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Influence of Passive Joint Stiffness on Proprioceptive Acuity in Individuals With Functional Instability of the Ankle. J Orthop Sports Phys Ther 2017; 47:899-905. [PMID: 28990440 DOI: 10.2519/jospt.2017.7030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Controlled laboratory study, cross-sectional. Background Deficits in ankle proprioceptive acuity have been reported in persons with functional instability of the ankle. Passive stiffness has been proposed as a possible mechanism underlying proprioceptive acuity. Objective To compare proprioceptive acuity and passive ankle stiffness in persons with and without functional ankle instability, and to assess the influence of passive joint stiffness on proprioceptive acuity in persons with functional ankle instability. Methods A sample of 18 subjects with and 18 without complaints of functional ankle instability following lateral ankle sprain participated. An isokinetic dynamometer was used to compare motion perception threshold, passive position sense, and passive ankle stiffness between groups. To evaluate the influence of passive stiffness on proprioceptive acuity, individuals in the lateral functional ankle instability group were divided into 2 subgroups: "high" and "low" passive ankle stiffness. Results The functional ankle instability group exhibited increased motion perception threshold when compared with the corresponding limb of the control group. Between-group differences were not found for passive position sense and passive ankle stiffness. Those in the functional ankle instability group with higher passive ankle stiffness had smaller motion perception thresholds than those with lower passive ankle stiffness. Conclusion Unlike motion perception threshold, passive position sense is not affected by the presence of functional ankle instability. Passive ankle stiffness appears to influence proprioceptive acuity in persons with functional ankle instability. J Orthop Sports Phys Ther 2017;47(12):899-905. Epub 7 Oct 2017. doi:10.2519/jospt.2017.7030.
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152
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Roach KE, Foreman KB, Barg A, Saltzman CL, Anderson AE. Application of High-Speed Dual Fluoroscopy to Study In Vivo Tibiotalar and Subtalar Kinematics in Patients With Chronic Ankle Instability and Asymptomatic Control Subjects During Dynamic Activities. Foot Ankle Int 2017; 38:1236-1248. [PMID: 28800713 PMCID: PMC5914166 DOI: 10.1177/1071100717723128] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Abnormal angular and translational (ie, kinematic) motion at the tibiotalar and subtalar joints is believed to cause osteoarthritis in patients with chronic ankle instability (CAI). METHODS In this preliminary study the investigators quantified and compared in vivo tibiotalar and subtalar kinematics in 4 patients with CAI (3 women) and 10 control subjects (5 men) using dual fluoroscopy during a balanced, single-leg heel-rise and treadmill walking at 0.5 and 1.0 m/s. RESULTS During balanced heel-rise, 69%, 54%, and 66% of mean CAI tibiotalar internal rotation/external rotation (IR/ER), subtalar inversion/eversion, and subtalar IR/ER angles, respectively, were outside the 95% confidence intervals of control subjects. During 0.5-m/s gait, 50% and 60% of mean CAI tibiotalar dorsi/plantarflexion and subtalar IR/ER angles, respectively, were outside the 95% confidence intervals of control subjects. During 1.0-m/s gait, 62%, 65%, and 73% of mean CAI subtalar dorsi/plantarflexion, inversion/eversion, and IR/ER, respectively, were outside the 95% confidence intervals of control subjects. Patients with CAI exhibited less tibiotalar and subtalar translational motion during gait; no clear differences in translations were noted during balanced heel-rise. CONCLUSION Overall, the balanced heel-rise activity exposed more tibiotalar and subtalar kinematic variation between patients with CAI and control subjects. Therefore, weight-bearing activities involving large range of motion, balance, and stability may be best for studying kinematic adaptations in patients with CAI. CLINICAL RELEVANCE These preliminary results suggest that patients with CAI require more tibiotalar external rotation, subtalar eversion, and subtalar external rotation during weight-bearing stability exercises, all with less overall joint translation.
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Affiliation(s)
- Koren E. Roach
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
- Department of Bioengineering, University of Utah, 36 S. Wasatch Drive, Room 3100, Salt Lake City, UT 84112, USA
| | - K. Bo Foreman
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
- Department of Physical Therapy, University of Utah, 520 Wakara Way, Suite 240, Salt Lake City, UT 84108, USA
| | - Alexej Barg
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Charles L. Saltzman
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
- Department of Bioengineering, University of Utah, 36 S. Wasatch Drive, Room 3100, Salt Lake City, UT 84112, USA
| | - Andrew E. Anderson
- Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
- Department of Bioengineering, University of Utah, 36 S. Wasatch Drive, Room 3100, Salt Lake City, UT 84112, USA
- Department of Physical Therapy, University of Utah, 520 Wakara Way, Suite 240, Salt Lake City, UT 84108, USA
- Scientific Computing and Imaging Institute, 72 S Central Campus Drive, Room 3750, Salt Lake City, UT 84112, USA
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153
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Ko J, Rosen AB, Brown CN. Cross-cultural adaptation, reliability, and validation of the Korean version of the identification functional ankle instability (IdFAI). Disabil Rehabil 2017; 40:3185-3190. [DOI: 10.1080/09638288.2017.1375032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Jupil Ko
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix, AZ, USA
| | - Adam B. Rosen
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Cathleen N. Brown
- College of Public Health and Human Science, Oregon State University, Corvallis, OR, USA
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154
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Terada M, Kosik KB, McCann RS, Gribble PA. Diaphragm Contractility in Individuals with Chronic Ankle Instability. Med Sci Sports Exerc 2017; 48:2040-5. [PMID: 27232242 DOI: 10.1249/mss.0000000000000994] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION/PURPOSE Previous investigations have identified impaired trunk and postural stability in individuals with chronic ankle instability (CAI). The diaphragm muscle contributes to trunk and postural stability by modulating the intra-abdominal pressure. A potential mechanism that could help to explain trunk and postural stability deficits may be related to altered diaphragm function due to supraspinal sensorimotor changes with CAI. The purpose of this study was to examine the diaphragm contractility in individuals with CAI and healthy controls. METHODS Twenty-seven participants with self-reported CAI and 28 healthy control participants volunteered. A portable ultrasound unit was used to visualize and measure the right and left hemidiaphragm thickness at the end of resting inspiration and expiration in supine while breathing quietly. The diaphragm movement was imaged and recorded on B-mode ultrasonography. The degree of diaphragm contractility was calculated from the mean of three images from the end of resting inspiration and expiration. Independent t-tests were used to compare the degree of diaphragm thickness of right and left sides between the CAI and the control groups. RESULTS The CAI group had a smaller degree of left hemidiaphragm contractility compared with the control group (P = 0.03). There was no between-group difference in other diaphragm variables. CONCLUSION Individuals with CAI appear to have altered diaphragm contractility, which may be an illustration of diaphragm dysfunction and central nervous system changes in CAI population. The association between CAI and altered diaphragm contractility provides clinicians a more comprehensive awareness of proximal impairments associated with CAI. Future investigation is needed to determine whether altered contractility of the diaphragm contributes to functional impairments, activity limitations, and participant restrictions commonly observed in patients with CAI.
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Affiliation(s)
- Masafumi Terada
- 1College of Sport and Health Science, Ritsumeikan University, Kusatus, Shiga, JAPAN; and 2Department of Rehabilitation Science, University of Kentucky, Lexington, KY
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155
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Lee HK, So WY. Effects of kinesiotaping therapy on the pain and discomfort of acute ankle sprains in Korean university students. ISOKINET EXERC SCI 2017. [DOI: 10.3233/ies-206161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hye-Kyung Lee
- Department of Nursing, College of Nursing and Health, Kongju National University, Gongju, Korea
| | - Wi-Young So
- Sports and Health Care Major, College of Humanities and Arts, Korea National University of Transportation, Chungju-si, Korea
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156
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Lee M, Youm C, Son M, Kim J, Kim Y. Effects of chronic ankle instability and induced mediolateral muscular fatigue of the ankle on competitive taekwondo athletes. J Phys Ther Sci 2017; 29:1329-1335. [PMID: 28878457 PMCID: PMC5574326 DOI: 10.1589/jpts.29.1329] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 05/09/2017] [Indexed: 12/19/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of chronic ankle instability and induced mediolateral muscular fatigue of the ankle on competitive Taekwondo athletes during single-leg drop landing. [Subjects and Methods] Fourteen competitive taekwondo athletes with chronic ankle instability and 14 healthy adults participated, and they performed three single-leg drop landings from a 40-cm height before and after induced fatigue. Ankle angular position, peak vertical ground reaction force, loading rate, eccentric work, and contribution were calculated and analyzed. [Results] Athletes had lower ankle eversion and abduction angle than the controls did at maximum knee flexion both pre- and post-fatigue. Furthermore, athletes had lower eccentric work of the hip than the controls did post-fatigue, and they had lower eccentric work of the knee than controls at both pre- and post-fatigue. The eccentric work of the knee increased while, peak vertical ground reaction force decreased in both, athletes as well as controls post-fatigue. [Conclusion] Taekwondo athletes with chronic ankle instability who participate in a high-intensity training program are continuously exposed to potential injuries of their ankle or knee joints. Therefore, competitive taekwondo athletes with chronic ankle instability should limit their participation in regular training until they complete the rehabilitation process.
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Affiliation(s)
- Myeounggon Lee
- Biomechanics Laboratory, College of Health Sciences, Dong-A University, Republic of Korea
| | - Changhong Youm
- Department of Health Care and Science, College of Health Sciences, Dong-A University, Republic of Korea
| | - Minji Son
- Biomechanics Laboratory, College of Health Sciences, Dong-A University, Republic of Korea
| | - Jinhee Kim
- Biomechanics Laboratory, College of Health Sciences, Dong-A University, Republic of Korea
| | - Youkyung Kim
- Biomechanics Laboratory, College of Health Sciences, Dong-A University, Republic of Korea
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157
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Mailuhu AKE, Oei EHG, van Putte-Katier N, van Ochten JM, Bindels PJE, Bierma-Zeinstra SMA, van Middelkoop M. Clinical and radiological predictors for persistent complaints five years after a lateral ankle sprain: A long-term follow-up study in primary care. J Sci Med Sport 2017; 21:250-256. [PMID: 28780197 DOI: 10.1016/j.jsams.2017.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/05/2017] [Accepted: 07/05/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine the five-year prognosis and potential prognostic factors of patients with an acute lateral ankle sprain in primary care setting. DESIGN Observational study. METHODS 206 patients who participated in a cross-sectional study and visited their general practitioner with an acute lateral ankle sprain 6-12 months prior to inclusion were approached for a 5-year follow-up measurement consisting of an online questionnaire. At baseline patients completed standardized questionnaires, underwent a standardized physical examination and radiological examination (radiography and Magnetic Resonance Imaging) and scored their perceived recovery. Logistic regression analysis was used to examine potential predictive factors at baseline for the presence of persistent complaints after 5 years. RESULTS 132 (64.1%) patients completed the 5-year follow-up. 18.2% reported persistent complaints and 30.3% had a re-sprain during follow-up. Baseline persistent complaints 6-12 months after an acute lateral ankle sprain (OR 6.38; CI 95% 1.54-26.44), dominant leg injury (OR 4.89; CI 95% 1.16-20.62) and a recurrent ankle sprain (OR 9.81; CI 95% 2.17-44.47) were significant predictors for persistent complaints 5 years after an acute ankle sprain. Physical examination and radiological findings did not add to the predictive value of the prognostic model. CONCLUSIONS Almost 20% of patients with an acute lateral ankle sprain experience persistent complaints after 5 years follow-up. Predictive factors for persistent complaints can be identified.
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Affiliation(s)
- Adinda K E Mailuhu
- Department of General Practice, Erasmus MC University Medical Center, The Netherlands,.
| | - Edwin H G Oei
- Department of Radiology, Erasmus MC University Medical Center, The Netherlands
| | | | - John M van Ochten
- Department of General Practice, Erasmus MC University Medical Center, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC University Medical Center, The Netherlands
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158
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Springer S, Gottlieb U. Effects of dual-task and walking speed on gait variability in people with chronic ankle instability: a cross-sectional study. BMC Musculoskelet Disord 2017; 18:316. [PMID: 28732483 PMCID: PMC5522594 DOI: 10.1186/s12891-017-1675-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 07/13/2017] [Indexed: 11/24/2022] Open
Abstract
Background Recent evidence suggests that impaired central sensorimotor integration may contribute to deficits in movement control experienced by people with chronic ankle instability (CAI). This study compared the effects of dual-task and walking speed on gait variability in individuals with and without CAI. Methods Sixteen subjects with CAI and 16 age- and gender-matched, able-bodied controls participated in this study. Stride time variability and stride length variability were measured on a treadmill under four different conditions: self-paced walking, self-paced walking with dual-task, fast walking, and fast walking with dual-task. Results Under self-paced walking (without dual-task) there was no difference in stride time variability between CAI and control groups (P = 0.346). In the control group, compared to self-paced walking, stride time variability decreased in all conditions: self-paced walking with dual-task, fast speed, and fast speed with dual-task (P = 0.011, P = 0.016, P = 0.001, respectively). However, in the CAI group, compared to self-paced walking, decreased stride time variability was demonstrated only in the fast speed with dual-task condition (P = 1.000, P = 0.471, P = 0.008; respectively). Stride length variability did not change under any condition in either group. Conclusions Subjects with CAI and healthy controls reduced their stride time variability in response to challenging walking conditions; however, the pattern of change was different. A higher level of gait disturbance was required to cause a change in walking in the CAI group compared to healthy individuals, which may indicate lower adaptability of the sensorimotor system. Clinicians may use this information and employ activities to enhance sensorimotor control during gait, when designing intervention programs for people with CAI. The study was registered with the Clinical Trials network (registration NCT02745834, registration date 15/3/2016).
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Affiliation(s)
- Shmuel Springer
- Faculty of Health Science, Department of Physical Therapy, Ariel University, Ariel, Israel.
| | - Uri Gottlieb
- Faculty of Health Science, Department of Physical Therapy, Ariel University, Ariel, Israel.,Israel Defense Force Medical Corps, Zerifin, Israel
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159
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Donnelly L, Donovan L, Hart JM, Hertel J. Eversion Strength and Surface Electromyography Measures With and Without Chronic Ankle Instability Measured in 2 Positions. Foot Ankle Int 2017; 38:769-778. [PMID: 28391722 DOI: 10.1177/1071100717701231] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Individuals with chronic ankle instability (CAI) have demonstrated strength deficits compared to healthy controls; however, the influence of ankle position on force measures and surface electromyography (sEMG) activation of the peroneus longus and brevis has not been investigated. The purpose of this study was to compare sEMG amplitudes of the peroneus longus and brevis and eversion force measures in 2 testing positions, neutral and plantarflexion, in groups with and without CAI. METHODS Twenty-eight adults (19 females, 9 males) with CAI and 28 healthy controls (19 females, 9 males) participated. Hand-held dynamometer force measures were assessed during isometric eversion contractions in 2 testing positions (neutral, plantarflexion) while surface sEMG amplitudes of the peroneal muscles were recorded. Force measures were normalized to body mass, and sEMG amplitudes were normalized to a resting period. RESULTS The group with CAI demonstrated less force when compared to the control group ( P < .001) in both the neutral and plantarflexion positions: neutral position, CAI: 1.64 Nm/kg and control: 2.10 Nm/kg) and plantarflexion position, CAI: 1.40 Nm/kg and control: 1.73 Nm/kg). There were no differences in sEMG amplitudes between the groups or muscles ( P > .05). Force measures correlated with both muscles' sEMG amplitudes in the healthy group (neutral peroneus longus: r = 0.42, P = .03; plantarflexion peroneus longus: r = 0.56, P = .002; neutral peroneus brevis: r = 0.38, P = .05; plantarflexion peroneus longus: r = 0.40, P = .04), but not in the group with CAI ( P > .05). CONCLUSIONS The group with CAI generated less force when compared to the control group during both testing positions. There was no selective activation of the peroneal muscles with testing in both positions, and force output and sEMG activity was only related in the healthy group. CLINICAL RELEVANCE Clinicians should assess eversion strength and implement strength training exercises in different sagittal plane positions and evaluate for other pathologies that may contribute to reduced eversion strength in patients with CAI. LEVEL OF EVIDENCE Level III, cross-sectional.
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Affiliation(s)
- Lindsy Donnelly
- 1 Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - Luke Donovan
- 2 Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Joseph M Hart
- 3 Department of Kinesiology and Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA
| | - Jay Hertel
- 3 Department of Kinesiology and Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA
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Skazalski C, Kruczynski J, Bahr MA, Bere T, Whiteley R, Bahr R. Landing-related ankle injuries do not occur in plantarflexion as once thought: a systematic video analysis of ankle injuries in world-class volleyball. Br J Sports Med 2017; 52:74-82. [DOI: 10.1136/bjsports-2016-097155] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/26/2017] [Accepted: 05/09/2017] [Indexed: 12/26/2022]
Abstract
BackgroundAnkle injuries are prevalent in elite volleyball and suggested to result from player contact at the net. Traditionally, ankle sprains are thought to happen in a plantarflexed position, but case studies suggest plantarflexion may not be involved.AimDescribe the injury situations and mechanisms of ankle injuries in world-class volleyball based on systematic video analysis of injuries reported through the Fédération Internationale de Volleyball (FIVB) Injury Surveillance System.MethodsVideos of 24 injuries from major FIVB tournaments were included for analysis (14 men, 10 women). Five analysts reviewed the videos to determine specific situations and mechanisms leading to injuries.ResultsThe majority of injuries occurred during two volleyball situations, blocking (n=15) and attacking (n=6). Injuries to blockers were the result of landing on an opponent (n=11) or teammate (n=4). Attacking injuries most frequently occurred when a back-row player landed on a front-row teammate (n=4 of 6). When landing on an opponent under the net, the attacker landed into the opponent’s court in 11 of 12 situations but without violating the centre line rule. Injuries mostly resulted from rapid inversion without any substantial plantarflexion.ConclusionsThe majority of injuries occur while blocking, often landing on an opponent. The attacker is overwhelmingly to blame for injuries at the net secondary to crossing the centre line. Injuries while attacking often result from a back-row player landing on a front-row teammate. Landing-related injuries mostly result from rapid inversion with the absence of plantarflexion.
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161
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Effect of taping on multi-segmental foot kinematic patterns during walking in persons with chronic ankle instability. J Sci Med Sport 2017; 20:835-840. [PMID: 28483559 DOI: 10.1016/j.jsams.2017.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 02/08/2017] [Accepted: 04/13/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate multi-segmental foot kinematic patterns in chronic ankle instability (CAI) participants during walking, and to investigate the influence of high-Dye and low-Dye taping on these kinematic patterns. DESIGN Cross-sectional study. METHODS Kinematic data of 12 non-injured controls and 15 CAI participants were measured with a three-dimensional motion analysis system during barefoot walking. In addition, the CAI participants walked with high-Dye and low-Dye taping. A rigid Plug-in gait model and the Rizzoli 3D Multi-Segment Foot Model were used to measure multi-segmental foot kinematic patterns. One-dimensional statistical parametric mapping was used to compare barefoot walking of the control and CAI group, and to evaluate differences between walking barefoot and walking with high-Dye and low-Dye taping within the CAI group. RESULTS Compared to the control group, CAI participants showed a decreased ankle dorsiflexion during loading response (p=0.025) and a more inverted calcaneus in relation to the shank during the initial swing phase (p=0.024). A more inverted position of the metatarsus in relation to the midfoot was observed after low-Dye taping during almost the entire stance phase (p=0.017). No significant differences were found for high-Dye taping. CONCLUSIONS Significant differences in kinematic patterns were found in the ankle joint and rearfoot, but not in the mid- and forefoot in CAI participants. The application of low-Dye taping resulted in a significantly increased inverted position of the forefoot, which can be considered as a less desirable effect for patients with CAI. No other effects of high-Dye and low-Dye taping on kinematic patterns were revealed.
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162
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Sousa ASP, Leite J, Costa B, Santos R. Bilateral Proprioceptive Evaluation in Individuals With Unilateral Chronic Ankle Instability. J Athl Train 2017; 52:360-367. [PMID: 28318316 DOI: 10.4085/1062-6050-52.2.08] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Despite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. OBJECTIVE To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. DESIGN Cohort study. SETTING Research laboratory center in a university. PATIENTS OR OTHER PARTICIPANTS Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. MAIN OUTCOME MEASURE(S) Ankle active and passive joint position sense, kinesthesia, and force sense. RESULTS We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P < .001): the FAI group demonstrated increased error versus the control group (injured limb: P < .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). CONCLUSIONS Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense.
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Affiliation(s)
- Andreia S P Sousa
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
| | - João Leite
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
| | - Bianca Costa
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
| | - Rubim Santos
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
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Abstract
PURPOSE OF REVIEW Ankle sprains, which account for 40% of sports injuries in the USA, can lead to chronic ankle instability. Chronic ankle instability can be classified as functional, mechanical, or a combination of both and is diagnosed using a combination of a physical exam, an MRI, and stress radiographs. This review focuses on different approaches to treatment, including non-operative and operative techniques, of chronic ankle instability, including reviewing traditional procedures as well as more novel and newer techniques. RECENT FINDINGS Based on existing literature, non-operative treatment should always precede operative treatment of chronic ankle instability. If rehabilitation fails, Brostrom-Gould type ankle stabilization has been the preferred surgical option. Recent literature suggests that arthroscopic repair might reduce recovery time and improve outcomes in certain populations; however, there are higher rates of complication following these surgeries. In more high-risk populations, some literature reports that ligament repair with peroneus brevis transfer could be a more effective treatment option. Currently, varying surgical techniques exist for the treatment of chronic ankle instability. While the more recently reported techniques show promise, it is important to note that there is little evidence showing they are more successful than traditional techniques. It is imperative that future studies focus on outcomes and complication rates of these newer procedures.
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Affiliation(s)
- Rachel J Shakked
- Rothman Institute, 3300 Tillman Drive, 2nd Floor, Bensalem, Philadelphia, PA, 19020-2071, USA.
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164
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Moisan G, Descarreaux M, Cantin V. Effects of chronic ankle instability on kinetics, kinematics and muscle activity during walking and running: A systematic review. Gait Posture 2017; 52:381-399. [PMID: 28063387 DOI: 10.1016/j.gaitpost.2016.11.037] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 02/02/2023]
Abstract
The aim of this study is to systematically review and appraise studies assessing the effects of chronic ankle instability (CAI) on kinetics, kinematics and muscle activity during walking and running. The primary search was conducted in PubMed, Embase, CINAHL, AMED and SPORTDiscus. Only studies that compared participants with CAI with healthy participants and assessed kinetics, kinematics or muscle activity during walking or running were included. The risk of bias assessment was conducted using a modified version of the Quality Index checklist. A total of 509 articles were retrieved. After the title and abstract review, 34 articles underwent full-text review and risk of bias assessment. Following a complementary search and assessment of full manuscripts, 24 articles fulfilled all inclusion criteria and methodological requirements, of which 8 articles investigated muscle activity, 14 kinematics and 7 kinetics. During walking, participants with CAI presented increased ankle and rearfoot inversion, ankle plantarflexion, lateral foot vertical forces and peroneus longus muscle activity. During running, kinematic differences were similar to those during walking, but few studies quantified kinetics and muscle activity to draw sound conclusions. This systematic review reports new information on the effects of CAI on gait parameters since the last published review, especially with regard to muscle activity, kinematic and kinetic parameters during running. Methodological quality of the studies assessing kinetics during walking was found to be poor. Future studies should use standardized selection criteria when assessing participants with CAI to increase the external validity of the results.
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Affiliation(s)
- Gabriel Moisan
- Université du Québec à Trois-Rivières, 3351 Boul Des Forges, Trois-Rivières, Quebec, G9A 5H7 Canada.
| | - Martin Descarreaux
- Université du Québec à Trois-Rivières, 3351 Boul Des Forges, Trois-Rivières, Quebec, G9A 5H7 Canada.
| | - Vincent Cantin
- Université du Québec à Trois-Rivières, 3351 Boul Des Forges, Trois-Rivières, Quebec, G9A 5H7 Canada.
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165
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Hadadi M, Ebrahimi I, Mousavi ME, Aminian G, Esteki A, Rahgozar M. The effect of combined mechanism ankle support on postural control of patients with chronic ankle instability. Prosthet Orthot Int 2017; 41:58-64. [PMID: 26271261 DOI: 10.1177/0309364615596068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Chronic ankle instability is associated with neuromechanical changes and poor postural stability. Despite variety of mechanisms of foot and ankle orthoses, almost none apply comprehensive mechanisms to improve postural control in all subgroups of chronic ankle instability patients. OBJECTIVES The purpose of this study was to investigate the effect of an ankle support implementing combined mechanisms to improve postural control in chronic ankle instability patients. STUDY DESIGN Cross-sectional study. METHODS An ankle support with combined mechanism was designed based on most effective action mechanisms of foot and ankle orthoses. The effect of this orthosis on postural control was evaluated in 20 participants with chronic ankle instability and 20 matched healthy participants. The single-limb stance balance test was measured in both groups with and without the new orthosis using a force platform. RESULTS The results showed that application of combined mechanism ankle support significantly improved all postural sway parameters in chronic ankle instability patients. There were no differences in means of investigated parameters with and without the orthosis in the healthy group. No statistically significant differences were found in postural sway between chronic ankle instability patients and healthy participants after applying the combined mechanism ankle support. CONCLUSION The combined mechanism ankle support is effective in improving static postural control of chronic ankle instability patients to close to the postural sway of healthy individual. the orthosis had no adverse effects on balance performance of healthy individuals. Clinical relevance Application of the combined mechanism ankle support for patients with chronic ankle instability is effective in improving static balance. This may be helpful in reduction of recurrence of ankle sprain although further research about dynamic conditions is needed.
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Affiliation(s)
- Mohammad Hadadi
- 1 Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ismaeil Ebrahimi
- 2 Department of Physical therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Mousavi
- 1 Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Gholamreza Aminian
- 1 Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Esteki
- 3 Department of Biomedical Engineering and Physics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Rahgozar
- 4 Department of Statistics and Computer Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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166
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McKeon PO, Wikstrom EA. Sensory-Targeted Ankle Rehabilitation Strategies for Chronic Ankle Instability. Med Sci Sports Exerc 2017; 48:776-84. [PMID: 26717498 DOI: 10.1249/mss.0000000000000859] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Deficient sensory input from damaged ankle ligament receptors is thought to contribute to sensorimotor deficits in those with chronic ankle instability (CAI). Targeting other viable sensory receptors may then enhance sensorimotor control in these patients. The purpose of this randomized controlled trial was to evaluate the effects of 2 wk of sensory-targeted ankle rehabilitation strategies (STARS) on patient- and clinician-oriented outcomes in those with CAI. METHODS Eighty patients with self-reported CAI participated. All patients completed patient-oriented questionnaires capturing self-reported function as well as the weight-bearing lunge test and an eyes-closed single-limb balance test. After baseline testing, patients were randomly allocated to four STARS groups: joint mobilization, plantar massage, triceps surae stretching, or control. Each patient in the intervention groups received six 5-min treatments of their respective STARS over 2 wk. All subjects were reassessed on patient- and clinician-oriented measures immediately after the intervention and completed a 1-month follow-up that consisted of patient-oriented measures. Change scores of the three STARS groups were compared with the control using independent t-tests and Hedges' g effect sizes with 95% confidence intervals. RESULTS The joint mobilization group had the greatest weight-bearing lunge test improvement. Plantar massage had the most meaningful single-limb balance improvement. All STARS groups improved patient-oriented outcomes with joint mobilization having the most meaningful effect immediately after the intervention and plantar massage at the 1-month follow-up. CONCLUSION Each STARS treatment offers unique contributions to the patient- and clinician-oriented rehabilitation outcomes of those with CAI. Both joint mobilization and plantar massage appear to demonstrate the greatest potential to improve sensorimotor function in those with CAI.
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Affiliation(s)
- Patrick O McKeon
- 1Department of Exercise & Sport Sciences, Ithaca College, Ithaca, NY; and 2Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
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167
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Doherty C, Bleakley C, Delahunt E, Holden S. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med 2016; 51:113-125. [PMID: 28053200 DOI: 10.1136/bjsports-2016-096178] [Citation(s) in RCA: 177] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ankle sprains are highly prevalent with high risk of recurrence. Consequently, there are a significant number of research reports examining strategies for treating and preventing acute and recurrent sprains (otherwise known as chronic ankle instability (CAI)), with a coinciding proliferation of review articles summarising these reports. OBJECTIVE To provide a systematic overview of the systematic reviews evaluating treatment strategies for acute ankle sprain and CAI. DESIGN Overview of intervention systematic reviews. PARTICIPANTS Individuals with acute ankle sprain/CAI. MAIN OUTCOME MEASUREMENTS The primary outcomes were injury/reinjury incidence and function. RESULTS 46 papers were included in this systematic review. The reviews had a mean score of 6.5/11 on the AMSTAR quality assessment tool. There was strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence of an ankle sprain. For the combined outcomes of pain, swelling and function after an acute sprain, there was strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques. There was conflicting evidence regarding the efficacy of surgery and acupuncture for the treatment of acute ankle sprains. There was insufficient evidence to support the use of ultrasound in the treatment of acute ankle sprains. CONCLUSIONS For the treatment of acute ankle sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques, for pain, swelling and function. Exercise therapy and bracing are supported in the prevention of CAI.
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Affiliation(s)
- Cailbhe Doherty
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland
| | - Chris Bleakley
- Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, UK
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Sinead Holden
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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168
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Donovan L, Hart JM, Saliba S, Park J, Feger MA, Herb CC, Hertel J. Effects of ankle destabilization devices and rehabilitation on gait biomechanics in chronic ankle instability patients: A randomized controlled trial. Phys Ther Sport 2016; 21:46-56. [DOI: 10.1016/j.ptsp.2016.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/15/2016] [Accepted: 02/18/2016] [Indexed: 12/26/2022]
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169
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Coordination and Symmetry Patterns During the Drop Vertical Jump in People With Chronic Ankle Instability and Lateral Ankle Sprain Copers. Phys Ther 2016; 96:1152-61. [PMID: 26893510 DOI: 10.2522/ptj.20150160] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 02/04/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND The drop vertical jump (DVJ) task has previously been used to identify movement patterns associated with a number of injury types. However, no current research exists evaluating people with chronic ankle instability (CAI) compared with people coping with lateral ankle sprain (LAS) (referred to as "LAS copers") during this task. OBJECTIVE The aim of this study was to identify the coping movement and motor control patterns of LAS copers in comparison with individuals with CAI during the DVJ task. DESIGN This was a case-control study. METHODS Seventy individuals were recruited at convenience within 2-weeks of sustaining a first-time acute LAS injury. One year following recruitment, these individuals were stratified into 2 groups: 28 with CAI and 42 LAS copers. They attended the testing laboratory to complete a DVJ task. Three-dimensional kinematic and sagittal-plane kinetic profiles were plotted for the lower extremity joints of both limbs for the drop jump phase (phase 1) and drop landing phase (phase 2) of the DVJ. The rate of impact modulation relative to body weight during both phases of the DVJ also was determined. RESULTS Compared with LAS copers, participants with CAI displayed significant increases in hip flexion on their "involved" limb during phase 1 of the DVJ (23° vs 18°) and bilaterally during phase 2 (15° vs 10°). These movement patterns coincided with altered moment-of-force patterns at the hip on the "uninvolved" limb. LIMITATIONS It is unknown whether these movement and motor control patterns preceded or occurred as a result of the initial LAS injury. CONCLUSIONS Participants with CAI displayed hip-centered changes in movement and motor control patterns during a DVJ task compared with LAS copers. The findings of this study may give an indication of the coping mechanism underlying outcome following initial LAS injury.
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170
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Hadadi M, Ebrahimi Takamjani I, Ebrahim Mosavi M, Aminian G, Fardipour S, Abbasi F. Cross-cultural adaptation, reliability, and validity of the Persian version of the Cumberland Ankle Instability Tool. Disabil Rehabil 2016; 39:1644-1649. [DOI: 10.1080/09638288.2016.1207105] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mohammad Hadadi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ismail Ebrahimi Takamjani
- Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Mosavi
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Gholamreza Aminian
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shima Fardipour
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Faeze Abbasi
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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171
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Deschamps K, Dingenen B, Pans F, Van Bavel I, Matricali GA, Staes F. Effect of taping on foot kinematics in persons with chronic ankle instability. J Sci Med Sport 2016; 19:541-6. [DOI: 10.1016/j.jsams.2015.07.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 06/09/2015] [Accepted: 07/14/2015] [Indexed: 11/16/2022]
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172
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Terada M, Bowker S, Hiller CE, Thomas AC, Pietrosimone B, Gribble PA. Quantifying levels of function between different subgroups of chronic ankle instability. Scand J Med Sci Sports 2016; 27:650-660. [DOI: 10.1111/sms.12712] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 12/26/2022]
Affiliation(s)
- M. Terada
- College of Sport and Health Science; Ritsumeikan University; Shiga Japan
| | - S. Bowker
- Kent State University; Kent Ohio USA
| | - C. E. Hiller
- Faculty of Health Sciences University of Sydney; Lidcombe New South Wales Australia
| | - A. C. Thomas
- Department of Kinesiology; University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - B. Pietrosimone
- Department of Exercise and Sport Science; University of North Carolina at Chapel Hill; Chapel Hill North Carolina USA
| | - P. A. Gribble
- Department of Rehabilitation Science; University of Kentucky; Lexington Kentucky USA
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173
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Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DTP, Hertel J, Hiller CE, Kaminski TW, McKeon PO, Refshauge KM, Verhagen EA, Vicenzino BT, Wikstrom EA, Delahunt E. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 2016; 50:1496-1505. [PMID: 27259753 DOI: 10.1136/bjsports-2016-096189] [Citation(s) in RCA: 308] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 02/06/2023]
Abstract
Lateral ankle sprains (LASs) are the most prevalent musculoskeletal injury in physically active populations. They also have a high prevalence in the general population and pose a substantial healthcare burden. The recurrence rates of LASs are high, leading to a large percentage of patients with LAS developing chronic ankle instability. This chronicity is associated with decreased physical activity levels and quality of life and associates with increasing rates of post-traumatic ankle osteoarthritis, all of which generate financial costs that are larger than many have realised. The literature review that follows expands this paradigm and introduces emerging areas that should be prioritised for continued research, supporting a companion position statement paper that proposes recommendations for using this summary of information, and needs for specific future research.
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Affiliation(s)
- Phillip A Gribble
- University of Kentucky, College of Health Sciences, Lexington, Kentucky, USA
| | - Chris M Bleakley
- Department of Life and Health Sciences, Ulster University, Jordanstown, Carrickfergus, UK
| | - Brian M Caulfield
- University College Dublin, Insight Centre for Data Analytics, Dublin, Ireland
| | - Carrie L Docherty
- Indiana University, School of Public Health, Bloomington, Indiana, USA
| | | | - Daniel Tik-Pui Fong
- National Centre for Sport and Exercise Medicine-East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Jay Hertel
- Departments of Kinesiology and Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Claire E Hiller
- University of Sydney, College of Health, Sydney, New South Wales, Australia
| | - Thomas W Kaminski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Patrick O McKeon
- Department of Exercise and Sport Sciences, Ithaca College, Ithaca, New York, USA
| | | | - Evert A Verhagen
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Bill T Vicenzino
- University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Queensland, Australia
| | - Erik A Wikstrom
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eamonn Delahunt
- University College Dublin, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
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174
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Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DTP, Hertel J, Hiller CE, Kaminski TW, McKeon PO, Refshauge KM, Verhagen EA, Vicenzino BT, Wikstrom EA, Delahunt E. 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 2016; 50:1493-1495. [PMID: 27259750 DOI: 10.1136/bjsports-2016-096188] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 12/31/2022]
Abstract
The Executive Committee of the International Ankle Consortium presents this 2016 position paper with recommendations for information implementation and continued research based on the paradigm that lateral ankle sprain (LAS), and the development of chronic ankle instability (CAI), serve as a conduit to a significant global healthcare burden. We intend our recommendations to serve as a mechanism to promote efforts to improve prevention and early management of LAS. We believe this will reduce the prevalence of CAI and associated sequelae that have led to the broader public health burdens of decreased physical activity and early onset ankle joint post-traumatic osteoarthritis. Ultimately, this can contribute to healthier lifestyles and promotion of physical activity.
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Affiliation(s)
- Phillip A Gribble
- University of Kentucky, College of Health Sciences, Lexington, Kentucky, USA
| | - Chris M Bleakley
- Department of Life and Health Sciences, Ulster University, Jordanstown, Carrickfergus, UK
| | - Brian M Caulfield
- University College Dublin, Insight Centre for Data Analytics, Dublin, Ireland
| | - Carrie L Docherty
- Indiana University, College of Public Health, Bloomington, Indiana, USA
| | | | - Daniel Tik-Pui Fong
- National Centre for Sport and Exercise Medicine-East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Jay Hertel
- Departments of Kinesiology and Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Claire E Hiller
- University of Sydney, College of Health, Sydney, New South Wales, Australia
| | - Thomas W Kaminski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Patrick O McKeon
- Department of Exercise and Sport Sciences, Ithaca College, Ithaca, New York, USA
| | | | - Evert A Verhagen
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Bill T Vicenzino
- University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Queensland, Australia
| | - Erik A Wikstrom
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eamonn Delahunt
- University College Dublin, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
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175
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Attenborough AS, Sinclair PJ, Sharp T, Greene A, Stuelcken M, Smith RM, Hiller CE. A snapshot of chronic ankle instability in a cohort of netball players. J Sci Med Sport 2016; 19:379-83. [DOI: 10.1016/j.jsams.2015.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 03/24/2015] [Accepted: 04/12/2015] [Indexed: 10/23/2022]
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176
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Koshino Y, Ishida T, Yamanaka M, Ezawa Y, Okunuki T, Kobayashi T, Samukawa M, Saito H, Tohyama H. Kinematics and muscle activities of the lower limb during a side-cutting task in subjects with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 2016; 24:1071-80. [PMID: 26254794 DOI: 10.1007/s00167-015-3745-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate lower limb kinematics and muscular activities during walking, side-turning while walking, and side-cutting movement in athletes with chronic ankle instability and compare the results to those of athletes without chronic ankle instability. METHODS Lower limb kinematics and muscular activities were evaluated in 10 athletes with chronic ankle instability and 10 healthy control athletes using a three-dimensional motion analysis system and surface electromyography during the 200-ms pre-initial contact (IC) and stance phases while walking, side-turning while walking, and side-cutting. RESULTS During walking or side-turning while walking, there were no significant differences in kinematics or muscle activities between the subjects with and without chronic ankle instability. For the side-cutting task, however, ankle inversion angles during the 200-ms pre-IC and late stance phases [effect sizes (ESs) = 0.95-1.43], the hip flexion angle (ESs = 0.94-0.96) and muscular activities of the gastrocnemius medialis (ESs = 1.04-1.73) during the early stance phase were significantly greater in the athletes with chronic ankle instability than in the healthy control athletes. CONCLUSIONS Alterations of kinematics in athletes with chronic ankle instability were found not only at the ankle but also at hip joints during the side-cutting movement. These alterations were not detected during walking or side-turning while walking. The findings of the present study indicate that clinicians should take into account the motion of the hip joint during the side-cutting movement in persons with chronic ankle instability. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Rehabilitation Center, NTT East Japan Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Department of Rehabilitation, Hokushin Orthopedic Hospital, Sapporo, Hokkaido, Japan
| | - Masanori Yamanaka
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.
| | - Yuya Ezawa
- Department of Rehabilitation, Matsuda Orthopedic Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Takumi Okunuki
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Department of Rehabilitation, Matsuda Orthopedic Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Takumi Kobayashi
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Chitose, Hokkaido, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Hiroshi Saito
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, West-5, North-12, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
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177
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Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Dynamic balance deficits in individuals with chronic ankle instability compared to ankle sprain copers 1 year after a first-time lateral ankle sprain injury. Knee Surg Sports Traumatol Arthrosc 2016; 24:1086-95. [PMID: 26254090 DOI: 10.1007/s00167-015-3744-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/28/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE To quantify the dynamic balance deficits that characterise a group with chronic ankle instability compared to lateral ankle sprain copers and non-injured controls using kinematic and kinetic outcomes. METHODS Forty-two participants with chronic ankle instability and twenty-eight lateral ankle sprain copers were initially recruited within 2 weeks of sustaining a first-time, acute lateral ankle sprain and required to attend our laboratory 1 year later to complete the current study protocol. An additional group of non-injured individuals were also recruited to act as a control group. All participants completed the anterior, posterior-lateral and posterior-medial reach directions of the star excursion balance test. Sagittal plane kinematics of the lower extremity and associated fractal dimension of the centre of pressure path were also acquired. RESULTS Participants with chronic ankle instability displayed poorer performance in the anterior, posterior-medial and posterior-lateral reach directions compared with controls bilaterally, and in the posterior-lateral direction compared with lateral ankle sprain copers on their 'involved' limb only. These performance deficits in the posterior-lateral and posterior-medial directions were associated with reduced flexion and dorsiflexion displacements at the hip, knee and ankle at the point of maximum reach, and coincided with reduced complexity of the centre of pressure path. CONCLUSION In comparison with lateral ankle sprain copers and controls, participants with chronic ankle instability were characterised by dynamic balance deficits as measured using the SEBT. This was attested to reduced sagittal plane motions at the hip, knee and ankle joints, and reduced capacity of the stance limb to avail of its supporting base. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Cailbhe Doherty
- A101 School of Public Health, Physiotherapy and Population Science, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.
| | - Chris Bleakley
- Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, Co., Antrim, Northern Ireland
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - Brian Caulfield
- A101 School of Public Health, Physiotherapy and Population Science, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland
| | - John Ryan
- St. Vincent's University Hospital, Dublin, Ireland
| | - Eamonn Delahunt
- A101 School of Public Health, Physiotherapy and Population Science, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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178
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Donovan L, Hart JM, Saliba SA, Park J, Feger MA, Herb CC, Hertel J. Rehabilitation for Chronic Ankle Instability With or Without Destabilization Devices: A Randomized Controlled Trial. J Athl Train 2016. [PMID: 26934211 DOI: 10.4085/1062-6050-51.3.09.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Individuals with chronic ankle instability (CAI) have deficits in neuromuscular control and altered movement patterns. Ankle-destabilization devices have been shown to increase lower extremity muscle activity during functional tasks and may be useful tools for improving common deficits and self-reported function. OBJECTIVE To determine whether a 4-week rehabilitation program that includes destabilization devices has greater effects on self-reported function, range of motion (ROM), strength, and balance than rehabilitation without devices in patients with CAI. DESIGN Randomized controlled clinical trial. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 26 patients with CAI (7 men, 19 women; age = 21.34 ± 3.06 years, height = 168.96 ± 8.77 cm, mass = 70.73 ± 13.86 kg). INTERVENTION(S) Patients completed baseline measures and were randomized into no-device and device groups. Both groups completed 4 weeks of supervised, impairment-based progressive rehabilitation with or without devices and then repeated baseline measures. MAIN OUTCOME MEASURE(S) We assessed self-reported function using the Foot and Ankle Ability Measure. Ankle ROM was measured with an inclinometer. Ankle strength was assessed using a handheld dynamometer during maximal voluntary isometric contractions. Balance was measured using a composite score of 3 reach directions from the Star Excursion Balance Test and a force plate to calculate center of pressure during eyes-open and eyes-closed single-limb balance. We compared each dependent variable using a 2 × 2 (group × time) analysis of variance and post hoc tests as appropriate and set an a priori α level at .05. The Hedges g effect sizes and associated 95% confidence intervals were calculated. RESULTS We observed no differences between the no-device and device groups for any measure. However, both groups had large improvements in self-reported function and ankle strength. CONCLUSIONS Incorporating destabilization devices into rehabilitation did not improve ankle function more effectively than traditional rehabilitation tools because both interventions resulted in similar improvements. Impairment-based progressive rehabilitation improved clinical outcomes associated with CAI.
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Affiliation(s)
- Luke Donovan
- Department of Kinesiology, University of Toledo, OH; Departments of
| | - Joseph M Hart
- Kinesiology and.,Orthopaedic Surgery, The University of Virginia, Charlottesville
| | | | - Joseph Park
- Orthopaedic Surgery, The University of Virginia, Charlottesville
| | | | - Christopher C Herb
- Department of Athletic Training & Nutrition, Weber State University, Ogden, UT
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179
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Abstract
The purpose of this paper is to present a current review of pathoanatomical features, differential diagnosis, objective assessment, intervention, and clinical course associated with managing lateral ankle ligament sprains. Proper diagnosis and identification of affected structures should be obtained through history and objective assessment. From this information, an individualized evidence-based intervention plan can be developed to enable recovery while decreasing the risk of reinjury. An appropriate evaluation is needed not only to determine the correct diagnosis but also to allow for grading and determining the prognosis of the injury in those with an acute lateral ankle sprain. Examination should include an assessment of impairments as well as a measure of activity and participation. Evidence-based interventions for those with an acute lateral ankle sprain should include weight bearing with bracing, manual therapy, progressive therapeutic exercises, and cryotherapy. For those with chronic ankle instability (CAI), interventions should include manual therapy and a comprehensive rehabilitation program. It is essential to understand the normal clinical course for athletes who sustain a lateral ankle sprain as well as risk factors for an acute injury and CAI. Risk factors for both an acute lateral ankle sprain and CAI include not using an external support and not participating in an appropriate exercise program. Incorporating the latest evidence-based rehabilitation techniques provides the best course of treatment for athletes with an acute ankle sprain or CAI.
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Affiliation(s)
- Ryan P McGovern
- Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - RobRoy L Martin
- Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA; Centers for Sports Medicine - University of Pittsburgh, Pittsburgh, PA, USA
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180
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Donovan L, Hart JM, Saliba SA, Park J, Feger MA, Herb CC, Hertel J. Rehabilitation for Chronic Ankle Instability With or Without Destabilization Devices: A Randomized Controlled Trial. J Athl Train 2016; 51:233-51. [PMID: 26934211 DOI: 10.4085/1062-6050-51.3.09] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Individuals with chronic ankle instability (CAI) have deficits in neuromuscular control and altered movement patterns. Ankle-destabilization devices have been shown to increase lower extremity muscle activity during functional tasks and may be useful tools for improving common deficits and self-reported function. OBJECTIVE To determine whether a 4-week rehabilitation program that includes destabilization devices has greater effects on self-reported function, range of motion (ROM), strength, and balance than rehabilitation without devices in patients with CAI. DESIGN Randomized controlled clinical trial. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 26 patients with CAI (7 men, 19 women; age = 21.34 ± 3.06 years, height = 168.96 ± 8.77 cm, mass = 70.73 ± 13.86 kg). INTERVENTION(S) Patients completed baseline measures and were randomized into no-device and device groups. Both groups completed 4 weeks of supervised, impairment-based progressive rehabilitation with or without devices and then repeated baseline measures. MAIN OUTCOME MEASURE(S) We assessed self-reported function using the Foot and Ankle Ability Measure. Ankle ROM was measured with an inclinometer. Ankle strength was assessed using a handheld dynamometer during maximal voluntary isometric contractions. Balance was measured using a composite score of 3 reach directions from the Star Excursion Balance Test and a force plate to calculate center of pressure during eyes-open and eyes-closed single-limb balance. We compared each dependent variable using a 2 × 2 (group × time) analysis of variance and post hoc tests as appropriate and set an a priori α level at .05. The Hedges g effect sizes and associated 95% confidence intervals were calculated. RESULTS We observed no differences between the no-device and device groups for any measure. However, both groups had large improvements in self-reported function and ankle strength. CONCLUSIONS Incorporating destabilization devices into rehabilitation did not improve ankle function more effectively than traditional rehabilitation tools because both interventions resulted in similar improvements. Impairment-based progressive rehabilitation improved clinical outcomes associated with CAI.
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Affiliation(s)
- Luke Donovan
- Department of Kinesiology, University of Toledo, OH; Departments of
| | - Joseph M Hart
- Kinesiology and.,Orthopaedic Surgery, The University of Virginia, Charlottesville
| | | | - Joseph Park
- Orthopaedic Surgery, The University of Virginia, Charlottesville
| | | | - Christopher C Herb
- Department of Athletic Training & Nutrition, Weber State University, Ogden, UT
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181
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Delahunt E, Thorborg K, Khan KM, Robinson P, Hölmich P, Weir A. Minimum reporting standards for clinical research on groin pain in athletes. Br J Sports Med 2016; 49:775-81. [PMID: 26031644 PMCID: PMC4484363 DOI: 10.1136/bjsports-2015-094839] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Groin pain in athletes is a priority area for sports physiotherapy and sports medicine research. Heterogeneous studies with low methodological quality dominate research related to groin pain in athletes. Low-quality studies undermine the external validity of research findings and limit the ability to generalise findings to the target patient population. Minimum reporting standards for research on groin pain in athletes are overdue. We propose a set of minimum reporting standards based on best available evidence to be utilised in future research on groin pain in athletes. Minimum reporting standards are provided in relation to: (1) study methodology, (2) study participants and injury history, (3) clinical examination, (4) clinical assessment and (5) radiology. Adherence to these minimum reporting standards will strengthen the quality and transparency of research conducted on groin pain in athletes. This will allow an easier comparison of outcomes across studies in the future.
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Affiliation(s)
- Eamonn Delahunt
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Arthroscopic Center Amager, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Karim M Khan
- Aspetar Sports Groin Pain Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Philip Robinson
- Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals, University of Leeds, Leeds, UK
| | - Per Hölmich
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Arthroscopic Center Amager, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark Aspetar Sports Groin Pain Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Adam Weir
- Aspetar Sports Groin Pain Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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182
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Kunugi S, Masunari A, Noh B, Mori T, Yoshida N, Miyakawa S. Cross-cultural adaptation, reliability, and validity of the Japanese version of the Cumberland ankle instability tool. Disabil Rehabil 2016; 39:50-58. [DOI: 10.3109/09638288.2016.1138555] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Shun Kunugi
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Akihiko Masunari
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Byungjoo Noh
- Department of Kinesiology and Integrative Physiology, Michigan Technology University, Michigan, USA
| | - Toshio Mori
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Naruto Yoshida
- Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
| | - Shumpei Miyakawa
- Department of Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
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183
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Donovan L, Feger MA, Hart JM, Saliba S, Park J, Hertel J. Effects of an auditory biofeedback device on plantar pressure in patients with chronic ankle instability. Gait Posture 2016; 44:29-36. [PMID: 27004629 DOI: 10.1016/j.gaitpost.2015.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/05/2015] [Accepted: 10/07/2015] [Indexed: 02/02/2023]
Abstract
Chronic ankle instability (CAI) patients have been shown to have increased lateral column plantar pressure throughout the stance phase of gait. To date, traditional CAI rehabilitation programs have been unable to alter gait. We developed an auditory biofeedback device that can be worn in shoes that elicits an audible cue when an excessive amount of pressure is applied to a sensor. This study determined whether using this device can decrease lateral plantar pressure in participants with CAI and alter surface electromyography (sEMG) amplitudes (anterior tibialis, peroneus longus, medial gastrocnemius, and gluteus medius). Ten CAI patients completed baseline treadmill walking while in-shoe plantar pressures and sEMG were measured (baseline condition). Next, the device was placed into the shoe and set to a threshold that would elicit an audible cue during each step of the participant's normal gait. Then, participants were instructed to walk in a manner that would not trigger the audible cue, while plantar pressure and sEMG measures were recorded (auditory feedback (AUD FB) condition). Compared to baseline, there was a statistically significant reduction in peak pressure in the lateral midfoot-forefoot and central forefoot during the AUD FB condition. In addition, there were increases in peroneus longus and medial gastrocnemius sEMG amplitudes 200 ms post-initial contact during the AUD FB condition. The use of this auditory biofeedback device resulted in decreased plantar pressure in the lateral column of the foot during treadmill walking in CAI patients and may have been caused by the increase in sEMG activation of the peroneus longus.
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Affiliation(s)
- Luke Donovan
- University of Toledo, Department of Kinesiology, 2801 W. Bancroft St, Toledo, Mail Stop 119, OH, 43606, USA.
| | - Mark A Feger
- University of Virginia, Department of Kinesiology, 210 Emmet Street South, Charlottesville, VA, 22903, USA.
| | - Joseph M Hart
- University of Virginia, Department of Kinesiology, 210 Emmet Street South, Charlottesville, VA, 22903, USA; University of Virginia, Department of Orthopaedic Surgery, Fontaine Clinic, 545 Ray C Hunt Drive, Charlottesville, VA, 22908, USA.
| | - Susan Saliba
- University of Virginia, Department of Kinesiology, 210 Emmet Street South, Charlottesville, VA, 22903, USA.
| | - Joseph Park
- University of Virginia, Department of Orthopaedic Surgery, Fontaine Clinic, 545 Ray C Hunt Drive, Charlottesville, VA, 22908, USA.
| | - Jay Hertel
- University of Virginia, Department of Kinesiology, 210 Emmet Street South, Charlottesville, VA, 22903, USA.
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184
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Kim KM, Hart JM, Saliba SA, Hertel J. Relationships between self-reported ankle function and modulation of Hoffmann reflex in patients with chronic ankle instability. Phys Ther Sport 2016; 17:63-8. [DOI: 10.1016/j.ptsp.2015.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 05/04/2015] [Accepted: 05/14/2015] [Indexed: 11/25/2022]
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185
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DOHERTY CAILBHE, BLEAKLEY CHRIS, HERTEL JAY, CAULFIELD BRIAN, RYAN JOHN, SWEENEY KEVIN, PATTERSON MATTHEWR, DELAHUNT EAMONN. Lower Limb Interjoint Postural Coordination One Year after First-Time Lateral Ankle Sprain. Med Sci Sports Exerc 2015; 47:2398-405. [DOI: 10.1249/mss.0000000000000673] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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186
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Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Sweeney K, Patterson MR, Delahunt E. Coordination and symmetry patterns during the drop vertical jump, 6-months after first-time lateral ankle sprain. J Orthop Res 2015; 33:1537-44. [PMID: 25940807 DOI: 10.1002/jor.22915] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 02/17/2015] [Accepted: 03/27/2015] [Indexed: 02/04/2023]
Abstract
To evaluate the adaptive movement and motor control patterns of a group with a 6-month history of first-time lateral ankle sprain (LAS) injury during a drop vertical jump (DVJ) task. Fifty-one participants with a 6-month history of first-time acute LAS injury and twenty controls performed a DVJ task. 3D kinematic and sagittal plane kinetic profiles were plotted for the lower extremity joints of both limbs for the drop jump (phase 1) and drop landing (phase 2) phases of the DVJ. Inter-limb symmetry and the rate of impact modulation (RIM) relative to bodyweight (BW) during both phases of the DVJ were also determined. LAS participants displayed bilateral increases in knee flexion and an increase in ankle inversion during phases 1 and 2, respectively. They also displayed reduced ankle plantar flexion on their injured limb during both phases of the DVJ (p < 0.05); increased inter-limb asymmetry of RIM was noted for both phases of the DVJ, while the moment-of-force profile exhibited bilaterally greater hip extensor dominance during phase 1. Participants with a 6-month history of first-time LAS display some movement patterns consistent with those observed in chronic ankle instability populations during similar tasks.
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Affiliation(s)
- Cailbhe Doherty
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Chris Bleakley
- Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, Co. Antrim, Northern Ireland
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| | - Brian Caulfield
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - John Ryan
- St. Vincent's University Hospital, Dublin, Ireland
| | - Kevin Sweeney
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Matthew R Patterson
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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187
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Strength-Duration Curves of the Common Fibular Nerve Show Hypoexcitability in People With Functional Ankle Instability. PM R 2015; 8:536-44. [PMID: 26409196 DOI: 10.1016/j.pmrj.2015.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/10/2015] [Accepted: 09/16/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Some motor impairments, such as decreased reaction of peroneal muscles, altered kinematics, or poor postural control, have been described in people with functional ankle instability. Evidence shows a possible relationship between fibular nerve impairments and functional ankle instability. OBJECTIVE To investigate the electrophysiologic excitability of the common fibular nerve, as measured by strength-duration curves, in subjects with functional ankle instability compared with a control group without ankle impairment. DESIGN A cross-sectional study. SETTING University Research laboratory. PARTICIPANTS Fifty subjects with functional ankle instability (35 men, 15 women; ages 24.36 ± 5.01 years) and 63 uninjured control patients (44 men, 19 women; ages 22.67 ± 4.85 years) were recruited by convenience sampling. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Strength-duration curves of the common fibular nerve were made in all participants. Rheobase, chronaxie, Bawen index, accommodation index, galvano-tetanic threshold, and intensity thresholds for different pulse durations were obtained and compared between the 2 groups. RESULTS Subjects with functional ankle instability show increased values of chronaxie (0.58 ± 0.24 ms versus 0.47 ± 0.16 ms; P = .004), Bawen index (1.53 ± 0.24 versus 1.39 ± 0.21; P = .002), and intensity thresholds for pulse durations ≤2 ms both for rectangular and triangular pulse wave forms. The accommodation index was smaller in subjects with functional ankle instability than controls (3.7 ± 0.72 versus 4.05 ± 0.98; P = .036). The remaining parameters did not show significant differences between groups. CONCLUSIONS These findings suggest that subjects with functional ankle instability show a decreased excitability in their common fibular nerve when compared with subjects without ankle injuries.
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188
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Houston MN, Hoch JM, Hoch MC. Patient-Reported Outcome Measures in Individuals With Chronic Ankle Instability: A Systematic Review. J Athl Train 2015; 50:1019-33. [PMID: 26332028 DOI: 10.4085/1062-6050-50.9.01] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT A comprehensive systematic literature review of the health-related quality-of-life (HRQOL) differences among individuals with chronic ankle instability (CAI), ankle-sprain copers, and healthy control participants has not been conducted. It could provide a better indication of the self-reported deficits that may be present in individuals with CAI. OBJECTIVE To systematically summarize the extent to which HRQOL deficits are present in individuals with CAI. DATA SOURCES We searched for articles in the electronic databases of EBSCO Host and PubMed Central using key words chronic, functional, mechanical, coper, instability, sprains, and patient-assessed. We also performed a hand search of reference lists, authors, and patient-reported outcomes (PROs) of the articles screened for inclusion. STUDY SELECTION Studies were included if they (1) incorporated a PRO as a participant descriptor or as a study outcome to compare adults with CAI to ankle-sprain copers or healthy controls, (2) were written in English, and (3) were published in peer-reviewed journals. DATA EXTRACTION Two authors independently assessed methodologic quality using the modified Downs and Black Index. Articles were filtered into 3 categories based on between-groups comparisons: CAI and copers, CAI and healthy control participants, copers and healthy participants. We calculated Hedges g effect sizes and 95% confidence intervals to examine PRO group differences. DATA SYNTHESIS Of the 124 studies assessed for eligibility, 27 were included. A total of 24 articles compared PROs in individuals with CAI and healthy controls, 7 compared individuals with CAI and copers, and 4 compared copers and healthy controls. Quality scores on the modified Downs and Black Index ranged from 52.9% to 88.2%, with 8 high-, 16 moderate-, and 3 low-quality studies. Overall, we observed moderate to strong evidence that individuals with CAI displayed deficits on generic and region-specific PROs compared with copers and healthy controls. However, evidence that differences exist between copers and healthy controls was conflicting. In addition, for dimension-specific outcomes, evidence to suggest that fear of reinjury is heightened in individuals with CAI was limited. CONCLUSIONS The evidence suggested that CAI is associated with functional and HRQOL deficits, particularly when examined with region-specific PROs. However, PROs do not appear to differ between copers and healthy controls.
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Affiliation(s)
- Megan N Houston
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
| | - Johanna M Hoch
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA
| | - Matthew C Hoch
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA
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189
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Kodesh E, Dar G. The effect of kinesiotape on dynamic balance following muscle fatigue in individuals with chronic ankle instability. Res Sports Med 2015; 23:367-78. [DOI: 10.1080/15438627.2015.1076417] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Einat Kodesh
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, 31905, Haifa, Israel
| | - Gali Dar
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, 31905, Haifa, Israel; Ribstein Center for Research and Sports Medicine, Wingate Institute, Netanya 42902, Israel
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190
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Dynamic Balance Deficits 6 Months Following First-Time Acute Lateral Ankle Sprain: A Laboratory Analysis. J Orthop Sports Phys Ther 2015; 45:626-33. [PMID: 26107043 DOI: 10.2519/jospt.2015.5653] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Controlled laboratory study. OBJECTIVE To utilize kinematic and stabilometric measures to compare dynamic balance during performance of the Star Excursion Balance Test between persons 6 months following first-time lateral ankle sprain (LAS) and a noninjured control group. BACKGROUND Biomechanical evaluation of dynamic balance in persons following first-time LAS during performance of the Star Excursion Balance Test could provide insight into the mechanisms by which individuals proceed to recover fully or develop chronic ankle instability. METHODS Sagittal plane kinematics of the lower extremity and the center-of-pressure path during the performance of the anterior, posterolateral, and posteromedial reach directions of the Star Excursion Balance Test were obtained from 69 participants 6 months following first-time acute LAS and from a control group of 20 noninjured participants. RESULTS Compared to the control group, the LAS group displayed lower normalized reach distances in all 3 reach directions on the injured and noninjured limbs, with the largest observed effect size in the posterolateral direction (P = .001, ηp(2) = 0.07). The performance impairment was associated with less hip and knee flexion and ankle dorsiflexion at the point of maximum reach (P<.02), and coincided with less complexity of the center-of-pressure path (P<.05). CONCLUSION Participants with a 6-month history of LAS exhibit a persistence of deficits previously established in the acute phase of injury.
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191
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Wilson B, Bialocerkowski A. The Effects of Kinesiotape Applied to the Lateral Aspect of the Ankle: Relevance to Ankle Sprains--A Systematic Review. PLoS One 2015; 10:e0124214. [PMID: 26103637 PMCID: PMC4477981 DOI: 10.1371/journal.pone.0124214] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 03/10/2015] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To identify, evaluate and synthesise evidence on the effect of kinesiotape applied to the lateral aspect of the ankle, through a systematic review of quantitative studies. DATA SOURCES A search for quantitative studies was undertaken using key terms of "kinesiotape" and "ankle" in seven electronic databases, using the maximum date ranges. Databases included: the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Physiotherapy Evidence Database, Scopus, SPORTDiscus and Web of Science. STUDY SELECTION Database hits were evaluated against explicit inclusion criteria. From 107 database hits, 8 quantitative studies were included. DATA EXTRACTION Two independent reviewers appraised the methodological rigour of the studies using the McMaster Critical Review Form for Quantitative Studies. Data were extracted on participant characteristics, kinesiotape parameters, comparison interventions, outcome measures and findings. DATA SYNTHESES Most studies (n=7) had good to very good methodological rigour. Meta-analysis was not possible due to heterogeneity in participants, interventions and outcome measures. No adverse events were reported. Kinesiotape may produce different effects in healthy and injured ankles. In healthy ankles, kinesiotape may increase postural control, whereas in injured ankles it may improve proprioception, plantarflexor endurance and the performance of activities. These trends were identified from a small body of evidence including 276 participants. CONCLUSIONS It is recommended that kinesiotape may be used in clinical practice to prevent lateral ankle injuries (through its effects on postural control) and manage lateral ankle injuries due to its positive effects on proprioception, muscle endurance and activity performance. It appears that kinesiotape may not provide sufficient mechanical support to improve postural control in unstable ankles. Adverse events associated with kinseiotape are unlikely.
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Affiliation(s)
- Brendan Wilson
- Menzies Health Institute Queensland/ School of Allied Health Sciences, Gold Coast Campus, Griffith University, Queensland, Australia
| | - Andrea Bialocerkowski
- Menzies Health Institute Queensland/ School of Allied Health Sciences, Gold Coast Campus, Griffith University, Queensland, Australia
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192
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Ross SE, Linens SW, Wright CJ, Arnold BL. Noise-Enhanced Eversion Force Sense in Ankles With or Without Functional Instability. J Athl Train 2015; 50:819-24. [PMID: 26090711 DOI: 10.4085/1062-6050-50.5.06] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Force sense impairments are associated with functional ankle instability. Stochastic resonance stimulation (SRS) may have implications for correcting these force sense deficits. OBJECTIVE To determine if SRS improved force sense. DESIGN Case-control study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Twelve people with functional ankle instability (age = 23 ± 3 years, height = 174 ± 8 cm, mass = 69 ± 10 kg) and 12 people with stable ankles (age = 22 ± 2 years, height = 170 ± 7 cm, mass = 64 ± 10 kg). INTERVENTION(S) The eversion force sense protocol required participants to reproduce a targeted muscle tension (10% of maximum voluntary isometric contraction). This protocol was assessed under SRSon and SRSoff (control) conditions. During SRSon, random subsensory mechanical noise was applied to the lower leg at a customized optimal intensity for each participant. MAIN OUTCOME MEASURE(S) Constant error, absolute error, and variable error measures quantified accuracy, overall performance, and consistency of force reproduction, respectively. RESULTS With SRS, we observed main effects for force sense absolute error (SRSoff = 1.01 ± 0.67 N, SRSon = 0.69 ± 0.42 N) and variable error (SRSoff = 1.11 ± 0.64 N, SRSon = 0.78 ± 0.56 N) (P < .05). No other main effects or treatment-by-group interactions were found (P > .05). CONCLUSIONS Although SRS reduced the overall magnitude (absolute error) and variability (variable error) of force sense errors, it had no effect on the directionality (constant error). Clinically, SRS may enhance muscle tension ability, which could have treatment implications for ankle stability.
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Affiliation(s)
| | | | | | - Brent L Arnold
- School of Health and Rehabilitation Sciences, Indiana University, Indianapolis
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193
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The correlation between postural control and upper limb position sense in people with chronic ankle instability. J Foot Ankle Res 2015; 8:23. [PMID: 26097509 PMCID: PMC4472401 DOI: 10.1186/s13047-015-0082-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 06/10/2015] [Indexed: 12/12/2022] Open
Abstract
Background Chronic ankle instability (CAI) is attributed to functional instability driven by insufficient proprioception. However, it is not clear whether the deficits are related to global impaired performance or to specific decrease in ankle motor-control. The aim of this study was to assess the correlation between lower limb postural control and upper limb position sense among people with CAI, in order to further explore the function of the central neural control in people with CAI. Methods Fourteen participants (10 males, 4 females) with self-reported CAI and 14 age- and gender-matched, healthy controls participated in this study. Each participant completed single-limb stance postural control tests and shoulder position sense tests. The Overall Stability Index (OSI) was used as a measure of postural stability. The average of the absolute error score (AES) was calculated as a measure of shoulder position sense. Pearson correlations between the scores of the four body sites –lower limb postural stability (preferred/non-preferred), shoulder (preferred/non-preferred) were determined separately for each group. Results In the control group, significant correlations were found between the OSI score of the right and left ankles (r = 0.887, p < 0.001), between the AES of the right and left shoulders (r = 0.656, p = 0.011), as well as between the OSI score and the AES of the non-preferred side (r = 0.649, p = 0.012). In the CAI group, significant correlation was found only between the OSI score at both ankles (r = 0.6, p = 0.002). Conclusions Individuals with CAI demonstrated lower limb postural control and upper limb position sense similar to those shown in healthy controls. However, correlations between the lower and upper limbs were observed only in the healthy controls. Clinicians can use this information and employ activities that focus on coordinating the upper and lower extremities when designing neuromuscular control training programs for people with CAI.
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194
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Terada M, Ball LM, Pietrosimone BG, Gribble PA. Altered visual focus on sensorimotor control in people with chronic ankle instability. J Sports Sci 2015; 34:171-80. [PMID: 26067161 DOI: 10.1080/02640414.2015.1043324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this investigation was to examine the effects of the combination of chronic ankle instability (CAI) and altered visual focus on strategies for dynamic stability during a drop-jump task. Nineteen participants with self-reported CAI and 19 healthy participants performed a drop-jump task in looking-up and looking-down conditions. For the looking-up condition, participants looked up and read a random number that flashed on a computer monitor. For the looking-down condition, participants focused their vision on the force plate. Sagittal- and frontal-plane kinematics in the hip, knee and ankle were calculated at the time points of 100 ms pre-initial foot contact to ground and at IC. The resultant vector time to stabilisation was calculated with ground reaction force data. The CAI group demonstrated less hip flexion at the point of 100 ms pre-initial contact (P < 0.01), and less hip flexion (P = 0.03) and knee flexion at initial contact (P = 0.047) compared to controls. No differences in kinematics or dynamic stability were observed in either looking-up or looking-down conditions (P > 0.05). Altered visual focus did not influence movement patterns during the drop-jump task, but the presence of CAI did. The current data suggests that centrally mediated changes associated with CAI may lead to global alterations in the sensorimotor control.
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Affiliation(s)
- Masafumi Terada
- a Musculoskeletal Laboratory, Department of Rehabilitation Science , College of Health Science, University of Kentucky , Lexington , KY , USA
| | - Lindsay M Ball
- b Kettering Sports Medicine Center , Kettering , OH , USA
| | - Brian G Pietrosimone
- c Neuromuscular Research Laboratory, Department of Exercise and Sports Science , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Phillip A Gribble
- a Musculoskeletal Laboratory, Department of Rehabilitation Science , College of Health Science, University of Kentucky , Lexington , KY , USA
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195
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Abstract
BACKGROUND The contribution of mechanical laxity and ligament stiffness to chronic ankle instability is unclear, particularly when using the inversion laxity test, and may have implications for diagnosis, prognosis, and treatment. Our purpose was to determine if individuals with chronic ankle instability demonstrate greater mechanical ligament laxity and altered stiffness compared to controls and copers (those with a healed sprain) during an instrumented arthrometer inversion stress test. METHODS Recreationally active individuals were classified as those with chronic ankle instability (n = 16), copers (n = 16), or controls (n = 16) based on injury history and self-reported score on the Cumberland Ankle Instability Tool (CAIT). Three trials of an inversion stress test were applied with an instrumented arthrometer utilizing a reliable tester. Talocrural inversion (degrees) and stiffness values were extracted. One-way ANOVAs were calculated, and Tukey post hoc testing was applied (α ≤ .05). RESULTS Groups were not different in age, height, or weight. The chronic ankle instability group (19 ± 6) had significantly lower CAIT scores than the control (30 ± 1) and coper (29 ± 1) groups (P < .001). The chronic ankle instability group (23 ± 12 degrees) demonstrated significantly greater inversion than the controls (13 ± 9 degrees) (P = .04) but was not significantly different than the copers (17 ± 10 degrees). No significant differences were detected in stiffness between the groups. CONCLUSION The chronic ankle instability group demonstrated decreased self-reported ankle function and increased mechanical laxity utilizing an instrumented arthrometer for inversion compared to the control group but not the coper group. Laxity, but not stiffness, may be a factor affecting chronic ankle instability and self-reported function. LEVEL OF EVIDENCE Level III, comparative study.
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Affiliation(s)
- Cathleen N Brown
- Biomechanics Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Adam B Rosen
- Biomechanics Research Building, School of Health, Physical Education and Recreation, University of Nebraska, Omaha, Nebraska, USA
| | - Jupil Ko
- Biomechanics Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA
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196
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Dingenen B, Peeraer L, Deschamps K, Fieuws S, Janssens L, Staes F. Muscle-Activation Onset Times With Shoes and Foot Orthoses in Participants With Chronic Ankle Instability. J Athl Train 2015; 50:688-96. [PMID: 25856056 DOI: 10.4085/1062-6050-50.2.02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Participants with chronic ankle instability (CAI) use an altered neuromuscular strategy to shift weight from double-legged to single-legged stance. Shoes and foot orthoses may influence these muscle-activation patterns. OBJECTIVE To evaluate the influence of shoes and foot orthoses on onset times of lower extremity muscle activity in participants with CAI during the transition from double-legged to single-legged stance. DESIGN Cross-sectional study. SETTING Musculoskeletal laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 15 people (9 men, 6 women; age = 21.8 ± 3.0 years, height = 177.7 ± 9.6 cm, mass = 72.0 ± 14.6 kg) who had CAI and wore foot orthoses were recruited. INTERVENTION(S) A transition task from double-legged to single-legged stance was performed with eyes open and with eyes closed. Both limbs were tested in 4 experimental conditions: (1) barefoot (BF), (2) shoes only, (3) shoes with standard foot orthoses, and (4) shoes with custom foot orthoses (SCFO). MAIN OUTCOME MEASURE(S) The onset of activity of 9 lower extremity muscles was recorded using surface electromyography and a single force plate. RESULTS Based on a full-factorial (condition, region, limb, vision) linear model for repeated measures, we found a condition effect (F(3,91.8) = 9.39, P < .001). Differences among experimental conditions did not depend on limb or vision condition. Based on a 2-way (condition, muscle) linear model within each region (ankle, knee, hip), earlier muscle-activation onset times were observed in the SCFO than in the BF condition for the peroneus longus (P < .001), tibialis anterior (P = .003), vastus medialis obliquus (P = .04), and vastus lateralis (P = .005). Furthermore, the peroneus longus was activated earlier in the shoes-only (P = .02) and shoes-with-standard-foot-orthoses (P = .03) conditions than in the BF condition. No differences were observed for the hip muscles. CONCLUSIONS Earlier onset of muscle activity was most apparent in the SCFO condition for ankle and knee muscles but not for hip muscles during the transition from double-legged to single-legged stance. These findings might help clinicians understand how shoes and foot orthoses can influence neuromuscular control in participants with CAI.
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Affiliation(s)
- Bart Dingenen
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences
| | - Louis Peeraer
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences;,Thomas More Kempen University College, Mobilab, Geel, Belgium
| | - Kevin Deschamps
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences
| | - Steffen Fieuws
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics; and
| | - Luc Janssens
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences;,Department of Electrical Engineering, Faculty of Engineering Technology Services, KU Leuven, Belgium
| | - Filip Staes
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences
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197
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Wikstrom EA, Hubbard-Turner T, Woods S, Guderian S, Turner MJ. Developing a Mouse Model of Chronic Ankle Instability. Med Sci Sports Exerc 2015; 47:866-72. [DOI: 10.1249/mss.0000000000000466] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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198
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Richie DH, Izadi FE. Return to play after an ankle sprain: guidelines for the podiatric physician. Clin Podiatr Med Surg 2015; 32:195-215. [PMID: 25804710 DOI: 10.1016/j.cpm.2014.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The ankle sprain is the most common injury in sport and has a high incidence of long-term disability. This disability may be partly due to early return to sport before ligament healing has been completed. The podiatric physician can follow sound guidelines for making a return-to-play decision for athletes suffering from an ankle sprain. The decision-making process requires the podiatric physician to monitor the rehabilitation process and then administer patient self-reported questionnaires as well as functional performance tests to assess the status of ankle function after injury.
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Affiliation(s)
- Douglas H Richie
- Seal Beach Podiatry Group Inc, 550 Pacific Coast Highway, Suite 209, Seal Beach, CA 90174, USA.
| | - Faye E Izadi
- Seal Beach Podiatry Group Inc, 550 Pacific Coast Highway, Suite 209, Seal Beach, CA 90174, USA
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199
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Lohrer H, Nauck T, Gehring D, Wissler S, Braag B, Gollhofer A. Differences between mechanically stable and unstable chronic ankle instability subgroups when examined by arthrometer and FAAM-G. J Orthop Surg Res 2015; 10:32. [PMID: 25890204 PMCID: PMC4359539 DOI: 10.1186/s13018-015-0171-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 02/17/2015] [Indexed: 12/26/2022] Open
Abstract
Background The objective measurement of the mechanical component and its role in chronic ankle instability is still a matter of scientific debate. We analyzed known group and diagnostic validity of our ankle arthrometer. Additionally, functional aspects of chronic ankle instability were evaluated in relation to anterior talar drawer. Methods By manual stress testing, 41 functionally unstable ankles were divided as mechanically stable (n = 15) or mechanically unstable (n = 26). Ankle laxity was quantified using an ankle arthrometer. Stiffness values from the load displacement curves were calculated between 40 and 60 N. Known group validity and eta2 were established by comparing manual and arthrometer testing results. Diagnostic validity for the ankle arthrometer was determined by a 2 × 2 contingency table. The functional ankle instability severity was quantified by the German version of the Foot and Ankle Ability Measure (FAAM-G). Stiffness (40–60 N) and FAAM-G values were correlated. Results Mechanically unstable ankles had lower 40–60 N stiffness values than mechanically stable ankles (p = 0.006 and <0.001). Eta for the relation between manual and arthrometer anterior talar drawer testing was 0.628. With 5.1 N/mm as cut-off value, accuracy, sensitivity, and specificity were 85%, 81%, and 93%, respectively. The correlation between individual 40–60 N arthrometer stiffness values and FAAM-G scores was r = 0.286 and 0.316 (p = 0.07 and 0.04). Conclusions In this investigation, the ankle arthrometer demonstrated a high diagnostic validity for the determination of mechanical ankle instability. A clear interaction between mechanical (ankle arthrometer) and functional (FAAM-G) measures could not be demonstrated. Electronic supplementary material The online version of this article (doi:10.1186/s13018-015-0171-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heinz Lohrer
- Institute for Sports Medicine, Otto-Fleck-Schneise 10, D-60528, Frankfurt am Main, Germany. .,Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, D-79117, Freiburg, Germany.
| | - Tanja Nauck
- Institute for Sports Medicine, Otto-Fleck-Schneise 10, D-60528, Frankfurt am Main, Germany.
| | - Dominic Gehring
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, D-79117, Freiburg, Germany.
| | - Sabrina Wissler
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, D-79117, Freiburg, Germany.
| | - Bela Braag
- Institute for Sports Medicine, Otto-Fleck-Schneise 10, D-60528, Frankfurt am Main, Germany. .,Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, D-60590, Frankfurt, Germany.
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, D-79117, Freiburg, Germany.
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200
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Lin CY, Kang JH, Wang CL, Shau YW. Relationship between viscosity of the ankle joint complex and functional ankle instability for inversion ankle sprain patients. J Sci Med Sport 2015; 18:128-32. [DOI: 10.1016/j.jsams.2014.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 02/07/2014] [Accepted: 02/12/2014] [Indexed: 10/25/2022]
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