PDF(Pubmed)
Abstract：
OBJECTIVE: To systematically review the literature to determine whether external ankle supports influence ankle biomechanics in participants with chronic ankle instability (CAI) during sport-related tasks.
METHODS: A literature search of MEDLINE, SPORTDiscus, and CINAHL databases was conducted in November 2021.
METHODS: Included studies were randomized crossover or parallel-group controlled trials in which researchers assessed ankle biomechanics during landing, running, or change of direction in participants with CAI using external ankle supports compared with no support.
METHODS: Two authors independently identified studies, extracted data, and assessed risk of bias (Cochrane risk-of-bias tool version 2) and quality of evidence (Grading of Recommendations Assessment, Development and Evaluation). Random-effects meta-analysis was used to compare between-groups mean differences with 95% CIs. Grading of Recommendations Assessment, Development and Evaluation recommendations were used to determine the certainty of findings.
RESULTS: A total of 13 studies of low to moderate risk of bias were included. During landing, very low-grade evidence indicated external ankle supports reduce frontal-plane excursion (mean difference [95% CI] = -1.83° [-2.97°, -0.69°], P = .002), plantar-flexion angle at initial contact (-3.86° [-6.18°, -1.54°], P = .001), and sagittal-plane excursion (-3.45° [-5.00°, -1.90°], P < .001) but not inversion angle at initial contact (-1.00° [-3.59°, 1.59°], P = .45). During running, very low- to low-grade evidence indicated external ankle supports reduce sagittal-plane excursion (-5.21° [-8.59°, -1.83°], P = .003) but not inversion angle at initial contact (0.32° [-2.11°, 1.47°], P = .73), frontal-plane excursion (-1.31° [-3.24°, 0.63°], P = .19), or plantar-flexion angle at initial contact (-0.12° [-3.54°, 3.29°], P = .94). Studies investigating changes of direction were insufficient.
CONCLUSIONS: Very low-grade evidence indicated external ankle supports reduce frontal-plane excursion but not inversion angle at initial contact in participants with CAI during landing. Limiting frontal-plane excursion may reduce ankle-sprain risk. Frontal-plane ankle kinematics were not influenced by external ankle supports during running. Sagittal-plane reductions were observed with external ankle supports during landing and running with low to very low certainty, but their influence on ankle-sprain risk is undetermined.
METHODS: A literature search of MEDLINE, SPORTDiscus, and CINAHL databases was conducted in November 2021.
METHODS: Included studies were randomized crossover or parallel-group controlled trials in which researchers assessed ankle biomechanics during landing, running, or change of direction in participants with CAI using external ankle supports compared with no support.
METHODS: Two authors independently identified studies, extracted data, and assessed risk of bias (Cochrane risk-of-bias tool version 2) and quality of evidence (Grading of Recommendations Assessment, Development and Evaluation). Random-effects meta-analysis was used to compare between-groups mean differences with 95% CIs. Grading of Recommendations Assessment, Development and Evaluation recommendations were used to determine the certainty of findings.
RESULTS: A total of 13 studies of low to moderate risk of bias were included. During landing, very low-grade evidence indicated external ankle supports reduce frontal-plane excursion (mean difference [95% CI] = -1.83° [-2.97°, -0.69°], P = .002), plantar-flexion angle at initial contact (-3.86° [-6.18°, -1.54°], P = .001), and sagittal-plane excursion (-3.45° [-5.00°, -1.90°], P < .001) but not inversion angle at initial contact (-1.00° [-3.59°, 1.59°], P = .45). During running, very low- to low-grade evidence indicated external ankle supports reduce sagittal-plane excursion (-5.21° [-8.59°, -1.83°], P = .003) but not inversion angle at initial contact (0.32° [-2.11°, 1.47°], P = .73), frontal-plane excursion (-1.31° [-3.24°, 0.63°], P = .19), or plantar-flexion angle at initial contact (-0.12° [-3.54°, 3.29°], P = .94). Studies investigating changes of direction were insufficient.
CONCLUSIONS: Very low-grade evidence indicated external ankle supports reduce frontal-plane excursion but not inversion angle at initial contact in participants with CAI during landing. Limiting frontal-plane excursion may reduce ankle-sprain risk. Frontal-plane ankle kinematics were not influenced by external ankle supports during running. Sagittal-plane reductions were observed with external ankle supports during landing and running with low to very low certainty, but their influence on ankle-sprain risk is undetermined.
摘要：
目的：系统回顾文献，以确定在运动相关任务期间，踝关节外部支撑是否会影响慢性踝关节不稳定（CAI）参与者的踝关节生物力学。
方法：MEDLINE文献检索，SPORTDiscus,和CINAHL数据库于2021年11月进行。
方法：纳入的研究是随机交叉或平行对照试验，CAI参与者使用外部踝关节支撑，与没有支持相比，评估着陆过程中的踝关节生物力学，跑步,或者改变方向。
方法：两位作者独立进行了研究鉴定，数据提取,偏见风险(RoB2)，和证据质量（等级）评估。使用随机效应的荟萃分析用于比较组间平均差异（MD）和95％置信区间（CI）。使用等级建议来确定结果的确定性。
结果：纳入了13项低度至中度偏倚风险研究。着陆期间,非常低等级的证据表明外部踝关节支撑可减少额平面偏移(MD[95%CI]-1.83°[-2.97，-0.69]，p=0.002),足底弯曲地面接触角（-3.86°（-6.18，-1.54），p=0.001),矢状面偏移(-3.45°[-5.00,-1.90],p<0.001)，但不反转地面接触角(-1.00°[-3.59，1.59]，p=0.45)。在运行过程中,非常低到低等级的证据表明外部踝关节支撑减少矢状面偏移（-5.21°[-8.59，-1.83]，p=0.003),但不反转地面接触角(0.32°[-2.11，1.47]，p=0.73),额平面偏移(-1.31°[-3.24,0.63],p=0.19),或plant屈地面接触角（-0.12°[-3.54，3.29]，p=0.94）。研究方向变化的研究不足。
结论：有低至极低等级的证据表明，在降落期间，CAI参与者的外部踝关节支撑可减少额叶平面偏移，但不会使地面接触角倒置。限制额平面偏移可能会降低踝关节扭伤的风险。跑步过程中，正面踝关节运动学不受外部踝关节支撑的影响。在着陆和跑步过程中，使用外部踝关节支撑观察到矢状平面减少，但其对踝关节扭伤风险的影响尚不确定。
方法：MEDLINE文献检索，SPORTDiscus,和CINAHL数据库于2021年11月进行。
方法：纳入的研究是随机交叉或平行对照试验，CAI参与者使用外部踝关节支撑，与没有支持相比，评估着陆过程中的踝关节生物力学，跑步,或者改变方向。
方法：两位作者独立进行了研究鉴定，数据提取,偏见风险(RoB2)，和证据质量（等级）评估。使用随机效应的荟萃分析用于比较组间平均差异（MD）和95％置信区间（CI）。使用等级建议来确定结果的确定性。
结果：纳入了13项低度至中度偏倚风险研究。着陆期间,非常低等级的证据表明外部踝关节支撑可减少额平面偏移(MD[95%CI]-1.83°[-2.97，-0.69]，p=0.002),足底弯曲地面接触角（-3.86°（-6.18，-1.54），p=0.001),矢状面偏移(-3.45°[-5.00,-1.90],p<0.001)，但不反转地面接触角(-1.00°[-3.59，1.59]，p=0.45)。在运行过程中,非常低到低等级的证据表明外部踝关节支撑减少矢状面偏移（-5.21°[-8.59，-1.83]，p=0.003),但不反转地面接触角(0.32°[-2.11，1.47]，p=0.73),额平面偏移(-1.31°[-3.24,0.63],p=0.19),或plant屈地面接触角（-0.12°[-3.54，3.29]，p=0.94）。研究方向变化的研究不足。
结论：有低至极低等级的证据表明，在降落期间，CAI参与者的外部踝关节支撑可减少额叶平面偏移，但不会使地面接触角倒置。限制额平面偏移可能会降低踝关节扭伤的风险。跑步过程中，正面踝关节运动学不受外部踝关节支撑的影响。在着陆和跑步过程中，使用外部踝关节支撑观察到矢状平面减少，但其对踝关节扭伤风险的影响尚不确定。
