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Oh M, Lee H, Han S, Bruening DA, Seeley MD, Hopkins JT. Effects of Chronic Pain on Static and Dynamic Postural Control in Chronic Ankle Instability. Clin J Sport Med 2024:00042752-990000000-00203. [PMID: 38967593 DOI: 10.1097/jsm.0000000000001248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/11/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE To identify the effects of chronic pain levels on static and dynamic postural (DP) control in individuals with chronic ankle instability (CAI). DESIGN Cross-sectional study. SETTING Controlled laboratory. PARTICIPANTS Sixty participants were divided into the following 3 groups: 20 high pain individuals with CAI (high pain), 20 low pain individuals with CAI (low pain), and 20 healthy controls (control). INDEPENDENT VARIABLES Groups (CAI with high pain, CAI with low pain, and control) and visual conditions (eyes open and closed) for single-leg stance. MAIN OUTCOME MEASURES Participants performed single-leg stance with eyes open and closed, the star excursion balance test, and single-leg hop to stabilization. RESULTS The high pain group experienced worse self-reported outcomes, including Foot and Ankle Ability Measure activities of daily living and sports, than the low pain and control groups. Regardless of visual condition, both the high and low pain groups exhibited decreased static postural control in mediolateral (ML) compared with the control group. Specifically, the high pain group showed decreased static postural control in ML under closed eyes compared with the low pain and the control groups. The high pain group showed less reach distance than the control group and increased DP control in vertical and overall DP stability index compared with the low and control groups. CONCLUSIONS Chronic pain can significantly affect both static and DP control in individuals with CAI. Therefore, clinicians should consider chronic pain as one of the factors affecting postural control in individuals with CAI.
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Affiliation(s)
- Minsub Oh
- Department of Exercise Science, Brigham Young University, Provo, Utah
| | - Hyunwook Lee
- Department of Exercise Science, Brigham Young University, Provo, Utah
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and
| | - Seunguk Han
- Department of Exercise Science, Brigham Young University, Provo, Utah
- Division of Sport Science, Pusan National University, Busan, South Korea
| | - Dustin A Bruening
- Department of Exercise Science, Brigham Young University, Provo, Utah
| | - Matthew D Seeley
- Department of Exercise Science, Brigham Young University, Provo, Utah
| | - J Ty Hopkins
- Department of Exercise Science, Brigham Young University, Provo, Utah
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Miyachi R, Kanazawa Y, Fujii Y, Kitagawa T, Yamazaki T. Effects of 6 weeks of whole-body vibration training on ankle motor control: a randomized controlled trial. J Sports Med Phys Fitness 2024; 64:676-684. [PMID: 38916091 DOI: 10.23736/s0022-4707.24.15788-x] [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: 06/26/2024]
Abstract
BACKGROUND Interventions on ankle motor control are important to prevent recurrent ankle sprains. Training using whole-body vibration may easily and effectively improve ankle motor control, but the effects have not been investigated. Therefore, this study aimed to clarify the effects of 6 weeks of training with whole-body vibration on ankle motor control in a dynamic movement task among healthy participants. METHODS Twenty healthy university students (6 males and 14 females) were randomly allocated to whole-body vibration training and control groups, with 10 participants in each group. The training was performed twice a week for 6 weeks in both groups. Primary outcome was mean ankle angular jerk cost in the star excursion balance test. Secondary outcomes were maximum ankle motion angle and maximum reach distance in the star excursion balance test, ankle proprioception, and range of ankle dorsiflexion motion in the loaded position. RESULTS There was a significant group × period (pre- and postintervention) interaction for mean ankle angular jerk cost in the direction of ankle abduction/adduction during posterolateral reaching, which was significantly lower at postintervention than that at preintervention in the whole-body vibration group In the whole-body vibration group, the maximum ankle dorsiflexion motion angle during anterior and posterolateral reaching was significantly higher at postintervention than that at preintervention. CONCLUSIONS Training with whole-body vibration improves ankle motor control in dynamic movement tasks, although the direction of reach and plane of motion are limited. Additionally, training with whole-body vibration is also effective in increasing the ankle dorsiflexion angle during dynamic movement tasks.
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Affiliation(s)
- Ryo Miyachi
- Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, Japan -
| | - Yuji Kanazawa
- Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, Japan
| | - Yoshinari Fujii
- Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, Japan
| | - Takashi Kitagawa
- School of Health Sciences, Department of Physical Therapy, Shinshu University, Matsumoto, Japan
| | - Toshiaki Yamazaki
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
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Heß T, Milani TL, Kilper A, Mitschke C. Immediate Effects of Wearing an Ankle Bandage on Fine Coordination, Proprioception, Balance and Gait in the Subacute Phase of Ankle Sprains. Life (Basel) 2024; 14:810. [PMID: 39063565 PMCID: PMC11277678 DOI: 10.3390/life14070810] [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: 05/29/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Ankle sprains are the most frequently occurring musculoskeletal injuries among recreational athletes. Ankle support through bandages following the initial orthotic treatment might be beneficial for rehabilitation purposes. However, the literature is sparse regarding the use of an ankle support directly after the acute phase of an ankle sprain. Therefore, this study investigates the hypothesis that wearing an ankle bandage immediately after an acute ankle sprain improves motor performance, stability and reduces pain. In total, 70 subjects with acute unilateral supination trauma were tested. Subjects were tested five weeks post-injury to assess immediate effects of the ankle bandage. On the testing day, subjects completed rating questionnaires and underwent comprehensive biomechanical assessments. Biomechanical investigations included fine coordination and proprioception tests, single leg stances, the Y-Balance test, and gait analysis. All biomechanical investigations were conducted for the subject's injured leg with and without a bandage (MalleoTrain® Bauerfeind AG, Zeulenroda-Triebes, Germany) and the healthy leg. Results indicated moderate to strong improvements in ankle stability and pain relief while wearing the bandage. Wearing the bandage significantly normalized single leg stance performance (p < 0.001), stance phase duration (p < 0.001), and vertical ground reaction forces during walking (p < 0.05). However, the bandage did not have a clear effect on fine coordination and proprioception. The findings of our study suggest that ankle bandages may play a crucial role in early-stage rehabilitation by enhancing motor performance and reducing pain.
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Affiliation(s)
- Tobias Heß
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Thomas L. Milani
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Anica Kilper
- Medical Center of Chemnitz, Department of Orthopaedics, Trauma and Hand Surgery, 09116 Chemnitz, Germany
| | - Christian Mitschke
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
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Olszewski M, Zając B, Mika A, Golec J. Ankle dorsiflexion range of motion and hip abductor strength can predict Lower Quarter Y-Balance Test performance in healthy males. J Bodyw Mov Ther 2024; 38:567-573. [PMID: 38763610 DOI: 10.1016/j.jbmt.2024.03.053] [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: 09/13/2023] [Revised: 03/08/2024] [Accepted: 03/18/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES The aim of the study was to assess whether strength and range of motion (ROM) of the hip and ankle are the factors determining performance in the Lower Quarter Y-Balance test (YBT-LQ). DESIGN Cross-sectional study. PARTICIPANTS 66 healthy males (age: 25.2±6.8 years) participated in this study. MAIN OUTCOME MEASURES Participants underwent assessments of ankle dorsiflexion (DF) ROM, hip internal rotation (IR) ROM, external rotation (ER) ROM and isometric strength of hip abductor (ABD), extensor (EXT) and external rotators (ERS) muscles together with YBT-LQ for both legs. A forward 2-steps multiple linear regression analysis was conducted to examine the relationship between the predictor variables and the criterion variable. RESULTS Ankle DF ROM predicted anterior (ANT) reach (R2 = 0.49; R2 = 0.33; p < 0.001). The model with hip ABD strength and ankle DF ROM explained posteromedial (PM) reach variance for stance leg (R2 = 0.35; p < 0.001), while only hip ABD strength was included for kicking leg (R2 = 0.19; p = 0.007). The model with ankle DF ROM and hip ABD strength explained posterolateral (PL) reach for stance leg (R2 = 0.41; p < 0.001). Hip ABD was the only predictor for kicking leg PL reach (R2 = 0.15; p < 0.001). YBT-LQ composite score was explained by ankle DF ROM and hip ABD strength for both legs (R2 = 0.44; p < 0.001) and (R2 = 0.25; p = 0.002). CONCLUSION Hip ABD strength and ankle DF ROM can determine performance in the YBT-LQ. Strength of hip EXT, ERS as well as ROM of hip IR and ER did not predict YBT-LQ performance.
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Affiliation(s)
- Maciej Olszewski
- Doctoral School, University of Physical Education in Kraków, 31-571, Kraków, Poland.
| | - Bartosz Zając
- Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education in Kraków, 31-571, Kraków, Poland
| | - Anna Mika
- Institute of Clinical Rehabilitation, University of Physical Education, 31-571, Kraków, Poland
| | - Joanna Golec
- Institute of Rehabilitation in Traumatology, University of Physical Education in Kraków, 31-571, Kraków, Poland
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Xue X, Yu L, Zheng S, Gu X, Na Y, Xia T, Jue H, Chen T, Li H, Li H, Wang R, Hua Y. Insufficient recovery of proprioception in chronic ankle instability after surgical restabilization: A systematic review. Asia Pac J Sports Med Arthrosc Rehabil Technol 2024; 35:48-58. [PMID: 38204486 PMCID: PMC10776890 DOI: 10.1016/j.asmart.2023.11.005] [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: 07/25/2023] [Revised: 10/16/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024] Open
Abstract
Surgical repair or reconstruction of the lateral ligaments for patients with chronic ankle instability (CAI) could, logically, restore the proprioception of ankle through retensing receptors. To validate this hypothesis, seven databases were systematically searched, and thirteen studies comprising a total of 347 patients with CAI were included. Although five studies reported improved proprioceptive outcomes after surgeries, the other five studies with between-limb/group comparisons reported residual deficits at final follow-up, which does not consistently support proprioceptive recovery after existing surgical restabilization for CAI. More controlled studies are needed to provide evidence-based protocols to improve proprioceptive recovery after ankle restabilization for CAI.
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Affiliation(s)
- Xiao'ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Le Yu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Shanshan Zheng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xicheng Gu
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyan Na
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tian Xia
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hao Jue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tianwu Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongyun Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ru Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Jamshidi AH, Mofateh R, Orakifar N, Seyedtabib M, Najarzadeh Z, Behdarvandan A. Immediate effects of local muscle vibration on static and dynamic balance control in individuals with chronic ankle instability. Phys Ther Sport 2024; 65:113-121. [PMID: 38128288 DOI: 10.1016/j.ptsp.2023.11.008] [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: 08/10/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES To investigate the immediate effects of local muscle vibration (LMV) on static and dynamic balance control in individuals with and without chronic ankle instability (CAI). DESIGN Quasi-experimental study. SETTING Research laboratory. PARTICIPANTS Twenty-six individuals with CAI and 26 healthy controls. MAIN OUTCOME MEASURES Center of pressure variables (mean total velocity and displacement in anteroposterior (AP) and mediolateral (ML) directions) during single-leg standing with eyes open and eyes closed and also reach distances in anterior (ANT), posteromedial (PM), and posterolateral (PL) directions of the modified star excursion balance test (MSEBT) were assessed before and after LMV. RESULTS Statistical analyses showed a significant decrease in mean total velocity and displacement in AP direction from before to after LMV in eyes open condition for both individuals with CAI (p = 0.025, p = 0.041, respectively) and healthy controls (p = 0.001, p = 0.003, respectively). Similar results were observed in eyes closed condition for both individuals with CAI (p < 0.001, p < 0.001, respectively) and healthy controls (p = 0.040, p = 0.014, respectively). The results also showed increased reach distances in ANT (p < 0.001), PM (p < 0.001), and PL directions (p < 0.001) in all participants after LMV. CONCLUSION Our results suggest that LMV may be a useful tool in rehabilitation of static and dynamic balance deficits in individuals with CAI.
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Affiliation(s)
- Amir Hossein Jamshidi
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Student Research Committee, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Razieh Mofateh
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Neda Orakifar
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Maryam Seyedtabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zahra Najarzadeh
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Amin Behdarvandan
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Wang L, Yu G, Zhang X, Wang YZ, Chen YP. Relationship between ankle pain, range of motion, strength and balance in individuals with functional ankle instability: a cross-sectional study. BMC Musculoskelet Disord 2023; 24:955. [PMID: 38066472 PMCID: PMC10704625 DOI: 10.1186/s12891-023-07079-1] [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: 08/20/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND About 15-60% of individuals with ankle sprains may develop functional ankle instability (FAI), which is characterised by ankle pain, decreased muscle strength, limited range of motion, and impaired balance, causing a decline in social activity and quality of life. However, the relationship between those characters is still unclear. This study aimed to investigate whether a relationship existed between ankle pain, active range of motion (AROM), strength and balance and if ankle pain, AROM and strength can predict balance in individuals with FAI. METHODS Seventy-seven subjects (46 males; 31 females) with unilateral FAI participated in this study. Ankle pain was measured by the visual analogue scale (VAS), ankle AROM was measured using a universal goniometer, ankle strength was measured using a handheld dynamometer, the static balance was measured by the Time in Balance Test (TBT) and the dynamic balance was measured by the modified Star Excursion Balance Test (mSEBT). Pearson product-moment correlations were used to determine the correlations between ankle pain, AROM, strength and balance. Multiple linear regressions were used to investigate if ankle pain, AROM and strength can predict balance in individuals with FAI. RESULTS VAS and AROM-plantarflexion predicted 25.6% of the TBT (f2 = 0.344, P < 0.001). AROM-dorsiflexion predicted 24.6% of the mSEBT-anterior reach (f2 = 0.326, P < 0.001). VAS, AROM-plantarflexion and strength-plantarflexion predicted 33.5% of the mSEBT-posteromedial reach (f2 = 0.504, P < 0.001). AROM-plantarflexion and strength-plantarflexion predicted 28.2% of the mSEBT-posterolateral reach (f2 = 0.393, P < 0.001). CONCLUSION This study shows that ankle plantarflexion strength, AROM of dorsiflexion and plantarflexion and pain are predictors of balance in individuals with FAI. These factors could be considered in the rehabilitation of FAI. TRIAL REGISTRATION Trial registration number: ChiCTR2200063532.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Ge Yu
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Xi Zhang
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Yu-Zhang Wang
- Department of Rehabilitation Medicine, Beijing Jishuitan Hospital of Capital Medical University, 31 Xinjiekou East Street, Beijing, 100035, China
| | - Ya-Ping Chen
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China.
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Kobayashi T, Kodesho T, Kinami K, Takahashi A, Taniguchi K, Taniguchi K. Characteristics of the static muscle stiffness of ankle plantar flexors in individuals with chronic ankle instability. J Med Ultrason (2001) 2023; 50:561-570. [PMID: 37640966 DOI: 10.1007/s10396-023-01360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Individuals with chronic ankle instability (CAI) have deficits in closed kinetic chain dorsiflexion that may perpetuate injury. Determining the characteristics of muscle stiffness in the plantar flexors of individuals with CAI may help in developing appropriate treatments. We aimed to highlight the characteristics of static muscle stiffness in ankle plantar flexor muscles during the passive dorsiflexion of the ankle joint in individuals with CAI. METHODS A total of 30 patients were included in the study based on the International Ankle Consortium criteria. The patients were categorized evenly into healthy, coper, and CAI groups (i.e., 10 patients in each group). After measuring the dorsiflexion range of motion (non-weight-bearing/weight-bearing) of the ankle joint, the static muscle stiffness measurements of the medial gastrocnemius, lateral gastrocnemius, soleus, and peroneus longus were obtained. The measurements were performed during the knee joint's extension and 50° flexion and passive dorsiflexion between the range of 40° plantar flexion and 20° dorsiflexion. RESULTS The dorsiflexion range of motion of the CAI group was significantly smaller than that of the healthy and coper groups in the weight-bearing position. No interaction was observed for muscle stiffness in both the knee flexion and extension positions, and no significant differences were identified among the three groups. The shear modulus of the soleus at 20° ankle dorsiflexion with knee flexion had a significant negative correlation with the weight-bearing range of motion of the ankle. CONCLUSION The limitation in the weight-bearing dorsiflexion range of motion in CAI was largely due to factors other than the increased elasticity of the ankle plantar flexor muscles.
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Affiliation(s)
- Takumi Kobayashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan.
| | - Taiki Kodesho
- Department of Sport Science and Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
| | - Keita Kinami
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Ayuka Takahashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Konatsu Taniguchi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Gribble PA, Bain KA, Davidson CD, Hoch MC, Kosik KB. Yoga as a balance intervention for middle-age and older adults with history of lateral ankle sprain: An exploratory study. J Bodyw Mov Ther 2023; 35:190-195. [PMID: 37330768 DOI: 10.1016/j.jbmt.2023.04.010] [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: 04/30/2021] [Revised: 09/20/2022] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Balance deficiencies are common among aging adults. Musculoskeletal injuries such as lateral ankle sprains (LAS) also contribute to compromised balance; potentially amplifying the postural insufficiencies in these age groups with a history of LAS. Yoga has emerged as an effective balance training intervention for aging adults; but limited application exists in these age cohorts with LAS history. This study may provide important guidance for the implementation of this intervention in these populations. METHODS In this cohort design study, middle-age and older adults with a history of LAS completed an 8-week beginner-level yoga class. Balance was measured before and after the yoga intervention statically (force plate) and dynamically (star excursion balance test [SEBT]) using single-limb balance tasks. RESULTS Following the yoga intervention, older adults improved static postural control in the anterior-posterior direction, as well as dynamic postural control in selected reach directions of the SEBT relative to the middle-age adults. CONCLUSION This is an important step in exploring how to help the aging population that likely has amplifications in balance deficiencies due to a common musculoskeletal injury, LAS. While more work is needed to determine how to optimize and document balance improvements in aging adults with LAS history, yoga appears to be a promising form of intervention, particularly for older adults.
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Affiliation(s)
| | | | | | | | - Kyle B Kosik
- University of Kentucky, College of Health Sciences, USA
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Yoshida K, Kuramochi R, Shinohara J. Effect of a Balance Adjustment System on Postural Control in Patients with Chronic Ankle Instability. Int J Sports Phys Ther 2023; V18:636-644. [PMID: 37425119 PMCID: PMC10324292 DOI: 10.26603/001c.74722] [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: 11/15/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background/Purpose This study aimed to evaluate how a two-week program using the in-phase mode of a balance adjustment system (the BASYS) affected postural control in participants with chronic ankle instability (CAI). It was hypothesized that the in-phase mode on the BASYS would lead to improved postural control compared with training on a balance disc. Study Design Randomized control trial. Methods Twenty participants with CAI were recruited. The participants were divided into two intervention groups: the BASYS (n = 10) and Balance Disc (BD; cushion type, n = 10). All participants underwent six supervised training sessions over a two-week period. Static postural control during single leg standing with closed eyes was assessed for the CAI limb. We collected COP data while participants balanced on the BASYS. The test was performed for 30 sec, and the total trajectory length and 95% ellipse area were calculated. In the assessment of dynamic postural stability, Y-Balance tests-anterior, posteromedial, and posterolateral directions were measured on the CAI limb for all participants and normalized to the individual's leg length. Participants were recorded at three instances: pretraining (Pre), post-training 1 (Post1: after the first training), and post-training 2 (Post2: after the last training). Results There was an effect on time in the COP total trajectory length of the BASYS group, which was significantly decreased for Post 1 and Post 2 than for the Pre (p = 0.001, 0.0001). Group differences and time-by-group interactions were not observed for either of the Y-balance test reach distances. Conclusions The study's primary finding was that two weeks of intervention in the in-phase mode on the BASYS improved static postural control in participants with CAI. Level of Evidence Level Ⅰ, randomized control trial.
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Affiliation(s)
- Kazushi Yoshida
- Graduate School of Health and Sports Sciences Chukyo University
| | - Rieko Kuramochi
- Graduate School of Health and Sports Sciences Chukyo University
- School of Health and Sports Sciences Chukyo University
| | - Junji Shinohara
- Graduate School of Health and Sports Sciences Chukyo University
- School of Health and Sports Sciences Chukyo University
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Kwon YU. Lower Extremity Muscle Activation during the Star Excursion Balance Test in Patients with Chronic Ankle Instability and Copers. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1040. [PMID: 37374243 DOI: 10.3390/medicina59061040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: The aim of this study was to assess the impact of ankle muscles on performance of the Star Excursion Balance Test (SEBT) among individuals with stable ankles, a history of ankle sprain, and chronic ankle instability (CAI). Materials and Methods: Sixty subjects (twenty per group) performed the SEBT in each of the anterior (A), posteromedial (PM), and posterolateral (PL) directions. Normalized maximum reach distance (NMRD) and normalized mean amplitude of the tibialis anterior (NMA_TA), fibularis longus (NMA_FL), and medial gastrocnemius (NMA_MG) were measured during performance of the SEBT. Results: Copers have greater NMRD than subjects with stable ankles and those with CAI, and subjects with stable ankles also have greater NMRD than those with CAI in only the PL direction. Subjects with stable ankles and those with CAI showed greater NMA_TA than copers. The A direction showed greater NMA_TA than the PM and PL directions. Copers showed greater NMA_FL than subjects with stable ankles. Subjects with CAI showed greater NMA_MG than copers and subjects with stable ankles. The A and PL directions showed greater NMA_MG than the PM direction. Conclusions: Overall, copers and/or subjects with CAI demonstrated altered neuromuscular function by compensating for their ankle muscles when compared to subjects with stable ankles due to a history of ankle sprain.
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Affiliation(s)
- Yong Ung Kwon
- Department of Sports Science, Chung-Ang University, Anseong 17546, Republic of Korea
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Tourillon R, Bothorel H, McKeon PO, Gojanovic B, Fourchet F. Effects of a Single Electrical Stimulation Session on Foot Force Production, Foot Dome Stability, and Dynamic Postural Control. J Athl Train 2023; 58:51-59. [PMID: 35142810 PMCID: PMC9913059 DOI: 10.4085/1062-6050-0561.21] [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: 11/09/2022]
Abstract
CONTEXT Mounting evidence suggests neuromuscular electrical stimulation (NMES) as a promising modality for enhancing lower limb muscle strength, yet the functional effects of a single electrical stimulation session for improving the function of the intrinsic foot muscles (IFM) has not been evaluated. OBJECTIVE To investigate the immediate effects of an NMES session compared with a sham stimulation session on foot force production, foot dome stability, and dynamic postural control in participants with static foot pronation. DESIGN Randomized controlled clinical trial. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 46 participants (23 males, 23 females) with static foot pronation according to their Foot Posture Index (score ≥ 6) were randomly assigned to an NMES (n = 23) or control (n = 23) group. INTERVENTION(S) The NMES group received a single 15-minute NMES session on the dominant foot across the IFM. The control group received a 15-minute sham electrical stimulation session. MAIN OUTCOME MEASURE(S) All outcome measurements were assessed before and after the intervention and consisted of foot force production on a pressure platform, foot dome stability, and dynamic postural control. Statistical analysis was based on the responsiveness of the outcome measures and responder analysis using the minimum detectable change scores for each outcome measure. RESULTS In the NMES group, 78% of participants were classified as responders for at least 2 of the 3 outcomes, compared with only 22% in the control group. The relative risk of being a responder in the NMES group compared with the control group was 3.6 (95% CI = 1.6, 8.1]. Interestingly, we found that all participants who concomitantly responded to foot strength and navicular drop (n = 8) were also responders in dynamic postural control. CONCLUSIONS Compared with a sham stimulation session, a single NMES session was effective in immediately improving foot function and dynamic postural control in participants with static foot pronation. These findings support the role of NMES for improving IFM function in this population.
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Affiliation(s)
- Romain Tourillon
- UJM-Saint-Etienne Interuniversity Laboratory of Human Movement Biology, EA 7424, University of Lyon, France
- Motion Analysis Lab, Physiotherapy and Sports Medicine Department, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - Hugo Bothorel
- Research Department, La Tour Hospital, Meyrin, Switzerland
| | - Patrick O. McKeon
- Department of Exercise Science and Athletic Training, Ithaca College, NY
| | - Boris Gojanovic
- Motion Analysis Lab, Physiotherapy and Sports Medicine Department, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - François Fourchet
- UJM-Saint-Etienne Interuniversity Laboratory of Human Movement Biology, EA 7424, University of Lyon, France
- Motion Analysis Lab, Physiotherapy and Sports Medicine Department, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
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Cao S, Tang Z, Wang C, Huang P, Zhang C, Huang J, Wang X, Ma X. Dynamic Reach Deficit Is a Predictive Factor of Inferior Outcomes After Modified Broström Procedure for Lateral Ankle Instability. Foot Ankle Int 2022; 43:1460-1464. [PMID: 36000205 DOI: 10.1177/10711007221115716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Only a few studies have analyzed functional predictive factors for inferior outcomes after modified Broström procedure (MBP). The aim of the current study is to identify the influence of the preoperative dynamic reach deficit on the surgical outcomes of MBP. METHODS Sixty-one patients with lateral ankle instability who underwent MBP were included in the current study and followed up for a median of 24 months. The Karlsson scores and the reaches of the Star Excursion Balance Test (SEBT) were evaluated before surgery and during the last follow-up. A total of 19 prognostic factors were analyzed. The relationship between the variables and inferior outcomes (Karlsson score < 90) in the bivariate analysis was tested through the Mann-Whitney U test or the Fisher exact test. A multivariate logistic regression model was developed to investigate the influence of the selected factors on inferior outcomes. RESULTS Thirty-two of the patients had superior outcomes, and the rest had inferior outcomes. The age, gender, and body mass index of the groups with superior and inferior outcomes did not differ. Preoperative dynamic reach deficit (P = .032), osteochondral lesion of the talus (P = .004), and decreased preoperative Karlsson score (P = .004) were independent predictors of inferior outcomes. CONCLUSION Patients with preoperative dynamic reach deficit, osteochondral lesion of the talus, or decreased preoperative Karlsson score have inferior outcomes after MBP. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Shengxuan Cao
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | | | - Chen Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Huang
- Department of Orthopedics, Ruijin Hospital, Shanghai, China.,Shanghai Institute of Traumatology and Orthopaedics, Shanghai Jiao Tong University, Shanghai, China
| | - Chao Zhang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiazhang Huang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
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Aguilaniu A, Croisier JL, Schwartz C, Dardenne N, D'Hooghe P, Martens G, Collin R, Kaux JF. Current practice for safe return-to-play after lateral ankle sprain: A survey among French-speaking physicians. Foot Ankle Surg 2022; 28:307-312. [PMID: 33858759 DOI: 10.1016/j.fas.2021.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/03/2021] [Accepted: 03/30/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recommendations are available for assessment criteria for safe return-to-play (RTP) after a lateral ankle sprain. However, their current use among physicians is unknown. METHODS French-speaking physicians in Belgium, France and Switzerland were asked to complete an online survey and report their clinical assessment of selected RTP criteria. RESULTS The respondent sample (n=109) included physicians with and without Sports Medicine education, varied level of experience and proportion of athletes in their practice population. Pain was the most selected criterion for safe RTP (90% of physicians), followed by ability to engage in functional tasks (82%), functional instability (73%), range of motion (61%), proprioception (47%), mechanical instability (39%), strength (38%) and swelling (31%). A low proportion of physicians use quantitative measures to assess these criteria (between 4% and 53%). CONCLUSIONS A large proportion of physicians consider the recommended criteria for RTP decisions. However, physicians do not frequently use quantitative measures.
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Affiliation(s)
- Aude Aguilaniu
- University of Liège, Sports Sciences Department, Human Motion Analysis Lab, Liège, Belgium.
| | - Jean-Louis Croisier
- University of Liège, Sports Sciences Department, Human Motion Analysis Lab, Liège, Belgium; Central University Hospital of Liège, Physical Medicine and Sports Traumatology Department, SportS(2), FIFA Medical Centre of Excellence, FIMS Collaborative Centre Sports Medicine, French-speaking Research Network for Athlete Health Protection & Performance (ReFORM) - IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
| | - Cédric Schwartz
- University of Liège, Sports Sciences Department, Human Motion Analysis Lab, Liège, Belgium; Central University Hospital of Liège, Physical Medicine and Sports Traumatology Department, SportS(2), FIFA Medical Centre of Excellence, FIMS Collaborative Centre Sports Medicine, French-speaking Research Network for Athlete Health Protection & Performance (ReFORM) - IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
| | - Nadia Dardenne
- University of Liège, Public Health and Biostatistics Department, Liège, Belgium
| | - Pieter D'Hooghe
- Aspetar Hospital, Orthopaedic Surgery and Sports Medicine Department, Doha, Qatar
| | - Géraldine Martens
- Central University Hospital of Liège, Physical Medicine and Sports Traumatology Department, SportS(2), FIFA Medical Centre of Excellence, FIMS Collaborative Centre Sports Medicine, French-speaking Research Network for Athlete Health Protection & Performance (ReFORM) - IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
| | - Romain Collin
- Central University Hospital of Liège, Physical Medicine and Sports Traumatology Department, SportS(2), FIFA Medical Centre of Excellence, FIMS Collaborative Centre Sports Medicine, French-speaking Research Network for Athlete Health Protection & Performance (ReFORM) - IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
| | - Jean-François Kaux
- University of Liège, Sports Sciences Department, Human Motion Analysis Lab, Liège, Belgium; Central University Hospital of Liège, Physical Medicine and Sports Traumatology Department, SportS(2), FIFA Medical Centre of Excellence, FIMS Collaborative Centre Sports Medicine, French-speaking Research Network for Athlete Health Protection & Performance (ReFORM) - IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
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A pilot randomised control trial of the efficacy of stability-based training with visualisation for people with chronic ankle instability. Med Biol Eng Comput 2022; 60:1199-1209. [PMID: 35247167 PMCID: PMC8933360 DOI: 10.1007/s11517-022-02533-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022]
Abstract
Chronic ankle instability (CAI) is associated with recurring symptoms that inhibit daily activity. Stability-based rehabilitative training is recommended for CAI. Visualisation (VIS) produces real-time feedback using motion capture and virtual reality. This pilot study aimed to determine the feasibility, adherence, safety, and efficacy of incorporating VIS into stability training for people with CAI. Efficacy was examined through effect of VIS training on dynamic stability, perception of stability, and rehabilitative experience. Individuals with CAI completed a 4-week stability-based training programme with VIS, or without visualisation (NO-VIS). Participants completed the Star Excursion Balance Test (SEBT) and Cumberland Ankle Instability Tool (CAIT) prior to, and after training. Enjoyment of training was recorded using the Physical Activity Enjoyment Scale (PACES-8). Of 17 participants (VIS = 10, NO-VIS = 7), there were 2 drop outs (VIS = 1, NO-VIS = 1). No adverse events were reported, and participant drop-out was due to injury unrelated to the study. The VIS group showed a significantly greater increase in average SEBT reach distance (d = 1.7, p = 0.02). No significant differences were reported for the CAIT or PACES-8. This study supports the feasibility and safety of stability-based training with VIS in those with CAI. The enhanced performance outcome on the SEBT suggests VIS may enhance stability-based training.
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Willemse L, Wouters EJM, Bronts HM, Pisters MF, Vanwanseele B. The effect of interventions anticipated to improve plantar intrinsic foot muscle strength on fall-related dynamic function in adults: a systematic review. J Foot Ankle Res 2022; 15:3. [PMID: 35057831 PMCID: PMC8772142 DOI: 10.1186/s13047-021-00509-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/28/2021] [Indexed: 12/30/2022] Open
Abstract
Background The plantar intrinsic foot muscles (PIFMs) have a role in dynamic functions, such as balance and propulsion, which are vital to walking. These muscles atrophy in older adults and therefore this population, which is at high risk to falling, may benefit from strengthening these muscles in order to improve or retain their gait performance. Therefore, the aim was to provide insight in the evidence for the effect of interventions anticipated to improve PIFM strength on dynamic balance control and foot function during gait in adults. Methods A systematic literature search was performed in five electronic databases. The eligibility of peer-reviewed papers, published between January 1, 2010 and July 8, 2020, reporting controlled trials and pre-post interventional studies was assessed by two reviewers independently. Results from moderate- and high-quality studies were extracted for data synthesis by summarizing the standardized mean differences (SMD). The GRADE approach was used to assess the certainty of evidence. Results Screening of 9199 records resulted in the inclusion of 11 articles of which five were included for data synthesis. Included studies were mainly performed in younger populations. Low-certainty evidence revealed the beneficial effect of PIFM strengthening exercises on vertical ground reaction force (SMD: − 0.31-0.37). Very low-certainty evidence showed that PIFM strength training improved the performance on dynamic balance testing (SMD: 0.41–1.43). There was no evidence for the effect of PIFM strengthening exercises on medial longitudinal foot arch kinematics. Conclusions This review revealed at best low-certainty evidence that PIFM strengthening exercises improve foot function during gait and very low-certainty evidence for its favorable effect on dynamic balance control. There is a need for high-quality studies that aim to investigate the effect of functional PIFM strengthening exercises in large samples of older adults. The outcome measures should be related to both fall risk and the role of the PIFMs such as propulsive forces and balance during locomotion in addition to PIFM strength measures. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-021-00509-0.
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17
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Validity and Test-Retest Reliability of a Novel Push Low-Cost Hand-Held Dynamometer for Knee Strength Assessment during Different Force Ranges. Diagnostics (Basel) 2022; 12:diagnostics12010186. [PMID: 35054353 PMCID: PMC8774426 DOI: 10.3390/diagnostics12010186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 02/05/2023] Open
Abstract
The objective was to assess the instrumental validity and the test–retest reliability of a low-cost hand-held push dynamometer adapted from a load-cell based hanging scale (tHHD) to collect compressive forces in different ranges of compressive forces. Three independent raters applied 50 pre-established compressions each on the tHHD centered on a force platform in three distinct ranges: ~70 N, ~160 N, ~250 N. Knee isometric strength was also assessed on 19 subjects in two sessions (48 h apart) using the tHHD anchored by an inelastic adjustable strap. Knee extension and flexion were assessed with the participant seated on a chair with the feet resting on the floor, knees, and hips flexed at 90°. The isometric force peaks were recorded and compared. The ICC and the Cronbach’s α showed excellent consistency and agreement for both instrumental validity and test–retest reliability (range: 0.89–0.99), as the correlation and determination coefficients (range: 0.80–0.99). The SEM and the MDC analysis returned adequate low values with a coefficient of variation less than 5%. The Bland–Altman results showed consistency and high levels of agreement. The tHHD is a valid method to assess the knee isometric strength, showing portability, cost-effectiveness, and user-friendly interface to provide an effective form to assess the knee isometric strength.
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18
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Lapanantasin S, Thongloy N, Samsee M, Wonghirunsombat N, Nuangpulsarp N, Ua-areejit C, Phattaraphanasakul P. Comparative Effect of Walking Meditation and Rubber-band Exercise on Ankle Proprioception and Balance Performance Among Persons With Chronic Ankle Instability: A Randomized Controlled Trial. Complement Ther Med 2022; 65:102807. [DOI: 10.1016/j.ctim.2022.102807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/03/2022] Open
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19
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de Castro Silva M, de Marche Baldon R, Lins C, de Andrade GM, de Castro GBB, Felicio LR. Immediate effect of manual therapy techniques on the limitation of ankle dorsiflexion: a randomized, controlled, blind clinical trial protocol. Trials 2021; 22:886. [PMID: 34872614 PMCID: PMC8647459 DOI: 10.1186/s13063-021-05858-6] [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: 04/08/2021] [Accepted: 11/22/2021] [Indexed: 12/26/2022] Open
Abstract
Background The range of motion (RoM) of dorsiflexion (DF) plays an important role in human mobility, such as absorption of body weight during gait deceleration, jump landings, balance, and eccentric movements. This limitation can generate potentially damaging movements. This way, evaluating techniques for DF RoM increase could help improve immediate performance in such functional activities. This being the case, the objective of this study will be to verify the sum effect of different joint mobilization techniques for DF gain in persons practicing physical activities and its relationship with functional performance and balance. Methodology This is a randomized, controlled, and blind clinical trial. Fifty-four (54) volunteers will be recruited, aged between 18 and 40 years, who have DF limitations. After checking eligibility criteria, the participants will be submitted to a physiotherapeutic evaluation. A researcher, blind to evaluation and treatment, will perform the randomization of patients in groups: (A) Joint Mobilization - Mulligan Concept and (B) Joint Mobilization - Maitland Method. All volunteers will be submitted by two blind evaluators for randomization and treatment groups. They will realize the initial evaluation (A0), immediately after techniques (A1) and after 3–4 days of the technique application (A2). A different researcher, blind for evaluation, will perform the treatment, according to the randomization group. Discussion It is already known that DF RoM limitation can lead to compensatory and potentially damaging lower limb movements and that joint mobilizations are effective to treatment. However, there is no consensus whether the application of these techniques would also improve aspects of dynamic postural balance and performance in individuals practicing physical activity, and whether the sum of two joint mobilization techniques could enhance this effect. Trial registration Brazilian Registry of Clinical Trials (ReBEC) RBR-93xv9t. Registered on 09 April 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05858-6.
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Affiliation(s)
- Matheus de Castro Silva
- Faculty of Physical Education and Physiotherapy, Pos Graduation Program UFTM/UFU, Uberlândia, Brazil
| | | | - Carolina Lins
- Faculty of Medical Sciences, Department de Orthopedics and Traumatology, UNICAMP, Campinas, Brazil
| | - Gustavo Martins de Andrade
- Faculty of Physical Education and Physiotherapy, Federal University of Uberlândia, Rua Benjamin Constant, 1.286. B. Aparecida CEP: 38, Uberlândia, MG, 38400-678, Brazil
| | - Gustavo Barros Braga de Castro
- Faculty of Physical Education and Physiotherapy, Federal University of Uberlândia, Rua Benjamin Constant, 1.286. B. Aparecida CEP: 38, Uberlândia, MG, 38400-678, Brazil
| | - Lilian Ramiro Felicio
- Faculty of Physical Education and Physiotherapy, Pos Graduation Program UFTM/UFU, Uberlândia, Brazil.
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Song K, Jang J, Nolte T, Wikstrom EA. Dynamic reach deficits in those with chronic ankle instability: A systematic review and meta-analysis. Phys Ther Sport 2021; 53:40-50. [PMID: 34808538 DOI: 10.1016/j.ptsp.2021.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this review with meta-analyses was to determine the dynamic reach differences 1) between chronic ankle instability (CAI) and uninjured individuals, 2) between the limbs of an individual with CAI, and 3) between the uninvolved CAI limb and the healthy control limb across all possible reach directions of the Star Excursion Balance Test (SEBT). METHODS PubMed, CINAHL, SPORTDiscus, and Scopus databases were searched up to October 2021. Data were extracted from the retained studies and underwent methodological quality assessment and meta-analysis using random-effect models. RESULTS After screening, 33 articles were included for the analyses. In all possible SEBT reach directions, the CAI group demonstrated significantly decreased normalized dynamic reach distances relative to the uninjured control group (SMDs: -0.66 to -0.48, p ≤ 0.05). Similarly, the involved CAI limb demonstrated significantly decreased normalized dynamic reach distances relative to the uninvolved CAI limb (SMDs: -0.61 to -0.33, p ≤ 0.05). However, no differences were noted between the uninvolved CAI limb and the healthy control limb (SMDs: -0.22 to 0.09, p ≥ 0.13). CONCLUSIONS Our findings were that the involved limb of those with CAI has dynamic postural deficits relative to (i) an uninjured control group and (ii) relative to their uninvolved limb. However, the uninvolved limb of the CAI group does not differ from an uninjured control group in any reach direction.
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Affiliation(s)
- Kyeongtak Song
- Sports Medicine Research Institute, Department of Athletic Training & Clinical Nutrition, University of Kentucky, United States.
| | - Jaeho Jang
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, United States
| | - Tiffanie Nolte
- Department of Health, Athletic Training, Recreation & Kinesiology, Longwood University, United States
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, United States
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21
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Perception of stability correlates with objective performance of dynamic stability for people with chronic ankle instability. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00860-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose
Lateral ankle sprains are one of the most prevalent musculoskeletal injuries, with one of the highest recurrence rates. One in five people develops chronic ankle instability (CAI) after a lateral ankle sprain. CAI is mainly described as a subjective phenomenon, but is associated with recurrent symptoms, reduced dynamic stability, and reduced physical activity and quality of life. Understanding the relationship between perception of stability and effect on performance for people with CAI could inform rehabilitative strategies in clinical practice. This study aimed to investigate the relationship between the perception of stability and objective performance of dynamic stability this population.
Methods
This study is a sub-analysis of data from four separate studies in Australia and the United Kingdom. Participants were screened and categorised as a CAI, coper, or healthy participant. Each participant completed the Star Excursion Balance Test (SEBT) and Cumberland ankle instability tool (CAIT). Distances reached in the anterior, posterior-medial, and posterior-lateral directions, and average, of the SEBT were analysed.
Results
Data from 95 participants with CAI, 45 copers, and 101 healthy participants was analysed. There was a significant moderate correlation between CAIT score and SEBT reach distance in all directions for the CAI group (p < 0.001). For copers, there was small significant correlation in the posterior-lateral direction (p < 0.05).
Conclusion
This study highlights the discrepancies between the perception of stability and objective dynamic stability, and reinforces the importance of using both types of measures for continual assessment in practice to optimise selecting rehabilitative strategies.
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22
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The Star Excursion Balance Test: An Update Review and Practical Guidelines. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2021. [DOI: 10.1123/ijatt.2020-0106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The Star Excursion Balance Test (SEBT) is a reliable, responsive, and clinically relevant functional assessment of lower limbs’ dynamic postural control. However, great disparity exists regarding its methodology and the reported outcomes. Large and specific databases from various population (sport, age, and gender) are needed to help clinicians when interpreting SEBT performances in daily practice. Several contributors to SEBT performances in each direction were recently highlighted. The purpose of this clinical commentary is to (a) provide an updated review of the design, implementation, and interpretation of the SEBT and (b) propose guidelines to standardize SEBT procedures for better comparisons across studies.
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Nagamoto H, Yaguchi H, Takahashi H. History of ankle sprain affect the star excursion balance test among youth football players. Foot Ankle Surg 2021; 27:784-788. [PMID: 33160832 DOI: 10.1016/j.fas.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/18/2020] [Accepted: 10/10/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The relationship between the results of the Star Excursion Balance Test (SEBT) and lateral ankle sprain (LAS) among youth football players was investigated. METHODS The dominant leg and history of LASs were asked from 33 male youth football players. The SEBT in the anterior, posterolateral, and posteromedial directions were measured for both limbs. The relationship between the history of LAS and reach difference over 4 cm between the dominant and nondominant legs in each direction was statistically analyzed. RESULTS The number of players with the history of LAS, whose dominant/nondominant reach difference was over 4 cm in the anterior direction, was significantly higher to that in players without a history of LAS in both the dominant (94% vs. 63%, p = 0.02) and nondominant (100% vs. 25%, p = 0.02) legs. CONCLUSION Youth football players with a history of LAS showed reach deficit in the anterior direction in the SEBT.
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Affiliation(s)
- Hideaki Nagamoto
- Department of Orthopaedic Surgery, Kurihara Central Hospital, Japan.
| | - Haruki Yaguchi
- Department of Physical Medicine and Rehabilitation, Tohoku University School of Medicine, Japan
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Yu P, Mei Q, Xiang L, Fernandez J, Gu Y. Differences in the locomotion biomechanics and dynamic postural control between individuals with chronic ankle instability and copers: a systematic review. Sports Biomech 2021; 21:531-549. [PMID: 34412557 DOI: 10.1080/14763141.2021.1954237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
An empirical consensus of differences between chronic ankle instability (CAI) individuals and copers (individuals who sprained ankle once and without recurrent symptoms or injury) has not been reported. This study aimed to review the locomotion biomechanics and dynamic postural control between these two populations. Database of ScienceDirect, PubMed and Web of Science was used to search ('chronic ankle instability' OR 'ankle instability') AND ('ankle sprain' OR 'coper*') until 30 November 2020. Articles that made a comparison about changes in biomechanical parameters between Copers and CAI individuals during locomotor or functional tasks were included in this review. Twenty-three articles met the inclusion criteria. CAI individuals exhibited an increased hip flexion to maintain stability, suggesting the adopted hip strategy compared to copers during landing. Dorsiflexion angle and ankle frontal displacement increased considerably compared to copers, which might increase risks of lateral ankle sprain injury. CAI individuals reduced the ankle displacements in the sagittal plane and indicated worse performance of Star Excursion Balance Test in the posterior-lateral direction compared to copers. Identified motion deficits or altered motion strategies provide opportunities for targeted intervention and scheme after index sprain or in CAI individuals.
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Affiliation(s)
- Peimin Yu
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Liangliang Xiang
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.,Department of Engineering Science, The University of Auckland, Auckland, New Zealand
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China.,Research Academy of Grand Health, Ningbo University, Ningbo, China.,Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
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Jeon J, Lee J, Hong J, Yu J, Kim J, Lee D. Comparison of lower limb muscle activity during the dynamic balance test between baseball pitchers and healthy young adults. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-203163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Dynamic balance is an essential factor for efficient pitching by baseball pitchers. OBJECTIVE: To compare distances reached and lower-extremity muscle activity during the star excursion balance test (SEBT) in baseball pitchers and healthy young adults. METHODS: Nineteen baseball pitchers (BPG) and 20 healthy adults (HAG) were recruited. Surface EMG was used to measure the activity of vastus medialis (VM), vastus lateralis (VL), tibialis anterior, and lateral gastrocnemius. RESULTS: The BPG exhibited greater dynamic balance than in the HAG (p< 0.05) in the posteromedial (PM) and posterolateral (PL) directions. For the PM and PL directions, significantly greater muscle activity of VM and VL was found in the BPG than in the HAG (p< 0.05). CONCLUSION: SEBT performance is characterized by high-level VM and VL muscle activities. Neuromuscular control of knee extensors, such as the VM and VL of pitchers, might affect the dynamic balance measured by the SEBT.
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Affiliation(s)
- Jeongwoo Jeon
- Department of Physical Therapy, College of Health Sciences, Sunmoon University, Asan-si, Chungcheongnam-do, Korea
| | - Jiyeon Lee
- Rehabilitation Center of Dawoori Hospital, Asan-si, Chungcheongnam-do, Korea
| | - Jiheon Hong
- Department of Physical Therapy, College of Health Sciences, Sunmoon University, Asan-si, Chungcheongnam-do, Korea
| | - Jaeho Yu
- Department of Physical Therapy, College of Health Sciences, Sunmoon University, Asan-si, Chungcheongnam-do, Korea
| | - Jinseop Kim
- Department of Physical Therapy, College of Health Sciences, Sunmoon University, Asan-si, Chungcheongnam-do, Korea
| | - Dongyeop Lee
- Department of Physical Therapy, College of Health Sciences, Sunmoon University, Asan-si, Chungcheongnam-do, Korea
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Freke MD, King M, Crossley KM, Sims KJ, Semciw A. Acute and sub-acute changes in dynamic postural control following hip arthroscopy and post-operative rehabilitation.". J Athl Train 2021; 57:494-501. [PMID: 35696599 PMCID: PMC9205559 DOI: 10.4085/1062-6050-0709.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Hip pain is associated with impairments in postural control and balance. The Star Excursion Balance Test (SEBT) is a reliable and valid method to measure dynamic postural control. OBJECTIVE Examine changes to dynamic postural control following hip arthroscopy and subsequent rehabilitation from pre-surgery to three and six months post arthroscopy. SETTING Sixty-seven individuals (47 men) scheduled for hip arthroscopy to address chondrolabral pathology were matched with sixty-seven healthy controls. The hip pain group underwent post-operative rehabilitation including SEBT training. MAIN OUTCOME MEASURES SEBT reach normalized to limb length was collected pre-surgery and at three and six months post surgery, and compared with healthy matched controls. Repeated measure analysis of variance (ANOVA) evaluated whether SEBT reach differed between the three time points and t-tests were used to evaluate between-limb and between-group differences. RESULTS Pre-surgical SEBT reach was significantly less than the control group in all directions (p<0.001). At three months post surgery, SEBT reach significantly increased in the posterior-lateral (PL) (p<0.001), anterior-lateral (AL) (p<0.001) and posterior-medial (PM) (p=0.006) directions from pre-surgery. At six months post surgery, all directions of reach had significantly increased (p<0.001) from baseline. Compared to the control group, AL (-2.5 %, p=0.038), anterior medial (AM) (-2.9%, p=0.019) and posterior-medial (PM) (-5.2%, p= 0.002) reach remained significantly less at six months post surgery. No significant difference existed between the control and surgical groups for reach in the PL (-3.6%, p=0.061) direction. CONCLUSIONS Pre-surgical dynamic balance control within a hip pain group was significantly poorer than matched controls as measured by the SEBT. At three months post hip arthroscopy, there were significant improvements in dynamic balance in the PM, PL and AL SEBT directions. By six months post surgery, all directions of SEBT reach had significantly improved but only PL reach improved to the level of healthy controls.
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Affiliation(s)
- Matthew D Freke
- 1Enoggera Health Centre, Gallipoli Barracks, Enoggera, Queensland.,3School of Health and Rehabilitation Sciences, University of Queensland. AUSTRALIA
| | - Matthew King
- 2School of Allied Health, College of Science, Health and Engineering, La Trobe University. AUSTRALIA
| | - Kay M Crossley
- 2School of Allied Health, College of Science, Health and Engineering, La Trobe University. AUSTRALIA
| | - Kevin J Sims
- 4Physiotherapist Cricket Australia and Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland. AUSTRALIA
| | - Adam Semciw
- 2School of Allied Health, College of Science, Health and Engineering, La Trobe University. AUSTRALIA.,3School of Health and Rehabilitation Sciences, University of Queensland. AUSTRALIA
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Short-Term Effects of Balance Training with Stroboscopic Vision for Patients with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105364. [PMID: 34069907 PMCID: PMC8157596 DOI: 10.3390/ijerph18105364] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/26/2022]
Abstract
Chronic Ankle Instability (CAI) is one of the most common musculoskeletal dysfunctions. Stroboscopic vision (SV) training has been deemed to enhance somatosensorial pathways in this population group; nevertheless, until recently no studies have addressed the additional effects of this treatment option to the traditional therapeutic approach. METHODS To evaluate the effectiveness of a partial visual deprivation training protocol in patients with CAI, a randomized controlled trial was carried out. Patients with CAI (n = 73) were randomized into either a balance training, SV training, or a control (no training) group. For participants assigned into training groups, they received 18 training sessions over 6 weeks. The primary outcome was dynamic balance as measured by the Star Excursion Balance Test assessed at baseline and after 6 weeks of intervention. Secondary outcome measures included ankle dorsiflexion range of motion, self-reported instability feeling, and ankle functional status. RESULTS Better scores in stroboscopic training and balance training groups in all outcome measures were observed in comparison with the control group with moderate to large effect sizes. Stroboscopic training was more effective than neuromuscular training in self-reported instability feeling (cohen's d = 0.71; p = 0.042) and anterior reach distance of the star excursion balance test (cohen's d = 1.23; p = 0.001). CONCLUSIONS Preliminary findings from the effects of SV Stroboscopic training in patients with CAI, suggest that SV may be beneficial in CAI rehabilitation.
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Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG80. [PMID: 33789434 DOI: 10.2519/jospt.2021.0302] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.
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Proprioceptive Training on Dynamic Neuromuscular Control in Fencers: A Clinical Trial. J Sport Rehabil 2021; 30:220-225. [DOI: 10.1123/jsr.2019-0469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/10/2019] [Accepted: 02/23/2020] [Indexed: 12/26/2022]
Abstract
Context: Fencing is a sport of agility, with a higher incidence of lower-limb injuries, of which the ankle sprain is the most prevalent. Injury prevention is very important to improve performance and decrease the withdrawal time of athletes. Proprioceptive training programs can be added to the training of athletes, since, in addition to easy application and low cost, proprioception has the function of stabilizing the ankle joint to prevent injuries. Objective: To verify the influence of a 12-week proprioceptive training program on dynamic neuromuscular control in fencing athletes. Design: The study was a clinical trial, and the athletes were allocated, for convenience, in the intervention group or in the control group. Setting: The study was developed in 4 stages (preintervention, intervention, postintervention, and follow-up of 3). The neuromuscular control during the star excursion balance test was evaluated. Participants: The participants were 19 fencing athletes (intervention group: 10, and control group: 9), aged 14–35 years, from a multisport club. Interventions: The athletes performed the proprioceptive training during 12 weeks, 3 times a week, with a duration of 30 minutes. Main Outcome Measures: Dynamic neuromuscular control. Results: The data and SE were considered for statistical analysis, submitted to the generalized estimates equations test with Bonferroni post hoc. The level of significance was .05. The distance reached in the star excursion balance test increased significantly in all 8 directions evaluated in the 2 legs of the intervention group. Conclusions: The proprioceptive training program was able to improve dynamic neuromuscular control in fencing athletes.
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Mullins JF, Hoch MC, Kosik KB, Heebner NR, Gribble PA, Westgate PM, Nitz AJ. Effect of Dry Needling on Spinal Reflex Excitability and Postural Control in Individuals With Chronic Ankle Instability. J Manipulative Physiol Ther 2020; 44:25-34. [PMID: 33248750 DOI: 10.1016/j.jmpt.2020.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 03/25/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to compare postural control and neurophysiologic components of balance after dry needling of the fibularis longus between individuals with chronic ankle instability (CAI) and a healthy control group. METHODS This quasi-experimental university-laboratory study included 50 adult volunteers-25 with CAI (16 female, 9 male; age: 26 ± 9.42 years; height: 173.12 ± 9.85 cm; weight: 79.27 ± 18 kg) and 25 healthy controls (15 female, 10 male; age: 25.8 ± 5.45 years; height: 169.47 ± 9.43 cm; weight: 68.47 ± 13 kg). Participants completed the Star Excursion Balance Test (SEBT), single-leg balance, and assessment of spinal reflex excitability before and after a single treatment of dry needling to the fibularis longus. The anterior, posterolateral, and posteromedial directions of the SEBT were randomized, and reach distances were normalized to a percentage of leg length. A composite SEBT score was calculated by averaging the normalized scores. Postural control was assessed in single-limb stance on a force plate through time-to-boundary measurements in eyes-open and eyes-closed conditions. Fibularis longus and soleus spinal reflexes were obtained by providing electrical stimulation to the common fibular and tibial nerves with participants lying prone. A Group × Time analysis examined changes in performance, and effect sizes were calculated to assess significance. RESULTS Significant group × time interactions were identified for composite (P = .006) and posteromedial (P = .017) SEBT scores. Significant time effects for all directions of the SEBT, time to boundary with eyes open, and the mediolateral direction with eyes closed indicate improved postural control following treatment (P < .008). Within-group effect sizes for significant time effects ranged from small to large, indicating potential clinical utility. CONCLUSION Dry needling demonstrated immediate short-term improvement in measures of static and postural control in individuals with CAI as well as healthy controls.
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Affiliation(s)
- Jennifer F Mullins
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky.
| | - Matthew C Hoch
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Kyle B Kosik
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Nicholas R Heebner
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Phillip A Gribble
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Philip M Westgate
- Department of Biostatistics, University of Kentucky, Lexington, Kentucky
| | - Arthur J Nitz
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
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Alghadir AH, Iqbal ZA, Iqbal A, Ahmed H, Ramteke SU. Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5318. [PMID: 32718066 PMCID: PMC7432694 DOI: 10.3390/ijerph17155318] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022]
Abstract
Background: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including pain, episodes of giving way, compromised proprioception and neuromuscular control, and re-injury leading to chronic ankle instability. The aim of this study was to see the effect of chronic ankle sprain on pain, range of motion, proprioception, and, static and dynamic balance among athletes. Methods: A total of 80 athletes, aged 18 to 25 years, involved in track-and-field sports were invited to participate in this study. They were divided in two groups. Athletes with history of grade 1 or 2 ankle sprain on either side requiring medical care who reported at least three episodes of ankle giving way in past 12 months were included in group A. An equal number of healthy athletes without any history of ankle sprain or injury in the lower limbs in the past one year matched by sex, age, height, weight, and limb dominance, were included in group B (control). Outcome measures: Participant's pain, range of motion, proprioception and balance (static and dynamic) was measured using visual analog scale, half circle goniometer, degree of foot position sense, single leg stance time and Y-balance test respectively. Results: Although there were no differences in the active ankle joint range of motion (p > 0.05) in comparison to the control group, athletes with chronic ankle sprain reported mild pain and statistically significant (p < 0.05) deficits in foot proprioception, static and dynamic balance. Conclusions: Deficits in foot proprioception, static and dynamic balance even one year after the ankle sprain could be the reason for limitations in the dynamic defense system of the joint that predisposes to recurrent injury and instability. It is essential to understand the normal clinical course and risk factors for athletes who sustain sprain before devising a long term comprehensive rehabilitation program that focuses on mechanical and functional insufficiencies in order to improve their functional performance and prevent the risk of recurrent sprain.
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Affiliation(s)
- Ahmad H. Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Zaheen A. Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Amir Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Hashim Ahmed
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia;
| | - Swapnil U. Ramteke
- Department of Musculoskeletal & Sports Physiotherapy, Sancheti Institute College of Physiotherapy, Shivaji Nagar, Pune 411005, Maharashtra, India;
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Ortega SL, Ibarra S, Pierce R, Levy S, Gombatto SP. Kinematic and kinetic factors associated with leg reach asymmetry during the Star Excursion Balance Test in division I athletes. Phys Ther Sport 2020; 45:63-70. [PMID: 32634730 DOI: 10.1016/j.ptsp.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To explore which balance and movement factors contribute most to reach distance asymmetry during the Star Excursion Balance Test (SEBT) in Division I athletes. DESIGN Cross-Sectional Study. SETTING Rehabilitation Biomechanics Laboratory, NCAA Division I Athletics Program. PARTICIPANTS 36 Division I athletes (20 Male; 16 Female). MAIN OUTCOME MEASURES Center of Pressure, Kinematic and Kinetic variables were measured during performance of anterior, Posterior-Medial (PM), and Posterior-Lateral (PL) directions of the SEBT in order to determine which factors predict reach distance asymmetry. RESULTS COP variables approached significance in predicting asymmetry for the anterior direction (p <0.08), kinematic variables approached significance in predicting asymmetry in the PL direction (p < 0.06), and kinetic variables were significant in predicting asymmetry in the PM direction (p < 0.03). CONCLUSIONS Findings suggest that different strategies could be used to improve leg reach asymmetry based on specific direction of the asymmetry. Improving ability to control COP area seems to be important for the anterior direction, while control of limb movement seems to be most important for leg reach asymmetry in the PM and PL directions.
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Affiliation(s)
- Santiago L Ortega
- Physical Therapy Program, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA; School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA.
| | - Sergio Ibarra
- Athletics Department, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA.
| | - Rebecca Pierce
- School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA.
| | - Susan Levy
- School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA.
| | - Sara P Gombatto
- Physical Therapy Program, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA; School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-7251, USA.
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Kosik KB, Johnson NF, Terada M, Thomas AC, Mattacola CG, Gribble PA. Decreased ankle and hip isometric peak torque in young and middle-aged adults with chronic ankle instability. Phys Ther Sport 2020; 43:127-133. [DOI: 10.1016/j.ptsp.2020.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 12/26/2022]
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Rosen AB, Needle AR, Ko J. Ability of Functional Performance Tests to Identify Individuals With Chronic Ankle Instability: A Systematic Review With Meta-Analysis. Clin J Sport Med 2019; 29:509-522. [PMID: 31688183 DOI: 10.1097/jsm.0000000000000535] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this systematic review with meta-analysis was to determine the effectiveness of functional performance tests (FPTs) in differentiating between individuals with chronic ankle instability (CAI) and healthy controls. DATA SOURCES The National Library of Medicine Catalog (PubMed), the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and the SPORTDiscus, from inception to June 2017 were searched. Search terms consisted of: "Functional Performance Test*" OR "Dynamic Balance Test*" OR "Postural Stability Test*" OR "Star Excursion Balance Test*" OR "Hop Test*" AND "Ankle Instability" OR "Ankle Sprain." Included articles assessed differences in FPTs in patients with CAI compared with a control group. MAIN RESULTS Included studies were assessed for methodological quality and level of evidence. Individual and mean effect sizes were also calculated for FPTs from the included articles. Twenty-nine studies met the criteria and were analyzed. The most common FPTs were timed-hop tests, side-hop, multiple-hop test, single-hop for distance, foot-lift test, and the Star Excursion Balance Tests (SEBTs). The side-hop (g = -1.056, P = 0.009, n = 7), timed-hop tests (g = -0.958, P = 0.002, n = 9), multiple-hop test (g = 1.399, P < 0.001, n = 3), and foot-lift tests (g = -0.761, P = 0.020, n = 3) demonstrated the best utility with large mean effect sizes, whereas the SEBT anteromedial (g = 0.326, P = 0.022, n = 7), medial (g = 0.369, P = 0.006, n = 7), and posteromedial (g = 0.374, P < 0.001, n = 13) directions had moderate effects. CONCLUSIONS The side-hop, timed-hopping, multiple-hop, and foot-lift seem the best FPTs to evaluate individuals with CAI. There was a large degree of heterogeneity and inconsistent reporting, potentially limiting the clinical implementation of these FPTs. These tests are cheap, effective, alternatives compared with instrumented measures.
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Affiliation(s)
- Adam B Rosen
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - Alan R Needle
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Jupil Ko
- Department of Physical Therapy & Athletic Training, Northern Arizona University, Flagstaff, Arizona
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Kosik KB, Johnson NF, Terada M, Thomas AC, Mattacola CG, Gribble PA. Decreased dynamic balance and dorsiflexion range of motion in young and middle-aged adults with chronic ankle instability. J Sci Med Sport 2019; 22:976-980. [DOI: 10.1016/j.jsams.2019.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/25/2019] [Accepted: 05/07/2019] [Indexed: 12/26/2022]
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Ruescas-Nicolau MA, Sánchez-Sánchez ML, Marques-Sule E, Espí-López GV. The immediate effect of plantar stimulation on dynamic and static balance: A randomized controlled trial. J Back Musculoskelet Rehabil 2019; 32:453-461. [PMID: 30507562 DOI: 10.3233/bmr-181145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To examine the immediate effect on dynamic and static balance of a manual protocol of plantar stimulation in healthy subjects. MATERIALS AND METHOD Of the 144 healthy and physically active volunteers recruited, 98 subjects participated. Subjects were randomly assigned and allocated to the experimental group (EG) (n= 50), in which a 10-min manual protocol of plantar stimulation was applied on the right foot, or to the control group (CG) (n= 48). The change scores of the modified Star Excursion Balance Test (mSEBT) and the Unipedal Stance Test (UPST) were used to assess the immediate effect of the protocol on dynamic and static balance, respectively. RESULTS In the dynamic balance, a group effect was found in the anterior direction, posteromedial direction and composite scores of the mSEBT when groups were compared by limb. Changes in the posteromedial direction of both limbs (right limb: p= 0.002, left limb: p= 0.05) and composite score of the right limb (p= 0.009) were significantly greater in the EG versus the CG. Non-significant results were found in the static balance (UPST time). CONCLUSIONS The application of a 10-minute manual stimulation protocol without joint mobilization, addressed to stimulate the plantar cutaneous mechanoreceptors, could elicit benefits on dynamic balance. This improvement was observed bilaterally even though only one plantar surface was stimulated. As balance deficits may impair functional movements and regular training in sports, this intervention aims to ameliorate dynamic balancing ability could improve the functional recovery of sport gestures.
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Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients. J Sci Med Sport 2019; 22:538-543. [DOI: 10.1016/j.jsams.2018.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 11/01/2018] [Accepted: 11/06/2018] [Indexed: 12/26/2022]
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TERADA MASAFUMI, JOHNSON NATHAN, KOSIK KYLE, GRIBBLE PHILLIP. Quantifying Brain White Matter Microstructure of People with Lateral Ankle Sprain. Med Sci Sports Exerc 2019; 51:640-646. [DOI: 10.1249/mss.0000000000001848] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Shi X, Han J, Witchalls J, Waddington G, Adams R. Does treatment duration of manual therapy influence functional outcomes for individuals with chronic ankle instability: A systematic review with meta-analysis? Musculoskelet Sci Pract 2019; 40:87-95. [PMID: 30753998 DOI: 10.1016/j.msksp.2019.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 01/04/2019] [Accepted: 01/30/2019] [Indexed: 12/26/2022]
Abstract
QUESTION Can manual therapy improve functional outcomes for individuals with chronic ankle instability? DESIGN Systematic review with meta-analysis of randomized controlled trials. PARTICIPANTS Individuals with chronic ankle instability. INTERVENTION Manual therapy is defined as an intervention that involves joint mobilization, and mobilization with movement. OUTCOME MEASURE The primary outcome is patient reported function (PRF) questionnaires scores, the secondary outcomes are ankle dorsiflexion range of motion (DFROM) and balance control. RESULTS Four studies were included (n = 208, mean age = 24.4) in the meta-analysis, with moderate to high quality on the PEDro scale (range 6-8). For patient reported function (PRF) questionnaires, two studies reported significant improvement after six-session manual therapy measured by foot and ankle ability measures sport subscale (FAAMS) and Cumberland ankle instability tool (CAIT), respectively. For DFROM, one session manual therapy had no significant effect on the weight-bearing lunge test (WBLT) (3 studies, n = 147, SMD = 1.24 (95%CI -0.87 to 3.36), I2 = 96%) or non-weight-bearing inclinometer test (2 studies, n = 47, MD = 3.41° (95%CI -0.26 to 7.09),I2 = 43%), while six-sessions manual therapy showed, a significantly positive effect on WBLT(2 studies, n = 80, SMD = 2.39, (95% CI 0.55, to 4.23), I2 = 93%). For the SEBT, one-session manual therapy had no significant effect on overall star excursion balance test (SEBT) score (3 studies, n = 137,MD = 2.05,95%CI (-0.96,5.05), I2 = 75%), while qualitative analysis of 2 included studies showed significant improvement both on the SEBT score and single limb balance test (SLBT). CONCLUSIONS Six sessions rather than one session of manual therapy improves ankle functional performance for individuals with CAI. TRIAL REGISTRATION NUMBER PROSPERO CRD42017054715.
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Affiliation(s)
- Xiaojian Shi
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China.
| | - Jia Han
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China; Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT, 2601, Australia.
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Park KN, Park SY. Description and Intrarater Test-Retest Reliability of a Reverse-Action Method to Assess Ankle Evertor Muscle Performance: The I-to-V Test. Physiother Can 2019; 70:306-313. [PMID: 30745715 DOI: 10.3138/ptc.2016-101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Reverse action (RA) of the ankle evertor muscle is when the proximal attachment moves toward the distal attachment, moving the lower leg in the frontal plane when the foot and ankle are fixed on the ground and inducing ankle eversion. The purpose of this study was to describe an RA method for measuring ankle evertor muscle performance. Method: Eighteen healthy individuals were recruited for this study. To assess the RA of their ankle evertors, the participants sat with their knees together and their feet firmly planted on the floor, then spread their knees as far apart as possible. A tester used a measuring tape to measured the distance (in cm) between the medial tibial tuberosity of the tested side and that of the non-tested side. In the end range position of the RA, ankle evertor electromyographic activity was recorded simultaneously. The intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were calculated to establish the intrarater test-retest reliability. The correlation between each performance value and muscle activity was assessed using a linear correlation model. Results: The proposed method of assessing RA performance was highly reliable (ICC=0.95) and had a low SEM (1.63 cm); in addition, the performance value showed a strong positive correlation with ankle evertor muscle activity (ρ=0.90; 95% CI: 0.79, 0.95; p=0.01). Conclusions: The proposed RA method of assessing the ankle evertor muscles can be used as a simple, reliable, economical performance test. It can also be used as an alternate method of testing the peroneal muscles rather than selectively measuring ankle evertor performance because hip external rotation occurs when performing RA.
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Affiliation(s)
- Kyue-Nam Park
- Department of Physical Therapy, College of Medical Science, Jeonju University, Jeonju
| | - So-Yeon Park
- Department of Physical Therapy, Sangji University, Wonju, South Korea
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Abstract
CONTEXT Traditional single-limb balance (SLB) and progressive dynamic balance-training programs for those with chronic ankle instability (CAI) have been evaluated in the literature. However, which training program may be more beneficial is not known. OBJECTIVE To investigate the effects of a progressive hop-to-stabilization balance (PHSB) program compared with an SLB program on self-reported function, dynamic postural control, and joint position sense (JPS) where angle and direction were self-reported by participants with CAI. DESIGN Randomized controlled clinical trial. SETTING A single testing location in a mid-Atlantic state. PATIENTS OR OTHER PARTICIPANTS A total of 18 participants (age = 18.38 ± 1.81 years; height = 175.26 ± 6.64 cm; mass = 75.79 ± 12.1 kg) with CAI. INTERVENTION(S) Participants were randomly assigned to the PHSB or SLB program. The PHSB and SLB groups pursued their 4-week programs 3 times a week. The PHSB group performed a battery of single-limb hop-to-stabilization exercises, while the SLB group performed a series of SLB exercises. Exercises were advanced throughout the 4 weeks for both groups. MAIN OUTCOMES MEASURE(S) Pretest and posttest measurements were the Foot and Ankle Ability Measure (FAAM)-Activities of Daily Living subscale; FAAM-Sports subscale; Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions; and weight-bearing JPS blocks (dorsiflexion, plantar flexion, inversion, eversion). RESULTS A significant main effect of time was present for the FAAM-Activities of Daily Living, FAAM-Sports, Star Excursion Balance Test (anterior, posteromedial, and posterolateral directions), and JPS (dorsiflexion, plantar flexion, inversion), as posttest results improved for the PHSB and SLB groups. The main effect of group was significant only for the FAAM-Sports, with the SLB group improving more than the PHSB group. CONCLUSIONS Either a 4-week PHSB or SLB can be used in athletes with CAI, as both programs resulted in similar gains.
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THE EFFECT OF BRACING AND BALANCE TRAINING ON ANKLE SPRAIN INCIDENCE AMONG ATHLETES: A SYSTEMATIC REVIEW WITH META-ANALYSIS. Int J Sports Phys Ther 2018. [PMID: 30038824 DOI: 10.26603/ijspt20180379] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Ankle sprains are common musculoskeletal injuries in the athletic population that have been addressed with prevention strategies that include bracing and balance training. Many authors have examined ankle sprain incidence after bracing or balance training in athletes at different levels of competition and in various sports. No systematic review has analyzed the results of both interventions. Purpose The purpose of this review was to compare the effect of balance training and bracing in reducing the incidence and relative risk of ankle sprains in competitive athletes, with or without prior injury, across different sports. Design Systematic review, with meta-analysis. Methods A literature search of four databases was conducted for randomized control trials that reported ankle sprain incidence published from 2005 through 2016. Included articles studied high school, college, or professional level athletes with or without a history of a prior sprain, who received bracing or balance training as an intervention compared to a non-intervention control group. Methodological study quality was assessed by two reviewers using the PEDro scale, with scores ≥5 considered moderate quality. Group incidence and relative risk were determined to assess the preventative effect of bracing or balance training compared to control. Results From 1832 total citations, 71 full-text articles were reviewed, and eight articles were included in the study. Methodological quality of the available evidence contained in the systematic review was moderate. Five studied the effect of balance training, two studied the effect of bracing, and one studied the effect of bracing and balance training compared to the control condition. In all eight studies, athletes in the control condition did not receive any intervention. Athletes who wore braces had fewer ankle sprains (p=0.0037) and reduced their risk of sprains by 64% (RR=0.36) compared to controls, based on analysis of 3,581 subjects. Athletes performing balance training had fewer ankle sprains (p=0.0057) and reduced their risk by 46% (RR=0.54) compared to controls, based on analysis of 3,577 subjects. Conclusion The findings of the current systematic review and meta-analysis support the use of bracing and balance training to reduce the incidence and relative risk of ankle sprains in athletic populations. Clinicians can utilize this information to educate their patients on wearing a brace or performing balance training exercises to decrease the risk of an ankle sprain. Level of evidence Level 1a.
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Eriksrud O, Federolf P, Anderson P, Cabri J. Hand reach star excursion balance test: An alternative test for dynamic postural control and functional mobility. PLoS One 2018; 13:e0196813. [PMID: 29738557 PMCID: PMC5940230 DOI: 10.1371/journal.pone.0196813] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 04/22/2018] [Indexed: 12/26/2022] Open
Abstract
Tests of dynamic postural control eliciting full-body three-dimensional joint movements in a systematic manner are scarce. The well-established star excursion balance test (SEBT) elicits primarily three-dimensional lower extremity joint movements with minimal trunk and no upper extremity joint movements. In response to these shortcomings we created the hand reach star excursion balance test (HSEBT) based on the SEBT reach directions. The aims of the current study were to 1) compare HSEBT and SEBT measurements, 2) compare joint movements elicited by the HSEBT to both SEBT joint movements and normative range of motion values published in the literature. Ten SEBT and HSEBT reaches for each foot were obtained while capturing full-body kinematics in twenty recreationally active healthy male subjects. HSEBT and SEBT areas and composite scores (sum of reaches) for total, anterior and posterior subsections and individual reaches were correlated. Total reach score comparisons showed fair to moderate correlations (r = .393 to .606), while anterior and posterior subsections comparisons had fair to good correlations (r = .269 to .823). Individual reach comparisons had no to good correlations (r = -.182 to .822) where lateral and posterior reaches demonstrated the lowest correlations (r = -.182 to .510). The HSEBT elicited more and significantly greater joint movements than the SEBT, except for hip external rotation, knee extension and plantarflexion. Comparisons to normative range of motion values showed that 3 of 18 for the SEBT and 8 of 22 joint movements for the HSEBT were within normative values. The findings suggest that the HSEBT can be used for the assessment of dynamic postural control and is particularly suitable for examining full-body functional mobility.
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Affiliation(s)
- Ola Eriksrud
- Department of Physical Performance, Norwegian School of Sports of Science, Oslo, Norway
- * E-mail:
| | - Peter Federolf
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Patrick Anderson
- Department of Physical Performance, Norwegian School of Sports of Science, Oslo, Norway
| | - Jan Cabri
- Department of Physical Performance, Norwegian School of Sports of Science, Oslo, Norway
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Hip Strength and Range of Movement Are Associated With Dynamic Postural Control Performance in Individuals Scheduled for Arthroscopic Hip Surgery. J Orthop Sports Phys Ther 2018; 48:280-288. [PMID: 29607762 DOI: 10.2519/jospt.2018.7946] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Cross-sectional. Background Hip pain is associated with reduced muscle strength and range of movement (ROM). These impairments may contribute to decreased postural stability and balance. The Star Excursion Balance Test (SEBT) is a reliable and valid method to measure dynamic postural control. Objectives To evaluate the association between SEBT performance and hip strength, hip ROM, trunk endurance, and group characteristics in individuals with hip pain. Methods One hundred eleven individuals with hip pain, scheduled for arthroscopic hip surgery, were matched with 62 healthy controls. Hip ROM and muscle strength, trunk endurance, and SEBT reach were measured prior to surgery. Data were analyzed for between-group differences using t tests, and associations between SEBT reach and hip strength, hip ROM, and population characteristics were evaluated with Pearson correlation coefficients and stepwise backward regression analyses. Results Star Excursion Balance Test performance (P<.01), hip strength (P<.01), and hip ROM (P<.05) were lower in the presurgery group compared to controls. In the presurgery group, when adjusted for height and weight, hip flexion strength and internal rotation ROM accounted for 44% of the variance in anteromedial SEBT reach. In the posteromedial direction, hip adduction strength and sex accounted for 53% of the variance. For the posterolateral direction, hip adduction and internal rotation strength accounted for 46% of reach variance. Conclusion The individuals who were scheduled for arthroscopic hip surgery were significantly weaker, had less hip mobility, and had reduced dynamic balance compared to controls. In this population, dynamic balance performance was associated with various hip strength and ROM measurements in a direction-specific manner. J Orthop Sports Phys Ther 2018;48(4):280-288. doi:10.2519/jospt.2018.7946.
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The Effect of Joint Mobilization on Dynamic Postural Control in Patients With Chronic Ankle Instability: A Critically Appraised Topic. J Sport Rehabil 2018; 27:103-108. [DOI: 10.1123/jsr.2016-0074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Hip strength and star excursion balance test deficits of patients with chronic ankle instability. J Sci Med Sport 2017; 20:992-996. [PMID: 28595864 DOI: 10.1016/j.jsams.2017.05.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 04/21/2017] [Accepted: 05/15/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To examine isometric hip strength in those with and without CAI, and determine the degree of Star Excursion Balance Test (SEBT) variance explained by isometric hip strength. DESIGN Single-blinded, cross-sectional, case-control study. METHODS Thirty individuals with CAI, 29 lateral ankle sprain (LAS) copers, and 26 healthy controls participated. We assessed dynamic postural control with the SEBT anterior (SEBT-ANT), posteromedial (SEBT-PM), and posterolateral (SEBT-PL) reaches, and isometric hip extension (EXT), abduction (ABD) and external rotation (ER) strength with hand-held dynamometry. The CAI and LAS coper groups' involved limbs and randomly selected limbs in controls were tested. Separate Kruskal-Wallis tests compared SEBT scores and isometric hip strength between groups. Backwards linear regression models determined the degree of SEBT variance explained by isometric hip strength. Statistical significance was set a priori at P<0.05. RESULTS The CAI group had lower SEBT-ANT scores compared to LAS copers (P=0.03) and controls (P=0.03). The CAI group had lower ABD compared to LAS copers (P=0.03) and controls (P=0.02). The CAI group had lower ER compared to LAS copers (P=0.01) and controls (P=0.01). ER (R2=0.25, P=0.01) and ABD (R2=0.25, P=0.01) explained 25% of the CAI group's SEBT-PM and SEBT-PL variances, respectively. CONCLUSIONS The CAI group had deficient dynamic postural control and isometric hip strength compared to LAS copers and controls. Additionally, the CAI group's isometric hip strength significantly influenced dynamic postural control performance. Future CAI rehabilitation strategies should consider hip muscular strengthening to facilitate improvements in dynamic postural control.
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Cuğ M. Stance foot alignment and hand positioning alter star excursion balance test scores in those with chronic ankle instability: What are we really assessing? Physiother Theory Pract 2017; 33:316-322. [PMID: 28362143 DOI: 10.1080/09593985.2017.1302028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The literature has consistently shown that the Star Excursion Balance Test (SEBT) is a reliable and valid tool to anticipate the risk of lower extremity injury, assess dynamic postural control differences among groups, and assess the effectiveness of balance training programs in both healthy individuals and people with lower extremity injuries. However, there is no standard administration technique for the SEBT in research, clinical practice, or performance settings. Therefore, the purpose of this investigation was to compare six different combinations (3 different foot alignments × 2 hand positions) on the SEBT performance in those with chronic ankle instability (CAI). DESIGN Repeated Measures Design. SETTING University Research Laboratory. PARTICIPANTS Twenty-five university students with CAI (12 males, 13 females; age: 20.3 ± 2.4 years, height: 172.7 ± 7.4 cm, weight: 77.5 ± 15.3 kg. , BMI 25.9 ± 4.0 kg/m2) voluntarily participated in the study. METHODS Six different SEBT positions were used to assess dynamic postural control. Three foot positions: 1) Foot centered; 2) Toe fixed; and 3) Toe-heel changing and two hand placements: 1) Hands free and 2) Hands on the hips were used in this study. After 6familiarization trials for each condition, three Star Excursion Balance Test scores were recorded. MAIN OUTCOME MEASURES Normalized reach distance (% of leg length) in the anterior, posteromedial, and posterolateral directions as well as a composite reach score quantified dynamic postural control. RESULTS Both foot alignment and hand position significantly altered normalized SEBT reach distance in the anterior (p < 0.003), posteromedial (p < 0.001), posterolateral (p < 0.001), and composite reach scores (p < 0.001). CONCLUSION Different foot alignments and hand constraints significantly altered normalized reach distances and the composite score in individuals with CAI. These results do not suggest that any combination of foot alignments and/or hand constraints is superior. However, changing the toe/heel position, while maintaining hands on the hips, may provide the best standardization for clinicians and researchers.
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Affiliation(s)
- Mutlu Cuğ
- a Physical Education and Sports Department , Cumhuriyet University , Sivas , Turkey
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Mittermaier C, Schindler M, Loader B, Waldhoer T, Ambrozy C, Crevenna R, Pieber K. Unique approach to sensorimotor training with a new device combining air cushion with stochastic translations-A prospective randomized controlled clinical trial. Gait Posture 2017; 52:153-158. [PMID: 27914309 DOI: 10.1016/j.gaitpost.2016.11.038] [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: 11/24/2015] [Revised: 11/16/2016] [Accepted: 11/24/2016] [Indexed: 02/02/2023]
Abstract
Sensorimotor training with a wide variety of available devices represents an important component in rehabilitation and prevention of different sports injuries and chronic diseases. The purpose of this study was to evaluate the effects of a sensorimotor training with a newly developed device, which consists of an instable platform moving on an air cushion, providing dynamic balance training by tilting and unanticipated stochastic translations on postural control. Seventy-two healthy young subjects were included in this prospective, randomized, controlled, and observer-blinded study. Balance was objectively assessed by posturography and Functional Reach Test (FRT). Additionally we evaluated the subjective rating of balance. After randomization the sensorimotor training group performed a training program on the new device over a 5-6 week study period. After this time improvement in objective and subjective measurements as a result of training became evident. A significant difference in challenging posturographic parameters (Sensory Organization Test 5: training group 5.32±5.25 vs. control group 1.78±5.05, p=0.006 and Head Shake Sensory Organization Test 5: training group 11.94±8.97 vs. control group 5.41±10.17, p=0.01) as well as a significant difference in the FRT (training group 3.34±3.35cm vs. control group 0.01±2.97cm, p=0.0001) was found. Subjective assessment revealed a significant improvement in the participants' rating of balance and alteration of balance. Subjects showed a high satisfaction with the new training device. Our findings suggest that the newly developed device could be a promising option for sensorimotor training to improve postural control.
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Affiliation(s)
- Christian Mittermaier
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria; Institute of Physical Medicine and Rehabilitation, Kepler University Hospital, Linz, Austria
| | - Maximilian Schindler
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria
| | - Benjamin Loader
- Department of Otorhinolaryngology, Medical University of Vienna, Austria
| | - Thomas Waldhoer
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, Austria
| | - Clemens Ambrozy
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria
| | - Karin Pieber
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria.
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Grindstaff TL, Dolan N, Morton SK. Ankle dorsiflexion range of motion influences Lateral Step Down Test scores in individuals with chronic ankle instability. Phys Ther Sport 2017; 23:75-81. [DOI: 10.1016/j.ptsp.2016.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 07/17/2016] [Accepted: 07/27/2016] [Indexed: 12/26/2022]
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Romero-Franco N, Jiménez-Reyes P, Montaño-Munuera JA. Validity and reliability of a low-cost digital dynamometer for measuring isometric strength of lower limb. J Sports Sci 2016; 35:2179-2184. [DOI: 10.1080/02640414.2016.1260152] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Natalia Romero-Franco
- Nursery and Physiotherapy department, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pedro Jiménez-Reyes
- Sports Science department, Catholic University of San Antonio of Murcia, Murcia, Spain
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