| Functional ankle instability(FAI)is characterized by recurrent sprains and persistent symptom development of the ankle joint.It is mainly related to the injury of proprioceptors during ankle sprains,the loss of strength of related muscle groups around the joint caused by injury,and the abnormal neuromuscular control of central regulation.The college students who often participate in physical exercise are the highrisk group of FAI.In sports,the body needs to adapt to a more complex environment,often facing the situation of dual task execution,and performing multiple tasks at the same time will increase the risk of lateral ankle sprain in FAI population.FAI not only has a decrease in muscle strength,but also affects neuromuscular control,which is manifested as abnormal gait.The abnormal gait pattern may increase the repetitive cartilage damage to the medial ankle joint.At present,there is still a lack of research on the influence of dual-task training on the gait characteristics of FAI population.It is necessary to carry out dual-task training for FAI population,and systematically observe the changes of gait performance from the perspectives of kinematics and dynamics,so as to explore the rehabilitation effect of this training form on FAI,and provide effective methods and new ideas for the prevention and treatment of ankle joint injury.Purpose:The purpose of this study is to observe the effect of dual-task training on the gait characteristics of FAI college students,and to compare and analyze the difference in the improvement of gait performance of FAI college students under single-task and dual-task conditions,so as to provide valuable theoretical and practical basis for the rehabilitation of functional ankle instability..Methods:According to the inclusion and exclusion criteria,20 FAI college students were recruited and randomly divided into single task group(n=10)and dual task group(n=10).In addition,10 healthy subjects were selected as normal reference values for this experiment.The single task group received single task training,the dual task group received dual task training,and the healthy control group did not receive training.The intervention time was 45 min each time,5 times a week for 6 weeks.The Cumberland Ankle Instability Scale(CAIT)score was tested before and after the intervention.Cybex isokinetic muscle strength system was used for ankle muscle strength test and proprioception test.Gait kinematics and dynamics parameters and surface electromyography data of the two groups of subjects were tested under single-task conditions and dual-task conditions.The dual-task cost(DTC)value was calculated by the formula to quantify the dual-task improvement.The research data were expressed as ’ mean ± standard deviation ’,and statistical software SPSS25.0 was used for statistical analysis.Paired sample t test was used to compare the intra-group differences of various parameters in the single-task group and the dual-task group before and after the intervention.One-way ANOVA was used to compare the inter-group differences of various parameters between the single-task group,the dual-task group and the healthy control group before and after the intervention.P<0.05 was considered statistically significant.Results:1.Gait parameters(1)Kinematic parametersWalking speed : Under the dual-task condition,the walking speed of the subjects in the single-task and dual-task groups was significantly lower than that in the healthy control group before intervention(P<0.05),and the walking speed of the subjects in the singletask group was still significantly lower than that in the healthy control group after intervention(P<0.05).Compared within the group,the walking speed of the subjects in the dual task group after intervention was higher than that before intervention,and the difference was significant(P<0.05).Ankle joint angle : Under the condition of double task,at the time of heel landing,the ankle plantar flexion angle of the subjects in the single and double task groups before intervention was significantly higher than that of the healthy control group(P<0.05).Within the group,the ankle plantar flexion angle of the single and double task groups after intervention was less than that before intervention,and the difference was significant(P<0.05).At the moment of toe off the ground,the ankle varus angle of the single and dual task groups was significantly higher than that of the healthy control group before the intervention(P<0.05).After the intervention,the ankle varus angle of the single task group was still significantly higher than that of the healthy control group(P<0.05).(2)Kinetic parametersGround reaction force(GRF): Under the single task condition,the X-axis second peak and Z-axis second peak of the single and dual task group were significantly lower than those of the healthy control group before the intervention(P<0.05).After the intervention,the X-axis second peak of the single task group was significantly lower than that of the dual task group and the healthy control group(P<0.05).Compared within the group,the Z-axis-second peak of the dual task group after intervention was higher than that before intervention,and the difference was significant(P<0.05).Under the dual-task condition,the X-axis second peak and Z-axis second peak of the singletask group and the dual-task group before intervention were significantly lower than those of the healthy control group(P<0.05).After the intervention,the X-axis second peak and Z-axis second peak of the single-task group were still significantly lower than those of the healthy control group(P<0.05).Compared within the group,the Z-axissecond peak of the dual task group after intervention was higher than that before intervention,and the difference was significant(P<0.05).The peak torque of ankle joint : under the condition of single task,the valgus peak torque of subjects in the single and double task groups before intervention was significantly lower than that in the healthy control group(P<0.05).After the intervention,the valgus peak torque of the subjects in the single task group,the dorsiflexion peak torque and the valgus peak torque of the subjects in the dual task group were higher than those before the intervention,and the difference was significant(P<0.05).Under the condition of double tasks,the peak torque of plantar flexion and valgus in the single task group and the double task group was significantly lower than that in the healthy control group before the intervention(P<0.05),and the peak torque of plantar flexion and valgus in the single task group was still significantly lower than that in the healthy control group after the intervention(P<0.05).After intervention,the valgus peak torque of the subjects in the dual task group was higher than that before intervention,and the difference was significant(P<0.05).(3)Surface electromyography parametersUnder the dual-task condition,the root mean square amplitude of the peroneus longus of the subjects in the single-task and dual-task groups before the intervention was significantly higher than that of the healthy control group(P<0.05).After the intervention,the root mean square amplitude of the peroneus longus of the subjects in the single-task group was significantly lower than that of the healthy control group(P<0.05).2.Isokinetic muscle strength(1)At the test speed of 60o/s,the relative peak torque(RPT)of plantar flexion,dorsiflexion,varus and valgus in the single task group and the dual task group before intervention were significantly lower than those in the healthy control group(P<0.05).After intervention,the RPT of plantar flexion,dorsiflexion,varus and valgus in the single task group and the dual task group were significantly higher than those before intervention(P<0.05).(2)At the test speed of 180o/s,the plantar flexion,dorsiflexion and varus RPT of the single task group and the dual task group before intervention were significantly lower than those of the healthy control group(P<0.05).After intervention,the RPT of plantar flexion,dorsiflexion,varus and valgus in the single task group and the dual task group were higher than those before intervention,and the difference was significant(P< 0.05).3.ProprioceptionCompared with the healthy control group,the absolute error of position sense(AEJPS)of the single task group and the double task group before intervention was higher than that of the healthy control group,and the difference was significant(P<0.05).After intervention,the AEJPS of the single task group was still significantly higher than that of the healthy control group(P<0.05).After 6 weeks of dual-task intervention,the AEJPS of the dual-task group was significantly lower than that before intervention(P<0.05).4.Dual-task costCompared with the healthy control group,the dual-task walking speed cost of the subjects in the single-task and dual-task groups before the intervention was significantly lower than that of the healthy control group(P<0.05),and the dual-task walking speed cost of the subjects in the single-task group after the intervention was still significantly lower than that of the healthy control group(P<0.05).After 6 weeks of dual-task training,the dual-task walking speed cost of the dual-task group increased from-27.73±7.83 to-21.04±8.79,which was significantly improved compared with that before the intervention(P<0.05).5.CAIT scoreAfter intervention,the CAIT score of the dual-task group was significantly higher than that of the single-task group(P<0.05).The CAIT scores of the subjects in the single and double task groups after intervention were higher than those before intervention,and the difference was significant(P<0.05).Conclusion:1.6 weeks of single-task and dual-task training can improve peri-ankle muscle strength and proprioception to varying degrees in FAI university students,and the effect of dualtask training on the improvement of proprioception is better than that of single-task training;2.6 weeks of dual-task training can effectively reduce the degree of interference during dual-task walking,improve the gait speed,ankle joint angle,ankle plantarflexion and valgus muscle groups during walking under single-and dual-task conditions,and normalize the recruitment of the peroneus longus muscle at the moment of foot following the ground,which is better than single-task training;3.6 weeks of dual-task training improved the ankle function of FAI students better than single-task training and contributed to the improvement of ankle stability. |
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