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Goulart Neto AM, Maffulli N, Migliorini F, de Menezes FS, Okubo R. Validation of Foot and Ankle Ability Measure (FAAM) and the Foot and Ankle Outcome Score (FAOS) in individuals with chronic ankle instability: a cross-sectional observational study. J Orthop Surg Res 2022; 17:38. [PMID: 35062990 PMCID: PMC8781557 DOI: 10.1186/s13018-022-02925-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/06/2022] [Indexed: 12/26/2022] Open
Abstract
Abstract
Background
Ankle sprain is the most common lower limb injury in physically active individuals. Loss of function, decreased postural control (PC), strength deficit, and reduced range of motion (ROM) are common after acute lateral ankle sprains. Some patients experienced long lasting symptoms, with recurrent sprains, and episodes of giving-way: a condition known as chronic ankle instability (CAI). Evaluating the function in patients with CAI in the clinical environment is important to identify the severity of the condition, in addition to allowing to assess the effectiveness of a given treatment. The aim of this study was to investigate the validation of the Foot and Ankle Ability Measure (FAAM) and the Foot and Ankle Outcome Score (FAOS) in terms of muscle strength, PC and ROM in adults with CAI.
Methods
This is a cross-sectional study. Individuals with CAI aged between 18 and 45 years were eligible. Individuals with CAI were identified using the Identification of Functional Ankle Instability (IdFAI). All patients filled in the FAAM and FAOS scores. Muscle strength was assessed by manual dynamometry, ROM by the Lunge test, PC by computerized posturography, modified Star Excursion Balance Test (mSEBT) and modified Balance Error Score System (mBESS).
Results
50 participants were enrolled in the present study. The mean age of the patients was 27.2 ± 6.3 years, and the mean body mass index was 26.4 ± 4.8 kg/m2. 58% (29 of 50) were men and 42% (21 of 50) women. 18 individuals had unilateral (36%) and 32 bilateral (64%) CAI. The results of FAAM were associated with MCT, mSEBT, invertor muscles strength, plantar flexor muscles strength, dorsiflexor muscles strength, and external hip rotator muscles strength (P < 0.05). The results of FAOS were associated with mSEBT, invertor muscles strength, plantar flexor muscles strength, dorsiflexor muscles strength, evertor muscles strength, and external hip rotator muscles strength, and mBEES (P < 0.05).
Conclusion
Both the FAAM and FAOS demonstrated validity to evaluate postural control and muscle strength in patients with CAI, while no association was found in relation to ankle dorsiflexion.
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Anatomical study of the inferior extensor retinaculum and the oblique superolateral band: implications for the Brostrom-Gould procedure. BMC Musculoskelet Disord 2022; 23:28. [PMID: 34983476 PMCID: PMC8729066 DOI: 10.1186/s12891-021-04932-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/05/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose The Brostrom-Gould procedure is currently the gold standard surgical choice for the treatment of chronic ankle instability; it can significantly improve ankle function and stability in patients. However, recent studies have reported doubts regarding the feasibility of the inferior extensor retinaculum (IER) after Brostrom-Gould and therapeutic effects compared with the Brostrom procedure. The purpose of the present study was to observe the anatomical characteristics of the lateral part of the IER using cadaveric bodies in order to guide the surgical operation of chronic ankle instability. Methods Twenty-three cadaveric ankles were dissected. The morphology of the IER and its internal structure was observed and recorded for each ankle. The shortest distance between the Stem ligament of the IER and the anterior fibular periosteum (AFP) was measured and recorded, then attempts were made to suture the Stem to the AFP. Results Twelve of the cadaveric ankles were observed as having an oblique superolateral band (OSLB) that had a tough texture upward of the lateral IER connecting with SL, as are the characteristics of the oblique superolateral band (OSLB) reported in previous studies. The inner and outer membrane of the OSLB were connected with inner and outer membrane of Stem. The average value of the distance between the Stem and AFP was 11.60 ± 2.71 mm, and the maximum and the minimum distance were 19.04 mm and 6.53 mm, respectively. The P -value (P = 0.2) resulting from a single sample K-S test confirmed that the distribution of distances conformed to normality. None of the SL in the study could be sutured to the AFP. Conclusion The OSLB of the IER has a tough texture and connects with the Stem, and has the potential be utilised in the Brostrom-Gould procedure. However, we do not recommend utilization of the Stem in this operation regardless of the distance between the AFP and the Stem. When the Stem cannot be used to enhance repair in this operation, other solutions can be used for strengthening and to protect the repaired ATFL.
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Tomás R, Visco CJ. Management of Acute Ankle Sprains in the Athlete. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-021-00336-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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104
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Walters R, Kasik J, Ettel C, Ortiz R. Evaluation of Sustained Acoustic Medicine for Treating Musculoskeletal Injuries in Military and Sports Medicine. Open Orthop J 2022; 16:e187432502211210. [PMID: 36694709 PMCID: PMC9869494 DOI: 10.2174/18743250-v16-e221130-2022-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Musculoskeletal injuries are common in collegiate, professional, and military personnel and require expedited recovery to reduce lost work time. Sustained acoustic medicine (SAM) provides continuous long-duration ultrasound at 3MHz and 132mW/cm2. The treatment is frequently prescribed to treat acute and chronic soft tissue injuries and reduce pain. The objective of this study was to evaluate the efficacy of SAM treatment for musculoskeletal injuries and accelerated recovery. Methods An 18-question electronic survey and panel discussion were conducted on Athletic Trainers (ATs) using SAM treatment in professional, collegiate, and military sports medicine. The survey included both qualitative and quantitative questions. In addition, a panel discussion discussed SAM effectiveness with expert ATs. Power calculation of sampling and statistical evaluation of data was utilized to generalize the results. Results Survey respondents (n=97) and panelists (n=142) included ATs from all National Athletic Trainers Association districts. SAM was primarily used for musculoskeletal injuries (83.9%, p<0.001) with a focus on healing tendons and ligaments (87.3%, p<0.001). SAM treatment was also used on joints (44.8%), large muscle groups (43.7%), and bone (41.4%). SAM provided clinical improvement in under 2 weeks (68.9%, p<0.001) and a 50% reduction in pain medication (63%, p<0.001). In addition, patients were highly receptive to treatment (87.3%, p<0.001), and ATs had a high level of confidence for improved function and returned to work after 30-days of SAM use (81.2%, p<0.001). Conclusion SAM is an effective, safe, easy-to-use, noninvasive, comfortable, and versatile therapeutic for healing musculoskeletal injuries.
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Affiliation(s)
- Rod Walters
- NATA Hall of Fame, Walters Inc. Consultants in Sports Medicine, Columbia, SC, USA
| | - John Kasik
- Atheltic Training and Sports Medicine, University of South Carolina, Columbia, SC, USA
| | - Cassie Ettel
- Atheltic Training, Jacksonville Jaguars, Jacksonville, FL, USA
| | - Ralph Ortiz
- Cayuga Medical Center, Medical Pain Consultants, Dryden, NY, USA,Address correspondence to this author at the Cayuga Medical Center, Medical Pain Consultants, Dryden, NY, USA; Tel: 6078449979;
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Delayed Rehabilitation Is Associated With Recurrence and Higher Medical Care Use After Ankle Sprain Injuries in the United States Military Health System. J Orthop Sports Phys Ther 2021; 51:619-627. [PMID: 34847698 DOI: 10.2519/jospt.2021.10730] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the influence of time taken to begin musculoskeletal rehabilitation on injury recurrence and ankle-related medical care use at 1 year after ankle sprain. DESIGN Retrospective cohort study of all beneficiaries of the US Military Health System seeking care for an ankle sprain over a 4-year period. METHODS Individuals were classified according to whether they did or did not receive physical rehabilitation. For those who received rehabilitation (n = 6150), linear relationships (with appropriate covariate controls) were analyzed with generalized linear models and generalized additive models to measure the effects of rehabilitation timing on injury recurrence and injury-related medical care use (costs and visits) at 1 year after injury. The nonlinear effect of rehabilitation timing on the probability of recurrence was assessed. RESULTS Approximately 1 in 4 people received rehabilitation. The probability of ankle sprain recurrence increased for each day that rehabilitation was not provided during the first week. The probability of ankle sprain recurrence plateaued until about 2 months after initial injury, then increased again, with 2 times greater odds of recurrence compared to those who received physical rehabilitation within the first month. When rehabilitation care was delayed, recurrence (odds ratio [OR] = 1.28), number of foot/ankle-related visits (OR = 1.22), and foot/ankle-related costs increased (OR = 1.13; up to $1400 per episode). CONCLUSION The earlier musculoskeletal rehabilitation care started after an ankle sprain, the lower the likelihood of recurrence and the downstream ankle-related medical costs incurred. J Orthop Sports Phys Ther 2021;51(12):619-627. doi:10.2519/jospt.2021.10730.
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106
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Waldrop NE, Kouk S. Rehabilitation and Return to Play Considerations. OPER TECHN SPORT MED 2021. [DOI: 10.1016/j.otsm.2021.150867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kirkham H. Limp referrals? Improving ankle and foot radiograph referral appropriateness in a military primary care setting. BMJ Mil Health 2021; 169:286-287. [PMID: 34819360 DOI: 10.1136/bmjmilitary-2021-002038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 11/04/2022]
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McCreadie J, Whyte O, Greig M. A critical appraisal of ankle rehabilitative interventions. Res Sports Med 2021:1-9. [PMID: 34779324 DOI: 10.1080/15438627.2021.2001648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Introduction Lateral ankle sprain is a common musculoskeletal pathology. Functional exercise progression is vital to restore full function. Aim The aim of this study was to compare the electromyographical response to a standard balance task on one stable and four unstable surfaces. Participants Twenty subjects (5 male, 15 females; age at 23 ± 7.1 years) were recruited to participate in the study. Methods A gym-based single session cross over design was used to compare peak and mean surface EMG (sEMG) activity of the Peroneus Longus, Tibilais Anterior and medial head of the gastrocnemius muscles whilst performing a standardized balance task on one stable surface and four unstable surfaces stable surface. Results A significant main effect for surface was found. Post-hoc testing revealed that the Floor and Trampoline (Trampet) elicited similar mean sEMG response. Discussion The results of the study propose a safe and stepwise progressive rehabilitation regime following ankle injury whilst considering the healing process of the injured structure.
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Affiliation(s)
- John McCreadie
- Sports Injuries Research Group, Faculty of Arts and Science, Edgehill University, Ormskirk, UK
| | - Olivia Whyte
- Sports Injuries Research Group, Faculty of Arts and Science, Edgehill University, Ormskirk, UK
| | - Matt Greig
- Sports Injuries Research Group, Faculty of Arts and Science, Edgehill University, Ormskirk, UK
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The Star Excursion Balance Test: An Update Review and Practical Guidelines. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2021. [DOI: 10.1123/ijatt.2020-0106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The Star Excursion Balance Test (SEBT) is a reliable, responsive, and clinically relevant functional assessment of lower limbs’ dynamic postural control. However, great disparity exists regarding its methodology and the reported outcomes. Large and specific databases from various population (sport, age, and gender) are needed to help clinicians when interpreting SEBT performances in daily practice. Several contributors to SEBT performances in each direction were recently highlighted. The purpose of this clinical commentary is to (a) provide an updated review of the design, implementation, and interpretation of the SEBT and (b) propose guidelines to standardize SEBT procedures for better comparisons across studies.
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110
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Chronic ankle instability has no correlation with the number of ruptured ligaments in severe anterolateral sprain: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2021; 29:3512-3524. [PMID: 33993320 DOI: 10.1007/s00167-021-06610-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/07/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Despite being a significant public health problem, ankle sprains' prognostic factors are largely unknown. This review aimed to systematically analyze the literature on acute ankle sprains to compare the prognosis of a combined anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments rupture with an isolated ATFL rupture in terms of progression to chronic ankle instability and other clinical outcomes. METHODS The databases for Pubmed, CENTRAL and Web of Science were searched. Clinical studies reporting the prognostic effect of combined ATFL-CFL rupture versus an isolated ATFL rupture in conservatively treated ankle sprains, with a minimum follow-up of 12 months, were eligible for inclusion. Only studies with a reliable diagnostic method for anterolateral ankle ligaments evaluation, namely ultrasonography, magnetic resonance imaging, arthrography or stress tenography, were included. The relative risk (RR), along with the 95% confidence interval (CI), was used to quantitatively analyze the main outcomes. RESULTS Nine papers were selected for inclusion, of which five were suitable for quantitative analysis. None of them found a statistically significant correlation between ligament injury severity and progression to chronic instability. Concerning other clinical outcomes, three studies found a statistically significant correlation between a combined ligament injury and a worse clinical prognosis. From the quantitative analysis, the relative risk (RR) of chronic ankle instability in a single versus a combined ligament rupture showed no significant difference. CONCLUSION A significant statistical correlation between a combined ATFL-CFL rupture and chronic ankle instability, compared to an isolated ATFL rupture, was not found. There is, however, fair evidence showing a worse clinical outcome score in the combined ruptures, as well as a decreased return to full sports activities. The use of reliable and accessible diagnostic methods to determine the number of ruptured ligaments might have a role in managing severe ankle sprains. LEVEL OF EVIDENCE Level III.
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111
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Chen X, Wang L, Li X, Fu P, Xu M, Zou C, Li X, Dong Y. Can virtual touch tissue imaging quantification be a reliable method to detect anterior talofibular ligament type I injury at the acute, subacute, and chronic stages? Quant Imaging Med Surg 2021; 11:4334-4341. [PMID: 34603988 DOI: 10.21037/qims-21-203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/06/2021] [Indexed: 11/06/2022]
Abstract
Background Anterior talofibular ligament (ATFL) injury affects ankle joint stability. To date, very few studies have examined tissue stiffness changes inside injured ligaments. Virtual touch tissue imaging quantification (VTIQ) allows for the non-invasive quantitative measurement of tissue stiffness. The present study aimed to examine the efficacy of VTIQ as a method for detecting ligament injury. Methods A total of 206 patients diagnosed with unilateral ATFL type I injury (81 acute cases, 69 subacute cases, and 56 chronic cases) were reviewed retrospectively. Shear wave velocity (SWV) values were collected from both the injured and non-affected sides of the ATFL using a virtual touch tissue imaging quantification technique (ACUSON Oxana 2, Siemens Medical Solutions USA, Inc.). Results The average SWV of injured ATFL was 4.09±1.15 m/s in the acute group, 5.60±1.39 m/s in the subacute group, and 7.74±1.44 m/s in the chronic group (P<0.001). The SWV values of the ATFL on the non-affected side were almost identical (acute 7.50±1.12 m/s, subacute 7.53±1.06 m/s, and chronic 7.61±1.30 m/s; P>0.05). The injured ATFL had a significantly lower SWV value than the non-affected ATFL in the acute and subacute groups (P<0.001); however, there was no significant difference in the chronic group (P>0.05). Concerning the validity of SWV as a predictor of acute and subacute ATFL injury, the receiver operator characteristics curve analysis showed that the best cut-off point for SWV was 6.165 m/s, with 84.3% sensitivity, 88.5% specificity, and an area under the curve of 0.93 (95% CI, 0.90-0.95). Conclusions VTIQ is a reliable sonographic method for detecting acute and subacute ATFL type I injury.
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Affiliation(s)
- Xiu Chen
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liang Wang
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiuyun Li
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Pinguo Fu
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Maosheng Xu
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chunpeng Zou
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xingwang Li
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yanyan Dong
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Christensen SWM, Rasmussen MB, Jespersen CL, Sterling M, Skou ST. Soft-collar use in rehabilitation of whiplash-associated disorders - A systematic review and meta-analysis. Musculoskelet Sci Pract 2021; 55:102426. [PMID: 34271416 DOI: 10.1016/j.msksp.2021.102426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Active rehabilitation of Whiplash Associated Disorders (WAD) is favoured over passive modalities such as soft-collars. However, the effectiveness of soft-collar use remains unclear. OBJECTIVE To investigate the effectiveness of soft-collar use on pain and disability in WAD. DESIGN Systematic review. METHOD Databases (AMED, CINAHL Complete, Cochrane Library, Embase, Medline, PEDro, PsycINFO, PubMed, SPORTDiscus) were searched for guidelines, reviews and RCTs on soft-collar use as part of WAD treatment. Reference lists of reviews and guidelines were screened for additional RCTs. Study quality was rated using the PEDro-scale and overall quality of evidence with GRADE. RESULTS Four RCTs (n = 409) of fair-good quality (PEDro-scores) were included with three using a soft collar in addition to other conservative treatment while one study compared soft-collar use to act-as-usual. All studies found that an active or act-as-usual approach was more effective in reducing pain intensity compared to soft-collar use, confirmed by meta-analysis (two RCTs with data: SMD of -0.80 (-1.20, -0.41)). No studies reported disability outcomes while contrasting results were found between groups regarding total cervical range of motion (two RCTs with data: SMD of 0.16 (-0.21, 0.54)) or rotation (two RCTs with data: SMD of 0.54 (-0.19, 1.27)). Overall quality of the evidence was low to very low. CONCLUSION All four RCTs favoured an active approach/act-as-usual over soft-collar treatment. However, due to methodological concerns and low certainty of evidence, future studies investigating soft collar use in combination with an active rehabilitation strategy for acute/subacute WAD are needed.
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Affiliation(s)
- Steffan Wittrup McPhee Christensen
- Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D-3, 9220, Aalborg, Denmark; Department of Physiotherapy, University College of Northern Denmark (UCN), Selma Lagerløfs Vej 2, 9220, Aalborg, Denmark.
| | - Michael Bo Rasmussen
- Department of Physiotherapy, University College of Northern Denmark (UCN), Selma Lagerløfs Vej 2, 9220, Aalborg, Denmark
| | - Christoffer Lund Jespersen
- Department of Physiotherapy, University College of Northern Denmark (UCN), Selma Lagerløfs Vej 2, 9220, Aalborg, Denmark
| | - Michele Sterling
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Søren Thorgaard Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200, Slagelse, Denmark
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113
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Lan R, Piatt ET, Bolia IK, Haratian A, Hasan L, Peterson AB, Howard M, Korber S, Weber AE, Petrigliano FA, Tan EW. Suture Tape Augmentation in Lateral Ankle Ligament Surgery: Current Concepts Review. FOOT & ANKLE ORTHOPAEDICS 2021; 6:24730114211045978. [PMID: 35097476 PMCID: PMC8532228 DOI: 10.1177/24730114211045978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Chronic lateral ankle instability (CLAI) is a condition that is characterized by persistent disability and recurrent ankle sprains while encompassing both functional and mechanical (laxity) instability. Failure of conservative treatment for CLAI often necessitates operative intervention to restore the stability of the ankle joint. The traditional or modified Broström techniques have been the gold standard operative approaches to address CLAI with satisfactory results; however, patients with generalized ligament laxity (GLL), prior unsuccessful repair, high body mass index, or high-demand athletes may experience suboptimal outcomes. Synthetic ligament constructs have been tested as an adjunct to orthopedic procedures to reinforce repaired or reconstructed ligaments or tendons with the hope of early mobilization, faster rehabilitation, and long-term prevention of instability. Suture tape augmentation is useful to address CLAI. Multiple operative techniques have been described. Because of the heterogeneity among the reported techniques and variability in postoperative rehabilitation protocols, it is difficult to evaluate whether the use of suture tape augmentation provides true clinical benefit in patients with CLAI. This review aims to provide a comprehensive outline of all the current techniques using suture tape augmentation for treatment of CLAI as well as present recent research aimed at guiding evidence-based protocols.
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Affiliation(s)
- Rae Lan
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Eric T. Piatt
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Ioanna K. Bolia
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Aryan Haratian
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Laith Hasan
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Alexander B. Peterson
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Mark Howard
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Shane Korber
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Alexander E. Weber
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Frank A. Petrigliano
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
| | - Eric W. Tan
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA
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Rhon DI, Greenlee TA, Cook CE, Westrick RB, Umlauf JA, Fraser JJ. Fractures and Chronic Recurrence are Commonly Associated with Ankle Sprains: a 5-year Population-level Cohort of Patients Seen in the U.S. Military Health System. Int J Sports Phys Ther 2021; 16:1313-1322. [PMID: 34631252 PMCID: PMC8486414 DOI: 10.26603/001c.27912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/05/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Whereas ankle-foot injuries are ubiquitous and affect ~16% of military service-members, granularity of information pertaining to ankle sprain subgroups and associated variables is lacking. The purpose of this study was to characterize and contextualize the burden of ankle sprain injuries in the U.S. Military Health System. METHODS This was a retrospective cohort study of beneficiaries seeking care for ankle sprains, utilizing data from the Military Health System Data Repository from 2009 to 2013. Diagnosis and procedural codes were used to identify and categorize ankle sprains as isolated lateral, isolated medial, concomitant medial/lateral, unspecified, or concomitant ankle sprain with a malleolar or fibular fracture. Patient characteristics, frequency of recurrence, operative cases, and injury-related healthcare costs were analyzed. RESULTS Of 30,910 patients included, 68.4% were diagnosed with unspecified ankle sprains, 22.8% with concomitant fractures, (6.9%) with isolated lateral sprains, (1.7%) with isolated medial sprains and 0.3% with combined medial/lateral sprains. Pertaining to recurrence, 44.2% had at least one recurrence. Sprains with fractures were ~2-4 times more likely to have surgery within one year following injury (36.2% with fractures; 9.7% with unspecified sprains) and had the highest ankle-related downstream costs. CONCLUSION Fractures were a common comorbidity of ankle sprain (one in five injuries), and operative care occurred in 16.4% of cases. Recurrence in this cohort approximates the 40% previously reported in individuals with first-time ankle sprain who progress to chronic ankle instability. Future epidemiological studies should consider reporting on subcategories of ankle sprain injuries to provide a more granular assessment of the distribution of severity. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Daniel I Rhon
- Military Performance Division, United States Army Research Institute of Environmental Medicine; Department of Rehabilitation Medicine, Brooke Army Medical Center
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Barini M, Zagaria D, Licandro D, Pansini S, Airoldi C, Leigheb M, Carriero A. Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2021; 11:1782. [PMID: 34679480 PMCID: PMC8534480 DOI: 10.3390/diagnostics11101782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The studies about injury to the anterior talo-fibular ligament (ATFL) are focused mainly on chronic symptoms and chronic instability, and the literature about the accuracy of magnetic resonance imaging (MRI) in acute injuries is quite lacking. METHODS This systematic review with meta-analysis analyzes the diagnostic accuracy of MRI on acute ATFL injury. Relative studies were retrieved after searching three databases (MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. The quality of the included articles was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data were extracted to calculate pooled sensitivity and specificity of MRI. RESULTS Seven studies met our inclusion and exclusion criteria. For MRI, the pooled sensitivities and specificity in diagnosing acute ATFL injury were respectively 1.0 (95% CI: 0.58-1) and 0.9 (95% CI: 0.79-0.96). Pooled LR+ and LR- were respectively 10.4 (95% CI: 4.6-23) and 0 (95% CI: 0-0.82). CONCLUSION This systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of acute ATFL injury. Our results demonstrated that MRI shows high diagnostic accuracy in the diagnosis of acute ATFL lesions. These results suggest that routine MRI in the case of suspected ATFL acute injury may be clinically useful, although this is not done in clinical practice due probably to high cost.
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Affiliation(s)
- Michela Barini
- Department of Radiodiagnostic and Interventional Radiology, AOU Maggiore della Carità, 28100 Novara, Italy; (M.B.); (D.L.); (S.P.); (A.C.)
| | - Domenico Zagaria
- Department of Radiodiagnostic and Interventional Radiology, AOU Maggiore della Carità, 28100 Novara, Italy; (M.B.); (D.L.); (S.P.); (A.C.)
| | - Davide Licandro
- Department of Radiodiagnostic and Interventional Radiology, AOU Maggiore della Carità, 28100 Novara, Italy; (M.B.); (D.L.); (S.P.); (A.C.)
| | - Sergio Pansini
- Department of Radiodiagnostic and Interventional Radiology, AOU Maggiore della Carità, 28100 Novara, Italy; (M.B.); (D.L.); (S.P.); (A.C.)
| | - Chiara Airoldi
- Unit of Medical Statistics and Epidemiology, Department of Translation Medicine, University of Piemonte Orientale, AOU Maggiore della Carità, 28100 Novara, Italy;
| | - Massimiliano Leigheb
- Orthopaedics and Traumatology Unit, Department of Health Sciences, University of Piemonte Orientale, AOU Maggiore della Carità, 28100 Novara, Italy;
| | - Alessandro Carriero
- Department of Radiodiagnostic and Interventional Radiology, AOU Maggiore della Carità, 28100 Novara, Italy; (M.B.); (D.L.); (S.P.); (A.C.)
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116
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Toyoshima Y, Akagi R, Nabeshima K. Isometric exercise during immobilization reduces the time to return to play after lateral ankle sprain. Phys Ther Sport 2021; 52:168-172. [PMID: 34547600 DOI: 10.1016/j.ptsp.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
[Objectives] Immobilization reduces symptoms after lateral ankle sprain but may worsen the range of motion (ROM) of the ankle and delay return to play (RTP). We aimed to elucidate the correlation between ankle ROM and time to RTP following immobilization for lateral ankle sprain and investigated if isometric exercise during immobilization would increase ROM and shorten the time to RTP. [Participants and outcome measures] Eighty-two patients with acute lateral ankle sprain were treated by a short-leg cast with or without isometric exercise and electrical muscle stimulation (EMS); intervention group or control group, respectively. The correlation between ankle ROM at cast removal and time to RTP was analyzed. The total and side-to-side ankle ROM and the time to RTP were compared between the two groups. [Results] Side-to-side difference in total ankle ROM significantly correlated with time to RTP (r = 0.38, p = 0.02). The intervention reduced the side-to-side difference in total ROM (20° versus 31°, p = 0.01) and time to RTP (46 versus 65 days, p = 0.01) compared to the control group. [Conclusion] Increased deficiency in ankle ROM led to a longer time to RTP, and isometric exercise combined with EMS during immobilization increased the total ankle ROM and shortened the time to RTP.
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Affiliation(s)
- Yasunao Toyoshima
- Health and Sports Association Nabeshima Orthopaedic Clinic, 4-23-2 Matsunami, Chuo-ku, Chiba, Chiba, 260-0044, Japan
| | - Ryuichiro Akagi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan; Sportsmedics Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan.
| | - Kazuo Nabeshima
- Health and Sports Association Nabeshima Orthopaedic Clinic, 4-23-2 Matsunami, Chuo-ku, Chiba, Chiba, 260-0044, Japan
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117
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Shumway JD, Vraa D. Short-Term Effect of Manual Therapy & Taping on Subacute Ankle Sprains with Potential Syndesmotic Sprain: A Case Series. J Man Manip Ther 2021; 30:116-123. [PMID: 34511056 DOI: 10.1080/10669817.2021.1974240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
STUDY DESIGN Case Series. BACKGROUND Syndesmotic ankle sprains can occur in up to 17% of ankle trauma and can lead to long-term disability. This study describes the management of seven patients with subacute, high-grade ankle sprains with concerns of concurrent syndesmotic strain utilizing manual therapy and rigid sports taping. METHODS Seven active duty military members with clinically diagnosed, high-grade ankle sprains and concern for syndesmotic sprain participated in this case series. All patients received multi-modal treatment consisting of manual therapy, rigid sports taping, progressive exercises, and proprioceptive training. Decrease in Numeric Pain Rating Scale (NPRS) following manual therapy and taping treatment, number of sessions before discharge, and the Global Rating of Change (GROC) at discharge were retrospectively reviewed. RESULTS All patients demonstrated an immediate decrease in NPRS following treatment on average of 5 points (range, 3-8 points) with a functional asterisk sign. The improvement in pain and function was maintained until the next treatment session with a mean GROC score of +3. The mean time until recovery was 5.4 weeks (range, 1-8 weeks). DISCUSSION A multimodal approach for patients diagnosed clinically with high-grade ankle sprains and concern for syndesmotic sprain was useful to immediately reduce pain and improve function, and improvements were maintained throughout the duration of care. This study is the first to assess a combination of manual therapy and rigid sports taping for the treatment of suspected syndesmotic ankle sprains, and more stringent research is needed to validate the findings. LEVEL OF EVIDENCE Therapy, 4.
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Affiliation(s)
- Joshua D Shumway
- Operational Medicine Readiness Squadron, Langley AFB, VA, United States.,Tactical Sports and Orthopedic Manual Physical Therapy Fellowship, US Air Force Academy, CO, United States
| | - Derek Vraa
- Tactical Sports and Orthopedic Manual Physical Therapy Fellowship, US Air Force Academy, CO, United States
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118
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Plangtaisong P, Shen W, Wheeler PC, Fong DT. Effect of exercise interventions and prophylactic devices on reducing peroneal muscle reaction time by sudden ankle perturbation: A systematic review and meta-analysis. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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119
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Kaldau NC, Kerr S, McCaig S, Hölmich P. Training and injuries among world elite junior badminton players - Identifying the problems. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2021; 26:21-26. [PMID: 34458102 PMCID: PMC8367832 DOI: 10.1016/j.asmart.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/01/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022]
Abstract
Background The game of badminton has evolved since the early injury epidemiology studies. Since there is no published literature on injuries in elite junior badminton players from an international cohort, this study provides an updated reference of injuries in this population to inform future injury prevention strategies. The objective of this study was to report injury prevalence and training hours in elite junior badminton players participating at the World Junior Championships in 2018. Methods A questionnaire was used to collect data and was available in English, French, Spanish, Korean, Japanese or Chinese. It was designed to collect information including basic demographics, hours of training and competition, number of tournaments per year, current and previous injuries characterized by anatomical region, diagnosis, treatment and injury duration. The questions were focused on previous significant injuries lasting a minimum of 30 days and current musculoskeletal symptoms. Results One hundred and sixty-four of 436 players with a mean age of 17.1 years (SD ± 0.8) filled in the questionnaire. Participants represented North and South America, Europe, Asia, Africa and The Pacific's including the top 10 performing nations, providing a good overall representation of tournament participants. A total of 104 significant injuries (median duration of 90 days) with disruption of full training or competition capacity were reported. Seventy-eight (48%) players reported one or more significant injury. The most common location of significant injury was in the knee, ankle and lower back. Eleven injuries were reported as stress fractures. In 35 cases a player felt lasting limitation from a significant injury and in 37 cases a player felt lasting pain. Conclusion Previously in their career almost 50% of the players had sustained a significant injury with a median duration of 90 days. The lower extremities and the lower back were the predominant injured regions. In one third of the injuries a player had lasting limitations or pain. Stress fractures may be a serious underestimated problem in badminton.
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Affiliation(s)
- Niels Christian Kaldau
- Sports Orthopedic Research Center - Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager & Hvidovre Hospital, Denmark
| | - Stewart Kerr
- Life Fit Wellness, Healthcare & Exercise Centre, Falkirk, Scotland, UK
| | - Steve McCaig
- Athlete Health Directorate, English Institute of Sport, Loughborough University, UK
| | - Per Hölmich
- Sports Orthopedic Research Center - Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager & Hvidovre Hospital, Denmark
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120
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Raeder C, Tennler J, Praetorius A, Ohmann T, Schoepp C. Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability - the later, the worse: a retrospective analysis. BMC Sports Sci Med Rehabil 2021; 13:86. [PMID: 34362431 PMCID: PMC8344223 DOI: 10.1186/s13102-021-00308-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/12/2021] [Indexed: 12/26/2022]
Abstract
Background The lateral ankle sprain (LAS) is one of the most common injuries in everyday and sports activities. Approximately 20–40 % of patients with LAS develop a chronic ankle instability (CAI). The underlying mechanisms for CAI have not yet been clearly clarified. An inadequate rehabilitation after LAS can be speculated, since the LAS is often handled as a minor injury demanding less treatment. Therefore, the aims of this retrospective study were to determine the CAI rate depending on age and sex and to identify possible determinants for developing CAI. Methods Between 2015 and 2018 we applied the diagnostic code “sprain of ankle” (ICD S93.4) to identify relevant cases from the database of the BG Klinikum Duisburg, Germany. Patients received a questionnaire containing the Tegner-Score, the Cumberland Ankle Instability Tool (CAIT) and the Foot and Ankle Disability Index. Additionally, there were questions about the modality and beginning of therapy following LAS and the number of recurrent sprains. There was a total of 647 completed datasets. These were divided into a CAI and non-CAI group according to a CAIT cut-off-score with CAI ≤ 24 and non-CAI > 24 points, representing one out of three criteria for having CAI based on international consensus. Results The overall CAI rate was 17.3 %. We identified a higher CAI rate in females and within the age segment of 41 to 55 years. A later start of therapy (> 4 weeks) after acute LAS significantly increases ankle instability in CAIT (p < .05). There was a significantly higher CAIT score in patients having no recurrent sprain compared to patients having 1–3 recurrent sprains or 4–5 recurrent sprains (p < .001). Conclusions Females over 41 years show a higher CAI rate which implies to perform specific prevention programs improving ankle function following acute LAS. A delayed start of therapy seems to be an important determinant associated with the development of CAI. Another contributing factor may be a frequent number of recurrent sprains that are also linked to greater levels of subjective ankle instability. Therefore, we would recommend an early start of functional therapy after acute LAS in the future to minimize the development of CAI.
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Affiliation(s)
- Christian Raeder
- Clinic for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.
| | - Janina Tennler
- Research Department, BG Klinikum Duisburg, Duisburg, Germany
| | - Arthur Praetorius
- Clinic for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Tobias Ohmann
- Research Department, BG Klinikum Duisburg, Duisburg, Germany
| | - Christian Schoepp
- Clinic for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
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121
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Machado M, Amado P, Babulal J. Ankle instability – review and new trends. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2021. [DOI: 10.1177/22104917211035552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Ankle instability is an old topic with increasing importance in Orthopaedics’ world, as we start now realising how underdiagnosed this pathology has been. A lot of effort has been made in recent years to better understand the pathomechanics of this injury, with new surgical techniques being tried and even new anatomic structures being described. The objective of this paper is to review and compile the most important and recent literature on this matter, in an academic way, but oriented to clinical practice, so it can help surgeons keep updated in this so important subject.
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Affiliation(s)
- Marino Machado
- Orthopaedics Department, Centro Hospitalar de Lisboa Central EPE, Portugal
| | - Paulo Amado
- Unidade de Medicina Desportiva e Artroscopia Avançada,
Hospital Lusíadas Porto, Portugal
| | - Jaime Babulal
- Unidade de Medicina Desportiva e Artroscopia Avançada,
Hospital Lusíadas Porto, Portugal
- Serviço de Ortopedia, Centro Hospitalar do Médio Ave
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122
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Izaola-Azkona L, Vicenzino B, Olabarrieta-Eguia I, Saez M, Lascurain-Aguirrebeña I. Effectiveness of Mobilization of the Talus and Distal Fibula in the Management of Acute Lateral Ankle Sprain. Phys Ther 2021; 101:6231218. [PMID: 33877325 DOI: 10.1093/ptj/pzab111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 01/20/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Distal fibular mobilization with movement (MWM), with and without a posterior gliding fibular tape, and anteroposterior mobilization of the talus (MOB) are widely used to treat acute lateral ankle sprains. The purpose of this study was to investigate the short-term and long-term relative effectiveness of these techniques. METHODS In this double-blind randomized controlled trial, 45 amateur soccer players with acute (<72 hours) lateral ankle sprain were randomly allocated to 6 sessions (3/wk within the first 2 weeks) of either MWM, MWM with tape (MWMtape), or MOB. All participants also received general advice, transcutaneous electrical nerve stimulation, edema draining massage, and a program of proprioception exercises. Participant ratings of function on the Foot and Ankle Ability Measure and Patient Global Impression of Improvement Scale were the primary outcomes measured over 52 weeks. Secondary outcomes were ankle pain, pressure pain threshold, range of motion, volume, and strength. RESULTS MWM and MWMtape were equally effective and participants demonstrated greater function on the Foot and Ankle Ability Measure at 12 and 52 weeks when compared with those receiving MOB; however, the latter demonstrated superior function at 2 weeks. No differences between groups were observed for Patient Global Impression of Improvement Scale or any of the secondary outcomes. CONCLUSION There are limited differences in the short term among techniques, with the exception of better sport function with MOB. Over the longer term, the distal fibular MWM is most effective to achieve activities of daily living and sport function when added to usual physical therapy care. The addition of a posterior gliding fibular tape provides no additional benefit. IMPACT Distal fibular mobilization with movement may be the most appropriate choice of treatment for acute lateral ankle sprain to achieve long-term activities of daily living and sport function. In the short term, anteroposterior mobilization of the talus offers greater improvement in sport function. The use of fibular tape provides no added benefit as an adjunct to a treatment that includes distal fibular mobilization with movement.
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Affiliation(s)
- Loitzun Izaola-Azkona
- Physiotherapy Department, University of Deusto, San Sebastian, Spain.,Mugi Fisioterapia, Sabino Arana 30, Sopelana, Spain
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, Department of Physiotherapy, University of Queensland, St Lucia, Queensland, Australia
| | | | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ion Lascurain-Aguirrebeña
- Physiotherapy, Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain
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123
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Kolokotsios S, Drousia G, Koukoulithras I, Plexousakis M. Ankle Injuries in Soccer Players: A Narrative Review. Cureus 2021; 13:e17228. [PMID: 34540455 PMCID: PMC8445148 DOI: 10.7759/cureus.17228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/12/2022] Open
Abstract
Soccer is one of the most popular sport, with many describing it as the "king of sports." In recent years, increased global participation in soccer has led to an inevitable increase in injury rates, especially in the lower extremities. Consequently, there is an increase in the epidemiology of soccer injuries, both in professionals and amateur athletes. The cause of an injury is multifactorial and depends on psychosocial, predisposing, intrinsic, and extrinsic factors. Also, contact with another player and non-contact injuries seem to be the most widespread mechanisms of injuries. The most common injuries recorded in soccer are ankle sprains and hamstrings injuries. More specifically, many studies have shown a correlation between the previous injury in lower extremities, weakness of abductors muscle, and psychosocial factors with the ankle sprain. Additionally, according to study results, injuries in adult men, adolescent men, and women during a match are higher than injuries during training. This narrative review aims to record the epidemiology of ankle injuries, risk factors, and the relationship between circadian rhythm, sleep, and injuries.
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Affiliation(s)
- Spyridon Kolokotsios
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
| | - Gianna Drousia
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
| | - Ioannis Koukoulithras
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Loannina, Athens, GRC
| | - Minas Plexousakis
- Department of Physical Therapy, University Hospital, University of West Attica, Athens, GRC
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The current clinical practice of general orthopaedic surgeons in the treatment of lateral ankle sprain: a questionnaire survey in Miyazaki, Japan. BMC Musculoskelet Disord 2021; 22:636. [PMID: 34303350 PMCID: PMC8310605 DOI: 10.1186/s12891-021-04527-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lateral ankle sprain (LAS) is one of the most common musculoskeletal injuries. Numerous studies regarding LAS have been performed. However, there are few studies evaluating the current clinical practice of orthopaedic surgeons regarding LAS. The purpose of this study was to evaluate the current clinical practice of general orthopaedic surgeons in the treatment of LAS. METHODS A questionnaire survey was conducted from September 2020 to December 2020 in Miyazaki, Japan, to evaluate the clinical practice of general orthopaedic surgeons in the treatment of LAS. The survey was composed of 12 questions that were developed with consideration of the recommendations in the current clinical practice guidelines (CPGs) published by the Dutch orthopaedic society. The questions in this study were focused on the diagnosis, conservative treatment, rehabilitation, and the criteria for return to sports (RTS). RESULTS The survey response rate was 82.7% (129/156). Among the respondents, 95.3% did not consider the Ottawa Ankle Rules in the decision to perform plain radiography for patients. Rehabilitation following LAS was performed in 58.9% of patients. Eighty-five (65.9%) of the surgeons used only one factor as the criterion for RTS. The absence of pain was the most frequently used criterion (45.7%). No objective criteria were used for the RTS decision in athletes with LAS. CONCLUSIONS The present study suggested that most general orthopaedic surgeons do not provide the care for patients with LAS recommended by the current CPGs. No objective criteria for the RTS decision are used for athletes with LAS.
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125
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Factors associated with new persistent opioid use after ankle sprain: a cross-sectional analysis. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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126
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Hanhan S, Goren K, Rivkin A, Saba F, Nevo H, Dar N, Shilo D, Liebergall M, Shoseyov O, Deutsch D, Blumenfeld A, Haze A. Regeneration of grade 3 ankle sprain, using the recombinant human amelogenin protein (rHAM + ) in a rat model. J Orthop Res 2021; 39:1540-1547. [PMID: 32410235 DOI: 10.1002/jor.24718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/03/2020] [Accepted: 05/08/2020] [Indexed: 02/04/2023]
Abstract
Lateral ligament tears, also known as high-grade ankle sprains, are common, debilitating, and usually heal slowly. Ten to thirty percent of patients continue to suffer from chronic pain and ankle instability even after 3 to 9 months. Previously, we showed that the recombinant human amelogenin (rHAM+ ) induced regeneration of fully transected rat medial collateral ligament, a common proof-of-concept model. Our aim was to evaluate whether rHAM+ can regenerate torn ankle calcaneofibular ligament (CFL), an important component of the lateral ankle stabilizers. Right CFLs of Sabra rats were transected and treated with 0, 0.5, or 1 µg/µL rHAM+ dissolved in propylene glycol alginate (PGA). Results were compared with the normal group, without surgery. Healing was evaluated 12 weeks after treatment by mechanical testing (ratio between the right and left, untransected ligaments of the same rat), and histology including immunohistochemical staining of collagen I and S100. The mechanical properties, structure, and composition of transected ligaments treated with 0.5 μg/μL rHAM+ (experimental) were similar to untransected ligaments. PGA (control) treated ligaments were much weaker, lax, and unorganized compared with untransected ligaments. Treatment with 1 μg/μL rHAM+ was not as efficient as 0.5 μg/μL rHAM+ . Normal arrangement of collagen I fibers and of proprioceptive nerve endings, parallel to the direction of the force, was detected in ligaments treated with 0.5 μg/μL rHAM+ , and scattered arrangement, resembling scar tissue, in control ligaments. In conclusion, we showed that rHAM+ induced significant mechanical and structural regeneration of torn rat CFLs, which might be translated into treatment for grades 2 and 3 ankle sprain injuries.
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Affiliation(s)
- Salem Hanhan
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Koby Goren
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Amit Rivkin
- Faculty of Agriculture, Food and Environment, Institute of Plant Sciences and Genetics in Agriculture, Hebrew University, Rehovot, Israel
| | - Faris Saba
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Hani Nevo
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Naama Dar
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Dekel Shilo
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Meir Liebergall
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Oded Shoseyov
- Faculty of Agriculture, Food and Environment, Institute of Plant Sciences and Genetics in Agriculture, Hebrew University, Rehovot, Israel
| | - Dan Deutsch
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Anat Blumenfeld
- Faculty of Dental Medicine, Institute of Dental Sciences, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Amir Haze
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Wang ZR, Ni GX. Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture? World J Clin Cases 2021; 9:4116-4122. [PMID: 34141774 PMCID: PMC8173427 DOI: 10.12998/wjcc.v9.i17.4116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/04/2021] [Accepted: 05/07/2021] [Indexed: 02/06/2023] Open
Abstract
Cold therapy has been used regularly as an immediate treatment to induce analgesia following acute soft-tissue injuries, however, a prolonged ice application has proved to delay the start of the healing and lengthen the recovery process. Hyperbaric gaseous cryotherapy, also known as neurocryostimulation, has shown the ability to overcome most of the limitations of traditional cold therapy, and meanwhile promotes the analgesic and anti-inflammatory effects well, but the current existing studies have shown conflicting results on its effects. Traditional cold therapy still has beneficial effect especially when injuries are severe and swelling is the limiting factor for recovery after soft-tissue injuries, and therefore no need to be entirely put out to pasture in the rehabilitation practice. Strong randomized controlled trials with good methodological quality are still needed in the future to evaluate the effects of different cryotherapy modalities.
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Affiliation(s)
- Zi-Ru Wang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
| | - Guo-Xin Ni
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
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128
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A four-experiment examination of ankle kinetics, kinematics and lateral ligament strains during different conditions: an examination using musculoskeletal simulation. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00751-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Clarke L, Dillon MP, Shiell A. A systematic review of health economic evaluation in orthotics and prosthetics: Part 2-orthotics. Prosthet Orthot Int 2021; 45:221-234. [PMID: 33856150 DOI: 10.1097/pxr.0000000000000003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/22/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Health economic evaluations (HEEs) in orthotics are in their infancy. Identification of evidence gaps and method design issues will inform the design of future HEEs that advance knowledge and contributes to policy and investment decisions. OBJECTIVES The aim of this systematic review was to critically appraise the existing orthotic/prosthetic health economic evaluation literature and therefore determine evidence gaps, critical method design issues, and the extent to which the literature informs orthotic policy and investment decisions. STUDY DESIGN Systematic review. METHODS A range of databases were searched using intervention- and HEE-related terms. The Consolidated Health Economic Checklist-Extended and the Checklist for Health Economic Evaluation Reporting Standards were used to identify issues with method design and reporting. RESULTS Nine orthotic HEEs were narrowly focused on the cost-effectiveness of low-cost orthotic devices (eg, ankle orthoses for ankle sprains). Method design (eg, cost identification and valuation) and reporting issues (eg, lack of detail about the study population) limited the extent to which this literature can inform policy and investment decisions. CONCLUSIONS HEEs comparing a wider variety of interventions are required, particularly for commonly used orthoses (eg, ankle-foot orthoses) and clinical presentations (eg, post-stroke). There are opportunities to strengthen future orthotic HEEs by adopting method design features (eg, microcosting and sensitivity analyses) as recommended by HEE appraisal and reporting tools.
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Affiliation(s)
- Leigh Clarke
- Discipline of Prosthetics and Orthotics, Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sports, La Trobe University, Melbourne, Victoria, Australia
- The Australian Orthotic Prosthetic Association, Camberwell, VIC, Australia
| | - Michael P Dillon
- Discipline of Prosthetics and Orthotics, Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sports, La Trobe University, Melbourne, Victoria, Australia
| | - Alan Shiell
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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WALDHELM A, PUCKETT A, SCHWARZ N, GUBLER C. Effects of lower extremity rotation on muscle activity during heel-raise exercise. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.19.04174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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131
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FONG DANIELTP, KO JACKYKL, YUNG PATRICKSH. USING FAST FOURIER TRANSFORM AND POLYNOMIAL FITTING ON DORSAL FOOT KINEMATICS DATA TO IDENTIFY SIMULATED ANKLE SPRAIN MOTIONS FROM COMMON SPORTING MOTIONS. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519421500408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ankle sprain is very common in sports, and a commonly suggested etiology is the delayed peroneal muscle reaction time. Recent studies showed the successful attempts to deliver electrical stimulation to the peroneal muscles externally to initiate contraction before it could react, however, the success relies on a workable method to detect ankle sprain injury in time. This study presented a fast Fourier transform and polynomial fitting method with dorsal foot kinematics data for quick ankle sprain detection. Five males performed 100 simulated ankle sprain and 250 common sporting motion trials. Eight gyrometers recorded the three-dimensional angular velocities at 500[Formula: see text]Hz. Data were trimmed with a 0.11[Formula: see text]s window size, the suggested duration of preinjury phase in ankle sprain, and were transformed from time to frequency domain by fast Fourier transform and fitted with a fifth-order polynomial. First-order coefficients from polynomial fitting on frequency space were obtained. The method achieved 97.0% sensitivity and 91.4% specificity in identifying simulated sprains, vertical jump–landing, cutting, stepping-down, running, and walking motions, with vertical jump–landing excluded due to its relatively low specificity (67.3%). The method can be used to detect ankle sprain in sports with mainly floor movements and minimal vertical jump–landing motion.
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Affiliation(s)
- DANIEL T. P. FONG
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - JACKY K. L. KO
- Department of Physics, Faculty of Science, The Chinese University of Hong Kong, Hong Kong
| | - PATRICK S. H. YUNG
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Yu R, Yang Z, Witchalls J, Adams R, Waddington G, Han J. Kinesiology tape length and ankle inversion proprioception at step-down landing in individuals with chronic ankle instability. J Sci Med Sport 2021; 24:894-899. [PMID: 34016535 DOI: 10.1016/j.jsams.2021.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/21/2021] [Accepted: 04/19/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To determine the effect of different lengths of kinesiology tape (KT) on ankle inversion proprioceptive performance in individuals with or without chronic ankle instability (CAI). DESIGN A repeated measures study. METHODS Fifteen participants with unilateral CAI and fifteen participants with no CAI volunteered. The Ankle Inversion Discrimination Apparatus for Landing (AIDAL) was used to measure ankle proprioceptive acuity. All participants were tested under four KT conditions: no tape (baseline), short tape length (only foot and ankle complex involved), mid length (below the knee) and long length (above the knee) taping. After the baseline test, participants underwent the 3 different taping tests in a random order. RESULTS Repeated measures ANOVA indicated that, compared to those without CAI, individuals with CAI performed significantly worse across the 4 different conditions (F = 8.196, p = 0.008). There was a significant KT main effect (F = 7.489, p < 0.001) and a significant linear effect (F = 17.083, p < 0.001), suggesting that KT significantly improved ankle proprioceptive performance in landing, and with longer tape length there was greater proprioceptive enhancement. Post-hoc analysis showed that for the CAI group, both mid length (p = 0.013, 95%CI = -0.063, -0.009) and long length (p = 0.010, 95%CI = -0.067, -0.011) taping can significantly improve ankle proprioceptive performance compared to no tape, whereas for the non-CAI group, ankle proprioceptive acuity was significantly improved only with long length taping (p = 0.007, 95%CI = -0.080, -0.015). CONCLUSIONS KT can be used to improve ankle inversion proprioceptive performance during landing in both individuals with and without CAI and increasing tape length may achieve greater proprioceptive improvement.
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Affiliation(s)
- Ruoni Yu
- School of Kinesiology, Shanghai University of Sport, China
| | - Zonghan Yang
- School of Kinesiology, Shanghai University of Sport, China; Faculty of Medicine, The university of Melbourne, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, Australia
| | - Jia Han
- School of Kinesiology, Shanghai University of Sport, China; Research Institute for Sport and Exercise, University of Canberra, Australia.
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Kataoka K, Hoshino Y, Nagamune K, Nukuto K, Yamamoto T, Yamashita T, Kanzaki N, Kakutani K, Matsushita T, Kuroda R. The quantitative evaluation of anterior drawer test using an electromagnetic measurement system. Sports Biomech 2021; 21:550-561. [PMID: 34016026 DOI: 10.1080/14763141.2021.1918754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The anterior drawer test (ADT) is the gold standard examination for the diagnosis of anterior talofibular ligamentinsufficiency,although there is noquantitative evaluation of ADT that is generally usable and reliable.An electromagnetic sensor (EMS)has been used to quantitatively evaluate joint kinematics, and has a high potential to be applied to the ankle joint. The aim of this study was to validatethe EMS measurement of the ADTin comparison to the fluoroscopic evaluationand to evaluate the reproducibility of the EMS measurement.Six feet were included,and an examinerperformed the ADT5 times for each foot while the anterior translation of the ankle jointwas quantitative evaluatedusing EMS and fluoroscope simultaneously. The anterior translation of the ankle joint during the ADT in EMS and in fluoroscope was 8.1 ± 5.7 mm and 3.6 ± 2.4 mm.Astrong correlation was observed between the measurements using EMS and fluoroscope (p < 0.01, the correlation coefficient = 0.91). Another 20 feet were included, and three examiners performed the ADT five times for each foot with the EMS measurement. The intra and inter-examiner reliability was 0.99 and 0.89.The EMS could quantify the anterior translation during the ADT which corresponds to fluoroscopic evaluation.
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Affiliation(s)
- Kiminari Kataoka
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuichi Hoshino
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kouki Nagamune
- Department of Human and Artificial Intelligent Systems, University of Fukui
| | - Koji Nukuto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsuya Yamamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takahiro Yamashita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noriyuki Kanzaki
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Lack of Consensus on Return-to-Sport Criteria Following Lateral Ankle Sprain: A Systematic Review of Expert Opinions. J Sport Rehabil 2021; 29:231-237. [PMID: 31141438 DOI: 10.1123/jsr.2019-0038] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/01/2019] [Accepted: 05/12/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Lateral ankle sprains (LAS) have one of the highest recurrence rates of all musculoskeletal injuries. An emphasis on rapid return to sport (RTS) following LAS likely increases reinjury risk. Unfortunately, no set of objective RTS criteria exist for LAS, forcing practitioners to rely on their own opinion of when a patient is ready to RTS. PURPOSE To determine if there was consensus among published expert opinions that could help inform an initial set of RTS criteria for LAS that could be investigated in future research. EVIDENCE ACQUISITION PubMed, CINHL, and SPORTDiscus databases were searched from inception until October 2018 using a combination of keywords. Studies were included if they listed specific RTS criteria for LAS. No assessment of methodological quality was conducted because all included papers were expert opinion papers (level 5 evidence). Extracted data included the recommended domains (eg, range of motion, balance, sport-specific movement, etc) to be assessed, specific assessments for each listed domain, and thresholds (eg, 80% of the uninjured limb) to be used to determine RTS. Consensus and partial agreement were defined, a priori, as ≥75% and 50% to 75% agreement, respectively. EVIDENCE SYNTHESIS Eight domains were identified within 11 included studies. Consensus was reached regarding the need to assess sport-specific movement (n = 9, 90.9%). Partial agreement was reached for the need to assess static balance (n = 7, 63.6%). The domains of pain and swelling, patient reported outcomes, range of motion, and strength were also partially agreed on (n = 6, 54.5%). No agreement was reached on specific assessments of cutoff thresholds. CONCLUSIONS Given consensus and partial agreement results, RTS decisions following LAS should be based on sport-specific movement, static balance, patient reported outcomes, range of motion, and strength. Future research needs to determine assessments and cutoff thresholds within these domains to minimize recurrent LAS risk.
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135
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Hadzic V, Sattler T, Pori P, Veselko M, Dervišević E, Šarabon N, Marković G. Quadriceps strength asymmetry as predictor of ankle sprain in male volleyball players. J Sports Med Phys Fitness 2021; 62:822-829. [PMID: 33969957 DOI: 10.23736/s0022-4707.21.12370-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ankle sprain is the most common acute time-loss injury in volleyball and occurs mainly during landing from a jump. Therefore we have evaluated the role of quadriceps strength and countermovement jump height on ankle sprain occurrence, as these intrinsic modifiable risk factors were not yet evaluated. We have also hypothesised that presence of quadriceps strength asymmetry could be a possible risk factor for ankle sprains in male volleyball players. METHODS This was a prospective cohort study. Male volleyball players (N = 99) from Slovenian national league participated in the study. Before the start of the season, all participants completed a preseason questionnaire and underwent evaluation of vertical jump performance and bilateral isokinetic strength of the quadriceps (Q) and hamstrings (H). During the subsequent season the players reported acute time loss injuries because of ankle sprain through a weekly questionnaire. RESULTS We have registered 19 ankle sprains during the season. Overall ankle sprain incidence was 0.41±0.24 per 1000 h. Previous ankle sprain (odd ratio 0.86; 95% CI 0.25 - 2.89, p = 0.802) and jump height (1.05; 95% C.I. 0.94 - 1.19, p = 0.393) were not significant risk factors, while Q strength asymmetry was a significant predictor of an ankle sprain (odd ratio 0.956; 95% CI 0.919-0.995, p = 0.026). Compared with the uninjured players, the injured players had higher right concentric Q strength, higher Q strength asymmetry, and lower concentric right H-Q strength ratio (all p<0.03). CONCLUSIONS Our results suggest that excessive concentric strength of the right Q, which leads to low H-Q strength ratio, and high bilateral Q strength asymmetry in favor of the right side, could be associated with increased risk of ankle sprains in male volleyball.
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Affiliation(s)
- Vedran Hadzic
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia -
| | - Tine Sattler
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Primož Pori
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Matjaž Veselko
- Department of Traumatology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Koper, Slovenia.,S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behaviour, Ljubljana, Slovenia
| | - Goran Marković
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.,Faculty of Kinesiology, University in Zagreb, Zagreb, Croatia
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136
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Mineta S, Inami T, Hoshiba T, Higashihara A, Kumai T, Torii S, Hirose N. Greater knee varus angle and pelvic internal rotation after landing are predictive factors of a non-contact lateral ankle sprain. Phys Ther Sport 2021; 50:59-64. [PMID: 33894569 DOI: 10.1016/j.ptsp.2021.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aimed to clarify the kinematic, kinetic characteristics associated with lateral ankle sprain. DESIGN A 16-month prospective cohort study. SETTING Laboratory. PARTICIPANTS A total of 179 college athletes. MAIN OUTCOME MEASURES Joint kinematics, moment during single-leg landing tasks, and ankle laxity were measured. The attendance of each participating team, injury mechanism, existence of body contact, presence of orthosis, with or without medical diagnosis, and periods of absence were recorded. RESULTS Twenty-nine participants incurred lateral ankle sprain during non-contact motion. The Cox regression analysis revealed that greater knee varus peak angle (hazard ratio: 1.16 [95% confidence interval: 1.10-1.22], p < 0.001) and greater pelvic internal rotation peak angle toward the support leg were associated with lateral ankle sprain (hazard ratio: 1.08 [95% confidence interval: 1.02-1.15], p = 0.009). The cut-off values for each predictive factor were -0.17° (area under the curve = 0.89, p < 0.001) and 6.63° (area under the curve = 0.74, p < 0.001), respectively. CONCLUSIONS A greater knee varus peak angle and pelvic internal rotation peak angle after single-leg landing are predictive factors for lateral ankle sprain.
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Affiliation(s)
- Shinshiro Mineta
- Graduate School of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan; Research Fellowships for Young Scientists, Japan Society for the Promotion of Science, Chiyoda-ku, Kojimachi, Japan.
| | - Takayuki Inami
- Institute of Physical Education, Keio University, Hiyoshi, Yokohama, Japan.
| | - Takuma Hoshiba
- Waseda Institute for Sport Sciences, Waseda University, Mikajima, Tokorozawashi, Saitama, Japan.
| | - Ayako Higashihara
- Institute of Physical Education, Keio University, Hiyoshi, Yokohama, Japan; Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Tokyo, Japan.
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137
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Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG80. [PMID: 33789434 DOI: 10.2519/jospt.2021.0302] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.
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138
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The Effect of Attending Physical Rehabilitation After the First Acute Lateral Ankle Sprain on Static Postural Control in Patients With Chronic Ankle Instability. J Sport Rehabil 2021; 30:1000-1007. [PMID: 33761463 DOI: 10.1123/jsr.2020-0346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Static postural control deficits are commonly documented among individuals with chronic ankle instability (CAI). Evidence suggests individuals with CAI who seek medical attention after an ankle sprain report fewer subjective symptoms. It is unknown if seeking medical attention and receiving supervised physical rehabilitation has a similar effect on objective outcomes, such as static postural control. OBJECTIVE To compare measures of single-limb postural control and center of pressure (COP) location between participants with CAI who did or did not self-report attending supervised rehabilitation at the time of their first lateral ankle sprain. DESIGN Retrospective cohort. SETTING Laboratory. Patients (or Other Participants): Twenty-nine participants with CAI who did (n = 14) or did not (n = 15) self-report attending supervised rehabilitation. INTERVENTION(S) Self-reported attendance or not of supervised rehabilitation at the time of initial injury. MAIN OUTCOME MEASURES Participants performed three 20-second trials of single-limb stance on a force plate with eyes open. Main outcome measures included the COP velocities, time-to-boundary (TTB) absolute minima, mean of TTB minima, and SD of TTB minima in the anteroposterior and mediolateral directions. The spatial distribution of the COP data points under the foot was quantified within 4 equally proportional sections labeled anteromedial, anterolateral, posteromedial, and posterolateral. RESULTS Participants who reported attending supervised rehabilitation after their initial ankle sprain had a lower COP velocity in the anterior-posterior direction (P = .030), and higher TTB anterior-posterior absolute minimum (P = .033) and mean minima (P = .050) compared with those who did not attend supervised rehabilitation. CONCLUSIONS Among individuals with CAI, not attending supervised rehabilitation at the time of initial injury may lead to worse static postural control outcomes. Clinicians should continue advocating for patients recovering from an acute ankle sprain to seek medical attention and provide continued care in the form of physical rehabilitation.
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139
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Terrier P, Piotton S, Punt IM, Ziltener JL, Allet L. Predictive Factors of Recovery after an Acute Lateral Ankle Sprain: A Longitudinal Study. Sports (Basel) 2021; 9:sports9030041. [PMID: 33803881 PMCID: PMC8003324 DOI: 10.3390/sports9030041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 12/26/2022] Open
Abstract
A prominent feature of ankle sprains is their variable clinical course. The difficulty of providing a reliable early prognosis may be responsible for the substantial rate of poor outcomes after an ankle sprain. The aim of the present study was to evaluate the prognostic value of objective clinical measures, pain, and functional scores for ankle sprain recovery. Fifty-two participants suffering from lateral ankle sprain were included. Sprain status was assessed four weeks following injury and included evaluations of ankle range of motion, strength, function, and pain. Seven months following injury, a second assessment classified the patients into recovered and non-recovered groups using ankle ability measures. Following a predictor pre-selection procedure, logistic regressions evaluated the association between the four-week predictors and the seven-month recovery status. Twenty-seven participants (52%) fully recovered and 25 did not (48%). The results of the logistic regressions showed that walking pain was negatively associated with the probability of recovering at seven months (odds ratio: 0.71, 95% CI: 0.53–0.95). Pain four weeks after ankle sprain had relevant predictive value for long-term recovery. Special attention should be paid to patients reporting persistent pain while walking four weeks following sprain to reduce the risk of chronicity.
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Affiliation(s)
- Philippe Terrier
- Haute-Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, 2000 Neuchâtel, Switzerland
- Division of Thoracic Surgery, University Hospitals of Geneva, 1205 Geneva, Switzerland
- Correspondence:
| | - Sébastien Piotton
- Division of Orthopaedics and Trauma Service, University Hospitals of Geneva, 1205 Geneva, Switzerland;
| | - Ilona M. Punt
- Department of Surgery and Trauma Surgery, Maastricht University Medical Center and NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HX Maastricht, The Netherlands;
- Department of Orthopaedics and Research School Caphri, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | | | - Lara Allet
- School of Health Sciences, HES-SO Valais Wallis University of Applied Sciences and Arts Western Switzerland, 1950 Sion, Switzerland;
- Department of Community Medicine, University Hospitals and University of Geneva, 1205 Geneva, Switzerland
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Gogate N, Satpute K, Hall T. The effectiveness of mobilization with movement on pain, balance and function following acute and sub acute inversion ankle sprain – A randomized, placebo controlled trial. Phys Ther Sport 2021; 48:91-100. [DOI: 10.1016/j.ptsp.2020.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 12/26/2022]
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141
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Allen T, Kelly M. Modern Open and Minimally Invasive Stabilization of Chronic Lateral Ankle Instability. Foot Ankle Clin 2021; 26:87-101. [PMID: 33487245 DOI: 10.1016/j.fcl.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Chronic lateral ankle instability is the sensation of the ankle giving way along with recurrent sprains, chronic pain and swelling of the ankle for 1 year. The lateral ankle complex comprises the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament. The anterior talofibular ligament is the most commonly injured ligament of the lateral ankle. Evaluation comprises a history and physical with concomitant imaging to confirm the diagnosis and can be used to evaluate for concurrent pathology. The most popular treatment is a direct anatomic repair; however, additional options can be used in specific patient populations.
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Affiliation(s)
- Tyler Allen
- University of Nevada Reno School of Medicine, 1890 Van Ness Avenue, Reno, NV 89503, USA
| | - Meghan Kelly
- Department of Orthopedic Surgery University of California at Davis; Department of Orthopedic Surgery, Mount Sinai Icahn School of Medicine, 425 West 59th Street 5th Floor, New York, NY 10019, USA.
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142
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Draper DO, Best T. Critical survey and panel review of sustained acoustic medicine in the treatment of sports-related musculoskeletal injuries by professional sports athletic trainers. CURRENT ORTHOPAEDIC PRACTICE 2021; 32:139-145. [PMID: 36687557 PMCID: PMC9854278 DOI: 10.1097/bco.0000000000000969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background The purpose of our study was two-fold. First, it was to discover American professional sports athletic trainers' (PSAT) use and opinions regarding the treatment with a small, portable ultrasound Sustained Acoustic Medicine (SAM) device on their athletes. Second, it was to discover the effectiveness of SAM treatment in their professional sports players (PSP). Methods There were two ways of collecting data from the PSATs. The first was by written survey. Questions included qualitative and quantitative feedback on SAM device use, clinical applications, and acceptance among PSP. The second part involved a panel discussion of four PSATs, who shared their personal experiences with SAM. Questions focused on the use of the technology, confidence level, manner of application, and communication with PSPs regarding the application of the SAM and recommended treatment protocols. Results The survey found that SAM is wearable, easy to use, comfortable, and that it can be used as a "go-to" device outside of the athletic training facility. PSATs reported an 87% satisfaction and increased confidence in the ability of SAM to accelerate the healing process. Thus, SAM was considered a recommended treatment for professional athletes to use as an adjunct therapy. PSATs agreed that SAM is one of the recommended choices as an adjunct therapy in multiple musculoskeletal injuries. Conclusions The survey and panel discussion concluded that SAM treatment is easy to use with no adverse effects and can be used at multiple stages of the healing process. Level of Evidence Level IV.
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Affiliation(s)
- David O. Draper
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Thomas Best
- Department of Orthopedics, UHealth Sports Medicine Institute, University of Miami, Coral Gables, Florida
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143
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Wagemans J, Kuppens K, Peeters G, Baert I. There is a difference in functional ankle stability between different types of footwear in male athletes: A cross-sectional study. Foot (Edinb) 2021; 46:101764. [PMID: 33279791 DOI: 10.1016/j.foot.2020.101764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 02/04/2023]
Abstract
CONTEXT Lateral ankle sprains (LAS) are among the most common injuries in sports, with a poor long - term prognosis due to high chronicity and recurrence rates. Chronic ankle instability (CAI) results up to 40% of people that endured a first - time LAS. OBJECTIVE The aim of this study was to compare ankle stability between groups characterised by the use of different types of footwear during their sport activities. DESIGN Cross-sectional study. SETTING Firm training surface, local sport clubs. PARTICIPANTS Fifty - one male subjects were recruited, distributed in four groups based on the type of footwear they use during their sport activities. MAIN OUTCOME MEASURES All subjects performed four clinical ankle stability tests, and completed the Dutch version of the Cumberland Ankle Instability Tool (CAIT) and Profile of Mood States (POMS). All clinical ankle stability tests were performed barefoot. RESULTS Subjects performing their sport activities barefoot scored better than subjects performing their sport with shoes at the multiple hop test (p=.002 to .047) and executed the figure-of-8 hop test significantly faster than subjects with submalleolar ankle support (AS) (p=.019). Subjects with submalleolar AS and studs showed significantly better results than subjects with supramalleolar AS on the CAIT- score (p=.024, p=.030) and the side- hop test (p=.050, p=.045). They also scored significantly better than subjects with submalleolar AS for the side - hop test (p=.032), foot - lift test (p=.019) and figure-of 8 hop test (p=.011). CONCLUSION Barefoot sports performing subjects appear to have better ankle stability compared to subjects performing their sports with shoe support. Subjects performing sports with high AS appear to have worst ankle stability. LEVEL OF EVIDENCE Level III, Cross-sectional study.
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Affiliation(s)
- Jente Wagemans
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Kevin Kuppens
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; MOVANT research group, University of Antwerp, Antwerp, Belgium(1)
| | - Greta Peeters
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; MOVANT research group, University of Antwerp, Antwerp, Belgium(1)
| | - Isabel Baert
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; MOVANT research group, University of Antwerp, Antwerp, Belgium(1)
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144
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Watabe T, Takabayashi T, Tokunaga Y, Kubo M. Individuals with chronic ankle instability exhibit altered ankle kinematics and neuromuscular control compared to copers during inversion single-leg landing. Phys Ther Sport 2021; 49:77-82. [PMID: 33621761 DOI: 10.1016/j.ptsp.2021.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study compares the ankle kinematics and muscle activities of the individuals with chronic ankle instability (CAI), coper, and control groups in normal and inversion single-leg landings. DESIGN cross-sectional study; SETTING: Biomechanics laboratory. PARTICIPANTS Physically active adults with CAI (N = 12); and coper (N = 12) and control (N = 12) groups. MAIN OUTCOME MEASURES The participants performed normal and inversion single-leg landing. The muscle activity 200 ms before and after landing of the tibialis anterior, the medial gastrocnemius, and the fibularis longus (FL) were recorded. The FL latency, sagittal and frontal co-contraction indexes (CCI), ankle inversion angle at the initial contact, and the maximum inversion angle were recorded. RESULTS Significantly longer FL latency, decreased FL muscle activity, frontal CCI, and an increased maximum inversion angle at post-landing were discovered during inversion single-leg landing in the CAI group compared to the coper and control groups. However, no significant difference was observed among the CAI and coper groups during normal single-leg landing. CONCLUSION These results suggest prolonged FL latency and altered ankle kinematics suggest an increased risk of recurrent lateral ankle sprains in CAI with inversion single-leg landing.
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Affiliation(s)
- Takaya Watabe
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
| | - Tomoya Takabayashi
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
| | - Yuta Tokunaga
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
| | - Masayoshi Kubo
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata, 950-3198, Japan.
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145
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Kosik KB, Bowers LC, Hoch MC, Humphries RL, Thurza MP, Bain KA, Slone S, Gribble PA. Pain Medication Administered and Prescribed to Patients With an Ankle Sprain Treated in an Emergency Department: A Record-Based Cohort Study. J Emerg Nurs 2021; 47:609-620.e3. [PMID: 33618903 DOI: 10.1016/j.jen.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Recent data indicate that patients treated in the emergency department for an ankle sprain receive multiple medications. However, research has not been able to accurately identify all the medications because of study limitations. The primary purpose of this study was to document the type of medication, number of doses, and number of encounters given a prescription at discharge or instructions to take over-the-counter medication. The secondary purpose was to determine if the proportion of encounters given each type of medication varied on the basis of age, sex, race, and year. METHODS A retrospective record-based cohort study design was used to review the electronic medical records (N = 1740) of encounters reporting to a southeast academic level 1 trauma center and diagnosed with an ankle sprain between 2013 and 2017. All relevant data were extracted for nonsteroidal anti-inflammatory drugs, muscle relaxants, opioids, and nonopioid analgesics. RESULTS Fifty-eight percent of the encounters had at least 1 dose of medication administered in the emergency department. Twenty-eight percent received a prescription at discharge, and 54.5% were instructed to take over-the-counter medication. Cumulatively, opioids accounted for most of the medications, but the yearly rates declined from 2013 to 2017. A greater proportion of patients aged ≤15 years received nonsteroidal anti-inflammatory drugs or nonopioid analgesics. Most of the patients aged >15 years received opioid medication. DISCUSSION Patients are primarily given an opioid or nonsteroidal anti-inflammatory drug in the emergency department. Fewer patients receive a prescription at discharge but are regularly instructed to take over-the-counter medication.
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146
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Chin M, Leppänen M, Kulmala JP, Vasankari T, Parkkari J, Pasanen K. A 3D motion capture analysis of a giving-way ankle episode during a 180-degree pivot turn: A case report. J Biomech 2021; 118:110318. [PMID: 33601183 DOI: 10.1016/j.jbiomech.2021.110318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 12/26/2022]
Abstract
Lateral ankle sprains are highly prevalent during sporting activities, as it accounts for approximately 60% of all athletic injuries. There is currently a paucity of research which provides kinetic and kinematic assessments of sprains and giving-way episodes of the ankle joint. The aim of this case study was to examine the kinetics and kinematics of the ankle and knee during a giving-way episode in a female ice hockey player during a 180-degree pivot turn, which was conducted in a 3D motion capture laboratory. Three trials were conducted on this participant (one accident trial, two control trials). Kinetic and kinematic analysis was conducted on the outside leg during a left 180-degree pivot turn (right leg). The plantarflexion angle of the giving-way trial was larger than the control trials from the point of initial contact until the end of the trial. Inversion was also 27-degrees greater 150 ms after initial contact in the giving-way trial and 26-degrees greater compared to control trials 1 and 2. Substantially greater plantarflexion, inversion and internal rotation angles of the ankle were observed during the giving-way trial compared to control trials. The maximum vertical and horizontal ground reaction forces, as well as ankle inversion and internal rotation moments, were lower for the giving-way trial in comparison to the control trials. Further research is needed to understand the influence of plantarflexion angle with a giving-way episode of the ankle. This study provides valuable kinetic and kinematic information regarding a giving-way episode of the ankle.
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Affiliation(s)
- Mathieu Chin
- Sports Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
| | - Mari Leppänen
- Tampere Research Centre of Sports Medicine, UKK Institute, Tampere, Finland
| | - Juha-Pekka Kulmala
- Motion Analysis Laboratory, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tommi Vasankari
- Tampere Research Centre of Sports Medicine, UKK Institute, Tampere, Finland
| | - Jari Parkkari
- Tampere Research Centre of Sports Medicine, UKK Institute, Tampere, Finland; University of Tampere, Tampere, Finland
| | - Kati Pasanen
- Sports Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada; Tampere Research Centre of Sports Medicine, UKK Institute, Tampere, Finland; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
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147
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Geist KT, Frierson EM, Goudiss HL, Kitchen H, Wilkins M, Pruszynski D, Carter VM. Short-term effects of dry needling at a spinal and peripheral site on functional outcome measures, strength, and proprioception among individuals with a lateral ankle sprain. J Bodyw Mov Ther 2021; 26:158-166. [PMID: 33992238 DOI: 10.1016/j.jbmt.2020.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The purpose of the study was to compare the effects of spinal and peripheral dry needling with peripheral dry needling alone, in addition to a strength and proprioception home exercise program, on pain, balance, strength, proprioception, and functional limitations among individuals with a history of a lateral ankle sprain. METHODS The study design is a single-blinded, repeated measures randomized clinical trial. Thirty-four participants, aged 18-50, with a history of a lateral ankle sprain within the last twelve months were randomly assigned into a peripheral dry needling (PDN) group or a spinal and peripheral dry needling (SPDN) group. Outcome measures included a pain assessment, strength testing, Modified Clinical Test of Sensory Integration and Balance, physical performance on hop tests, Cumberland Ankle Instability Tool and the Foot and Ankle Disability Index assessed at baseline, one week, and at four to six weeks. RESULTS The mixed model ANOVAs showed significant side by time interaction (p < 0.05) for inverter/dorsiflexion strength and significant improvements in side, time, and side by time (p < 0.05) for the CAIT. CONCLUSION Trigger point dry needling demonstrated short-term improvements in strength of the inverters/dorsiflexors and the CAIT scores on the involved side at one week and at four to six weeks irrespective of a PDN or SPDN approach. DISCUSSION These results suggest that improvements in strength and function can be achieved with PDN without additional needling at the corresponding spinal level.
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Affiliation(s)
- Kathleen T Geist
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA.
| | | | - Harrison L Goudiss
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Hope Kitchen
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Maggie Wilkins
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - David Pruszynski
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Vincent M Carter
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
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148
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Gan QF, Foo CN, Leong PP, Cheong SK. Incorporating regenerative medicine into rehabilitation programmes: a potential treatment for ankle sprain. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2019.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ankle sprain has a great effect on morbidity and complications of chronic diseases. Experts have come to a consensus where ankle sprain can be managed by rest, ice, compression and elevation, non-steroidal anti-inflammatory drugs, immobilisation, functional support such as the use of an ankle brace, exercise, surgery and other therapies that include physiotherapy modalities and acupuncture. However, the time required for healing is still relatively long in addition to post-operative complications. Because of the challenges and setbacks faced by interventions to manage ankle sprains and in view of the recent trend and development in the field of regenerative medicine, this article discusses future treatments focusing on a personalised and holistic approach for ankle sprain management. This narrative review provides a novel idea for incorporating regenerative medicine into conventional therapy as an intervention for ankle sprain based on theoretical concepts and available evidence on regenerative medicine involving ligament injuries.
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Affiliation(s)
- Quan Fu Gan
- Pre-clinical Department, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Chai Nien Foo
- Population Medicine Department, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Pooi Pooi Leong
- Pre-clinical Department, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Soon Keng Cheong
- Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
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149
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Mendonça LD, Schuermans J, Wezenbeek E, Witvrouw E. Worldwide Sports Injury Prevention. Int J Sports Phys Ther 2021; 16:285-287. [PMID: 33604156 PMCID: PMC7872462 DOI: 10.26603/001c.18700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/01/2021] [Indexed: 12/14/2022] Open
Abstract
The number one goal of the sports physical therapist is to make sure that the athlete is in optimal shape to perform, but with a minimal risk for developing an injury at the same time. The aim of this International Federation of Sports Physical Therapy (IFSPT) Perspective is to raise awareness about the importance of contextual and behavioral factors when planning and implementing injury prevention. Also, it outlines the potential role of the IFSPT as a facilitator of data and information exchange among sports physical therapists worldwide.
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Affiliation(s)
- Luciana D Mendonça
- Graduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil.; Postdoctoral researcher at Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; CAPES Foundation, Ministry of Education of Brazil, Brasília, Distrito Federal, Brazil
| | - Joke Schuermans
- Postdoctoral researcher at Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Evi Wezenbeek
- Postdoctoral researcher at Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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150
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Borra V, Berry DC, Zideman D, Singletary E, De Buck E. Compression Wrapping for Acute Closed Extremity Joint Injuries: A Systematic Review. J Athl Train 2021; 55:789-800. [PMID: 32688372 DOI: 10.4085/1062-6050-0093.20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Current prehospital recommendations for an acute closed extremity joint injury (ACEJI) are to apply compression in some manner. However, the effectiveness of compression is unclear. We performed a systematic review to summarize and synthesize the evidence for the use of a compression bandage for ACEJI in the prehospital setting. DATA SOURCES Cochrane Library, PubMed, and Embase were searched for relevant literature in November 2019. STUDY SELECTION Controlled trials involving adults in the prehospital setting with a recent ACEJI were included when compressive, nonimmobilizing interventions, feasible in a first aid setting, were applied and compared with no compression or any noncompressive intervention, such as braces, splints, or noncompressive stockings. Articles in all languages were included if an English abstract was available. DATA EXTRACTION Data on study design, study population, intervention, outcome measures, and methodologic quality were extracted from each included article. DATA SYNTHESIS Eight studies out of 1193 possibly relevant articles were included. All authors examined compression in the treatment of acute ankle sprains; no studies involved compression for the treatment of other ACEJIs. No difference in the major outcomes of pain reduction or swelling, ankle-joint function, or range of motion could be demonstrated. For the outcome of recovery time, no benefit was shown when comparing compression with no compression. Evidence was insufficient to inform a conclusion about the outcomes of time to return to work or sport. All evidence was of low to very low certainty. CONCLUSIONS The evidence for the use of a compression wrap was limited to patients with closed ankle injuries. In this systematic review, we could not demonstrate either a beneficial or harmful effect from the application of a compression or elastic bandage compared with no compression or a noncompressive stocking, splint, or brace as a first aid treatment in the prehospital environment.
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Affiliation(s)
- Vere Borra
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Cochrane First Aid, Mechelen, Belgium
| | - David C Berry
- Department of Kinesiology, College of Health and Human Services, Saginaw Valley State University, University Center, MI
| | | | - Eunice Singletary
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Cochrane First Aid, Mechelen, Belgium.,Department of Public Health and Primary Care, KU Leuven, Belgium
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