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目的:观察神经肌肉关节促进法(neuromuscular joint facilitation,NJF)对功能性踝关节不稳(functional ankle instability,FAI)患者的干预效果。方法:采用坎伯兰踝关节不稳问卷(cruamberland ankle instability tool,CAIT)筛选2020年10月至2021年1月华北理工大学FAI受试者53例作为研究对象。应用计算机随机数字法将53例受试者随机分为对照组27例和NJF组26例。对照组接受常规康复训练;NJF组在常规康复训练基础上增加NJF手法干预。分别在干预前和干预8周后采用Biodex等速测试训练系统比较两组受试者等速向心离心模式下受累踝关节内、外翻肌群相对峰值力矩和内外翻肌群相对峰值力矩比;采用Tecnobody平衡仪评估比较两组受试者静态平衡能力;采用星状平衡偏移测试(star excursion balance test,SEBT)评估比较两组受试者动态平衡能力;记录比较两组受试者采用 CAIT方法。采用前瞻性队列研究方法。正态分布的计量资料以n xˉ±s表示,两组间比较采用独立样本n t检验,组内干预前后比较采用配对n t检验;计数资料以例(%)表示,组间比较采用χn 2检验。n 结果:干预后NJF组在60°/s角速度下内翻相对峰值力矩为(30.28±5.17)%、外翻相对峰值力矩为(28.93±5.15)%、内外翻相对峰值力矩比1.05±0.08;180°/s角速度下内翻相对峰值力矩(27.17±5.24)%、外翻相对峰值力矩(24.62±3.57)%、内外翻相对峰值力矩比1.10±0.12,对照组以上各指标分别为(27.05±5.95)%、(23.90±3.81)%、1.13±0.15和(24.12±5.36)%、(20.35±3.74)%、1.19±0.18,差异均有统计学意义(n t值分别为2.11、4.06、2.35、2.09、4.25、2.10,n P值分别为0.040、<0.001、0.024、0.042、<0.001、0.040)。干预后NJF组前后方向平均速度[睁眼:(23.19±5.25)mm/s、闭眼:(65.65±10.51)mm/s]、左右方向平均速度[睁眼:(23.73±4.73)mm/s、闭眼:(72.08±10.28)mm/s]、运动椭圆面积[睁眼:(913.77±348.90)mmn 2、闭眼:(3 271.65±1024.48)mmn 2]和运动长度[睁眼:(845.04±146.68)mm;闭眼:(2 055.42±548.89)mm]均低于对照组(26.41±4.89)mm/s、(71.52±9.85)mm/s、(27.56±7.68)mm/s、(78.67±11.74)mm/s、(1 174.33±424.20)mmn 2、(3 989.41±1 410.00)mmn 2,(1 041.93±291.28)mm、(2 490.93±541.94)mm,差异均有统计学意义(n t值分别为2.31、2.10、2.17、2.17、2.44、2.11、3.13、2.97,n P值分别为0.025、0.041、0.034、0.035、0.018、0.040、0.003、0.005)。干预后NJF组SEBT 8个方向评分分别为前(73.16±6.04)%、前外(65.90±5.54)%、外(74.36±7.77)%、后外(88.05±6.76)%、后(83.31±6.64)%、后内(86.01±7.62)%、内(77.39±8.44)%、前内(72.36±6.74)%,对照组分别为(67.65±6.03)%、(61.08±5.96)%、(67.72±8.28)%、(78.33±8.06)%、(76.22±8.71)%、(79.31±7.24)%、(71.36±7.00)%和(67.12±7.21)%,两组比较差异均有统计学意义(n t值分别为3.32、3.05、3.01、4.75、3.33、3.28、2.83、2.73,n P值分别为0.002、0.004、0.004、<0.001、0.002、0.002、0.007、0.009)。干预后NJF组CAIT评分(23.04±3.96)分高于对照组(19.15±3.56)分,两组比较差异有统计学意义(n t=3.76,n P<0.001)。n 结论:NJF可显著改善FAI患者的踝关节内外翻肌力并增进内外翻肌群协调性,有效提升其静动态平衡能力。“,”Objective:To observe the intervention effect of neuromuscular joint facilitation (NJF)in patients with functional ankle instability (FAI).Methods:Fifty-three FAI subjects from North China University of Science and Technology from October 2020 to January 2021 were selected by cruamberland ankle instability tool (CAIT). According to the computer random number method, the 53 subjects were randomly divided into the control group (27 cases) and NJF group (26 cases). The control group received routine rehabilitation training, while the NJF group received NJF manipulation intervention on the basis of routine rehabilitation training. Before intervention and 8 weeks after intervention,ankle joint isokinetic muscle strength (invertor\\evertor relative reak tergue) and the ratio of invertor to evertor of subjects in the two groups was evaluated and compared by Biodex isokinetic test training system, and the static balance ability of subjects in the two groups was evaluated and compared by Tecnobody balance instrument,and the dynamic balance ability of subjects in the two groups was evaluated and compared by star excursion balance test (SEBT), and the two groups were recorded and compared using the CAIT. A prospective cohort study was used. The measurement data of normal distribution are expressed by ± s. The mean between the two groups is compared by independent sample t-test, and the comparison before and after Intervention in the group is compared by paired t-test; The counting data were expressed in cases (%), and the comparison between groups was adopted χn 2 inspection.n Results:After intervention, the NJF group at 60°/s angular velocity: invertor relative reak tergue (30.28±5.17) 0%, evertor relative reak tergue (28.93±5.15)%, the ratio of invertor to evertor (1.05±0.08) and 180°/s angular velocity: invertor relative reak tergue (27.17±5.24)%, evertor relative reak tergue (24.62±3.57)%, the ratio of invertor to evertor (1.10±0.12) were better than control group (27.05±5.95)%, (23.90±3.81)%, (1.13±0.15) and (24.12±5.36)%, (20.35±3.74)%, (1.19±0.18), and the differences were statistically significant (n t value were 2.11, 4.06, 2.35, 2.09, 4.25, 2.10, respectively; n P value were 0.040, <0.001, 0.024, 0.042, <0.001, 0.040, respectively). After intervention, average AP speed of COP in the NJF group (open eyes: (23.19±5.25) mm/s; closed eyes: (65.65±10.51) mm/s), average ML speed of COP (open eyes: (23.73±4.73) mm/s; closed eyes: (72.08±10.28) mm/s), ellipse area of COP (open eyes: (913.77±348.90) mm n 2; closed eyes: (3 271.65±1 024.48) mmn 2) and perimeter of COP (open eyes: (845.04±146.68) mm; closed eyes: (2 055.42±548.89) mm) were lower than those of the control group (26.41±4.89) mm/s, (71.52±9.85) mm/s, (27.56±7.68) mm/s, (78.67±11.74) mm/s, (1 174.33±424.20) mmn 2, (3 989.41±1 410.00) mmn 2, (1 041.93±291.28) mm, (2 490.93±541.94) mm, the differences were statistically significant (n t value were 2.31, 2.10, 2.17, 2.17, 2.44, 2.11, 3.13, 2.97, respectively; n P value were 0.025, 0.041, 0.034, 0.035, 0.018, 0.040, 0.003, 0.005, respectively). After intervention,the 8 directions of SEBT scores in the NJF group:Anterior (73.16±6.04)%, Anterolateral (65.90±5.54)%, Lateral (74.36±7.77)%, Posterolateral (88.05±6.76)%, Posterior (83.31±6.64)%, Posteromedial (86.01±7.62)%, Medial (77.39±8.44)% and Anteromedial (72.36±6.74)% were all higher than the control group (67.65±6.03)%, (61.08±5.96)%, (67.72±8.28)%, (78.33±8.06)%, (76.22±8.71)%, (79.31±7.24)%, (71.36±7.00)%, and (67.12±7.21)%,the differences were statistically significant (n t value were 3.32, 3.05, 3.01, 4.75, 3.33, 3.28, 2.83, 2.73, respectively; n P value were 0.002 ,0.004, 0.004, <0.001, 0.002, 0.002, 0.007, 0.009, respectively). After intervention, the CAIT score of NJF group (23.04±3.96) points was higher than that of control group (19.15±3.56) points, and the difference was statistically significant ( n t=3.76, n P<0.001).n Conclusion:NJF can significantly improve the internal and external muscle strength of the ankle joint and enhance the coordination of the internal and external muscle group, and effectively improve the static and dynamic balance ability of FAI patients.