjured ankles of both groups with more viscosity. There is a moderate relationship between the ankle viscosity and the severity of FAI. These findings reveal that, the reliable instrument studying the viscoelastic properties of the ankle not only may provide a clinical examination for objectively assessment of the severity of lateral ankle ligament injuries, but also may provide a clinical tool for assisting in quantifying the severity of FAI.
|Appears in Collections:||應用力學研究所|
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