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Stuelcken MC, Hiller CE, Toohey L. Mechanisms of lateral ankle ligament sprains in professional netball: A systematic video analysis. Phys Ther Sport 2024; 69:8-14. [PMID: 38971091 DOI: 10.1016/j.ptsp.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/18/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVES To undertake a systematic analysis of 17 medical attention and time-loss lateral ankle ligament sprain (LALS) events from televised Australian professional netball games during the 2020-2023 seasons. DESIGN Case series. METHODS Three analysts independently assessed the video footage and then convened to review and discuss each case until a consensus was reached. RESULTS When in possession (7 cases) a player was commonly performing an agility-based manoeuvre to break free from an opponent and reposition themselves to be a passing option (5/7 cases). When out of possession (10 cases) a player was either attempting to intercept a pass (6 cases) or marking an opponent (4 cases). Players tended to land on the anterior one-third of the plantar surface of the foot - forefoot or shoe tip (7 cases). Players often landed on either the ground (7 cases) or the opponent's shoe then the ground (8 cases). In 9 cases the ankle-foot was considered to be in a neutral alignment in the frontal plane at landing. At the estimated index frame the players' weight tended to be all on the foot on the injured side (11 cases) or favouring the foot on the injured side (5 cases). Inversion and adduction was a common injury mechanism. Plantar-flexion was rarely involved. CONCLUSION Landing on the anterior one-third of the plantar surface of the foot and subsequent weight transference onto the injured limb side was more important than ankle-foot inversion at initial ground contact. Exercises involving external perturbations that challenge the control of frontal and transverse plane ankle-foot motion and improve proprioception, neuromuscular control, and dynamic balance are warranted.
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Affiliation(s)
- Max C Stuelcken
- School of Health, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia.
| | - Claire E Hiller
- Sydney School of Health Sciences, The University of Sydney, D18 Susan Wakil Health Building, Western Avenue, Camperdown NSW 2006, Australia.
| | - Liam Toohey
- University of Canberra Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, ACT, 2617, Australia.
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Ko D, Choi Y, Lee K. Effects of Peroneus Brevis versus Peroneus Longus Muscle Training on Muscle Function in Chronic Ankle Instability: A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:547. [PMID: 38470658 PMCID: PMC10930769 DOI: 10.3390/healthcare12050547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Chronic ankle instability (CAI) is a common injury that can occur in daily life or sporting events. Injuries to the anterior talofibular, posterior talofibular, and calcaneofibular ligaments are common, and the core of rehabilitation training involves strengthening the peroneus muscle. Many studies on rehabilitation training have focused on strengthening the peroneus brevis muscle, and few studies have focused on specific training to strengthen the peroneus longus muscle. Therefore, this study aims to investigate changes in the symptoms and functions of patients by applying training to strengthen the peroneus longus and peroneus brevis muscles. Home-based training and mobile monitoring were utilized for 12 weeks, divided into peroneus brevis training (PBT) and peroneus longus training (PLT), in 52 adult males with CAI. Participation was voluntary, with enrollment done through a bulletin board, and intervention training allocation was randomly assigned and conducted in a double-blind manner. This study was registered as a trial protocol (KCT 0008478). Foot and ankle outcome scores (FAOS), isokinetic ankle strength tests, and Y-balance tests were performed before and after the intervention. Both PLT and PBT significantly improved in FAOS, inversion, and eversion at angular velocities of 30°/s and 120°/s and in the anterior and posterolateral directions of the Y-balance test (p < 0.05). Interaction effects by time and group were not significant for the FAOS (p > 0.05). However, PLT improved eversion muscle strength and muscle power to a greater degree, compared with PBT, in the anterior and posterolateral directions of the Y-balance test (p < 0.05). In conclusion, both PLT and PBT were effective for CAI patients; in addition, PLT had greater potential for improving strength and balance.
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Affiliation(s)
- Dukhan Ko
- Department of Sports Science Convergence, Dongguk University, Seoul 04620, Republic of Korea;
| | - Yongchul Choi
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea
| | - Kyujin Lee
- Department of Instructor Education, College of Cultural Convergence, Jeonju University, Jeonju 55070, Republic of Korea
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Xu J, Goss DD, Saliba SA. A Novel Intrinsic Foot Muscle Strength Dynamometer Demonstrates Moderate-To-Excellent Reliability and Validity. Int J Sports Phys Ther 2023; 18:997-1008. [PMID: 37547834 PMCID: PMC10399096 DOI: 10.26603/001c.84310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Background Intrinsic foot muscle (IFM) weakness can result in reduced foot function, making it crucial for clinicians to track IFM strength changes accurately. However, assessing IFM strength can be challenging for clinicians, as there is no clinically applicable direct measure of IFM strength that has been shown to be reliable and valid with the foot on the ground. Purpose The purpose was to investigate the intra-rater and inter-rater reliability of a novel, budget-friendly IFM dynamometer and determine its agreement with a handheld dynamometer (HHD). The researchers also examined correlations of foot morphology and activity level to IFM strength. Study design Descriptive Laboratory Study. Methods Two assessors measured IFM strength of 34 healthy volunteers (4 male, 30 female; age=21.14±2.57, height=164.66 ±7.62 cm, mass=64.45±11.93 kg) on two occasions 6.62±0.78 days apart with the novel dynamometer to assess intra- and inter-rater reliability. The HHD was used to measure IFM in the first session in order to assess validity. Results For the novel dynamometer, intra- and inter-rater reliability was moderate-to-excellent (ICC = 0.73 - 0.95), and the majority of the strength tests were within the 95% limits of agreement with the HHD. Wider foot morphology and a higher number of days walking over the prior seven days had small but significant correlations with IFM strength (dominant foot r = 0.34, non-dominant foot r = 0.39; r = -0.33, -0.39 respectively). Conclusion This novel IFM dynamometer is a budget-friendly ($75) tool that was shown to be reliable and valid in a healthy population. Levels of evidence Level 3©The Author(s).
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Bestwick-Stevenson T, Toone R, Neupert E, Edwards K, Kluzek S. Assessment of Fatigue and Recovery in Sport: Narrative Review. Int J Sports Med 2022; 43:1151-1162. [PMID: 35468639 DOI: 10.1055/a-1834-7177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Fatigue is a phenomenon associated with decreases in both physical and cognitive performances and increases in injury occurrence. Competitive athletes are required to complete demanding training programs with high workloads to elicit the physiological and musculoskeletal adaptations plus skill acquisition necessary for performance. High workloads, especially sudden rapid increases in training loads, are associated with the occurrence of fatigue. At present, there is limited evidence elucidating the underlying mechanisms associating the fatigue generated by higher workloads and with an increase in injury risk. The multidimensional nature and manifestation of fatigue have led to differing definitions and dichotomies of the term. Consequently, a plethora of physiological, biochemical, psychological and performance markers have been proposed to measure fatigue and recovery. Those include self-reported scales, countermovement jump performance, heart rate variability, and saliva and serum biomarker analyses. The purpose of this review is to provide an overview of fatigue and recovery plus methods of assessments.
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Affiliation(s)
- Thomas Bestwick-Stevenson
- School of Medicine, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Rebecca Toone
- Mountain Biking, English Institute of Sport, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Emma Neupert
- School of Sport Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom of Great Britain and Northern Ireland
| | - Kimberley Edwards
- School of Medicine, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Stefan Kluzek
- School of Medicine, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
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Adillón C, Gallegos M, Treviño S, Salvat I. Ankle Joint Dorsiflexion Reference Values in Non-Injured Youth Federated Basketball Players: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11740. [PMID: 36142013 PMCID: PMC9517286 DOI: 10.3390/ijerph191811740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The aim of the present study was to establish ankle joint dorsiflexion reference values among youth federated basketball players. (2) Methods: Cross-sectional study. The participants were basketball players who belonged to youth basketball developmental teams (female and male) from under-12 (U12) to under-17 (U17) categories. Ankle joint dorsiflexion range of motion was evaluated with the weight-bearing lunge test through the Leg Motion system. The distance achieved was recorded in centimeters. (3) Results: 693 basketball players who met the eligibility criteria and volunteered to participate were included in the study. The mean (SD) of ankle joint dorsiflexion was 10.68 (2.44) cm and the reference values were: excessive hypomobility < 6.09 (0.54) cm; hypomobility 6.09 (0.88) cm-8.43 (0.77) cm; normal 8.44 (0.77)-13.11 (0.79) cm; hypermobility 13.11 (0.74)-15.44 (0.86) cm; and excessive hypermobility >15.44 (0.86) cm. (4) Conclusions: This study provides ankle joint dorsiflexion reference values in youth basketball players from 12 to under 17 years old.
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Affiliation(s)
- Cristina Adillón
- Faculty of Medicine and Health Sciences, Department of Medicine and Surgery, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43003 Tarragona, Spain
| | - Montse Gallegos
- Health Department, Catalan Basketball Federation, 08018 Barcelona, Spain
| | - Silvia Treviño
- Health Department, Catalan Basketball Federation, 08018 Barcelona, Spain
| | - Isabel Salvat
- Faculty of Medicine and Health Sciences, Department of Medicine and Surgery, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43003 Tarragona, Spain
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Khan B, Ikram M, Rehman SSU, Un Nisa Z. Urdu translation and cross-cultural validation of Cumberland Ankle Instability Tool (CAIT). BMC Musculoskelet Disord 2022; 23:443. [PMID: 35549689 PMCID: PMC9097047 DOI: 10.1186/s12891-022-05408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022] Open
Abstract
Background The Cumberland Ankle Instability Tool (CAIT) is a self-assessment tool for people with chronic ankle instability (CAI). This tool had been translated and validated in many languages but there is no Urdu version of CAIT available. Objective The aim was to translate the CAIT into the Urdu Language and determine its validity and reliability. Methods A standardized step-wise forward and backward translation process was followed. Content, construct, convergent validity, internal consistency, and test–retest reliability were determined. A pilot study was done on 10 patients with CAI. The final version was investigated in 120 patients (mean age 26.6 ± 4.8 yrs) with CAI for validity and test–retest reliability in which 105 participants filled the questionnaire in the second week. Internal consistency was calculated by Cronbach’s alpha. Intraclass correlation (ICC2,1) was calculated to assess test–retest reliability between two weeks. Standard error of measurement (SEM) and smallest detectable change (SDC) were calculated. Convergent validity was determined by correlating Urdu CAIT with the Foot and Ankle Outcome Score (FAOS) using Spearman’s correlation co-efficient. Factor analysis describes the structure of underlying factors. Results Content validity index was > 0.80 of each question. Internal consistency was acceptable (Cronbach’s alpha > 0.75). Convergent validity with FAOS total score showed a moderate negative correlation (r = -0.68) with U-CAIT and negatively correlated with subscales of FAOS. Test–retest reliability was excellent ICC2,1 > 0.80. Scree plot showed 3 factors > 1eigen value. Conclusion The Urdu version of CAIT is a valid and reliable assessment tool for patients with chronic ankle instability. It has good content validity, construct validity and reliability. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05408-4.
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Affiliation(s)
- Basma Khan
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan
| | - Mehwish Ikram
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan.
| | - Syed Shakil Ur Rehman
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan
| | - Zaib Un Nisa
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Lahore Campus, Pakistan
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Sánchez-Barbadora M, Cuerda-Del Pino A, González-Rosalén J, Moreno-Segura N, Escriche-Escuder A, Martín-San Agustín R. Differences in lower limb muscle activation between global and selective instability devices in single-leg stance in healthy active subjects. PeerJ 2022; 10:e13317. [PMID: 35462768 PMCID: PMC9022643 DOI: 10.7717/peerj.13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/01/2022] [Indexed: 01/13/2023] Open
Abstract
Background Balance and strength training are frequent strategies to address lower limb injuries, including ankle injuries, which are usually performed in single-leg stance on global instability devices, producing generalized muscular activation of the lower limb. In this context, new specific instability devices arise from the need to selectively work the ankle, specifically the peroneus longus. This study aimed to compare the EMG muscle activation of the peroneus longus, as well as other lower limbs muscles, in a single-leg stance on different balance training devices (BOSU, wobble board, power board, and Blackboard) in standing or squatting positions. Methods Twenty healthy recreationally trained subjects participated in the study. Subjects performed three repetitions of 15 s (one for familiarization and two for measurement) in standing and squatting positions on the floor, BOSU, wobble board, power board, and Blackboard. Surface electromyography (EMG) was used to record activity of the peroneus longus, soleus, gastrocnemius medialis, tibialis anterior, rectus femoris, and gluteus maximus. Results The main outcome was that no differences were found for the peroneus longus normalized EMG, neither between devices (p = 0.09) nor between conditions (p = 0.11), nor in the interaction between them (p = 0.16). For the normalized EMG of the other muscles, there were multiple differences between devices and conditions. Of the devices studied, the Blackboard was the one that implied a lower activation of the lower limb muscles and a lower degree of instability, activating the peroneus longus similarly to global instability devices. The BOSU and wobble board achieved high levels of EMG muscle activation for most muscles of the lower limbs. Therefore, they should be considered as potential devices for work in highly unstable conditions or when high activation levels are sought.
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Affiliation(s)
| | | | | | | | - Adrian Escriche-Escuder
- Physiotherapy, University of Malaga, Malaga, Spain,Faculty of Health Sciences, Universidad Internacional de Valencia—VIU, Valencia, Spain
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Labanca L, Mosca M, Ghislieri M, Agostini V, Knaflitz M, Benedetti MG. Muscle activations during functional tasks in individuals with chronic ankle instability: a systematic review of electromyographical studies. Gait Posture 2021; 90:340-373. [PMID: 34564008 DOI: 10.1016/j.gaitpost.2021.09.182] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND It has been reported that individuals with chronic ankle instability (CAI) show motor control abnormalities. The study of muscle activations by means of surface electromyography (sEMG) plays a key role in understanding some of the features of movement abnormalities. RESEARCH QUESTION Do common sEMG activation abnormalities and strategies exists across different functional movements? METHODS Literature review was conducted on PubMed, Web-of-Science and Cochrane databases. Studies published between 2000 and 2020 that assessed muscle activations by means of sEMG during any type of functional task in individuals with CAI, and used healthy individuals as controls, were included. Methodological quality was assessed using the modified Downs&Black checklist. Since the methodologies of different studies were heterogeneous, no meta-analysis was conducted. RESULTS A total of 63 articles investigating muscle activations during gait, running, responses to perturbations, landing and hopping, cutting and turning; single-limb stance, star excursion balance task, forward lunges, ball-kicking, y-balance test and single-limb squatting were considered. Individuals with CAI showed a delayed activation of the peroneus longus in response to sudden inversion perturbations, in transitions between double- and single-limb stance, and in landing on unstable surfaces. Apparently, while walking on ground there are no differences between CAI and controls, walking on a treadmill increases the variability of muscles activations, probably as a "safety strategy" to avoid ankle inversion. An abnormal activation of the tibialis anterior was observed during a number of tasks. Finally, hip/spine muscles were activated before ankle muscles in CAI compared to controls. CONCLUSION Though the methodology of the studies herein considered is heterogeneous, this review shows that the peroneal and tibialis anterior muscles have an abnormal activation in CAI individuals. These individuals also show a proximal muscle activation strategy during the performance of balance challenging tasks. Future studies should investigate whole-body muscle activation abnormalities in CAI individuals.
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Affiliation(s)
- Luciana Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Massimiliano Mosca
- II Clinic of Orthopaedics and Traumatology, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Ghislieri
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy; PoliTo(BIO)MedLab, Politecnico di Torino, Torino, Italy
| | - Valentina Agostini
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy; PoliTo(BIO)MedLab, Politecnico di Torino, Torino, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy; PoliTo(BIO)MedLab, Politecnico di Torino, Torino, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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