Efficacy of Closed and Open Kinematic Chain Exercises on Ankle Sprain Rehabilitation

Zusammenfassung

Hintergrund: Knöchelverstauchungen führen oft zur Instabilität des Sprunggelenks, welche höchstwahrscheinlich durch Schäden an passiven Strukturen und durch neuromuskuläre Funktionsstörungen verursacht werden. Die meisten Verstauchungen werden nicht-operativ, sondern mit einem Rehabilitationsprogramm behandelt.

Methoden: Eine Studiengruppe von 40 Patienten mit einer subakuten lateralen Knöchelverstauchung (Grad II) mit einem mittleren Alter von 21,8±2,9 Jahre nahm an dieser Studie teil. Diese 40 Patienten wurden in 2 Gruppen eingeteilt. Die erste Gruppe (n=20) führte Kräftigungsübungen in offener kinematische Kette (OKC) durch, während die zweite Gruppe (n=20) mit geschlossener kinematischer Ketten (CKC) an den Muskelgruppen der Dorsalflexoren, Plantarflexoren, Evertoren und Invertoren beübte. Beide Studiengruppen führten ein Trainingsprogramm bestehend aus 3 Sitzungen pro Woche für insgesamt 6 Wochen durch. Das Studienergebnis wurde durch eine rein funktionelle Bewertung (ADLs), ein Punkte-System des Japanischen Verbandes der Orthopäden, durch das Messen des Bewegungsumfangs (ROM) der Dorsalflexion und der Plantarflexion mit Hilfe eines universellen Goniometers und durch eine visuelle Analogskala (VAS), die verwendet wird um die Schmerzstärke zu messen, ermittelt.

Ergebnisse: Es gab signifikante Unterschiede in den Ergebnissen von VAS, ROM und ADLs in der OKC- bzw. der CKC-Gruppe (p>0,05). Insbesondere gab es einen deutlichen Unterschied bei ADLs zwischen der CKC-Gruppe und der OKC-Gruppe (p>0,05).

Fazit: Im Rahmen dieser Studie konnte beobachtet werden, dass die Behandlung von Knöchelverstauchungen mit Hilfe von OKC- und CKC-Übungen wirksam ist. Trotzdem ist festzustellen, dass CKC-Übungen möglicherweise OKC-Übungen vorzuziehen sind, wenn wir funktionelle Aktivitäten, vor allem ADLs, betrachten.

Abstract

Background: Ankle sprains often result in ankle instability, which is most likely caused by damage to passive structures and neuromuscular impairment. Most ankle sprains are treated non-surgically with a rehabilitation program.

Methods: A sample of 40 subacute grade II lateral ankle sprain with a mean age of 21.8±2.9 years were participated in this study and divided them into 2 groups. The first group (n=20) followed strengthening exercises in the form of Open Kinematic Chain (OKC) whereas, the second group (n=20) undergone Closed Kinematic Chain (CKC) for dorsiflexors, planterflexors, evertors, and invertors muscle groups. Both study groups performed respective exercise program for 3 sessions per week for 6 weeks. Study outcome measured by functional rating (ADLs) score system of the Japanese orthopedic association, range of motion (ROM) of ankle dorsiflexion and planterflexion by universal goniometer and visual analogue scale (VAS) used to measure the pain severity.

Results: There was a significant difference in VAS, ROM and ADLs in both OKC and CKC groups (p>0.05). However, between group comparisons; there was a significant difference in ADLs in the CKC group than in the OKC group (p>0.05).

Conclusion: This study observed that ankle sprain patient rehabilitation with both OKC and CKC exercises are effective, Although CKC exercise is may be a better choice than OKC exercise when we consider functional activities especially ADLs.

Key words

Rehabilitation - Therapie - Physiotherapie

Schlüsselwörter

effectiveness - exercise therapy - physiotherapy

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