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Phuaklikhit C, Junsri T, Saito S, Muraki S, Loh PY. Biomechanical and Physiological Variables in Dynamic and Functional Balance Control during Single-Leg Loading in Individuals with Chronic Ankle Instability: A Scoping Review. Sports (Basel) 2024; 12:224. [PMID: 39195600 DOI: 10.3390/sports12080224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/12/2024] [Accepted: 08/12/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND This scoping review summarizes the tasks and outcomes in dynamic and functional balance assessments of individuals with chronic ankle instability, focusing on the physiological and biomechanical characteristics. METHOD A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and MEDLINE databases in September 2023 and revised in April 2024. Studies evaluating dynamic and functional balance in chronic ankle instability using clinical tests, as well as biomechanical and physiological outcomes, were included. RESULTS Out of 536 publications, 31 met the screening criteria. A history of ankle sprain was the main focus of the inclusion criteria (28 articles, 90%). The star excursion balance test, emphasizing maximum reach distance, was the most common quantitative task (12 articles, 66%). Physiological data mainly came from electromyography studies (7 articles, 23%), while biomechanical variables were often assessed through center of pressure studies using force plates (17 articles, 55%). CONCLUSIONS The preferred quantitative clinical assessment was the star excursion balance test, focusing on normalized reach outcomes. Qualitative functional balance assessments emphasize landing activities and center of pressure displacement. Electromyography is commonly used to analyze the tibialis anterior and peroneus longus muscles. However, there is a lack of qualitative data on dynamic balance control, including morphological characteristics and the center of mass adaptation.
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Affiliation(s)
- Chairat Phuaklikhit
- Graduate School of Design, Kyushu University, Fukuoka 815-8540, Japan
- Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani 12000, Thailand
| | - Thanwarat Junsri
- Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathum Thani 12000, Thailand
| | - Seiji Saito
- Faculty of Computer Science and Systems Engineering, Okayama Prefectural University, Soja 719-1197, Japan
| | - Satoshi Muraki
- Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan
| | - Ping Yeap Loh
- Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan
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Lee H, Han S, Hopkins JT. Balance Training With Stroboscopic Glasses and Neuromechanics in Patients With Chronic Ankle Instability During a Single-Legged Drop Landing. J Athl Train 2024; 59:633-640. [PMID: 37459365 PMCID: PMC11220764 DOI: 10.4085/1062-6050-0605.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
CONTEXT Therapeutic interventions for individuals with chronic ankle instability (CAI) are recommended to improve muscle strength, postural control, and range of motion. However, their effects on neuromechanics during a drop landing remain unclear. In addition, even though therapeutic interventions with stroboscopic glasses appear to effectively improve postural control, how they affect landing neuromechanics remains unclear. OBJECTIVE To identify the effect of balance training with stroboscopic glasses on neuromechanics during a single-legged drop landing in patients with CAI. DESIGN Randomized controlled clinical trial. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 50 participants with CAI were randomly assigned to 1 of 2 groups: strobe (n = 25; age = 22 ± 3 years, height = 174.7 ± 8.2 cm, mass = 71.8 ± 12.2 kg) or control (n = 25; age = 21 ± 2 years, height = 173.1 ± 8.3 cm, mass = 71.1 ± 13.5 kg). INTERVENTION(S) The 4-week rehabilitation (3 sessions per week) included hop-based tasks and single-legged stance. The strobe group wore stroboscopic glasses during the training, whereas the control group did not. MAIN OUTCOME MEASURE(S) Ankle-, knee-, and hip-joint kinematics and 4 lower extremity muscle activations 150 milliseconds before and after initial contact during a single-legged drop landing in the 2 groups. RESULTS The strobe group showed greater eversion (from 150 milliseconds before to 30 milliseconds after initial contact) and dorsiflexion (from 30 to 96 milliseconds after initial contact) angles and peroneal longus (from 35 milliseconds before to 5 milliseconds after initial contact) and tibialis anterior (from 0 to 120 milliseconds after initial contact) activation in the posttest than the pretest. CONCLUSIONS Patients with CAI who underwent a 4-week rehabilitation with stroboscopic glasses demonstrated changes in neuromechanics, including increased ankle-dorsiflexion and -eversion angles and tibialis anterior and peroneus longus activation, during a single-legged drop landing. This finding suggests that use of stroboscopic glasses during rehabilitation could help patients with CAI develop safe landing mechanics.
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Affiliation(s)
- Hyunwook Lee
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill
| | - Seunguk Han
- Division of Sport Science, Pusan National University, Busan, South Korea
| | - J. Ty Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, UT
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Hu X, Feng T, Li P, Liao J, Wang L. Bilateral Sensorimotor Impairments in Individuals with Unilateral Chronic Ankle Instability: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:33. [PMID: 38589676 PMCID: PMC11001848 DOI: 10.1186/s40798-024-00702-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is manifested by sensorimotor impairments in the sprained ankle, including deficits in sensation, motor function, and central integration or processing. These impairments have a significant impact on physical activities and daily life. Recently, some studies have suggested that bilateral deficits were observed in unilateral CAI, but contradictory evidence disputes this finding. Therefore, the objective of this study was to investigate whether bilateral sensorimotor deficits presented in individuals with unilateral CAI. METHODS Without language restriction, the following databases were retrieved from database inception up until 3 November 2023, including PubMed, WOS, EMBASE, Cochrane, SPORTDiscus and CINAHL. Case-control and cross-sectional studies that investigated bilateral sensorimotor functions in individuals with unilateral CAI were included. Sensorimotor functions contained static and dynamic balance, functional performance, muscle strength and activation, as well as sensation. Outcome measures contained centre-of-pressure parameters, normalised reach distance, activation time and magnitude of muscle, sensory errors and threshold. The risk of bias and quality assessment of included studies were evaluated using a standardised tool recommended by the Cochrane Collaboration and the Epidemiological Appraisal Instrument, respectively. To explore the potential bilateral deficits associated with unilateral CAI, a comprehensive meta-analysis was conducted using Review Manager version 5.4. The analysis compared the injured limb of unilateral CAI with healthy controls and the uninjured limb with healthy controls. The main focus of this study was to investigate the differences between the uninjured limb and healthy controls. A random-effects model was employed and effect sizes were estimated using the standardised mean difference (SMD) with 95% confidence intervals (CIs). Effect sizes were deemed as weak (0.2-0.5), moderate (0.5-0.8), or large (> 0.8). RESULTS A total of 11,442 studies were found; 30 studies were contained in the systematic review and 20 studies were included in the meta-analysis. Compared with healthy controls, those with unilateral CAI presented weak to moderate impairments in their uninjured limbs in static balance with eyes open (SMD = 0.32, 95% CI: 0.08 to 0.56), functional performance (SMD = 0.37; 95% CI: 0.08 to 0.67), kinesthesia (SMD = 0.52; 95% CI: 0.09 to 0.95) and tibialis anterior activation (SMD = 0.60, 95% CI: 0.19 to 1.01). There were no significant differences in other comparisons between the uninjured limb and healthy controls. CONCLUSIONS Patients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinaesthesia. However, further evidence is required to confirm this point due to limited studies included in some analyses and small effect size. REGISTRATION The protocol was registered in the International Prospective Register of Systematic Reviews platform (CRD: 42,022,375,855).
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Affiliation(s)
- Xiaomei Hu
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Tianyi Feng
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Pan Li
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Jingjing Liao
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China.
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Mao M, Yin Y, Luo D, Liu H, Yu B. Evaluation of dynamic postural control during single-leg landing tasks using initial impact force, landing leg stiffness and time to stabilisation. Sports Biomech 2024; 23:182-195. [PMID: 33594918 DOI: 10.1080/14763141.2020.1833969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/05/2020] [Indexed: 10/22/2022]
Abstract
Time to stabilisation (TTS) provides limited information to evaluate the dynamic postural control for individuals with functional ankle instability in single-leg landing task. More information is needed to understand TTS and evaluate the dynamic postural control better. The purpose is to develop a method estimating TTS, initial impact force (IIF) and landing leg stiffness (LLS) through fitting ground reaction force (GRF) decay in single leg landing with exponential vibration decay function (EVDF), and investigate effects of landing directions and GRF components on these parameters. Thirty-nine healthy participants were recruited. EVDF was used to fit GRF decays in different single-leg landings. TTS, IIF, and LLS were compared across landing directions and GRF components. The mean regression determinants of fitting GRF decays with EVDF were greater than 0.50. TTS was sensitive to GRF components (P = 0.041 females, P = 0.028 males). IIF was sensitive to GRF components (P = 0.001) for both genders. LLS was sensitive to GRF components (P = 0.023) for males. This method showed a moderate to strong feasibility for reporting GRF decay during landing, and provided movement characteristic information for better understanding of dynamic postural control together with TTS during landing.
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Affiliation(s)
- Min Mao
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yan Yin
- Department of Physical Education, Beijing University of Post and Telecommunication, Beijing, China
| | - Dongmei Luo
- College of Human Movement Science, Beijing Sport University, Beijing, China
| | - Hui Liu
- College of Human Movement Science, Beijing Sport University, Beijing, China
| | - Bing Yu
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Lee H, Dennis HE, Han S, Hopkins JT, Seeley MK. Decreased rate of torque development in ankle evertors for individuals with chronic ankle instability. Clin Biomech (Bristol, Avon) 2023; 109:106096. [PMID: 37725866 DOI: 10.1016/j.clinbiomech.2023.106096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Individuals with chronic ankle instability have decreased peak torque during maximum voluntary contraction in ankle evertors/invertors, and hip abductors. However, it is unclear whether individuals with chronic ankle instability and/or copers demonstrate decreased rate of torque development in ankle evertors/invertors, and hip abductors. METHODS 54 university-aged participants (18 chronic ankle instability, 18 copers, and 18 controls) performed three maximal isometric contractions for ankle evertors and invertors, and hip abductors. Rate of torque development was defined as the linear slope of the torque-time curve during the first 200 ms of each contraction and compared between the three groups using a one-way analysis of variance (α = 0.05). FINDINGS The chronic ankle instability group showed 38.1% less rate of torque development than the coper (P = 0.03 and d = 0.84) and 37.1% than the control groups (P = 0.03 and d = 1.03) in the ankle evertors. For the hip abductors, there were moderate effects between the chronic ankle instability group and the copers (P = 0.06 and d = 0.70), and control groups (P = 0.06 and d = 0.75). INTERPRETATIONS The observed between-groups differences in rate of torque development indicate that restoring rate of torque development after lateral ankle sprain may be important to reduce risk of reinjury and development of chronic ankle instability. Clinicians should consider the rate of torque development in the ankle evertors and hip abductors during rehabilitation chronic ankle instability patients.
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Affiliation(s)
- Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA; Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hayden E Dennis
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Seunguk Han
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA.
| | - J Ty Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Matthew K Seeley
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
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Shadegani R, Khanmohammadi R, Olyaei G. Comparison of effects of Mulligan taping and Kinesio taping on ankle neuromuscular control in response to a sudden inversion perturbation in individuals with chronic ankle instability. Phys Ther Sport 2023; 63:58-66. [PMID: 37506655 DOI: 10.1016/j.ptsp.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES This study was aimed to compare the effects of Mulligan taping (MT) with Kinesio taping (KT) and the un-taped ankle on neuromuscular control during a sudden inversion perturbation in individuals with chronic ankle instability (CAI). DESIGN Randomized, single blind cross-over. SETTING Biomechanics lab. PARTICIPANTS 16 individuals with chronic ankle instability. MAIN OUTCOME MEASURES The outcome measures were the onset time and magnitude of short (SLR) and medium latency response (MLR) for peroneus brevis (PB), peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) muscles and the TA/P and SOL/TA antagonist co-activation. RESULTS In the groups of KT and MT, the onset time was significantly decreased at post-taping compared to pre-taping, such that for the onset time of PB MLR, the groups of KT and MT had an earlier onset time than the un-taped group. For the magnitude of TA SLR and PB MLR, groups exhibited different behaviors. In the KT group, the magnitude was significantly increased post-taping, however, in the MT group, it was decreased. Regarding the TA/P and SOL/TA co-activation, the groups of KT and MT showed significant changes post-taping. CONCLUSION This study suggests that KT and MT significantly affect neuromuscular control in response to a sudden perturbation in individuals with CAI, although the behavior of KT and MT appears to be somewhat different from each other.
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Affiliation(s)
- Roghaye Shadegani
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran.
| | - Gholamreza Olyaei
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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Lee H, Han S, Son SJ, Seeley MK, Hopkins JT. Disrupted vision impairs force steadiness and accuracy in chronic ankle instability patients. J Orthop Res 2023; 41:1729-1737. [PMID: 36694291 DOI: 10.1002/jor.25522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/02/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
The primary purpose of this study was to examine the effect of visual disruption on submaximal force steadiness and accuracy among three groups including chronic ankle instability (CAI) patients, lateral ankle sprain copers, and healthy controls. Twenty patients with CAI, 20 copers, and 20 matched-healthy controls volunteered to participate in the study. Submaximal force steadiness and accuracy for evertors, invertors, and hip abductors (10% and 20% of their maximal voluntary isometric contraction) were measured with an isokinetic dynamometer. All groups performed the tasks with and without stroboscopic glasses. The CAI group showed worse steadiness and accuracy in evertors with visual disruption compared to nonvisual disruption (p < 0.0001 and = 0.02, respectively). Relative to the control group, the CAI group showed worse force steadiness and accuracy in evertors (p < 0.0001, both), worse force accuracy in hip abductors (p = 0.02), and the coper group also showed worse accuracy in evertors (p = 0.02). Individuals with CAI demonstrated impaired force steadiness and accuracy in evertors and hip abductors compared to healthy controls. In addition, they tended to rely more on visual feedback during the force steadiness task than copers and healthy controls.
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Affiliation(s)
- Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Seunguk Han
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - S Jun Son
- CHA Motion Science Lab, Graduate School of Sports Medicine, CHA University, Seongnam-si, Korea
| | - Matthew K Seeley
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - J Ty Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
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Römer C, Zessin E, Czupajllo J, Fischer T, Wolfarth B, Lerchbaumer MH. Effect of Physical Parameters and Training Load on Patellar Tendon Stiffness in Professional Athletes. Diagnostics (Basel) 2023; 13:2541. [PMID: 37568903 PMCID: PMC10417388 DOI: 10.3390/diagnostics13152541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Injuries of the patellar tendon commonly occur as a result of mechanical loading of the tendon during physical activity. Shear wave elastography (SWE) is an established technique for assessing tendon stiffness, and has good interindividual reliability. The aim of this study was to investigate the impacts of physical parameters and different sports on patellar tendon stiffness in professional athletes using SWE. METHODS Standardized patellar tendon SWE was performed in a relaxed supine position with a small roll under the knee (20° flexion) in 60 healthy professional athletes (30 female, 30 male). Multiple linear regression was performed for patellar tendon stiffness including gender, age, body mass index (BMI), and type of sport. RESULTS Patellar tendon stiffness showed no significant difference between female (3.320 m/s) and male (3.416 m/s) professional athletes. Mean age (female: 20.53 years; male: 19.80 years) and BMI (female: 23.24 kg/m2; male: 23.52 kg/m2) were comparable. Female professional athletes with oral contraceptive (OC) intake showed higher patellar tendon stiffness than athletes without OC intake (3.723 versus 3.017; p = 0.053), but not significantly. CONCLUSION In professional athletes, there are no significant differences in patellar tendon stiffness according to gender, age, BMI and type of sport (handball, volleyball, soccer, sprint, hammer throw). Oral contraceptives may not have an impact on patellar tendon stiffness in female athletes. Further studies are necessary.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Enrico Zessin
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
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Lee H, Oh M, Han S, Hopkins JT. Unexpected inversion perturbation during a single-leg landing in patients with chronic ankle instability. Sports Biomech 2023:1-15. [PMID: 37339269 DOI: 10.1080/14763141.2023.2226649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/13/2023] [Indexed: 06/22/2023]
Abstract
It remains unclear how unexpected perturbations during single-leg landings affect lower extremity kinematics and muscle activations in patients with chronic ankle instability (CAI). The purpose of this study was to identify the differences in lower extremity movement patterns among CAI subjects, copers, and healthy controls. Sixty-six people including 22 CAI subjects, 22 copers, and 22 healthy controls volunteered to participate in the study. Lower extremity joint kinematics and EMG activations from 200-ms pre to 200-ms post the initial contact during unexpected tilted landings were measured. Functional data analysis was used to evaluate between-group differences for outcome measures. Relative to copers and healthy controls, CAI subjects showed more inversion from 40-ms to 200-ms after initial contact. Relative to healthy controls, CAI subjects and copers showed more dorsiflexion. Relative to healthy controls, CAI subjects and copers showed more muscle activation in tibialis anterior and peroneus longus, respectively. In conclusion, CAI subjects demonstrated greater inversion angles and muscle activation before initial contact compared to LAS copers and healthy controls. This suggests that CAI subjects and copers prepare for their landing with protective movements, but the prepared movements shown by CAI subjects may be insufficient to reduce risk of recurrent injury.
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Affiliation(s)
- Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Minsub Oh
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Seunguk Han
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - J Ty Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
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Kang M, Zhang T, Yu R, Ganderton C, Adams R, Han J. Effect of Different Landing Heights and Loads on Ankle Inversion Proprioception during Landing in Individuals with and without Chronic Ankle Instability. Bioengineering (Basel) 2022; 9:bioengineering9120743. [PMID: 36550949 PMCID: PMC9774139 DOI: 10.3390/bioengineering9120743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Proprioception is essential for neuromuscular control in relation to sport injury and performance. The effect of landing heights and loads on ankle inversion proprioceptive performance in individuals with or without chronic ankle instability (CAI) may be important but are still unclear. Forty-three participants (21 CAI and 22 non-CAI) volunteered for this study. The Ankle Inversion Discrimination Apparatus for Landing (AIDAL), with one foot landing on a horizontal surface and the test foot landing on an angled surface (10°, 12°, 14°, 16°), was utilized to assess ankle proprioception during landing. All participants performed the task from a landing height of 10 cm and 20 cm with 100% and 110% body weight loading. The four testing conditions were randomized. A repeated measures ANOVA was used for data analysis. The result showed that individuals with CAI performed significantly worse across the four testing conditions (p = 0.018). In addition, an increased landing height (p = 0.010), not loading (p > 0.05), significantly impaired ankle inversion discrimination sensitivity. In conclusion, compared to non-CAI, individuals with CAI showed significantly worse ankle inversion proprioceptive performance during landing. An increased landing height, not loading, resulted in decreased ankle proprioceptive sensitivity. These findings suggest that landing from a higher platform may increase the uncertainty of judging ankle positions in space, which may increase the risk of ankle injury.
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Affiliation(s)
- Ming Kang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Tongzhou Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Ruoni Yu
- School of Medicine, Jinhua Polytechnic, Jinhua 321000, China
| | - Charlotte Ganderton
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT 2234, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
- Correspondence:
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Lee I, Ha S, Chae S, Jeong HS, Lee SY. Altered Biomechanics in Individuals With Chronic Ankle Instability Compared With Copers and Controls During Gait. J Athl Train 2022; 57:760-770. [PMID: 34404090 PMCID: PMC9661934 DOI: 10.4085/1062-6050-0605.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
CONTEXT Given that motions of 1 segment affect those of an adjacent segment, the authors of biomechanical studies must thoroughly investigate the kinematics and kinetics of the proximal joints (hip and knee) as well as the ankle joints in patients with chronic ankle instability (CAI). However, few researchers have investigated the altered movement strategies of the lower extremities of patients with CAI compared with lateral ankle-sprain (LAS) copers and control participants throughout the full gait cycle of walking and jogging. OBJECTIVE To evaluate lower extremity biomechanical differences in patients with CAI, LAS copers, and control individuals during gait. DESIGN Case-control study. SETTING Controlled laboratory setting. PATIENTS OR OTHER PARTICIPANTS A total of 54 participants, consisting of 18 patients with CAI (age = 24.6 ± 2.8 years, height = 173.0 ± 8.0 cm, mass = 67.8 ± 14.6 kg), 18 LAS copers (age = 26.0 ± 4.6 years, height = 173.4 ± 7.5 cm, mass = 66.9 ± 10.3 kg), and 18 control individuals (age = 26.2 ± 2.3 years, height = 172.2 ± 8.2 cm, mass = 63.3 ± 11.2 kg). MAIN OUTCOME MEASURE(S) Three-dimensional kinematics and kinetics of the lower extremity during walking and jogging. RESULTS The CAI group exhibited dorsiflexion deficits and more inverted ankles compared with the LAS coper and control groups during walking and jogging. In addition, the LAS coper group generated greater knee internal-rotation moments than did the CAI group during jogging. The other variables did not differ among groups. CONCLUSIONS Participants with CAI demonstrated altered biomechanics, which need to be addressed via intervention programs.
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Affiliation(s)
- Inje Lee
- Department of Sports Rehabilitation Medicine, Kyungil University, Gyeongsan, Republic of Korea
,International Olympic Committee Research Centre Korea, Seoul, Republic of Korea
| | - Sunghe Ha
- International Olympic Committee Research Centre Korea, Seoul, Republic of Korea
,Department of Physical Education, Yonsei University, Seoul, Republic of Korea
| | - Seongok Chae
- Department of Physical Education, Yonsei University, Seoul, Republic of Korea
| | - Hee Seong Jeong
- International Olympic Committee Research Centre Korea, Seoul, Republic of Korea
,Department of Sports and Health Management, Mokwon University, Daejeon, Republic of Korea
| | - Sae Yong Lee
- International Olympic Committee Research Centre Korea, Seoul, Republic of Korea
,Department of Physical Education, Yonsei University, Seoul, Republic of Korea
,Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea
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Watabe T, Takabayashi T, Tokunaga Y, Watanabe T, Kubo M. Copers exhibit altered ankle and trunk kinematics compared to the individuals with chronic ankle instability during single-leg landing. Sports Biomech 2022:1-13. [PMID: 35435154 DOI: 10.1080/14763141.2022.2058989] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
Copers are individuals who have had a lateral ankle sprain but have no history of recurrent lateral ankle sprain, residual symptoms, or functional disability. Copers have shown no significant difference in lower limb kinematics in landing for proactive conditions compared with a control (CTR) group. However, the copers (CPR) group has shown differences compared to CTR and chronic ankle instability (CAI) groups for dynamic balance conditions, suggesting that the trunk may compensate for foot instability during shock absorption. This study aimed to examine the differences in the kinematics and kinetics among CPR, CAI and CTR groups in reactive and proactive single-leg landing tasks. Participants were physically active adults with CAI (n = 14), CPR (n = 14), and CTR (n = 14), who performed proactive and reactive single-leg landings. The lower limb, trunk kinematics, vertical ground reaction force (vGRF) peak value, and the time to minimum peak vGRF were analysed. It might be conceivable that the CPR group could absorb vGRF efficiently by increasing the trunk flexion angle and increasing the time to reach the minimum peak vGRF regardless of landing condition. The results suggest that evaluating the movements of the entire body, including the ankle and trunk, is essential.
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Affiliation(s)
- Takaya Watabe
- Section of Rehabilitation, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Tomoya Takabayashi
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Yuta Tokunaga
- Terrabyte Corporation, 3-10-7 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
| | - Takahiro Watanabe
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Masayoshi Kubo
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
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13
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Yi Tammy CL, Ting Noah SY, Fei KG, Bin Abd Razak HR. Effect of chronic ankle instability on lower extremity kinematics, dynamic postural stability, and muscle activity during unilateral jump-landing tasks: A systematic review and meta-analysis. Phys Ther Sport 2022; 55:176-188. [DOI: 10.1016/j.ptsp.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/27/2022]
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14
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Wu HW, Chang YS, Arefin MS, You YL, Su FC, Lin CF. Six-Week Remodeled Bike Pedal Training Improves Dynamic Control of Lateral Shuffling in Athletes With Functional Ankle Instability. Sports Health 2021; 14:348-357. [PMID: 34399650 DOI: 10.1177/19417381211035781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Remodeled bicycle pedal training with multidirectional challenges through muscle strengthening and neuromuscular facilitation may increase dynamic postural control and performance during lateral shuffling for athletes with functional ankle instability (FAI). HYPOTHESIS The 6-week remodeled bicycle pedal training is effective on the ankle joint control and muscle activation, and especially that of the ankle evertor muscle co-contraction to improve dynamic postural control during lateral shuffling for athletes with FAI. STUDY DESIGN Laboratory randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS Fourteen healthy athletes (healthy group) and 26 athletes with FAI aged 18 to 30 years were included in the study. The athletes with FAI were randomly assigned to either the training group (FAI-T group) or the nontraining group (FAI-NT group). The athletes in the FAI-T group underwent 6 weeks of remodeled bicycle pedal training, whereas those in the FAI-NT group did not undergo any intervention. Muscle co-contraction index and muscle activation in the initial contact (IC) and propulsion phases, and ankle joint angle in the IC and propulsion phases were measured during lateral shuffling before and after 6 weeks of training. RESULTS After remodeled bicycle pedal training, the FAI-T group demonstrated greater muscle activation in the hamstring (P = 0.01), greater muscle coactivation of the tibialis anterior (TA) and the peroneus longus (P = 0.01), and greater ankle eversion angle in the IC phase. Significantly greater muscle activation of the TA (P = 0.01), greater coactivation of quadriceps and hamstring (P = 0.03), and a smaller ankle inversion angle (P = 0.04) in the propulsion phase were observed in the FAI-T group after training compared with those in the FAI-NT group. CONCLUSION Remodeled bicycle pedal training facilitates the TA and peroneus longus activation and the coactivation of the quadriceps and hamstring muscles during lateral shuffling and resulted in enhanced ankle and knee joint stability. In addition, a better ankle movement strategy during a dynamic task can be achieved via a 6-week remodeled pedal training program. CLINICAL RELEVANCE This remodeled bicycle pedal training can be effective for rehabilitating athletes with FAI to recover lateral dynamic movement capability.
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Affiliation(s)
- Hong-Wen Wu
- Department of Physical Education, National Taiwan University of Sport, Taichung, Taiwan
| | - Yi-Shuo Chang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Md Samsul Arefin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Lin You
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Feng Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
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15
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Pereira BS, Andrade R, Espregueira-Mendes J, Marano RPC, Oliva XM, Karlsson J. Current Concepts on Subtalar Instability. Orthop J Sports Med 2021; 9:23259671211021352. [PMID: 34435065 PMCID: PMC8381447 DOI: 10.1177/23259671211021352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conservative or surgical treatment and result in chronic ankle instability. Understanding the accurate anatomy and biomechanics of the subtalar joint, their interplay, and the contributions of the different subtalar soft tissue structures is fundamental to correctly diagnose and manage subtalar instability. An accurate diagnosis is crucial to correctly identify those patients with instability who may require conservative or surgical treatment. Many different nonsurgical and surgical approaches have been proposed to manage combined or isolated subtalar instability, and the clinician should be aware of available treatment options to make an informed decision. In this current concepts narrative review, we provide a comprehensive overview of the current knowledge on the anatomy, biomechanics, clinical and imaging diagnosis, nonsurgical and surgical treatment options, and outcomes after subtalar instability treatment.
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Affiliation(s)
- Bruno S. Pereira
- Facultad de Medicina, University of Barcelona, Casanova, 143, 08036
Barcelona, Spain
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Hospital Privado de Braga, Lugar da Igreja Nogueira, Braga,
Portugal
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports,
University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto,
Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, Minho University, Braga, Portugal
- 3B’s–PT Government Associate Laboratory, Braga/Guimarães,
Portugal
- 3B’s Research Group– Biomaterials, Biodegradables and Biomimetics,
University of Minho, Headquarters of the European Institute of Excellence on Tissue
Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
| | | | - Xavier Martin Oliva
- Facultad de Medicina, University of Barcelona, Casanova, 143, 08036
Barcelona, Spain
- Orthopedic Surgery Department, Clínica Ntra. Sra. Del Remei,
Barcelona, Spain
| | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, Sahlgrenska
University Hospital, Gothenburg University, Gothenburg, Sweden
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16
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Liu K, Delaney AN, Kaminski TW. A review of the role of lower-leg strength measurements in ankle sprain and chronic ankle instability populations. Sports Biomech 2021; 21:562-575. [PMID: 33938376 DOI: 10.1080/14763141.2021.1912165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Lower-leg strength training has been a cornerstone of ankle sprain and chronic ankle instability (CAI) rehabilitation and an important consideration for return-to-play in athletes with ankle injuries. The purpose of this literature review is to offer a contemporary, evidence-based overview of the role of ankle strength measurements as they relate to acute ankle sprain rehabilitation and those who have developed CAI. A comprehensive 20-year scan of the relevant research was conducted to assist us in providing this important update for clinicians and biomechanists working with patients and subjects with acute and chronic ankle sprains. While variability exists with measurement devices and methodology, strength assessment remains a critical component of ankle sprain and CAI treatment schemes. Helpful tips on obtaining and processing the most accurate strength assessments for lower-leg musculature are presented.
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Affiliation(s)
- Kathy Liu
- Department of Health Sciences, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Amanda N Delaney
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Thomas W Kaminski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
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17
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López-González L, Falla D, Lázaro-Navas I, Lorenzo-Sánchez-Aguilera C, Rodríguez-Costa I, Pecos-Martín D, Gallego-Izquierdo T. Effects of Dry Needling on Neuromuscular Control of Ankle Stabilizer Muscles and Center of Pressure Displacement in Basketball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042092. [PMID: 33669979 PMCID: PMC7924825 DOI: 10.3390/ijerph18042092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/26/2022]
Abstract
This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.
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Affiliation(s)
- Luis López-González
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
- Department of Physical Therapy, University Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham B15 2TT, UK;
| | - Irene Lázaro-Navas
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
- Department of Physical Therapy, University Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Cristina Lorenzo-Sánchez-Aguilera
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
| | - Isabel Rodríguez-Costa
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
| | - Daniel Pecos-Martín
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
- Correspondence: ; Tel.: +34-918-854-719
| | - Tomás Gallego-Izquierdo
- Department of Physical Therapy, University of Alcalá, 28805 Alcalá de Henares, Spain; (L.L.-G.); (I.L.-N.); (C.L.-S.-A.); (I.R.-C.); (T.G.-I.)
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18
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Watabe T, Takabayashi T, Tokunaga Y, Yoshida T, Kubo M. Copers adopt an altered movement pattern compared to individuals with chronic ankle instability and control groups in unexpected single-leg landing and cutting task. J Electromyogr Kinesiol 2021; 57:102529. [PMID: 33588176 DOI: 10.1016/j.jelekin.2021.102529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/22/2020] [Accepted: 02/03/2021] [Indexed: 11/19/2022] Open
Abstract
Individuals with chronic ankle instability (CAI) demonstrate altered ankle kinematics during landing compared to uninjured individuals. However, if copers may have adopted unique movement strategy to prevent repeated ankle sprains is unclear. The purpose of this study compares the lower-extremity joint kinematics and muscle activities of CAI (N = 8), coper (COP) (N = 8), and control (CON) (N = 8) groups in unexpected single-leg landing and cutting. Performance time (from initial contact to toe-off), number of mistakes in the jumping direction, low-extremity joint angle are assessed. Muscle activities were recorded from the tibialis anterior, medial gastrocnemius, and peroneus longus (PL), and mean muscle activity, co-contraction index (CI), and PL latency were analyzed. Results of performance time and CI are not significant. Significantly less number of mistakes in the jumping direction and a shorter PL latency were discovered in the COP and CON compared with the CAI group (P < 0.05). The peak hip joint flexion angle is significantly smaller in the COP than in the CON (P = 0.04). In dynamic tasks requiring quick judgments of ankle inclination, the COP may be able to accurately sense the inclination of the foot. Additionally, movement strategies differed between the COP and CON groups in an unexpected single-leg landing and cutting.
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Affiliation(s)
- Takaya Watabe
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
| | - Tomoya Takabayashi
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
| | - Yuta Tokunaga
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
| | | | - Masayoshi Kubo
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
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19
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Ly K, Michaud L, Lajoie Y. The effects of Kinesiology Tape on static postural control in individuals with functional ankle instability. Phys Ther Sport 2021; 48:146-153. [PMID: 33486407 DOI: 10.1016/j.ptsp.2021.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 01/03/2021] [Accepted: 01/08/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate if applying Kinesiology Tape (KT) on the unstable ankle may improve static postural control in individuals with Functional ankle instability. DESIGN A repeated measured study. Participants performed a series of static quiet bipedal and unipedal stances on a force platform. Measurements were taken at three different times: baseline or no tape, immediately and 24 h after the taping application with the tape remaining on the ankle. SETTING A university's psychomotor laboratory. PARTICIPANTS Twenty young adults with Functional ankle instability aged from 18 to 30 years old. OUTCOME MEASURES Postural control was assessed by four measures derived from the centre of pressure data: Area of 95% Confidence ellipse, standard deviation of displacements, mean velocity and mean power frequency. The analysis of variance (ANOVA) was performed to determine any significant improvement in postural control over time due to KT. RESULTS Only minor changes in mean velocity and MPF in unipedal stances were observed immediately after KT application. However, the overall results indicated statistically insignificant improvements in postural control neither immediately after KT application nor after 24 h. CONCLUSION Results suggest that the use of KT did not affect bipedal and unipedal stances of individuals with functional ankle instability.
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Affiliation(s)
- Kien Ly
- School of Human Kinetics, University of Ottawa, ON, Canada
| | - Lucas Michaud
- School of Human Kinetics, University of Ottawa, ON, Canada
| | - Yves Lajoie
- School of Human Kinetics, University of Ottawa, ON, Canada.
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20
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Lee J, Pathak P, Panday SB, Moon J. Effect of Foot-Planting Strategy on Anterior Cruciate Ligament Loading in Women During a Direction Diversion Maneuver: A Musculoskeletal Modeling Approach. Orthop J Sports Med 2020; 8:2325967120963180. [PMID: 33283003 PMCID: PMC7686614 DOI: 10.1177/2325967120963180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/03/2020] [Indexed: 11/15/2022] Open
Abstract
Background Although there is a higher prevalence of noncontact anterior cruciate ligament (ACL) injuries during a direction diversion maneuver (DDM), no previous studies have reported how foot-planting strategies affect ACL loading. Purpose To investigate the effect of foot-planting strategies on ACL loading in women during a DDM task using a musculoskeletal modeling approach. Study Design Descriptive laboratory study. Methods A total of 13 female participants performed a DDM task, which involved running at 4.5 ± 0.2 m/s and turning left at 35° to 55° under a foot-planting strategy in 3 directions: neutral, toe-in, and toe-out. Kinematic and kinetic data were measured with the use of a 3-dimensional motion capture system and force platform to calculate variables such as joint angle, shear force, and moment. Anterior ACL and posterior ACL forces were extracted using musculoskeletal modeling. Results The peak anterior ACL force was significantly larger for the toe-out condition (31.29 ± 4.02 N/body weight [BW]) compared with the toe-in condition (25.43 ± 5.68 N/BW) (P = .047), with no significant difference in the neutral condition. The toe-out condition had a higher knee valgus angle (2.98° ± 4.20°; P = .041), knee shear force (10.20 ± 1.69 N/BW; P = .009), and knee internal rotation moment (-0.18 ± 0.16 N·m/BW×height; P = .012) than the toe-in and neutral conditions. Conclusion Through musculoskeletal modeling, we were able to conclude that the toe-out condition during the DDM might result in a higher risk of ACL injuries. Athletes and sports practitioners should avoid the toe-out foot-planting strategy when participating in a sporting activity. Clinical Relevance Based on these findings, medical professionals and athletic coaches can gain knowledge on how foot-planting strategy affects ACL loading. Understanding the actual cause of an ACL injury can be useful for designing preventive training programs or strategies to decrease the risk of such injuries.
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Affiliation(s)
- Jusung Lee
- Department of Sport Science, Kangwon National University, Chuncheon, Republic of Korea
| | - Prabhat Pathak
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Siddhartha Bikram Panday
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea.,Department of Sport and Leisure Studies, Keimyung University, Daegu, Republic of Korea
| | - Jeheon Moon
- Department of Physical Education, Korea National University of Education, Cheongju, Republic of Korea.,Department of Sport Science, Korea Institute of Sport Science, Seoul, Republic of Korea
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21
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Chang YS, Arefin MS, You YL, Kuo LC, Su FC, Wu HW, Lin CF. Effect of Novel Remodeled Bicycle Pedal Training on Balance Performance in Athletes With Functional Ankle Instability. Front Bioeng Biotechnol 2020; 8:600187. [PMID: 33195176 PMCID: PMC7642596 DOI: 10.3389/fbioe.2020.600187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 09/30/2020] [Indexed: 12/26/2022] Open
Abstract
Context Appropriate training without risk of injury is a critical concern for athletes. Remodeled bicycle pedal training with multi-directional challenges may be effective in improving the balance performance of athletes with functional ankle instability (FAI). Objective To evaluate the effects of 6-week modified bicycle pedal training on the balance ability and proprioception of athletes with FAI. Design Randomized controlled trial. Setting University motion analysis laboratory. Participants Fourteen healthy athletes (healthy group) and twenty-six athletes with FAI and an age of 18 to 30 years old. The participants with FAI were randomly distributed to two groups, designated as the training group (AI-T group) and non-training group (AI-NT group), respectively. The athletes in the AI-T group received 6-week remodeled bicycle pedal training, while those in the AI-NT group received no intervention at all. Intervention A 6-week training using modified bicycle pedal capable of moving freely during loading cycle vs no intervention. Main Outcome Measures The passive ankle joint position sense (JPS) in four angles and the center of pressure (COP) parameters were analyzed during single-leg standing with and without vision, respectively. Results A 6-week remodeled pedal training: (1) significantly improved the passive JPS of ankle in all directions (P < 0.05); (2) reduced the excursion of the COP in the medial-lateral (ML) direction (p < 0.05), the velocity of the COP in the ML direction (p < 0.05), and the RMS of the COP in the ML direction (P < 0.05) during single-leg standing both with and without vision. Conclusion The remodeled bicycle pedal training improved the passive JPS and reduced the postural sway in single-leg standing both with and without vision. Therefore, remodeled bicycle pedal training can be considered for inclusion in rehabilitation programs for athletes with FAI to restore the proprioception and balance ability.
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Affiliation(s)
- Yi-Shuo Chang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Md Samsul Arefin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Lin You
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chieh Kuo
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Hong-Wen Wu
- Department of Physical Education, National Taiwan University of Sport, Taichung, Taiwan
| | - Cheng-Feng Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
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22
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Gago PR, Arndt A, Marques MC, Marinho DA, Ekblom MM. Effects of post activation potentiation on electromechanical delay. Clin Biomech (Bristol, Avon) 2019; 70:115-122. [PMID: 31476603 DOI: 10.1016/j.clinbiomech.2019.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 02/07/2023]
Abstract
Electromechanical delay (EMD) presumably depends upon both contractile and tensile factors. It has recently been used as an indirect measure of muscle tendon stiffness to study adaptations to stretching and training. The aim of the present study was to investigate whether contractile properties induced by a 6 s maximum voluntary isometric contraction (MVIC) could affect EMD without altering passive muscle tendon stiffness or stiffness index. Plantar flexor twitches were evoked via electrical stimulation of the tibial nerve in eight highly trained male sprinters before and after a 6 s MVIC in passive isometric or passively shortening or lengthening muscles. For each twitch, EMD, twitch contractile properties and SOLM-Wave were measured. Passive muscle tendon stiffness was measured from the slope of the relation between torque and ankle angle during controlled passive dorsal flexion and stiffness index by curve-fitting the torque angle data using a second-order polynomial function. EMD did not differ between isometric, lengthening or shortening movements. EMD was reduced by up to 11.56 ± 5.64% immediately after the MVIC and stayed depressed for up to 60 s after conditioning. Peak twitch torque and rate of torque development were potentiated by up to 119.41 ± 37.15% and 116.06 ± 37.39%, respectively. Rising time was reduced by up to 14.46 ± 7.22%. No significant changes occurred in passive muscle tendon stiffness or stiffness index. Using a conditioning MVIC, it was shown that there was an acute enhancement of contractile muscle properties as well as a significant reduction in EMD with no corresponding changes in stiffness. Therefore, caution should be taken when using and interpreting EMD as a proxy for muscle tendon stiffness.
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Affiliation(s)
- Paulo R Gago
- Biomechanics and Motor Control Laboratory, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Anton Arndt
- Biomechanics and Motor Control Laboratory, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden; Institution CLINTEC, Karolinska Institute, Stockholm, Sweden
| | - Mário C Marques
- University of Beira Interior (UBI), Covilhã, Portugal; Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Covilhã, Portugal
| | - Daniel A Marinho
- University of Beira Interior (UBI), Covilhã, Portugal; Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), Covilhã, Portugal.
| | - Maria M Ekblom
- Biomechanics and Motor Control Laboratory, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
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23
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Rinaldin CDP, Cabral LPA, Krueger E, Nogueira-Neto GN, Nohama P, Scheeren EM. Fatigue in complete spinal cord injury and implications on total delay. Artif Organs 2019; 44:305-313. [PMID: 31553061 DOI: 10.1111/aor.13573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/11/2022]
Abstract
The use of neuromuscular electrical stimulation (NMES) to artificially restore movement in people with complete spinal cord injury (SCI) induces an accelerated process of muscle fatigue. Fatigue increases the time between the beginning of NMES and the onset of muscle force (DelayTOT ). Understanding how much muscle fatigue affects the DelayTOT in people with SCI could help in the design of closed-loop neuroprostheses that compensate for this delay, thus making the control system more stable. The aim of this study was to evaluate the impact of the extent of fatigue on DelayTOT and peak force of the lower limbs in people with complete SCI. Fifteen men-young adults with complete SCI (paraplegia and tetraplegia) and stable health-participated in the experiment. DelayTOT was defined as the time interval between the beginning of NMES application until the onset of muscle force. The electrical intensity of NMES applied was adjusted individually and consisted of the amplitude required to obtain a full extension of the knee (0°), considering the maximum electrically stimulated extension (MESE). Subsequently, 70% of the MESE was applied during the fatigue induction protocol. Significant differences were identified between the moments before and after the fatigue protocol, both for peak force (P ≤ .026) and DelayTOT (P ≤ .001). The medians and interquartile range of the DelayTOT were higher in postfatigue (199.0 ms) when compared to the moment before fatigue (146.5 ms). The medians and interquartile range of the peak force were higher in unfatigued lower limbs (0.43 kgf) when compared to the moment postfatigue (0.27 kgf). The results support the hypothesis that muscle fatigue influences the increase in DelayTOT and decrease in force production in people with SCI. For future applications, the combined evaluation of the delay and force in SCI patients provides valuable feedback for NMES paradigms. The study will provide potentially critical muscle mechanical evidence for the investigation of the evolution of atrophy.
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Affiliation(s)
| | - Luciane Patrícia Adreani Cabral
- Human Motricity Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil.,Regional University Hospital of Campos Gerais, Campus of Ponta Grossa State University, Ponta Grossa, Brazil
| | - Eddy Krueger
- Neural Engineering and Rehabilitation Laboratory, Master and Doctoral Program in Rehabilitation Sciences UEL-UNOPAR, Anatomy Department, State University of Londrina, Londrina, Brazil.,Rehabilitation Engineering Laboratory/CPGEI/PPGEB, Federal Technological University of Paraná (UTFPR), Curitiba, Brazil
| | - Guilherme N Nogueira-Neto
- Rehabilitation Engineering Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Percy Nohama
- Rehabilitation Engineering Laboratory/CPGEI/PPGEB, Federal Technological University of Paraná (UTFPR), Curitiba, Brazil.,Rehabilitation Engineering Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Eduardo M Scheeren
- Human Motricity Laboratory/PPGTS, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
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Schmid L, Klotz T, Siebert T, Röhrle O. Characterization of Electromechanical Delay Based on a Biophysical Multi-Scale Skeletal Muscle Model. Front Physiol 2019; 10:1270. [PMID: 31649554 PMCID: PMC6795131 DOI: 10.3389/fphys.2019.01270] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/19/2019] [Indexed: 01/20/2023] Open
Abstract
Skeletal muscles can be voluntary controlled by the somatic nervous system yielding an active contractile stress response. Thereby, the active muscle stresses are transmitted to the skeleton by a cascade of connective tissue and thus enable motion. In the context of joint perturbations as well as the assessment of the complexity of neural control, the initial phase of the muscle-tendon system's stress response has a particular importance and is analyzed by means of electromechanical delay (EMD). EMD is defined as the time lag between the stimulation of a muscle and a measurable change in force output. While EMD is believed to depend on multiple structures / phenomena, it is hard to separate their contributions experimentally. We employ a physiologically detailed, three-dimensional, multi-scale model of an idealized muscle-tendon system to analyze the influence of (i) muscle and tendon length, (ii) the material behavior of skeletal muscle and tendon tissue, (iii) the chemo-electro-mechanical behavior of the muscle fibers and (iv) neural control on EMD. Comparisons with experimental data show that simulated EMD values are within the physiological range, i.e., between 6.1 and 68.6 ms, and that the model is able to reproduce the characteristic EMD-stretch curve, yielding the minimum EMD at optimal length. Simulating consecutive recruitment of motor units increases EMD by more than 20 ms, indicating that during voluntary contractions neural control is the dominant factor determining EMD. In contrast, the muscle fiber action potential conduction velocity is found to influence EMD even of a 27 cm long muscle by not more than 3.7 ms. We further demonstrate that in conditions where only little pre-stretch is applied to a muscle-tendon system, the mechanical behavior of both muscle and tendon tissue considerably impacts EMD. Predicting EMD for different muscle and tendon lengths indicates that the anatomy of a specific muscle-tendon system is optimized for its function, i.e., shorter tendon lengths are beneficial to minimize the neural control effort for muscles primary acting as motor in concentric contractions.
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Affiliation(s)
- Laura Schmid
- Chair for Continuum Biomechanics and Mechanobiology, Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany
| | - Thomas Klotz
- Chair for Continuum Biomechanics and Mechanobiology, Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany
| | - Tobias Siebert
- Department of Motion and Exercise Science, Institute of Sport and Motion Science, University of Stuttgart, Stuttgart, Germany
| | - Oliver Röhrle
- Chair for Continuum Biomechanics and Mechanobiology, Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany.,Stuttgart Center for Simulation Sciences (SC SimTech), University of Stuttgart, Stuttgart, Germany
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Al-Qahtani M, Al-Tayyar S, Mirza EH, Al-Musallam A, Al-Suwayyid A, Javed R. Body Mass Index and Segmental Mass Correlation With Elastographic Strain Ratios of the Quadriceps Tendon. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2005-2013. [PMID: 30570166 DOI: 10.1002/jum.14889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/04/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The aim of this study was to establish a relationship between quadriceps tendon stiffness and its properties and variations in the body mass index (BMI) and segmental mass. METHODS This study was conducted in 3 groups according to their BMI (A, low [<18.5 kg/m2 ]; B, normal [18.5-25.0 kg/m2 ]; and C, high [>25.0 kg/m2 ]). All of the participants included had a sedentary lifestyle and did not do any weightlifting or any kind of sports activity in the previous 6 months. Ultrasound measurements were performed on the participants' lower right extremities, since it was the dominant side for all of the participants. RESULTS A total of 40 healthy untrained men participated in the study. The mean age of the participants ± SD was 22.1 ± 1.3 years; the age ranges for groups A (n = 6), B (n = 18), and C (n = 16) were 19-23, 19-25, and 20-25 years, respectively; 28 of the participants were nonsmokers, and 12 of were smokers. A strong statistical difference (all P < .05) was witnessed for most of the parameters (BMI, body fat mass, dominant leg body fat content, fat-free mass index, tendon thickness, and strain ratio) among the groups. CONCLUSIONS The length of the tendon did not show a significant increase with an increase in the BMI, body fat mass, dominant leg body fat content, and fat-free mass index. However, a greater intensification was observed for the thickness of the tendon with a significant increase in tendon stiffness (with the use of external reference material).
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Affiliation(s)
- Mahdi Al-Qahtani
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Saleh Al-Tayyar
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Eraj Humayun Mirza
- Biomedical Engineering Department, NED University of Engineering and Technology, Karachi, Pakistan
| | - Abdulrhman Al-Musallam
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Al-Suwayyid
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ravish Javed
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Abstract
Lateral ankle sprains (LASs) are among the most common injuries incurred during participation in sport and physical activity, and it is estimated that up to 40% of individuals who experience a first-time LAS will develop chronic ankle instability (CAI). Chronic ankle instability is characterized by a patient's being more than 12 months removed from the initial LAS and exhibiting a propensity for recurrent ankle sprains, frequent episodes or perceptions of the ankle giving way, and persistent symptoms such as pain, swelling, limited motion, weakness, and diminished self-reported function. We present an updated model of CAI that aims to synthesize the current understanding of its causes and serves as a framework for the clinical assessment and rehabilitation of patients with LASs or CAI. Our goal was to describe how primary injury to the lateral ankle ligaments from an acute LAS may lead to a collection of interrelated pathomechanical, sensory-perceptual, and motor-behavioral impairments that influence a patient's clinical outcome. With an underpinning of the biopsychosocial model, the concepts of self-organization and perception-action cycles derived from dynamic systems theory and a patient-specific neurosignature, stemming from the Melzack neuromatrix of pain theory, are used to describe these interrelationships.
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Affiliation(s)
- Jay Hertel
- Department of * Kinesiology, University of Virginia, Charlottesville.,Department of Orthopaedic Surgery, University of Virginia, Charlottesville
| | - Revay O Corbett
- Department of * Kinesiology, University of Virginia, Charlottesville
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Simpson JD, Stewart EM, Turner AJ, Macias DM, Wilson SJ, Chander H, Knight AC. Neuromuscular control in individuals with chronic ankle instability: A comparison of unexpected and expected ankle inversion perturbations during a single leg drop-landing. Hum Mov Sci 2019; 64:133-141. [DOI: 10.1016/j.humov.2019.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/17/2018] [Accepted: 01/28/2019] [Indexed: 12/31/2022]
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Factors Contributing to Chronic Ankle Instability: A Systematic Review and Meta-Analysis of Systematic Reviews. Sports Med 2018; 48:189-205. [PMID: 28887759 DOI: 10.1007/s40279-017-0781-4] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Many factors are thought to contribute to chronic ankle instability (CAI). Multiple systematic reviews have synthesised the available evidence to identify the primary contributing factors. However, readers are now faced with several systematic reviews that present conflicting findings. OBJECTIVE The aim of this systematic review and meta-analysis was to establish the statistical significance and effect size of primary factors contributing to CAI and to identify likely reasons for inconsistencies in the literature. METHODS Relevant health databases were searched: CINAHL, MEDLINE, PubMed, Scopus and SPORTDiscus. Systematic reviews were included if they answered a focused research question, clearly defined the search strategy criteria and study selection/inclusion and completed a comprehensive search of the literature. Included reviews needed to be published in a peer-reviewed journal and needed to review observational studies of factors and/or characteristics of persons with CAI, with or without meta-analysis. There was no language restriction. Studies using a non-systematic review methodology (e.g. primary studies and narrative reviews) were excluded. Methodological quality of systematic reviews was assessed using the modified R-AMSTAR tool. Meta-analysis on included primary studies was performed. RESULTS Only 17% of primary studies measured a clearly defined CAI population. There is strong evidence to support the contribution of dynamic balance, peroneal reaction time and eversion strength deficits and moderate evidence for proprioception and static balance deficits to non-specific ankle instability. CONCLUSIONS Evidence from previous systematic reviews does not accurately reflect the CAI population. For treatment of non-specific ankle instability, clinicians should focus on dynamic balance, reaction time and strength deficits; however, these findings may not be translated to the CAI population. Research should be updated with an adequately controlled CAI population. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2016, CRD42016032592.
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The Effect of Static Stretching of Peroneal and Tibialis Anterior Muscles on Reaction Time: A Randomized Controlled Study. Am J Phys Med Rehabil 2018; 98:136-146. [PMID: 30198912 DOI: 10.1097/phm.0000000000001036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the acute and chronic effects of static stretching on peroneal and tibialis anterior reaction characteristics. DESIGN All 23 participants who volunteered for this study were randomly divided into static (n = 12) and control (n = 11) groups. The subjects in the static stretching group performed stretching exercises for the ankle evertor and dorsiflexor muscles 5 days a week for 6 wks. Peroneal and tibialis anterior muscle reaction characteristics were evaluated at the beginning (2 times for acute effect) and end of this period. Electromyographic activity parameters of the muscles were measured using an ankle inversion tilting platform that simulated a sudden ankle inversion. The following were the four different ankle inversion conditions: (a) ankle-neutral, 15-degree inversion; (b) ankle-neutral, 30-degree inversion; (c) ankle-20-degree plantarflexion, 15-degree inversion; and (d) ankle-20-degree plantarflexion, 30-degree inversion. RESULTS Either in terms of acute or chronic effects, no significant differences were found after static stretching exercises for peroneal and tibialis anterior muscle reaction time, reaction duration, and muscle activity evaluated in four positions on the ankle inversion simulation platform (P > 0.05). CONCLUSIONS In light of these results, it is possible to state that the short duration of static stretching exercises can still be applied before sports activities.
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Gokeler A, Seil R, Kerkhoffs G, Verhagen E. A novel approach to enhance ACL injury prevention programs. J Exp Orthop 2018; 5:22. [PMID: 29916182 PMCID: PMC6005994 DOI: 10.1186/s40634-018-0137-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/06/2018] [Indexed: 12/22/2022] Open
Abstract
Efficacy studies have demonstrated decreased anterior cruciate ligament (ACL) injury rates for athletes participating in injury prevention programs. Typically, ACL injury prevention programs entail a combination of plyometrics, strength training, agility and balance exercises. Unfortunately, improvements of movement patterns are not sustained over time. The reason may be related to the type of instructions given during training. Encouraging athletes to consciously control knee movements during exercises may not be optimal for the acquisition of complex motor skills as needed in complex sports environments. In the motor learning domain, these types of instructions are defined as an internal attentional focus. An internal focus, on one's own movements results in a more conscious type of control that may hamper motor learning. It has been established in numerous studies that an external focus of attention facilitates motor learning more effectively due to the utilization of automatic motor control. Subsequently, the athlete has more recourses available to anticipate on situations on the field and take appropriate feed forward directed actions. The purpose of this manuscript was to present methods to optimize motor skill acquisition of athletes and elaborate on athletes' behavior.
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Affiliation(s)
- Alli Gokeler
- Luxembourg Institute of Research for Orthopedics, Medicine and Science in Sports, 76 rue d'Eich, L-1460, Luxembourg, Luxembourg. .,Department of Applied Neuroscience in Sports and Exercise, Institute of Sports Medicine, University of Paderborn, Paderborn, Germany. .,University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, Netherlands.
| | - Romain Seil
- Luxembourg Institute of Research for Orthopedics, Medicine and Science in Sports, 76 rue d'Eich, L-1460, Luxembourg, Luxembourg
| | - Gino Kerkhoffs
- Academic Center for Evidence based Sports Medicine (ACES), Academic Medical Center, Amsterdam, Netherlands.,Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, Netherlands.,Amsterdam Collaboration for Health & Safety in Sports (ACHSS), IOC Research Center, Academic Medical Center/VU Medical Center, Amsterdam, Netherlands
| | - Evert Verhagen
- Amsterdam Collaboration for Health & Safety in Sports (ACHSS), IOC Research Center, Academic Medical Center/VU Medical Center, Amsterdam, Netherlands.,Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, Netherlands.,Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
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The effect of additional joint mobilization on neuromuscular performance in individuals with functional ankle instability. Phys Ther Sport 2017; 30:22-28. [PMID: 29310055 DOI: 10.1016/j.ptsp.2017.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 10/23/2017] [Accepted: 12/17/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine the effects of joint mobilization and exercise training on neuromuscular performance in individuals with functional ankle instability (FAI). DESIGN A cross-sectional study. PARTICIPANTS Forty five subjects with FAI were randomized into three groups: control (CG, n = 15, 27.9 ± 6.6yr), training (TG, n = 15, 26.9 ± 5.8yr) and mobilization with training group (MTG, n = 15, 26.5 ± 4.8yr). INTERVENTION Four weeks of neuromuscular training for TG; neuromuscular training and joint mobilization for MTG. MAIN OUTCOME MEASURES Electromyography of the peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) and the reaching distance of the Y balance test (YBT), dorsiflexion range of motion (DFROM), Cumberland ankle instability tool (CAIT), and global rating scale (GRS). Two-way repeated measures MANOVA were used with the significance level p < .05. RESULTS MANOVA found significant group by time interactions on posterolateral reaching distance (p = .032), PL activation (p = .006-.03), DFROM (p < .001), CAIT (p < .001) and GRS (p < .001). The post hoc tests indicated significantly improved PL muscle activity and posterolateral reaching distance for MTG compared to TG (p = .004) and CG (p = .006). CONCLUSION Joint mobilization resulted in additional benefits on self-reported ankle instability severity, dorsiflexion mobility, and posterolateral balance performance in individuals with FAI, but its effects on general improvement, muscle activation, and other balance tasks remained uncertain.
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Lee SY, Lee SM, Jung JM. Peroneus Longus activity according to various angles of a ramp during cross-ramp walking and one-legged standing. J Back Musculoskelet Rehabil 2017; 30:1215-1219. [PMID: 28655126 DOI: 10.3233/bmr-150510] [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: 02/04/2023]
Abstract
BACKGROUND Ankle sprain are one of the most common injuries in sports and public health in general. Cross-slope may creat a risk for ankle sprain and are commonly found in both urban and rural environment. OBJECTIVE The purpose of study was to clarify the environmental risk factor that can be easily occurred ankle sprain during walking (stance phase) and one leg standing at various ramp environment. METHODS Participants was measured muscle activation on peroneus longus during both conditions (walk across the ramp and one leg stand in the transverse direction) of seven different angle (0∘, 2∘, 5∘, 10∘, 15∘, 20∘, 25∘). The measured data were analyzed using one-way ANOVA to investigate the effect of muscle activation on the each condition. RESULTS Ankle sprain can be easily occurred when cross walk and one-leg stand on a ramp from higher than 10∘, and highest risk was angle of 25∘ or more. As a people with peroneus longus weakness walks a ramp, the ramp angle has a cross relationship with the sprain on the ankle. CONCLUSIONS If people with peroneus longus weakness walk on the more than 10∘ of ramp angle, they will need a lot of attention for prevent ankle sprain.
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Affiliation(s)
- Sang-Yeol Lee
- Department of Physical Therapy, College of Science, Kyungsung University, Busan, Korea
| | - Seung-Min Lee
- Department of Physical Therapy, Graduate School of Clinical Medicine and Health, Kyungsung University, Busan, Korea
| | - Jae-Min Jung
- Biomechanics Team, Footwear Industrial Promotion Center, Busan Economic Promotion Agency, Busan, Korea
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SON SJUN, KIM HYUNSOO, SEELEY MATTHEWK, HOPKINS JTY. Movement Strategies among Groups of Chronic Ankle Instability, Coper, and Control. Med Sci Sports Exerc 2017; 49:1649-1661. [DOI: 10.1249/mss.0000000000001255] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Peroneal electromechanical delay and fatigue in patients with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 2017; 25:1903-1907. [PMID: 27401005 DOI: 10.1007/s00167-016-4243-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effect of chronic ankle instability (CAI) on electromechanical delay times (EMD) before and after fatigue. Understanding the mechanisms that contribute to CAI is essential for the development of effective rehabilitation programmes. It was hypothesized that patients with CAI will demonstrate prolonged EMD times compared to healthy subjects and that fatigue will cause greater increases in EMD times in the CAI group. METHODS Twenty-one male volunteers participated in the study providing data on 16 ankles with CAI and 26 with no history of ankle injury. EMD was measured on an isokinetic dynamometer. Measurements were taken with the ankle in neutral (0°) and at 30° of inversion. All subjects followed an isokinetic fatigue protocol until eversion torque fell below 50 % of initial torque for three consecutive repetitions. A 2 × 2 × 2 ANOVA was used to calculate the effect of ankle status (CAI vs. healthy), fatigue, angle (0° vs. 30°) and their interactions on EMD. RESULTS Fatigue caused a significant increase on EMD [non-fatigued: 122(29)ms vs. fatigue 155(54)ms; p < 0.001]. EMD times were shorter at 30° of inversion compared to neutral [neutral: 145(39)ms vs. 30° of inversion: 132(40)ms, p = 0.015]. An interaction effect for ankle status and angle was found (p = 0.026) with CAI ankles demonstrating longer EMD [CAI: 156(45)ms vs. healthy: 133(40)ms] in neutral but not at 30° of inversion [CAI: 133(46)ms vs. 132(33)ms]. CONCLUSIONS Patients with CAI had longer EMD times in neutral, but not when the ankle was placed in inversion. This suggests that rehabilitation programmes may be more effective when retraining occurs with the ankle in neutral position. It is likely that low EMD times prevent ankle acceleration at the beginning of the mechanism of injury, but they are less important when the ankle has already inverted at 30°. Both CAI and healthy subjects demonstrated longer EMD after fatigue, emphasizing the importance of proper conditioning in the prevention of delayed peroneal response and subsequent ankle injury. Improving resistance to fatigue of the peroneals may prove to be an effective prevention tool of ankle sprain recurrence in patients with CAI. LEVEL OF EVIDENCE III.
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Effects of treadmill incline and speed on peroneus longus muscle activity in persons with chronic stroke and healthy subjects. Gait Posture 2017; 54:221-228. [PMID: 28351742 DOI: 10.1016/j.gaitpost.2017.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 02/15/2017] [Accepted: 03/04/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the effects of walking at different inclines and speeds on Peroneus Longus (PL) muscle activation and medial gastrocnemius (MG) coactivation with PL in healthy controls and subjects with stroke. DESIGN Nineteen persons post-stroke (13M/6F) and fifteen healthy controls (10M/5F) walked on a treadmill at different inclines (0°, 3°, and 6°) and speeds (self-selected, self-selected+20%, self-selected+40%). The electromyographic activity of the PL and MG muscles in the stance phase of gait cycle was measured. RESULTS The paretic PL muscle activity did not change with incline, but increased at +40% speed only (p<0.05). The nonparetic PL increased at 6° incline and at faster speeds (p<0.05). In the healthy group, PL muscle activity increased only on the right side at 6° incline, but increased bilaterally at +40% faster speed (p<0.05). The timing of PL muscle activity did not change with incline (p>0.05), but was significantly delayed at +40% faster speed on the paretic side only (p<0.05). In healthy controls, PL muscle activation timing was unchanged with incline (p>0.05), but was significantly delayed at +40% speed only on the left side (p<0.05). The MG/PL amplitude and timing ratios were not significantly different between various walking conditions (p>0.05). CONCLUSION An increase in PL activity occurs to provide ankle stability at walking speeds up to 40% faster than the self-selected speed. Important interlimb differences which may be related to leg dominance and motor control were observed in both stroke and healthy control groups in both PL muscle timing and their clinical impact should be investigated in future studies.
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Taş S, Yılmaz S, Onur MR, Soylu AR, Altuntaş O, Korkusuz F. Patellar tendon mechanical properties change with gender, body mass index and quadriceps femoris muscle strength. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2017; 51:54-59. [PMID: 28010997 PMCID: PMC6197583 DOI: 10.1016/j.aott.2016.12.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 03/24/2016] [Accepted: 06/27/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study is to assess the effect and correlation of gender, body mass index (BMI) and quadriceps femoris (QF) muscle strength on patellar tendon (PT) thickness and stiffness in healthy sedentary individuals. METHODS This study was carried out with 67 (36 female, 31 male) healthy sedentary individuals between the ages of 18-44 (28.0 ± 7.5 years). The individuals included in the study were divided into two groups according to their gender and BMI (18.5<BMI<25 and 25<BMI). The body composition was determined with Tanita Body Composition Analyser. PT thickness and stiffness was measured with ACUSON S3000 Ultrasonography Device using 9L4 ultrasonography probe. QF concentric muscle strength of the individuals was measured with Biodex® System 4 Dynamometer at 60°/sec angular speed. RESULTS It was found that PT stiffness was higher in males compared to females (p<0.001). It was found that PT stiffness was lower in obese individuals compared to individuals with normal weight (p = 0.017). A negative and weak correlation was found between BMI and PT stiffness (r = -0.26, p = 0.032), whereas a negative and moderate correlation was found between fat percentage and PT stiffness (r = -0.50, p<0.001). A moderate correlation was found between BMI and PT thickness (r = 0.54, p<0.001). It was found that peak torque at 60°/sec angular speed had a moderate correlation with PT stiffness (r = 0.44, p<0.001) and PT thickness (r = 0.45, p<0.001). CONCLUSIONS PT stiffness is correlated and affected by gender, BMI and QF muscle strength whereas PT thickness is correlated and affected only to BMI and QF muscle strength.
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Kosik KB, McCann RS, Terada M, Gribble PA. Therapeutic interventions for improving self-reported function in patients with chronic ankle instability: a systematic review. Br J Sports Med 2016; 51:105-112. [PMID: 27806951 DOI: 10.1136/bjsports-2016-096534] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To identify which therapeutic intervention may be most effective for improving self-reported function in patients with chronic ankle instability (CAI). DESIGN Systematic literature review. Articles were appraised using the Downs and Black Checklist by 3 reviewers. DATA SOURCES PubMed along with CINAHL, MEDLINE and SPORTDiscus within EBSCOhost for pertinent articles from their inception through August 2016. ELIGIBILITY CRITERIA FOR SELECTED STUDIES Articles included were required to (1) be written in English, (2) report adequate data to calculate effect sizes, (3) identify patients with CAI, (4) use some form of therapeutic intervention and (5) use a self-reported questionnaire as a main outcome measurement. RESULTS A broad spectrum of therapeutic interventions were identified related to balance training, multimodal rehabilitation, joint mobilisation, resistive training, soft-tissue mobilisation, passive calf stretching and orthotics. All of the articles included in the balance training category had moderate-to-strong Hedges g with none of the 95% CIs crossing 0. Hedges g effect sizes ranged from -0.67 to -2.31 and -0.51 to -1.43 for activities of daily living and physical activity, respectively. The multimodal rehabilitation category also produced moderate-to-strong Hedges g effect sizes but with large CIs crossing 0. Hedges g effect sizes ranged from -0.47 to -9.29 and -0.62 to -24.29 for activities of daily living and physical activity, respectively. CONCLUSIONS The main findings from this systematic review were balance training provided the most consistent improvements in self-reported function for patients with CAI.
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Affiliation(s)
- Kyle B Kosik
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Ryan S McCann
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Masafumi Terada
- College of Sport and Health Sciences, Ritsumeikan University, Kyoto, Japan
| | - Phillip A Gribble
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA
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Feger MA, Snell S, Handsfield GG, Blemker SS, Wombacher E, Fry R, Hart JM, Saliba SA, Park JS, Hertel J. Diminished Foot and Ankle Muscle Volumes in Young Adults With Chronic Ankle Instability. Orthop J Sports Med 2016; 4:2325967116653719. [PMID: 27570782 PMCID: PMC4999538 DOI: 10.1177/2325967116653719] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Patients with chronic ankle instability (CAI) have demonstrated altered neuromuscular function and decreased muscle strength when compared with healthy counterparts without a history of ankle sprain. Up to this point, muscle volumes have not been analyzed in patients with CAI to determine whether deficits in muscle size are present following recurrent sprain. Purpose: To analyze intrinsic and extrinsic foot and ankle muscle volumes and 4-way ankle strength in young adults with and without CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Five patients with CAI (mean age, 23.0 ± 4 years; 1 male, 4 females) and 5 healthy controls (mean age, 23.8 ± 4.5 years; 1 male, 4 females) volunteered for this study. Novel fast-acquisition magnetic resonance imaging (MRI) was used to scan from above the femoral condyles through the foot and ankle. The perimeter of each muscle was outlined on each axial slice and then the 2-dimensional area was multiplied by the slice thickness (5 mm) to calculate the muscle volume. Plantar flexion, dorsiflexion, inversion, and eversion isometric strength were measured using a handheld dynamometer. Patients with CAI were compared with healthy controls on all measures of muscle volume and strength. Extrinsic muscle volumes of patients with CAI were also compared with a normative database of healthy controls (n = 24) by calculating z scores for each muscle individually for each CAI subject. Results: The CAI group had smaller total shank, superficial posterior compartment, soleus, adductor hallucis obliqus, and flexor hallucis brevis muscle volumes compared with healthy controls as indicated by group means and associated 90% CIs that did not overlap. Cohen d effect sizes for the significant group differences were all large and ranged from 1.46 to 3.52, with 90% CIs that did not cross zero. The CAI group had lower eversion, dorsiflexion, and 4-way composite ankle strength, all with group means and associated 90% CIs that did not overlap. No other significant differences were identified. Conclusion: Patients with CAI demonstrate atrophy of intrinsic and extrinsic foot and ankle musculature accompanied by lower ankle strength. Clinical Relevance: Clinicians should be aware of the muscle atrophy and strength deficits when prescribing rehabilitation for patients with lateral ankle sprain or CAI.
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Affiliation(s)
- Mark A Feger
- University of Virginia, Charlottesville, Virginia, USA
| | - Shannon Snell
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | | | - Rachel Fry
- University of Virginia, Charlottesville, Virginia, USA
| | - Joseph M Hart
- University of Virginia, Charlottesville, Virginia, USA
| | | | - Joseph S Park
- University of Virginia, Charlottesville, Virginia, USA
| | - Jay Hertel
- University of Virginia, Charlottesville, Virginia, USA
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Hall EA, Simon JE, Docherty CL. Using Ankle Bracing and Taping to Decrease Range of Motion and Velocity During Inversion Perturbation While Walking. J Athl Train 2016; 51:283-90. [PMID: 27111586 DOI: 10.4085/1062-6050-51.5.06] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Prophylactic ankle supports are commonly used. However, the effectiveness of external supports in preventing an inversion stress has been debated. OBJECTIVE To evaluate how ankle bracing and taping affect inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability compared with a control condition during a dynamic inversion perturbation while walking. DESIGN Crossover study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 42 physically active participants (16 men, 26 women; age = 21.2 ± 3.3 years, height = 168.9 ± 8.9 cm, mass = 66.1 ± 11.4 kg) volunteered. INTERVENTION(S) Participants walked on a custom-built walkway that suddenly inverted their ankles to 30° in 3 conditions: brace, tape, and control (no external support). We used an ASO ankle brace for the brace condition and a closed basketweave technique for the tape condition. Three trials were completed for each condition. Main Outcome Measure(s) Maximum inversion (degrees), time to maximum inversion (milliseconds), and inversion velocity (degrees per second) were measured using an electrogoniometer, and perceived stability (centimeters) was measured using a visual analog scale. RESULTS Maximum inversion decreased more in the brace condition (20.1°) than in the control (25.3°) or tape (22.3°) conditions (both P values = .001), and the tape condition restricted inversion more than the control condition (P = .001). Time to maximum inversion was greater in the brace condition (143.5 milliseconds) than in the control (123.7 milliseconds; P = .001) or tape (130.7 milliseconds; P = .009) conditions and greater in the tape than in the control condition (P = .02). Inversion velocity was slower in the brace condition (142.6°/s) than in the control (209.1°/s) or tape (174.3°/s) conditions (both P values = .001) and slower in the tape than in the control condition (P = .001). Both the brace and tape conditions provided more perceived stability (0.98 cm and 0.94 cm, respectively) than the control condition (2.38 cm; both P values = .001). CONCLUSIONS Both prophylactic conditions affected inversion range of motion, time to maximum inversion, inversion velocity, and perceived ankle stability. However, bracing provided more restriction at a slower rate than taping.
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Affiliation(s)
- Emily A Hall
- Department of Kinesiology, Indiana University, Bloomington
| | - Janet E Simon
- Division of Athletic Training, Ohio University, Athens
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Juchler I, Blasimann A, Baur H, Radlinger L. The effect of kinesio tape on neuromuscular activity of peroneus longus. Physiother Theory Pract 2016; 32:124-9. [PMID: 26863268 DOI: 10.3109/09593985.2015.1110737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Functional ankle instability is the result of sensorimotor or structural deficits. The commonly used kinesio tape (KT) is supposed to have a positive influence on sensorimotor functions. METHODS Eight women and two men (mean ± SD, age 24.4 ± 3.3 years) with functional ankle instability with recurrent ankle sprains ran downhill on a treadmill (3.3 m/s and a negative slope of 5°). The first trial was without KT, the second with KT on the peroneus longus (PL) muscle. Neuromuscular activity was measured using surface electromyography for 15 seconds. Sensation of giving way was assessed with a visual analog scale (VAS). Comparisons were made between measurements with and without KT using the Wilcoxon rank sum test. The level of significance was set at P ≤ 0.05. RESULTS None of the chosen parameters for preactivation, reflex activation, or total activation showed statistically significant differences between the two trials (P > 0.05). The mean values for the sensation of giving way were lower with KT (VAS, median 1.2, range 0-2.8) than without (VAS, median 1.8, range 0-3.9), but did not reach statistical significance (P = 0.102) or clinical relevance. CONCLUSION KT in participants with functional ankle instability (FAI) seems to have no effect on the neuromuscular activity of PL and sensation of giving way during downhill running.
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Affiliation(s)
- Isabelle Juchler
- a Bern University of Applied Sciences, Health, Research and Development Physiotherapy , Bern , Switzerland
| | - Angela Blasimann
- a Bern University of Applied Sciences, Health, Research and Development Physiotherapy , Bern , Switzerland
| | - Heiner Baur
- a Bern University of Applied Sciences, Health, Research and Development Physiotherapy , Bern , Switzerland
| | - Lorenz Radlinger
- a Bern University of Applied Sciences, Health, Research and Development Physiotherapy , Bern , Switzerland
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Jeon K, Seo BD, Lee SH. Comparative study on isokinetic capacity of knee and ankle joints by functional injury. J Phys Ther Sci 2016; 28:250-6. [PMID: 26957768 PMCID: PMC4756014 DOI: 10.1589/jpts.28.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/16/2015] [Indexed: 12/30/2022] Open
Abstract
[Purpose] To collect basic data for exercise programs designed to enhance functional knee
and ankle joint stability based on isokinetic measurement and muscle strength evaluations
in normal and impaired functional states. [Subjects and Methods] Twenty-four subjects were
randomly assigned to the athlete group and the control group (n = 12 each). Data were
collected of isokinetic knee extensor and flexor strength at 60°/sec, 180°/sec, and
240°/sec and ankle plantar and dorsiflexor strength at 30°/sec and 120°/sec. [Results]
Significant intergroup differences were observed in peak torque of the right extensors at
60°/sec, 180°/sec, and 240°/sec and the right flexors at 240°/sec. Significant differences
were observed in peak torque/body weight in the right extensors at 60°/sec, 180°/sec, and
240°/sec and in the right flexors at 180°/sec and 240°/sec. Significant peak torque
differences were noted in the left ankle joint dorsiflexor at 30°/sec and 120°/sec, right
plantar flexor at 120°/sec, left plantar flexor at 30°/sec, left dorsiflexor at 30°/sec
and 120°/sec, and right dorsiflexor at 120°/sec. [Conclusion] Isokinetic evaluation
stimulates muscle contraction at motion-dependent speeds and may contribute to the
development of intervention programs to improve knee and ankle joint function and correct
lower-extremity instability.
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Affiliation(s)
- Kyoungkyu Jeon
- Sport Science Institute, Incheon National University, Republic of Korea
| | - Byoung-Do Seo
- Department of Physical Therapy, College of Health, Kyungwoon University, Republic of Korea
| | - Sang-Ho Lee
- Department of Physical Education, College of Education, Hankuk University of Foreign Studies, Republic of Korea
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42
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Akagi R, Yamashita Y, Ueyasu Y. Age-Related Differences in Muscle Shear Moduli in the Lower Extremity. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:2906-12. [PMID: 26314496 DOI: 10.1016/j.ultrasmedbio.2015.07.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 07/09/2015] [Accepted: 07/13/2015] [Indexed: 05/12/2023]
Abstract
This study investigated the age-related differences in shear moduli of the rectus femoris muscle (RF), the lateral head of the gastrocnemius muscle (LG) and the soleus muscle (SOL) using shear wave ultrasound elastography. Thirty-one young individuals and 49 elderly individuals volunteered for this study. The shear modulus of RF was determined at 50% of the thigh length, and those of LG and SOL were determined at 30% of the lower leg length. RF and LG shear moduli were significantly higher in young individuals than in elderly individuals, but there was no age-related difference in SOL shear modulus. From the standpoint of an index reflecting muscle mechanical properties, it is suggested that the lower muscle shear moduli of RF and LG are the reason for the decreased explosive muscle strength in the lower extremity and the increased risk of falls for elderly individuals.
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Affiliation(s)
- Ryota Akagi
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan.
| | - Yota Yamashita
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Yuta Ueyasu
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
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43
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Jeon KK, Kim TY, Lee SH. The effects of a strategic strength resistance exercise program on the isokinetic muscular function of the ankle. J Phys Ther Sci 2015; 27:3295-7. [PMID: 26644696 PMCID: PMC4668187 DOI: 10.1589/jpts.27.3295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/27/2015] [Indexed: 01/22/2023] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of a strategic strength resistance exercise program on the isokinetic muscular function of the ankle joint. [Subjects] This study included 22 males in their twenties who were diagnosed with functional injury of the ankle joint. [Methods] To strengthen plantar flexion and dorsiflexion of the ankle joint, 8 weeks of weight, resistance band, and plyometric training, and training using props were performed. [Results] A medical examination by interview indicated that pain, swelling, instability, running, and support capacity of the ankle joint significantly improved with the strategic strength resistance exercise program. For the isokinetic peak torque of the ankles, significant differences were observed in right plantar flexion and bilateral dorsiflexion. [Conclusion] The strategic strength resistance exercise program is highly recommended for the functional stability of the ankle joint. Efficient exercise therapy is useful for muscle damage prevention, muscle strengthening, and functional interventions.
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Affiliation(s)
- Kyoung-Kyu Jeon
- Sport Science Institute, Incheon National University, Republic of Korea
| | - Tae-Young Kim
- Department of Physical Education, College of Education, Hankuk University of Foreign Studies, Republic of Korea
| | - Sang-Ho Lee
- Department of Physical Education, College of Education, Hankuk University of Foreign Studies, Republic of Korea
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De Ridder R, Willems T, Vanrenterghem J, Robinson MA, Palmans T, Roosen P. Multi-segment foot landing kinematics in subjects with chronic ankle instability. Clin Biomech (Bristol, Avon) 2015; 30:585-92. [PMID: 25887076 DOI: 10.1016/j.clinbiomech.2015.04.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic ankle instability has been associated with altered joint kinematics at the ankle, knee and hip. However, no studies have investigated possible kinematic deviations at more distal segments of the foot. The purpose of this study was to evaluate if subjects with ankle instability and copers show altered foot and ankle kinematics and altered kinetics during a landing task when compared to controls. METHODS Ninety-six subjects (38 subjects with chronic ankle instability, 28 copers and 30 controls) performed a vertical drop and side jump task. Foot kinematics were obtained using the Ghent Foot Model and a single-segment foot model. Group differences were evaluated using statistical parametric mapping and analysis of variance. RESULTS Subjects with ankle instability had a more inverted midfoot position in relation to the rearfoot when compared to controls during the side jump. They also had a greater midfoot inversion/eversion range of motion than copers during the vertical drop. Copers exhibited less plantar flexion/dorsiflexion range of motion in the lateral and medial forefoot. Furthermore, the ankle instability and coper group exhibited less ankle plantar flexion at touchdown. Additionally, the ankle instability group demonstrated a decreased plantar flexion/dorsiflexion range of motion at the ankle compared to the control group. Analysis of ground reaction forces showed a higher vertical peak and loading rate during the vertical drop in subjects with ankle instability. INTERPRETATION Subjects with chronic ankle instability displayed an altered, stiffer kinematic landing strategy and related alterations in landing kinetics, which might predispose them for episodes of giving way and actual ankle sprains.
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Affiliation(s)
- Roel De Ridder
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185, Ghent 9000, Belgium.
| | - Tine Willems
- Department of Physiotherapy and Orthopedics, Ghent University, De Pintelaan 185, Ghent 9000, Belgium.
| | - Jos Vanrenterghem
- Faculty of Science, School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Mark A Robinson
- Faculty of Science, School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Tanneke Palmans
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185, Ghent 9000, Belgium.
| | - Philip Roosen
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185, Ghent 9000, Belgium.
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45
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Terada M, Bowker S, Thomas AC, Pietrosimone B, Hiller CE, Rice MS, Gribble PA. Alterations in stride-to-stride variability during walking in individuals with chronic ankle instability. Hum Mov Sci 2015; 40:154-62. [DOI: 10.1016/j.humov.2014.12.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/02/2014] [Accepted: 12/08/2014] [Indexed: 12/26/2022]
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Hoch MC, McKeon PO. Peroneal reaction time after ankle sprain: a systematic review and meta-analysis. Med Sci Sports Exerc 2014; 46:546-56. [PMID: 23899892 DOI: 10.1249/mss.0b013e3182a6a93b] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Many studies have examined the temporal response of the peroneal muscles to sudden inversion perturbation in patients with a previous ankle sprain. The purpose of this systematic review with meta-analysis was to synthesize the evidence and determine whether peroneal reaction time (PRT) impairments are present after ankle sprain. METHODS An electronic search was conducted using PubMed Central and EBSCOhost (1965-January 2013). Articles were included if they 1) examined the PRT to sudden inversion perturbation in patients with a history of ankle sprain using a mechanical tilt platform, 2) made comparisons with a control group or contralateral limb with no history of ankle sprain, and 3) provided data for the calculation of effect sizes (ES). In addition to examining the overall effect of sustaining an ankle sprain on PRT, the effects of study design and subject characteristics on PRT were evaluated. Bias-corrected Hedges g ES and 95% confidence intervals (CI) were calculated to make comparisons across studies. RESULTS A total of 23 studies met the inclusion criteria. The overall ES was 0.67 (95% CI = 0.37-0.95, P < 0.001), indicating that a previous ankle sprain, regardless of study design or subject characteristics, resulted in moderate-to-strong PRT deficits. Further analyses determined studies with patients classified as having chronic ankle instability demonstrated large magnitude PRT deficits in between groups (ES = 0.72, 95% CI = 0.29-1.14, P = 0.001) and side-to-side (ES = 1.24, 95% CI = 0.70-1.79, P < 0.001) comparisons, whereas patients with all other ankle sprain histories demonstrated weak PRT alterations in between groups (ES = -0.21, 95% CI = -1.01 to 0.59, P = 0.61) and side-to-side (ES = 0.21, 95% CI = -0.19 to 0.60, P = 0.31) comparisons. CONCLUSIONS Overall, this meta-analysis determined that individuals with a previous ankle sprain exhibit delayed PRT. Further analyses determined that these deficits are more evident in patients with chronic ankle instability when compared with the contralateral uninvolved limb or a healthy control group.
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Affiliation(s)
- Matthew C Hoch
- 1School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA; and 2School of Health Sciences and Human Performance, Ithaca College, Ithaca NY
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Electromyographic patterns of tibialis posterior and related muscles when walking at different speeds. Gait Posture 2014; 39:1080-5. [PMID: 24618372 DOI: 10.1016/j.gaitpost.2014.01.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 12/04/2013] [Accepted: 01/22/2014] [Indexed: 02/02/2023]
Abstract
The effect of walking speed on superficial lower limb muscles, such as tibialis anterior and triceps surae, is well established. However, there are no published data available for tibialis posterior - a muscle that plays an important role in controlling foot motion. The purpose of this study was to characterise the electromyographic timing and amplitude of selected lower limb muscles across five walking speeds. Thirty young adults were instructed to walk barefoot while electromyographic activity was recorded from tibialis posterior and peroneus longus via intramuscular electrodes, and medial gastrocnemius and tibialis anterior via surface electrodes. At faster walking speeds, peak electromyographic amplitude increased systematically during the contact and midstance/propulsion phases. Changes in the time of peak amplitude were also observed for tibialis posterior, tibialis anterior and peroneus longus activity; however, these were muscle and phase specific. During contact phase, peak electromyographic amplitude for tibialis posterior and peroneus longus was similar across very slow to slow walking speeds. During midstance/propulsion phase, peak electromyographic amplitude for tibialis posterior and medial gastrocnemius was similar across very slow to slow walking speeds. These findings may reflect a relatively higher than expected demand for peroneus longus and tibialis posterior to assist with medio-lateral foot stability at very slow speeds. Similarly, peak amplitude of medial gastrocnemius was also relatively unchanged at the very slow speed, presumably to compensate for the reduced forward momentum. The data presented in this study may serve as a reference for comparing similarly matched participants with foot deformity and/or pathological gait.
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Inglis JG, Vandenboom R, Gabriel DA. Sex-related differences in maximal rate of isometric torque development. J Electromyogr Kinesiol 2013; 23:1289-94. [DOI: 10.1016/j.jelekin.2013.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 09/04/2013] [Accepted: 09/20/2013] [Indexed: 11/29/2022] Open
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Donahue MS, Docherty CL, Riley ZA. Decreased fibularis reflex response during inversion perturbations in FAI subjects. J Electromyogr Kinesiol 2013; 24:84-9. [PMID: 24295544 DOI: 10.1016/j.jelekin.2013.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 11/30/2022] Open
Abstract
Investigate reflex responses in muscles throughout the lower limb and low back during sudden inversion perturbations in individuals with and without Functional Ankle Instability (FAI) while walking. Forty subjects participated in the study. Surface electromyogram recordings were obtained from the fibularis (FIB), gluteus medius (GM), erector spinae (ES), and sternocleidomastoid (SCM) of the injured/matched side as well as the uninjured/matched contralateral side (FIB_CLS, GM_CLS, or ES_CLS). Latency and amplitude data were collected while subjects were walking on a custom-built perturbation walkway. The onset of the short-latency stretch reflex of the FIB was significantly later in the injured side of the FAI individuals when compared to the control group (P=0.009). Both the short and long latency reflex amplitude was significantly smaller in the FIB muscle in the FAI group than in the control group (P<0.008). No significant differences in latency or amplitude reflex responses were identified between the two groups in the GM, ES, FIB_CLS, GM_CLS, or ES_CLS (P>.05). Interpretation of these results indicate that during a dynamic perturbation task individuals with FAI demonstrate longer fibularis muscle latencies on the injured side while no significant changes in the proximal muscle groups. Additionally, short and long latency reflex amplitude was significantly decreased in FAI individuals.
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Affiliation(s)
| | | | - Zachary A Riley
- Indiana University-Purdue University-Indianapolis, Indianapolis, IN, United States
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Keles SB, Sekir U, Gur H, Akova B. Eccentric/concentric training of ankle evertor and dorsiflexors in recreational athletes: muscle latency and strength. Scand J Med Sci Sports 2013; 24:e29-38. [PMID: 23941193 DOI: 10.1111/sms.12105] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2013] [Indexed: 12/26/2022]
Abstract
The aim of this study was to investigate the effects of a combined eccentric-concentric exercise program of the ankle evertors and dorsiflexors on the latency time of the peroneus longus and tibialis anterior muscles. Twenty-four healthy male recreational athletes were admitted to this study and were randomly assigned to either the exercise group (n = 12) or the control group (n = 12). Subjects in the exercise group performed an isokinetic exercise program of the ankle evertors and dorsiflexors in a combined eccentric-concentric mode for 3 days per week for 6 weeks. Before and after the exercise program, muscle reaction times of the peroneus longus and tibialis anterior muscles to sudden supinating maneuvers on a tilting platform, and isokinetic strength of the ankle joint musculature were evaluated. The peroneus longus and tibialis anterior reaction times showed significant (P < 0.01-0.05) reductions following six weeks of intervention in the exercise group. Additionally, eccentric peak torques for the ankle evertor and dorsiflexors represented significant (P < 0.05) increases in the exercise group compared with the control group. The results of this study suggest that it is possible to reduce peroneal and anterior tibial reaction times following a six week eccentric/concentric isokinetic training program in healthy ankles.
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Affiliation(s)
- S B Keles
- Department of Sports Medicine, Bursa Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
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