| Objects:The purpose of this research is to develop and apply an ankle inversion discrimination apparatus for landing(AIDAL),a test device that can simulate ankle proprioception in a scene of inversion of the foot and to ensures that it can reliably and effectively detect the differences in proprioceptive function between CAI patients and normal people when they are drop on the floor.Based on the establishment of the reproducing reliability,study 1 aims to establish the validity of the AIDAL and to explore the different learning effects that CAI patients and normal people may have through three repeated AIDAL repeated testing.In study 2 CAI patients and normal people were involved in two types of ankle proprioceptive tests: Active movement extent discrimination assessment(AMEDA)when standing and AIDAL test of varus proprioception during drop landing and the aim is to distinguish the difference in performance of those two types of subjects in ankle different proprioception tests.Study 3 aims to analyze differences using AIDAL in sensation in different foot and ankle undercover conditions(barefoot vs Kinesio taping vs.Kinesio taping + wearing sports shoes),and to explore the effects of Kinesio taping and wearing sports shoes on the ankle proprioception of CAI patients.Methods:A total of 36 subjects were volunteered,including 18 CAI(male = 10,average age 23.5 ± 1.1,female = 8,average age = 23.9 ± 3.5),and 18 normal controls(male = 11,average age 23.4).± 2.2,female = 7,average age = 24.1 ± 2.3).The research instrument used a self-developed AIDAL device to measure the proprioception of the subject's foot inversion when drop landing.The device consists of three parts: the first part is a landing support platform,the second part is a landing test platform,and the third part is a jumping stand platform.The landing test platform is composed of 4 wedge-shaped wedges providing slopes of 11.48 degrees,14.36 degrees,17.25 degrees,and 18.16 degrees,respectively.The drop difference between the jumping standing platform and the landing support platform is 10 cm.AIDAL's testing process consists of two parts: the first part is the learning part,and the second part is the formal test.In the learning part,subjects were asked to familiar with the four test angles of AIDAL in the order of 1,2,3,and 4.This process was repeated 3 times for a total of 12 jumps.In the formal test,the test sequence appears randomly.The subjects give a response immediately after drop landing on the test platform and the experimenter will not give feedback.There will be 10 jumps for each test angle for a total of 40 jumps.After the test is completed,the experimenter records the actual test angle of each group and the response of the subject and calculates the test subject using non-parametric signal detection analysis based on the results of actual test angle-subject response.The ratio of the cumulative “true positive rate” and “false positive rate” judged by each angle was used to draw the Receiver Operating Characteristic curves(ROC),and the area under the curve(Area Under the Curve(AUC)is used as the criterion for judging the subject's proprioception.Results: When testing the CAI patients,AIDAL has an ICC of 0.824(95% CI = 0.499-0.946),as contrast normal control groups' ICC of 0.709(95% CI = 0.257-0.907),and a combined test-retest reliability of 0.785(95% CI = 0.564-0.901).The ICC is between 0.75-0.90,so the AIDAL has a good test-retest reliability.Pearson correlation analysis showed that there was a significant positive correlation between the AUC value measured by AIDAL and the results of the CAIT questionnaire(r=0.424,p=0.010).Secondly,in the three repeated tests of AIDAL,the ankle proprioception of CAI patients was significantly lower than that of the normal control group(F = 10.182,p = 0.004),suggesting that CAI patients lacked foot varus proprioception sensitivity during the drop landing,and the AIDAL device can identify CAI Patients and normal populations.Also,in the AIDAL and AMEDA comparison experiment,univariate analysis of variance showed that the ankle proprioception sensation obtained by CAI patients in AIDAL tests was significantly lower than the normal population(F = 5.107,p = 0.030),but there was no significant correlation between the two ankle proprioception test results(r=0.211,p=0.216).In the Kinesio taping experiments,the taping alone is not enough to significantly improve the ankle proprioception when the foot is inverted(F = 2.069,p = 1.60),but compared with barefoot the ankle is covered with sneakers and Kinesio tape can significantly improve the score of CAI patients in the AIDAL test(F = 5.147,p = 0.03)and can making CAI patients proprioception in drop landing to normal level(F=0.242,p=0.626).Conclusion: AIDAL,as the first test device to measure the proprioception of ankle joints in the scene of foot varus jumping,has a good test-retest reliability,and can effectively detect the differences in ankle proprioception of CAI patients and normal people.In three consecutive repeated tests of AIDAL,the learning effect of the normal population was significantly higher than that of CAI patients,suggesting that the important reason for the lower proprioception of ankle joints in CAI patients may lie in the central mechanism difference between proprioceptive information processing and the normal population.Secondly,although AMEDA is also measuring the proprioception of the ankle joint,there is no significant correlation between the scores of AMEDA and AIDAL,and once again support the argument put forward by the research group: that proprioception is not a general ability,but has a task-specific ability.Finally,this study found that using Kinesio tape alone does not significantly improve the proprioception of ankle joints of CAI patients,while using Kinesio tape and wearing sports shoes the proprioception of the ankle joint was significantly improved,and it could approach the level of normal people(F = 0.242,p = 0.626).Based on the series of research results of this master's thesis,it is recommended that AIDAL can be used as a tool for evaluating ankle proprioceptive function in patients with CAI.In the future,the study of ankle proprioceptive function in CAI patients should focus more on the central nervous mechanism.The use of Kinesio tape and wearing sports shoes may provide CAI patients with optimized ankle proprioceptive information,which can effectively improve the ankle proprioceptive function of CAI patients,which may help patients to enhance their performance and prevent ankle sprains happen once again. |
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