Effect of CCEP on muscle activation index.

Limited ankle dorsiflexion range of motion is one of the most important risk factors for lower limb injury, which changes the biomechanics and the neuromuscular control of the lower limb muscles. This study aims to test the effectiveness of a comprehensive corrective exercise program (CCEP) on the range of motion, proprioception, dynamic balance, and muscle activation in female athletes with limited weight-bearing lunge ankle dorsiflexion range of motion. 30 female athletes aged 15 to 25 years with dorsiflexion under 34° were randomized to two groups. The intervention group (n = 15) received eight weeks of CCEP including soft tissue mobilization, joint mobilization, stretching, and strengthening, and the control (n = 15) group did not receive any intervention. range of motion, proprioception, dynamic balance, and muscle activation were assessed before and after the intervention. The training group showed clinically acceptable and statistically significant changes in ankle dorsiflexion range of motion (ES = 0.714), balance (ES = 0.423), and proprioception (ES = 0.253; P < 0.05). There were significant changes in the activity of the tibialis anterior and soleus muscles in the dynamic overhead squat test (descending and ascending phases) and the activity of the medial gastrocnemius in the descending phase decreased significantly (P < 0.05). No significant change was observed in the activity of the peroneus longus muscle (P > 0.05). The findings show that CCEP appears to be beneficial in increasing dorsiflexion range of motion, proprioception, balance, and decreasing ankle muscle activity among individuals with limited ankle dorsiflexion. Improving the dorsiflexion range of motion may be promising for reducing ankle sprain injury.

踝背屈活动度（ankle dorsiflexion range of motion）受限是下肢损伤（lower limb injury）最重要的危险因素之一，其可改变下肢肌肉的生物力学（biomechanics）与神经肌肉控制（neuromuscular control）。本研究旨在评估综合矫正训练方案（comprehensive corrective exercise program, CCEP）对负重弓步状态下踝背屈活动度受限的女性运动员的活动度、本体感觉（proprioception）、动态平衡（dynamic balance）及肌肉激活（muscle activation）水平的改善效果。招募30名年龄15~25岁、踝背屈活动度低于34°的女性运动员，将其随机分为两组：干预组（n=15）接受为期8周的CCEP训练，内容涵盖软组织松动术（soft tissue mobilization）、关节松动术（joint mobilization）、牵伸训练与力量训练；对照组（n=15）不接受任何干预。分别于干预前后对受试者的上述指标进行评估。结果显示，干预组在踝背屈活动度（ES=0.714）、平衡能力（ES=0.423）及本体感觉（ES=0.253；P<0.05）方面均呈现出临床可接受且具有统计学意义的改善。在动态过头深蹲测试（dynamic overhead squat test）的下蹲与起身阶段，胫骨前肌（tibialis anterior）与比目鱼肌（soleus）的激活水平均出现显著变化；其中腓肠肌内侧头（medial gastrocnemius）在下降阶段的激活水平显著降低（P<0.05），而腓骨长肌（peroneus longus muscle）的激活水平未出现显著变化（P>0.05）。本研究结果表明，CCEP可有效提升踝背屈活动度受限人群的踝背屈活动度、改善本体感觉与动态平衡能力，并降低踝关节周围肌肉的异常激活水平。提升踝背屈活动度或可为降低踝关节扭伤（ankle sprain injury）风险提供新的干预思路。