Effects of fatigue and gender on peroneal reflexes elicited by sudden ankle inversion

Acute effects of Nordic hamstring exercise on hip and knee joints proprioception

BACKGROUND AND OBJECTIVES

Nordic Hamstring Exercise (NHE) is one of the best exercises proposed for injury prevention of hamstring muscles. However, its effects on lower extremity proprioception are unclear. The aim of this study was to investigate the immediate effects of a single bout of NHE on hip and knee joints' proprioception.

METHODS

Forty collegiate male soccer players participated in this study with a mean age of 22.85 ± 1.82 years and were randomized into either control (n = 20) or experimental (n = 20) groups. Each subject participated in pre-test measurements in which hip and knee active joints position sense (JPS) were assessed in standing and lying tasks using the image-capturing method. The experimental group then performed three sets of NHE with 10 repetitions in each set, while the control group rested for 10 min. Paired and independent t-tests were used for calculating the differences within and between groups on SPSS software, respectively. The level of significance was P ≤ 0.05.

RESULTS

Hip JPS in the lying task and knee JPS in both of the standing and lying tasks were impaired significantly after performing a single bout of NHE (P ≤ 0.05). However, the effects of this exercise on hip JPS in the standing task were not significant (P ≥ 0.05).

CONCLUSIONS

NHE performing with three sets of 10 repetitions can significantly impair hip and knee JPS immediately after exercise and reduce the proprioception acuity of the lower limbs. It is recommended to perform this exercise at a time rather than before training or match sessions.

The effectiveness of fatigue on repositioning sense of lower extremities: systematic review and meta-analysis

INTRODUCTION

An injury can significantly harm both individual and team performance. One of the most important risk factors for sports-related injuries, especially non-collision injuries, is fatigue. It seems that poor proprioception may play an essential role to impose athletes to further injuries. This systematic review and meta-analysis aimed to examine the effectiveness of fatigue on the repositioning sense of the lower extremity joints.

METHOD

The electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar were systematically searched from inception to 11January 2024. The obtained records were exported to the EndNote Software version 8. Then, two investigators examined the records independently to find eligible studies based on the inclusion/exclusion criteria. In the case of disagreements, a consequence method was utilized. The quality of the eligible studies was evaluated using the Downs and Black checklist. Comprehensive Meta-Analysis (CMA) software ver. 3 software was used for statistical analysis. Q-test and I2 were employed to examine the data homogeneity. In addition, considering the risk of bias, the Funnel Plot and trim-and-fill method were used.

RESULTS

After reviewing the titles and abstracts of 3883 studies found in the selected databases, 43 articles were found to be eligible to include in meta-analyses. The results showed that fatigue led to a significant increase in the active absolute error of the knee (SDM = 0.524, 95% CI = 0.406-0.841), ankle in the horizontal plane (SDM = 0.541, 95% CI = 0.367-0.715), ankle in the sagittal plane (SDM = 0.443, 95% CI = 0.088-0.798), and hip (SDM = 0.988, 95% CI = 0.135-1.841). However, fatigue had no significant effects on the passive absolute error of the knee and ankle in horizontal plane and relative angular error of the knee.

CONCLUSION

Fatigue can diminish the active joint position sense of the lower extremities and thus may increase the risk of injury by reducing proprioception. Therefore, future research could be conducted to investigate the potential impact of integrated fatigue-mitigating exercises into athletes' training programs, with the aim of reducing the incidence of sports-related injuries.

Take a load off: skeletal implications of sedentism in the feet of modern body donors

Background and Objectives

Modern biocultural environments continue to place selective pressures on our skeletons. In the past century, a major cultural pressure has been the rise in sedentism. However, studies considering the effects of sedentism on the foot have largely considered pathological changes to the gross foot without particular regard for the pedal skeleton. To address this gap in the literature, temporal trends in the development of osteoarthritis and entheseal changes on the tarsals and metatarsals were analyzed in the context of biodemographic data for recent modern humans.

Methodology

The sample utilized for this project is comprised of 71 individuals from the William M. Bass Donated Skeletal Collection, with birth years ranging from 1909 to 1993. Temporal trends in osteoarthritis and entheseal changes were determined via ANCOVA, using year of birth as the explanatory variable and biodemographic variables (age, sex, stature, body mass index and tibial robusticity) as covariates.

Results

Results indicate that entheseal changes and osteoarthritis have decreased over time, and these trends are statistically significant. Temporal trends in pedal entheseal changes and osteoarthritis vary by sex.

Conclusions and Implications

The increase in sedentary behavior over time has usually been framed as a net negative for human health and well-being. However, considered in isolation, the decrease in entheseal changes and osteoarthritis presented here might be considered a positive development as they suggest overall less stress on the modern human foot. This study also has the potential to inform the health sciences and general public about biocultural contributors to modern foot health.

Assessment of Fatigue and Recovery in Sport: Narrative Review

Fatigue is a phenomenon associated with decreases in both physical and cognitive performances and increases in injury occurrence. Competitive athletes are required to complete demanding training programs with high workloads to elicit the physiological and musculoskeletal adaptations plus skill acquisition necessary for performance. High workloads, especially sudden rapid increases in training loads, are associated with the occurrence of fatigue. At present, there is limited evidence elucidating the underlying mechanisms associating the fatigue generated by higher workloads and with an increase in injury risk. The multidimensional nature and manifestation of fatigue have led to differing definitions and dichotomies of the term. Consequently, a plethora of physiological, biochemical, psychological and performance markers have been proposed to measure fatigue and recovery. Those include self-reported scales, countermovement jump performance, heart rate variability, and saliva and serum biomarker analyses. The purpose of this review is to provide an overview of fatigue and recovery plus methods of assessments.

Factors associated with musculoskeletal injuries in an infantry commanders course

OBJECTIVES

To evaluate the prevalence of injuries among young combat soldiers as assessed and reported by the military physicians, and to investigate whether parameters such as anthropometric measures, postural balance, proprioceptive ability, and chronic ankle instability are related to injuries during and following an infantry commanders course.

METHODS

In this cross-sectional study, 165 soldiers were tested for anthropometric measurements, proprioceptive ability, and dynamic postural balance (DPB), as well as for their responses to an ankle stability questionnaire (CAIT), on three occasions: pre-course, middle-course, and end-course testing. All musculoskeletal injuries were assessed and recorded in the digital medical file of each participant by specialist military physicians before and during/following the course.

RESULTS

Ninety-eight soldiers (59.4%) were injured before the course. Forty soldiers (24.2%) incurred an injury during/following the course (with 33 out of the 40 [82.5%] soldiers that were injured during/following the course having also been injured before the course). Sixty soldiers had no injury before/during/following the course. A survival curve showed that half of the soldiers who were injured during/following the course (20 soldiers) were recorded as injured in the first half of the course (during the first 46 days of the 92-day course). Logistic regression showed that the pre-course parameters that were significant among injured soldiers compared with the non-injured soldiers were: low CAIT results (OR = 2.736, 95% CI = 1.178-6.354), high BMI (OR = 1.234, 95% CI = 1.082-1.406) and reduced proprioceptive ability (OR =.858, 95% CI =.797-.924).

CONCLUSION

With a high prevalence of soldiers injured during and following a commanders course, a somatosensory intervention program should be generalized into the practical daily preparation and training routines of the soldiers for improving somatosensory abilities, optimizing military physical readiness, and for preventing future musculoskeletal injuries.

The influence of fatigue in evertor muscles during lateral ankle sprain

Ankle sprain in plantarflexion and inversion is one of the most common injuries occurring in daily activities and sports. Although acute symptoms may resolve quickly, many individuals have reported persistent pain and instability. Thus, understanding the factors that contribute to the occurrence of this type of injury is extremely important. Although sprains are multifactorial, a relationship can be established between sprain and fatigue. Therefore, the present study examined the latency and intensity of activation of the peroneus longus and brevis muscles under conditions of fatigue. Twenty-three women participated in the study, including 12 with functional instability of the ankle and 11 without a history of sprain. To induce fatigue, the volunteers maintained the force of eversion and plantarflexion at 70% of the maximum voluntary isometric contraction for as long as possible until a 10% decline in the rated force occurred. Ten simulations of ankle sprains were performed before and after fatigue at random for each side, with simultaneous recordings of the electromyographic signals, using a simulator platform for inversion sprain and plantarflexion. As a result, after fatigue, no change in latency was observed. However, a reduction in the intensity of contraction of the muscles analyzed in both groups was observed. Neuromuscular control was concluded to be compromised in situations of fatigue, while differences in muscle behavior were not observed between stable and unstable ankles.

The effect of ankle tape on joint position sense after local muscle fatigue: a randomized controlled trial

Background

Ankle tape is widely used by athletes to prevent ankle sprain. Although there is growing evidence that ankle tape improve joint position sense, but yet it is not clear even if tape improve joint position sense after muscle fatigue, because fatigue impair joint position sense and raise the risk of ankle sprain. The aim of this study is to examine the effect of ankle tape on joint position sense after local muscle fatigue.

Method

This trial is a randomized controlled trial. 34 healthy subjects participated in this trial. Subjects were randomized distributed into two groups: with tape and without tape. Active and passive absolute error and variable error mean values for two target positions of the ankle joint (15° inversions and inversion minus 5°) before and after fatigue protocol consisted of 30 consecutive maximal concentric/concentric contractions of the ankle evertors and invertors. In this trail joint position sense for all subjects was assessed using The Biodex System isokinetic dynamometer 3, this system is used also for fatigue protocol.

Results

For the variable error (VE), significant mean effect was found for active joint position sense in 15° of inversion after muscle fatigue (P < 0, 05). It was a significant decrease in the work in the last third of inversion detected (P < 0, 05). There was no significant main effect found for fatigue index of eversion.

Conclusion

Ankle tape can improve joint position sense at the fatigue session when joint position sense becomes worse. As a result, ankle tape may be useful to prevent ankle sprain during playing sports. We suggest athletes and individuals at risk of ankle sprain to apply taping before high-load activity.

Trial registration

The study was retrospectively registered on the ISRCTN registry with study ID ISRCTN30042335 on 12th December 2017.

The effect of repetitive ankle perturbations on muscle reaction time and muscle activity

The use of a tilt platform to simulate a lateral ankle sprain and record muscle reaction time is a well-established procedure. However, a potential caveat is that repetitive ankle perturbation may cause a natural attenuation of the reflex latency and amplitude. This is an important area to investigate as many researchers examine the effect of an intervention on muscle reaction time. Muscle reaction time, peak and average amplitude of the peroneus longus and tibialis anterior in response to a simulated lateral ankle sprain (combined inversion and plantar flexion movement) were calculated in twenty-two physically active participants. The 40 perturbations were divided into 4 even groups of 10 dominant limb perturbations. Within-participants repeated measures analysis of variance (ANOVA) tests were conducted to assess the effect of habituation over time for each variable. There was a significant reduction in the peroneus longus average amplitude between the aggregated first and last 10 consecutive ankle perturbations (F2.15,45.09=3.90, P=0.03, ɳp(2)=0.16). Authors should implement no more than a maximum of 30 consecutive ankle perturbations (inclusive of practice perturbations) in future protocols simulating a lateral ankle sprain in an effort to avoid significant attenuation of muscle activity.

Ankle muscle strength influence on muscle activation during dynamic and static ankle training modalities

Muscle weakness is considered a risk factor for ankle injury. Balance training and barefoot running have been used in an attempt to strengthen the muscles crossing the ankle. It is expected that training tasks that successfully strengthen the ankle would elicit increased muscular activity. However, it is unknown how an individual's ankle strength will influence the muscle activity used during a given task. Twenty-six participants performed dynamic (shod, barefoot running) and static tasks (squat on ground, squat on ®Bosu Ball) believed to strengthen the muscles surrounding the ankle. Electromyographic signals of the tibialis anterior, peroneus longus, gastrocnemius lateralis (GL) and gastrocnemius medialis (GM) were recorded and analysed using a non-linearly scaled wavelet analysis. Participants were divided into a strong group and a weak group according to their isometric plantar-flexion torque. The weak group required more relative GL and GM muscle activity during each training task compared to the strong group. No difference was observed between shod and barefoot running. There was a significant effect of training task on muscle activation level for the weak group. Differences in ankle strength had a significant impact on muscle activation.

A fadiga influencia a resposta dos músculos eversores após a simulação de uma entorse do tornozelo?

INTRODUÇÃO: a entorse em inversão do tornozelo, uma das lesões mais comuns do esporte, muitas vezes ocorre na fase final de um treino ou competição. Mesmo sabendo que a entorse é multifatorial, tal característica gera a hipótese que a fadiga muscular possa ser um fator predisponente para o desenvolvimento da lesão.OBJETIVO: a presente investigação propõe o estudo da resposta reflexa dos músculos fibular curto e longo em condições de fadiga.MÉTODOS: participaram do estudo 10 voluntárias do sexo feminino, sem histórico de entorse do tornozelo, fisicamente ativas. Utilizou-se uma plataforma simuladora da entorse em inversão do tornozelo, na qual ambos os pés das voluntárias foram fixados e somente abaixo do fixador do pé direito encontrava-se um transdutor de força. Para a indução da fadiga, inicialmente foi registrada a contração isométrica voluntária máxima (CIVM) em eversão. Durante a indução, as voluntárias foram orientadas a manter 70% da CIVM. No momento em que a força aplicada era menor que 60% da CIVM o protocolo era interrompido e as voluntárias imediatamente posicionadas sobre a plataforma simuladora. Antes e após a fadiga foram realizadas 10 simulações da entorse em ambos os tornozelos, de forma aleatória, e simultaneamente, o sinal eletromiográfico foi registrado. A análise, no domínio do tempo, contemplou o estudo da latência e da amplitude do sinal.RESULTADOS: após a fadiga não houve alteração da latência, no entanto, ocorreu uma redução da amplitude do sinal. A queda da amplitude do sinal pode ser considerada uma resposta ao processo de fadiga. Esse decréscimo é um indicativo da diminuição da capacidade de recrutamento das unidades motoras decorrentes das alterações do input neural que chega ao músculo.CONCLUSÃO: a fadiga muscular diminui a amplitude da resposta dos músculos eversores após a entorse do tornozelo.

Military exercises, knee and ankle joint position sense, and injury in male conscripts: a pilot study

CONTEXT

The high incidence of lower limb injuries associated with physical exercises in military conscripts suggests that fatigue may be a risk factor for injuries. Researchers have hypothesized that lower limb injuries may be related to altered ankle and knee joint position sense (JPS) due to fatigue.

OBJECTIVE

To evaluate if military exercises could alter JPS and to examine the possible relation of JPS to future lower extremity injuries in military service.

DESIGN

Cohort study.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

A total of 50 male conscripts (age = 21.4 ± 2.3 years, height = 174.5 ± 6.4 cm, mass = 73.1 ± 6.3 kg) from a unique military base were recruited randomly. main outcome measure(s): Participants performed 8 weeks of physical activities at the beginning of a military course. In the first part of the study, we instructed participants to recognize predetermined positions before and after military exercises so we could examine the effects of military exercise on JPS. The averages of the absolute error and the variable error of 3 trials were recorded. We collected data on the frequency of lower extremity injuries over 8 weeks. Next, the participants were divided into 2 groups: injured and uninjured. Separate 2 × 2 × 2 (group-by-time-by-joint) mixed-model analyses of variance were used to determine main effects and interactions of these factors for each JPS measure. In the second part of the study, we examined whether the effects of fatigue on JPS were related to the development of injury during an 8-week training program. We calculated Hedges effect sizes for JPS changes postexercise in each group and compared change scores between groups.

RESULTS

We found group-by-time interactions for all JPS variables (F range = 2.86-4.05, P < .01). All participants showed increases in JPS errors postexercise (P < .01), but the injured group had greater changes for all the variables (P < .01).

CONCLUSIONS

Military conscripts who sustained lower extremity injuries during an 8-week military exercise program had greater loss of JPS acuity than conscripts who did not sustain injuries. The changes in JPS found after 1 bout of exercise may have predictive ability for future musculoskeletal injuries.

Effects of Inversion Perturbation After Step-Down on the Latency of the Peroneus Longus and Peroneus Brevis

The purpose of this investigation was to determine the effect of different types of ankle sprains on the response latency of the peroneus longus and peroneus brevis to an inversion perturbation, as well as the time to complete the perturbation (time to maximum inversion). To create a forced inversion moment of the ankle, an outer sole with fulcrum was used to cause 25 degrees of inversion at the ankle upon landing from a 27 cm step-down task. Forty participants completed the study: 15 participants had no history of any ankle sprain, 15 participants had a history of a lateral ankle sprain, and 10 participants had a history of a high ankle sprain. There was not a significant difference between the injury groups for the latency measurements or the time to maximum inversion. These findings indicate that a previous lateral ankle sprain or high ankle sprain does not affect the latency of the peroneal muscles or the time to complete the inversion range of motion.

Peroneal reaction time measurement in unipodal stance for two different destabilization axes

BACKGROUND

The variability of peroneal reaction time measurements is a major problem when using this parameter to control rehabilitation or proprioceptive training processes. In order to control peroneal reaction time values, some extrinsic factors should be considered. The purpose of this study was to measure peroneal reaction time in unipodal stance for two different destabilization axes.

METHODS

The peroneal reaction time of 10 healthy subjects was measured from kinematic and electromyograhic data in an experimental study using an ankle destabilization device.

FINDINGS

In a preliminary analysis, results showed that the destabilization axis orientation did not affect peroneal reaction time values (68.5 ms, standard deviation=9.5 ms and 71.5 ms, standard deviation=8 ms for destabilizations in the frontal plane and around the Henke's axis, respectively). However, the inter-trial variance of inversion velocity peaks explained between 40% and 49% of the peroneal reaction time variance. When trials were selected on the basis of homogeneous inversion velocity peaks, results showed that peroneal reaction time values for the peroneus brevis were shorter during inversion movements performed around the physiological Henke's tilting axis (63 ms, standard deviation=9 ms vs. 71 ms, standard deviation=8 ms).

INTERPRETATION

Our findings evidenced that tilting axis orientation must be considered as an extrinsic factor that may influence peroneal reaction time. Moreover it also seems necessary to consider inversion speed values to adequately compare peroneal reaction time values.

Effects of ankle fatigue on functional reflex activity during gait perturbations in young and elderly men

There is growing evidence that aging and muscle fatigue result in impaired postural reflexes in humans. Therefore, the objective of this study was to examine the effects of ankle fatigue on functional reflex activity (FRA) during gait perturbations in young and elderly men. Twenty-eight young (27.0+/-3.1 years, n=14) and old (67.2+/-3.7 years, n=14) healthy active men participated in this study. Fatigue of the plantarflexors and dorsiflexors was induced by isokinetic contractions. Pre and post-fatigue, subjects were tested for their ability to compensate for decelerating gait perturbations while walking on a treadmill. Latency, FRA of lower extremity muscles and angular velocity of the ankle joint complex were analysed by means of surface electromyography and goniometry. After the fatigue protocol, no significant main and interaction effects were detected for the parameter latency in m. tibialis anterior (TA). For both groups, a significant pre to post-test decrease in FRA in TA (p<.001) was observed coming along with increases in antagonist coactivity (p=.013) and maximal angular velocity of the ankle joint (p=.007). However, no significant groupxtest interactions were found for the three parameters. Ankle fatigue has an impact on the ability to compensate for gait perturbations in young and elderly adults. However, no significant differences in all analysed parameters were detected between young and elderly subjects. These results may imply that age-related deteriorations in the postural control system do not specifically affect the ability to compensate for gait perturbations under fatigued condition.

Effects of fatigue due to contraction of evertor muscles on the ankle joint position sense in male soccer players

BACKGROUND

The high incidence of ankle sprains that occur later in matches suggests that fatigue may contribute to altered neuromuscular control of the ankle. Moreover, deficits in ankle joint position sense (JPS) were seen in patients with a history of recurrent ankle sprains. It has been hypothesized that ankle sprains may be related to altered ankle JPS as a consequence of fatigue.

PURPOSE

To evaluate if fatiguing contractions of evertor muscles alter the ankle JPS.

STUDY DESIGN

Controlled laboratory study.

METHODS

Thirty-six soccer players (age, 24.7 +/- 1.3 years; height, 183.7 +/- 8.2 cm; weight, 78.9 +/- 7.9 kg) were recruited. Subjects were asked to recognize 2 positions (15 degrees of inversion and maximal active inversion minus 5 degrees ) for 2 conditions: normal and fatigue. Muscular fatigue was induced in evertor muscles of the dominant leg by using isometric contractions. The average of the absolute and variable errors of 3 trials were recorded for both fatigue and nonfatigue conditions. A matched control group of 36 soccer players (age, 23.9 +/- 0.9 years; height, 181.2 +/- 6.9 cm; weight, 77.8 +/- 6.5 kg) was asked to recognize the same positions, before a soccer match and after 45 minutes of playing, and their same scores were recorded. Finally, results of the 2 groups were compared.

RESULTS

There was significant decrease in subjects' ability to recognize passive and active repositioning of their ankle after a fatigue protocol (P <.001). Passive and active JPS were reduced after playing (P <.001). There was no significant difference between 2 groups in the results of JPS before and after the intervention (P > .1).

CONCLUSION

The acuity of the ankle JPS is reduced subsequent to a fatigue protocol and after a soccer match.

CLINICAL RELEVANCE

Evaluation of athletes' ankle JPS before returning to physical activity may prevent further injuries.

Ankle bracing, plantar-flexion angle, and ankle muscle latencies during inversion stress in healthy participants

CONTEXT

Ankle braces may enhance ankle joint proprioception, which in turn may affect reflexive ankle muscle activity during a perturbation. Despite the common occurrence of plantar-flexion inversion ankle injuries, authors of previous studies of ankle muscle latencies have focused on inversion stresses only.

OBJECTIVE

To examine the latency of the peroneus longus (PL), peroneus brevis (PB), and tibialis anterior (TA) muscles in response to various degrees of combined plantar-flexion and inversion stresses in braced and unbraced asymptomatic ankles.

DESIGN

Repeated measures.

SETTING

University biomechanics laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twenty-eight healthy females and 12 healthy males (n = 40: mean age = 23.63 years, range = 19 to 30 years; height = 172.75 +/- 7.96 cm; mass = 65.53 +/- 12.0 kg).

INTERVENTION(S)

Participants were tested under 2 conditions: wearing and not wearing an Active Ankle T1 brace while dropping from a custom-made platform into 10 degrees , 20 degrees , and 30 degrees of plantar flexion and 30 degrees of inversion.

MAIN OUTCOME MEASURE(S)

The time between platform drop and the onset of PL, PB, and TA electromyographic activity was measured to determine latencies. We calculated a series of 2-way analyses of variance to determine if latencies were different between the conditions (braced and unbraced) and among the plantar-flexion angles (alpha = .05).

RESULTS

No interaction was found between condition and plantar-flexion angle. No significant main effects were found for condition or plantar-flexion angle. Overall means for braced and unbraced conditions were not significantly different for each muscle tested. Overall means for angle for the PL, PB, and TA were not significantly different.

CONCLUSIONS

Reflexive activity of the PL, PB, or TA was unaffected by the amount of plantar flexion or by wearing an Active Ankle T1 brace during an unanticipated plantar-flexion inversion perturbation.