高精度经颅直流电刺激对慢性踝关节不稳人群平衡功能、肌力及本体感觉的影响

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中图分类号：G804.6 文献标志码：A文章编号：1000-4939（2025）03-0694-08

Abstract：Objective To investigate the effects of high-definition transcranial direct current stimulation （HD-tDCS）on balance function，muscle strength and proprioception in patients with chronic ankle instability（CAI）.Methods In this double-blinded sham-controlled study，26 patients with CAI were enrolled and randomly completed two trials with a 20-minute session of tDCS targeting the sensorimotor cortex or a sham stimulation.The interval between two interventions was at least one week.Dynamic balance （Y balance），static balance，maximum muscle strength of plantar flexion/dorsiflexion of ankle joint and proprioception were completed before and after each intervention.Two-way ANOVA with repeated measures was used to analyze the efects of each variable on the above indicators.Results Twenty-five subjects completed all tests，and the overall accuracy of the stimulus was 43.1% .Two-way ANOVA showed that there was a significant interaction effect on the composite score of Y balance ′=6.279，P=0.016 ， ηp2=0.112） . In addition，there were significant interaction efects on the left-right range of the pressure center of static balance （ F=4.73 ， P=0.035 ， ηp2=0.088 ）and the average left-right velocity （ F=4.98，P=0.030 ， ηp2= 0.092）as well. There was no significant interaction effect on maximum muscle strength and proprioception.Further analysis showed that the composite score of Y balance increased significantly by 1.5% （ P< 0.001）after true stimulation；The range and velocity of the pressure center in the left and right directions decreased by 13.7% and 14.8% （ P<0.001，P<0.001） .The maximum voluntary contraction of the ankle plantar flexion increased by 5% （ P=0.022 ）. Conclusion The use of HD-tDCS to regulate the excitability of the sensorimotor cortex can effctively improve the ankle muscle strength，dynamic posture control ability and static balance ability of the population with CAI，which helps to reduce the symptoms of ankle instability and the risk of re-injury in this population.

Key words：high-definition transcranial electrical stimulation ;posture control;lower limb muscle strength; proprioception ;chronic ankle instability

踝关节扭伤是肌肉骨骼系统中最常见的运动损伤，高达 40% 的人在踝关节初次扭伤后，最终发展成为慢性踝关节不稳（chronicankle instability，CAI）[1]。（剩余17589字）