| Objective This study mainly verifies the validity of the De-A somatosensory balance detection system for evaluating balance ability in patients with chronic ankle instability and hemiparesis.At the same time,to explore the functional characteristics of ankle joint and knee joint in patients with chronic ankle instability and hemiplegia,and to analyze the effect of ankle joint and knee joint function on the balance ability of patients with chronic ankle instability and hemiplegia.Methods A total of 128 subjects were recruited in a tertiary hospital in Beijing,including 40 patients with chronic ankle instability,25 patients with stroke hemiplegia,and 63 cases in the normal control group.The subjects underwent platform tilt standing stress test on the motion platform of DE-A somatosensory balance detection system,and the root mean square of acceleration(RMS)and acceleration change rate(Jerk)data were obtained.At the same time,the patients with chronic ankle instability and their control group underwent knee and ankle joint proprioception,ankle joint strength and lower limb Y-Balance test(YBT).Hemiplegia patients and their control group were evaluated by knee proprioception,ankle strength,standing up and walking timing test(TUGT),functional extension test(FRT),and BBS.Results(1)The YBT composite scores,the anterior extension distance,and the posterior and medial extension distance of patients with ankle instability were smaller than those of the control group,and the differences were statistically significant(P<0.05,P<0.01).In the somatosensory balance test,the RMS and Jerk values of the patients with chronic ankle instability were greater than those of the control group during the forward tilt stimulus and the affected side tilt stimulus,and the difference was statistically significant(P<0.05,P<0.01).(2)RMS and Jerk in the left and right directions when the stimulus is tilted to the affected side have a significant negative correlation with the Y-balance test composite score,anterior,posterolateral,and posteromedial(P<0.05,P<0.01).(3)The AUC of the area under the ROC curve for Jerk in the left and right direction during forward,healthy,and affected side tilt stimuli and for RMS in the left and right direction during forward and affected side tilt were statistically significant when tested by the DE-A somatosensory balance detection system in patients with chronic ankle instability(P<0.05,P<0.01).(4)The strength of dorsiflexion,toe flexion,varus,and eversion of the ankle joints on the affected side of chronic ankle instability was less than that of the contralateral side and normal control group,and the absolute error values of proprioception indexes were greater than that of the control group,which was statistically significant(P<0.01);The absolute error values of proprioception indexes on the affected side compared with the healthy side in patients with chronic ankle instability were not statistically significant(P>0.05).(5)RMS and Jerk during forward leaning in chronic ankle instability and was negatively correlated with ankle varus and valgus strength(P<0.05,P<0.01).(6)FRT,TUGT and BBS values were worse in hemiplegic patients than in controls(P<0.01).RMS and Jerk’s values during somatosensory balance testing in the forward,backward and leftright directions when tilting to the affected side were greater in hemiplegic than in control subjects(P<0.05,P<0.01).The Jerk value in the anterior posterior direction when tilting to the contralateral side,which is greater in hemiplegic patients than in controls,was statistically significant(P<0.05).(7)The DE-A somatosensory balance detection system tested RMS,Jerk during hemiplegic stimulation in addition to backward leaning stimulation and jerk during forward leaning stimulation were not significantly associated with BBS(P>0.05),RMS and Jerk’s when stimulated in each of the remaining directions showed a significant negative correlation with BBS(P<0.05,P<0.01);RMS with anterior and unhealthy tilt stimuli was significantly positively correlated with TUGT(P<0.05),Jerk in the anteroposterior direction when tilted to the unhealthy side was positively correlated with TUGT(P<0.05).There is no correlation between DE-A somatosensory balance detection system and FRT(P>0.05).(8)The DEA somatosensory balance detection system tested patients with hemiplegia when tilting forward,backward,and to the affected side to stimulate the left and right RMS and the area AUC under the ROC curve of Jerk were statistically significant(P<0.05,P<0.01);The area AUC under the ROC curve of Jerk in the anteroposterior direction when the stimulus is tilted to the healthy side is statistically significant(P<0.05).(9)The strength of dorsiflexion,toe flexion,varus,and eversion of the ankle joints on the affected side of hemiplegic patients was less than that of the contralateral side and normal controls(P<0.01).The absolute error values of proprioceptive indexes on the affected side of the hemiplegic patients were higher than those on the healthy side and the normal control group,and the difference was statistically significant(P<0.05,P<0.01).(10)Ankle strength and knee proprioception in patients with hemiplegia were not significantly correlated with RMS and Jerk indicators in the left and right directions when the stimulus was tilted forward,backward,and to the affected side(P>0.05).Conclusion(1)Patients with chronic ankle instability and hemiplegia have varying degrees of reduced balance relative to normal participants.(2)The RMS and Jerk of DE-A somatosensory balance detection system can effectively distinguish between normal people,patients with chronic ankle instability and hemiplegia when the stimulation is tilted forward and the affected side is stimulated,and provides an objective and effective method for evaluating balance ability in clinical practice.(3)Patients with chronic ankle instability and hemiplegia have decreased ankle muscle strength and knee and ankle proprioception compared with normal people.(4)Ankle valgus force can affect the magnitude of oscillation on the coronal plane in patients with chronic ankle instability. |
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