內翻踝關節扭傷風險因子與傷害預防之建議──系統性回顧

Inversion ankle sprain risk factors and injury prevention recommendations: A systematic review

內翻踝關節扭傷是運動場上最常見的一種運動傷害之一，且有高再次扭傷與慢性傷害的風險。探討首次與再次內翻踝關節扭傷的潛在風險因子，可協助臨床工作者篩選傷害風險較高的運動員，以提供精準的傷害預防策略。本系統性回顧之目的為：（一）探討內翻踝關節扭傷的潛在風險因子，並依照收錄文獻之證據力加以分級，與（二）依照運動傷害動態迴圈模型與運動傷害成因模組，統整內翻踝關節扭傷之風險因子，提供臨床工作者與研究人員內翻踝關節扭傷預防之實證指引。本研究發現，大部分研究探討可調控之內在風險因子，探討外在風險因子的研究相當稀少。研究證實動態姿勢控制不穩定為內翻踝關節扭傷的風險因子。部分研究指出，髖關節肌力可能藉由影響踝關節動力學與運動學，進而提升踝關節內翻扭傷的風險。本研究建議臨床工作者設計個人化的預防內翻踝關節扭傷訓練與復健課表時，可加入改善可調控的內在風險因子（動態的姿態平衡與髖關節肌力）之介入。此外，本研究發現缺乏足夠高品質研究，與探討外在風險因子的研究不足，為本研究發現之知識缺口。建議未來應有更多研究投入此議題，提供更多高證據力的研究成果並補足此缺口，協助設計更全面首次與再次內翻踝關節扭傷傷害預防計畫。

Inversion ankle sprain (IAS) is one of the most common sport injuries on the sports field, with a high risk of secondary injury and chronic condition. Investigating the potential risk factors for first-time and recurrent IAS can assist clinicians in identifying high-risk athletes and providing appropriate injury prevention strategies. This systematic review aims to (1) holistically summarize the research evidence in IAS risk factors according to the dynamic recursive and injury aetiology model, and (2) based on the level of evidence of each research, provide clinicians with injury prevention recommendations. According to this systematic review, most of the literature examined the modifiable intrinsic risk factors, and dynamic postural control instability is one of the prevalent IAS risk factors. Additionally, some research suggested that hip muscle strength may affect ankle kinetics and kinematics, increasing IAS risk. Therefore, we recommend that clinicians design personalized training and rehabilitation regimens that target modifiable intrinsic risk factors, including dynamic postural control and hip muscle strength. Finally, the lack of high-quality research, and the lack of research on extrinsic risk factors, are the knowledge gaps identified in the present study. Future studies are warranted to provide more high-level evidence to assist clinicians in a more comprehensive review of the risk factors for IAS and achieve injury prevention for first-time and recurrent IAS.