经皮神经电刺激联合弹力带训练对慢性踝关节不稳患者康复影响研究与机制探讨

A Study on the Impact of Transcutaneous Electrical Nerve Stimulation Combined with Elastic Band Training on the Rehabilitation of Patients with Chronic Ankle Instability and Its Mechanism Exploration

摘要: 目的：探讨经皮神经电刺激(Transcutaneous Electrical Nerve Stimulation, TENS)联合弹力带训练对慢性踝关节不稳(Chronic Ankle Instability, CAI)患者姿势控制能力的影响。方法：共纳入45名CAI患者，随机分为TENS组、弹力带运动训练组和联合训练组各15名。在3个月的训练干预前后，对所有患者进行静态和动态平衡测试以及肌肉电生理测试，对采集数据进行重复测量双因素(干预方式 × 时间)方差分析其自变量对动、静态平衡能力以及肌肉激活模式的影响。结果：经3个月干预，三组的静动态平衡能力和肌肉活性均有所提高，但联合训练组在静态平衡测试中摆动距离和速度下降最显著，完成动态平衡测试所需时间最短以及肌肉活性显著提高(p < 0.05)，表明TENS联合弹力带训练可有效提高CAI患者姿势控制能力。结论：连续3个月的TENS联合弹力带训练在增强肌肉力量与活性、促进神经功能恢复、提升肢体平衡与协调功能等方面均表现出显著效果，为CAI康复提供了新的策略。该结果表明多模式康复策略可能通过协同作用优化CAI患者的神经肌肉功能。

Abstract: Objective: To investigate the effect of transcutaneous electrical nerve stimulation (TENS) combined with elastic band training on postural control in patients with chronic ankle instability (CAI). Methods: A total of 45 patients with CAI were randomly divided into TENS group, elastic band exercise training group and joint training group, with 15 in each group. Before and after the three-month and six-week training intervention, static and dynamic balance tests and muscle electrophysiology tests were performed on all patients, and repeated measures of two-way (intervention mode × time) variance analysis were performed on the collected data, and the effects of independent variables on dynamic and static balance ability and muscle activation patterns were performed. Results: After 3 months and 6 weeks of intervention, the static and dynamic balance ability and muscle activity of the three groups were improved, but the swing distance and speed decreased most significantly in the static balance test in the joint training group, the time required to complete the dynamic balance test was the shortest, and the muscle activity was significantly increased (p < 0.05), indicating that TENS combined with elastic band training could effectively improve the posture control ability of CAI patients. Conclusion: TENS combined with elastic band training for three months and six weeks showed significant effects in enhancing muscle strength and activity, promoting neurological recovery, and improving limb balance and coordination function, which provided a new strategy for CAI rehabilitation. The results suggest that a multimodal rehabilitation strategy may optimize neuromuscular function in patients with CAI through synergistic effects.