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Brown EC, Kilgore LJ, Pierce K, Knox A, Haworth JL. Movement pattern definitions for resistance training behavior measurement in diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1447595. [PMID: 39258167 PMCID: PMC11385598 DOI: 10.3389/fcdhc.2024.1447595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 07/29/2024] [Indexed: 09/12/2024]
Abstract
Type 2 diabetes can result in debilitating vascular complications, and resistance training (RT) is an effective therapy for improving cardiovascular outcomes. However, only 10-30% of adults meet the public health guidance for RT. While current RT guidelines focus on targeting major muscle groups, guidance specific to simplified movement categorization may augment understanding of RT programming and improve uptake and outcomes. Current movement pattern definitions and descriptions lack clarity, accuracy, and consistency. This paper proposes movement definitions and descriptions to be used for RT intervention design and prescription, and includes the following categories: hip, knee, ankle, vertebral column, vertical push, horizontal push, vertical pull, and horizontal pull. These categories are intended to aid clinicians, researchers, and trainers in RT surveillance and RT intervention design for improving vascular complications in type 2 diabetes. Simplified RT program design using these categories may also facilitate greater RT program understanding and adherence for patients.
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Affiliation(s)
- Elise C Brown
- Department of Public and Environmental Wellness, Oakland University, Rochester, MI, United States
| | - Lon J Kilgore
- Department of Curriculum Development & Delivery, Kilgore Academy, Halfway, MO, United States
| | - Kyle Pierce
- Kinesiology & Health Science, Louisiana State University Shreveport, Shreveport, LA, United States
| | - Allan Knox
- Department of Exercise Science, California Lutheran University, Thousand Oaks, CA, United States
| | - Joshua L Haworth
- Department of Human Movement Science, Oakland University, Rochester, MI, United States
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Hu D, Sun H, Wang S, Wang H, Zheng X, Tang H, Hou H. Treatment and prevention of chronic ankle instability: An umbrella review of meta-analyses. Foot Ankle Surg 2024:S1268-7731(24)00159-0. [PMID: 39107216 DOI: 10.1016/j.fas.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/13/2024] [Accepted: 07/26/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is a common and highly disabling condition. Although several studies have evaluated and analyzed prevention and treatment strategies for CAI, an unbiased and systematic synthesis of evidence is required to provide the most powerful and comprehensive evidence-based measures for the its prevention and treatment of CAI. This study aimed to synthesize evidence from the existing literature addressing the treatment and prevention of CAI. METHODS The PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for relevant studies from inception to December 12, 2023. Data on effect sizes and corresponding 95 % confidence intervals for selected intervention measures were extracted. Systematic reviews were assessed for quality of included studies using a measurement tool (i.e., "AMSTAR 2"). RESULTS In total, 37 studies were included, among which 21 (57 %) were of high or moderate quality. Strong evidence suggested that lower weight (P < 0.001), lower body mass index (P = 0.002), and non-stability defects (P = 0.04) significantly reduced the risk of developing CAI. Strong evidence supported exercise and moderate evidence supported manual therapy, acupuncture, and surgery for improving CAI. Additionally, external support plays an active role in the treatment process of CAI. CONCLUSION This is the first study synthesizing evidence supporting interventions for the treatment and prevention of CAI. Low body weight and body mass index were effective preventive measures against CAI. Exercise, manual therapy, acupuncture, and surgery can improve ankle function in patients with CAI. Plantar sensory treatment and neuromuscular training may be good therapeutic options for patients with CAI. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Dahai Hu
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, 510630 Guangzhou, China; International School, Jinan University, Guangzhou, Guangdong 510632, China
| | - Hongyan Sun
- The Biomedical Translational Research Institute, Jinan University, Guangzhou 510632, China
| | - Shengli Wang
- The Biomedical Translational Research Institute, Jinan University, Guangzhou 510632, China
| | - Huajun Wang
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, 510630 Guangzhou, China
| | - Xiaofei Zheng
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, 510630 Guangzhou, China.
| | - Hui Tang
- The Clinical Medicine Research Institute, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China; The Clinical Medicine Research Institute, The Fifth Affiliated Hospital of Jinan University, Heyuan 517000, China.
| | - Huige Hou
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, 510630 Guangzhou, China.
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Kazemi K, Javanshir K, Saadi F, Goharpey S, Shaterzadeh Yazdi MJ, Calvo-Lobo C, López-López D, Nassadj G. The Effect of Additional Neuromuscular Training on Peri-Ankle Muscle Morphology and Function in Chronic Ankle Instability Subjects: A Randomized Controlled Trial. Sports Health 2024:19417381241258467. [PMID: 38898814 DOI: 10.1177/19417381241258467] [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: 06/21/2024] Open
Abstract
BACKGROUND Lateral ankle sprain is one of the most common musculoskeletal issues during sports and activities of daily living. This study investigated the effect of combined neuromuscular training and conventional training (including strengthening, range of motion, and balance exercises) on muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with chronic ankle instability (CAI). HYPOTHESIS The combination of neuromuscular and conventional training programs might result in additional benefits on the morphology of muscle, dynamic balance, and functional capacity in subjects with CAI. STUDY DESIGN A single-blind parallel-arm randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS A total of 34 participants with CAI were divided randomly into experimental (EG) and control groups (CG). The EG received conventional and neuromuscular training, while the CG underwent conventional training. Cross-sectional areas of the peroneus longus and tibialis anterior muscles were measured using ultrasonography. Measurements included reaching direction distance, ankle instability, and the foot and ankle outcome score, all evaluated before and immediately after 12 intervention sessions and 4 weeks later in the follow-up phase. RESULTS Repeated-measures analysis of variance (ANOVA) revealed significant improvement in the EG, particularly in the cross-sectional area of the tibialis anterior muscle on the injured side and the posteromedial reaching direction displacement of the Y balance test. Moreover, the EG's foot and ankle outcome scores increased significantly compared with the CG (P < 0.05). However, the group effect size ranged from minor to moderate (Hedges g, 0.40-0.73). CONCLUSION Combining neuromuscular and conventional training programs yields greater benefits than conventional training alone regarding tibialis anterior muscle morphology, posteromedial dynamic balance, and functional capacity in persons with CAI. CLINICAL RELEVANCE The combination of neuromuscular and conventional training programs could enhance muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with CAI.
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Affiliation(s)
- Khadijeh Kazemi
- Department of Rehabilitation, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Khodabakhsh Javanshir
- Department of Physiotherapy, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Feryal Saadi
- Department of Radiology, Medicine School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahin Goharpey
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Jafar Shaterzadeh Yazdi
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - César Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniel López-López
- Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
| | - Gholamhossein Nassadj
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Stanković M, Čaprić I, Katanić B, Špirtović O, Maljanović D, Nailović H, Muković I, Jelaska I, Trajković N. Proprioceptive training methods (PTM) in female soccer players - a systematic review. BMC Sports Sci Med Rehabil 2024; 16:101. [PMID: 38689340 PMCID: PMC11061981 DOI: 10.1186/s13102-024-00892-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Although previous studies have reported that proprioceptive training methods (PTM) have positive effects, there is a relatively small number of studies regarding the impact of PTM in women's soccer. Therefore, there is a need to systematize the given results. In this regard, this systematic review aimed to investigate the effect of proprioceptive training methods in female soccer players. METHODS The studies' search and analysis were done according to the PRISMA guidelines. The following databases were checked (Google Scholar, PubMed Cochrane and ProQuest), with additional publication time criteria (2000-2023) using the following keywords: proprioceptive, balance, neuromuscular, training, exercise, intervention, method, activity, female football players, female soccer players, woman soccer players. RESULTS A total of 7 studies were included in the quantitative synthesis that meet all the criteria with the number of participants being 2.247. Based on the analysis of the previous research and detailed discussion, the main findings of the study resulted in the partial improvement of explosive strength (66%), strength (50%), muscle imbalance and flexibility (50%) and the prevention and reduction of lower extremity injuries in female soccer players (60%). Only one study reported no significant differences between groups, where rate of major injuries was higher in experimental group. CONCLUSION The obtained results indicate the necessity to implement proprioceptive training in female soccer training programs, in order to influence the prevention and reduction of injuries and improve balance, proprioceptive ability and body control.
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Affiliation(s)
- Mima Stanković
- Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia.
| | - Ilma Čaprić
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Borko Katanić
- Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia
| | - Omer Špirtović
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Džejla Maljanović
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Hamza Nailović
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Iso Muković
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Igor Jelaska
- Faculty of Kinesiology, University of Split, Split, 21000, Croatia
| | - Nebojša Trajković
- Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia
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Marvulli R, Ianieri G, Pignatelli G, Santagati D, Ranieri M, Megna M. Electronic Method (Pro-Kin) for Improving and Speeding Up the Recovery After Ankle Sprain. Endocr Metab Immune Disord Drug Targets 2024; 24:1572-1580. [PMID: 35616674 DOI: 10.2174/1871530322666220523155452] [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: 01/14/2021] [Revised: 05/07/2021] [Accepted: 05/24/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Ankle sprains, very common injuries occurred especially during sports activities, are mainly caused by indirect trauma, which influences exaggerated stress exceeding the strength of stabilization mechanisms. Up to 85% of such injuries result from a sudden flexion and inversion of the foot. In this study, we analyzed the effectiveness of the platform Pro-kin, an innovative system that has given us the possibility to combine the functionality of the older proprioceptive boards with very accurate software in order to improve and accelerate the recovery after ankle injuries. METHODS 30 patients with moderate ankle sprain outcomes in two groups (A and B) were included in this study. Group A was only treated with proprioceptive exercises for 3 weeks, while the group B was trained with the innovative Pro-kin. In both groups, we evaluated VAS scale, the ratio between the number of circumductions performed by the injured foot and the time spent on doing them and the percentage of load among the injured and the healthy foot in statics and dynamics with electronic baropodometry. Our data has been collected at t0 (beginning of study), t1 (one week later), t2 (two weeks later), t3 (one month later), t4 (two months later), and then analyzed by the two-way analysis of variance (2-way ANOVA) test. RESULTS At t0 no statistical differences of pain in the 2 groups (3.3 and 3.4); the values were similar, as well as at time t1, t2, t3 and t4. Therefore we deduce that Pro-kin treatment is not painful. The number of circumductions performed was definitely better in B group since the first week; for the A group the values considerably increased only at t3 (one month later). Comparing the load percentages on two feet detected by the electronic baropodometer in statics and in dynamics, we deduced that the patients of A group tend to lean mostly on the healthy foot than B group. CONCLUSION This study demonstrates that new technological resources (such as Pro-kin) may be helpful to improve and speed up the recovery of ankle sprain in athletes.
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Affiliation(s)
- Riccardo Marvulli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
- Local Healthcare Company of Bari-Health District of Bari City, Bari, Italy
| | - Giancarlo Ianieri
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Giovanni Pignatelli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
- Local Healthcare Company of Brindisi-Health District of Brindisi 1, Bari, Italy
| | - Dario Santagati
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
- Rehabilitation Center Marcoccio SRL, Via Umberto I, 121, 95129 Catania, Italy
| | - Maurizio Ranieri
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Marisa Megna
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Policlinico of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
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Fakontis C, Iakovidis P, Kasimis K, Lytras D, Koutras G, Fetlis A, Algiounidis I. Efficacy of resistance training with elastic bands compared to proprioceptive training on balance and self-report measures in patients with chronic ankle instability: A systematic review and meta-analysis. Phys Ther Sport 2023; 64:74-84. [PMID: 37801793 DOI: 10.1016/j.ptsp.2023.09.009] [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: 07/31/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Proprioceptive training and resistance training are physiotherapy treatment methods for Chronic Ankle Instability (CAI). OBJECTIVE To compare the efficacy of proprioceptive training to resistance training with elastic bands for treating CAI as measured by the Star Excursion Balance Test (SEBT), the Foot and Ankle Ability Measure (FAAM), and the Cumberland Ankle Instability Tool (CAIT). METHOD Our systematic study and meta-analysis was based on the PICOS and PRISMA protocols. The PubMed, PEDro, and ScienceDirect databases were searched for randomized clinical trials on proprioceptive and resistance training. Risk of bias was assessed according to Cochrane guidelines and quality of evidence was reported using the Grading of Recommendations Assessment, Development, and Evaluation approach (GRADE). RESULTS Five studies involving 259 patients were included in the review. According to the findings of the meta-analysis, proprioceptive training was similarly effective with resistance training in SEBT and FAAM measures. Compared with resistance exercise, proprioceptive training demonstrated some benefits in CAIT scores (weighted mean difference [WMD] = -2.21, 95% CI = -4.05-0.36), but these intervention results were not clinically significant (MDC, MCID score >3 points). CONCLUSION Low-quality evidence from studies showed that neither of the interventions was superior on the SEBT or the FAAM scores in individuals with CAI because no clinically significant differences were found. More high-quality studies comparing the two interventions are needed to draw firm conclusions.
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Affiliation(s)
- Christos Fakontis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Paris Iakovidis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Konstantinos Kasimis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Dimitrios Lytras
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece.
| | - Georgios Koutras
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Antonis Fetlis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
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Tennler J, Raeder C, Praetorius A, Ohmann T, Schoepp C. Effectiveness of the SMART training intervention on ankle joint function in patients with first-time acute lateral ankle sprain: study protocol for a randomized controlled trial. Trials 2023; 24:162. [PMID: 36869403 PMCID: PMC9985260 DOI: 10.1186/s13063-023-07195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The lateral ankle sprain (LAS) is the most common injury in the field of everyday and sports-related activities. There is a high rate of patients with LAS who will develop chronic ankle instability (CAI). A possible explanation for this high rate is an insufficient rehabilitation and/or a premature return to intense exercise and workloads. Currently, there are general rehabilitation guidelines for LAS but there is a lack of standardized evidenced-based rehabilitation concepts for LAS, which effectively reduce the high CAI rate. The primary aim of the study is to investigate the effectiveness of a 6-week sensorimotor training intervention (SMART-Treatment, SMART) in contrast to standard therapy (Normal Treatment, NORMT) after an acute LAS on perceived ankle joint function. METHODS This study will be a prospective, single-center, interventional randomized controlled trial with an active control group. Patients (14-41 years) with an acute LAS and a MRI confirmed lesion or rupture of at least one ankle ligament will be included. Exclusion criteria are acute concomitant injuries of the ankle, pre-injuries of the ankle, serious lower-extremity injuries of the last 6 months, lower-extremity surgery, and neurological diseases. The primary outcome measure will be the Cumberland Ankle Instability Tool (CAIT). Secondary outcomes include the Foot and Ankle Ability Measurement (FAAM), isokinetic and isometric strength diagnostics, joint repositioning sense, range of motion, measurements of postural control, gait and run analysis, and jump analysis. This protocol will follow the SPIRIT guidance. DISCUSSION Current management of LAS rehabilitation lacks since there is a high rate of patients developing a CAI. It has been shown that exercise therapy improves ankle function in acute LAS as well as in patients with CAI. It is further recommended to address specific impairment domains in ankle rehabilitation. However, empirical data for such a holistic treatment algorithm is missing. Therefore, this study has the potential to improve the healthcare for LAS patients and might be used for a future standardized evidence-based rehabilitation concept. TRIAL REGISTRATION "Prospectively registered" ISRCTN - ISRCTN13640422 17/11/2021; DRKS (German Clinical Trials Register) - DRKS00026049.
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Affiliation(s)
- Janina Tennler
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.
| | - Christian Raeder
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Arthur Praetorius
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Tobias Ohmann
- Research Department, BG Klinikum Duisburg, Duisburg, Germany
| | - Christian Schoepp
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.,Department of Trauma and Reconstructive Surgery, University Hospital, Essen, Germany
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de Ruvo R, Russo G, Lena F, Giovannico G, Neville C, Turolla A, Torre M, Pellicciari L. The Effect of Manual Therapy Plus Exercise in Patients with Lateral Ankle Sprains: A Critically Appraised Topic with a Meta-Analysis. J Clin Med 2022; 11:4925. [PMID: 36013167 PMCID: PMC9409935 DOI: 10.3390/jcm11164925] [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: 06/17/2022] [Revised: 08/08/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
A high percentage of patients with lateral ankle sprains report poor outcomes and persistent neuromuscular impairment leading to chronic ankle instability and re-injury. Several interventions have been proposed and investigated, but the evidence on manual therapy combined with therapeutic exercise for pain reduction and functional improvement is still uncertain. The purpose was to study the effectiveness of adding manual therapy to therapeutic exercise in patients with lateral ankle sprains through a critically appraised topic. The literature search was performed in PubMed, PEDro, EMBASE and CINAHL databases, and only randomized clinical trials were included according to following criteria: (1) subjects with acute episodes of lateral ankle sprains, (2) administered manual therapy plus therapeutic exercise, (3) comparisons with therapeutic exercise alone and (4) reported outcomes for pain and function. Three randomized clinical trials (for a total of 180 patients) were included in the research. Meta-analyses revealed that manual therapy plus exercise was more effective than only exercises in improving dorsal (MD = 8.79, 95% CI: 6.81, 10.77) and plantar flexion (MD = 8.85, 95% CI 7.07, 10.63), lower limb function (MD = 1.20, 95% CI 0.63, 1.77) and pain (MD = -1.23; 95% IC -1.73, -0.72). Manual therapy can be used with therapeutic exercise to improve clinical outcome in patients with lateral ankle sprains.
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Affiliation(s)
- Rocco de Ruvo
- Fondazione Centri di Riabilitazione “Padre Pio Onlus”, 71013 San Giovanni Rotondo, Italy
| | - Giuseppe Russo
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Francesco Lena
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
- IRCCS INM Neuromed, 86077 Isernia, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Christoper Neville
- Department of PT Education, Upstate Medical University, Syracuse, NY 13210, USA
| | - Andrea Turolla
- Dipartimento di Scienze Biomediche e Neuromotorie—DIBINEM, Università degli Studi di Bologna, 40126 Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria, 40138 Bologna, Italy
| | - Monica Torre
- Sanstefar Abruzzo Riabilitazione, 65100 Pescara, Italy
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Glasser L, Frey M, Frias GC, Varghese B, Melendez JX, Hawes JD, Escobar J, Katt BM. Ballet Rehabilitation: A Novel Return to Sport Protocol. Cureus 2022; 14:e27896. [PMID: 36120223 PMCID: PMC9467490 DOI: 10.7759/cureus.27896] [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] [Accepted: 08/11/2022] [Indexed: 11/05/2022] Open
Abstract
Dance injuries and re-injuries are common but can be difficult to rehabilitate because of the unique demands and motor skills required. During tissue healing, pain resolves prior to tissue maturation and re-injury often occurs if the original injury is not properly rehabilitated. The purpose of this narrative review is to analyze the existing literature addressing ballet injury, re-injury, and recovery, and to provide clinicians with timing guidelines for entering and implementing a Return to Sport (RTS) ballet rehabilitation protocol designed to prevent re-injury by progressive, sport-specific tissue loading. Thus far, a literature-based ballet-specific and body region-specific late-stage rehabilitation RTS protocol has not been established. The authors sought to address this literature gap by combining this comprehensive narrative review with our extensive clinical expertise to develop a late-stage rehabilitation RTS protocol to help guide medical clinicians treating injured ballet dancers.
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Otsuka S, Papadopoulos K, Bampouras TM, Maestroni L. What is the effect of ankle disk training and taping on proprioception deficit after lateral ankle sprains among active populations? – A systematic review. J Bodyw Mov Ther 2022; 31:62-71. [DOI: 10.1016/j.jbmt.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/05/2022] [Accepted: 04/02/2022] [Indexed: 11/24/2022]
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Tomás R, Visco CJ. Management of Acute Ankle Sprains in the Athlete. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-021-00336-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lin CW, You YL, Chen YA, Wu TC, Lin CF. Effect of Integrated Training on Balance and Ankle Reposition Sense in Ballet Dancers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312751. [PMID: 34886476 PMCID: PMC8657441 DOI: 10.3390/ijerph182312751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the effects of a 6-week integrated training program on the ankle joint reposition sense and postural stability in ballet dancers. METHODS Sixteen female ballet dancers participated in the study and underwent a 6-week integrated training program consisting of plyometric, proprioception and core stability exercises along with a home program involving additional ankle muscle strengthening and stretching. The ankle joint reposition tests and the parameters of the center of pressure (COP) while performing grand-plie (deep squatting) and releve en demi-pointe (standing on balls of foot) movements were measured before and after training. RESULTS After 6 weeks, participants showed significantly smaller absolute ankle joint reposition errors in dorsiflexion (p = 0.031), plantarflexion (p = 0.003) and eversion (p = 0.019) compared to the pre-training measurement. Furthermore, after training, a significantly slower average COP speed at pre-equilibrium during grand-plie movement (p = 0.003) and pre-equilibrium phase of releve en demi-pointe (p = 0.023) were observed. In addition, the maximum COP displacement in the medial-lateral direction was significantly smaller at pre-equilibrium phase during grand-plie (p = 0.044) and releve en demi-pointe movements (p = 0.004) after training. CONCLUSIONS The 6-week integrated training program improved the ankle joint reposition sense and postural control in the medial-lateral direction during grand-plie and releve en demi-pointe movements.
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Affiliation(s)
- Chai-Wei Lin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan 701, Taiwan; (C.-W.L.); (Y.-L.Y.)
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821, Taiwan
| | - Yu-Lin You
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan 701, Taiwan; (C.-W.L.); (Y.-L.Y.)
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-A.C.); (T.-C.W.)
| | - Yi-An Chen
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-A.C.); (T.-C.W.)
| | - Tzu-Chan Wu
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-A.C.); (T.-C.W.)
| | - Cheng-Feng Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (Y.-A.C.); (T.-C.W.)
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan 701, Taiwan
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 5911)
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Chen Z. Clinical evaluation of a wrist sensorimotor rehabilitation program for triangular fibrocartilage complex injuries. HAND THERAPY 2021; 26:123-133. [PMID: 37904835 PMCID: PMC10584051 DOI: 10.1177/17589983211033313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 06/30/2021] [Indexed: 11/01/2023]
Abstract
Introduction Triangular fibrocartilage complex (TFCC) injuries are associated with distal radioulnar joint (DRUJ) instability and impaired wrist proprioception. Sensorimotor training of extensor carpi ulnaris (ECU) and pronator quadratus (PQ) can enhance DRUJ stability. With limited evidence on effectiveness of TFCC sensorimotor rehabilitation, this study aimed to evaluate the effects and feasibility of a novel wrist sensorimotor rehabilitation program (WSRP) for TFCC injuries. Methods Patients diagnosed with TFCC injuries were recruited from May 2018 to January 2020 at an outpatient hand clinic in Singapore General Hospital. There are four stages in WSRP: (1) pain control, (2) muscle re-education and joint awareness, (3) neuromuscular rehabilitation, and (4) movement normalization and function. WSRP also incorporated dart throwing motion and proprioceptive neuromuscular facilitation. Outcome measures included grip strength measured with grip dynamometer, numerical pain rating scale, joint position sense (JPS) measurement, weight bearing measured with the 'push-off' test, and wrist function reported on the Patient Rated Wrist Hand Evaluation. Results Ten patients completed the WSRP. Mean changes were compared with minimal clinically important differences (MCID) for outcomes. All patients achieved MCID on pain, 70% of patients achieved MCID on grip strength, weight bearing and wrist function. Paired t-tests and Cohen's D for outcome measures were calculated. There were large effect sizes of 2.47, 1.35, and 2.81 for function, grip strength and pain respectively, and moderate effect sizes of 0.72 and 0.39 for axial loading and JPS respectively. Discussion WSRP presents a potential treatment approach in TFCC rehabilitation. There is a need for future prospective clinical trials with control groups.
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Affiliation(s)
- Zhiqing Chen
- Occupational Therapy Department, Singapore General Hospital, Singapore, Singapore
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14
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Correia FD, Molinos M, Neves C, Janela D, Carvalho D, Luis S, Francisco GE, Lains J, Bento V. Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study. JMIR Rehabil Assist Technol 2021; 8:e31247. [PMID: 34499038 PMCID: PMC8517823 DOI: 10.2196/31247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/16/2021] [Accepted: 07/30/2021] [Indexed: 12/21/2022] Open
Abstract
Background Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. Objective We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. Methods We performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. Results In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of –2.72 points (95% CI –3.31 to –2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM–ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Conclusions Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. Trial Registration ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022
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Affiliation(s)
- Fernando D Correia
- Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Maria Molinos
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Carlos Neves
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Dora Janela
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Diana Carvalho
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Sara Luis
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Gerard E Francisco
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, TX, United States.,TIRR Memorial Hermann, Houston, TX, United States
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal.,Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | - Virgilio Bento
- SWORD Health Technologies, Inc, Draper, UT, United States
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15
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Effectiveness of Hospital-Based Systemic Rehabilitation in Improving Ankle Function after Surgery in Chronic Ankle Instability Patients. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6695096. [PMID: 33575340 PMCID: PMC7861910 DOI: 10.1155/2021/6695096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 11/17/2022]
Abstract
We investigated the therapeutic effect of a postoperative hospital-based systemic rehabilitation protocol on ankle function in chronic ankle instability (CAI) patients. Thirty-five patients who underwent a modified Broström procedure for CAI were recruited in this prospective randomized controlled trial. Fifty-minute sessions of hospital-based rehabilitation were performed three times weekly for 12 weeks in the intervention group. Education-based rehabilitation was conducted at home in the control group. The outcomes were evaluated at baseline (T0), 12 weeks (T1), and 16 weeks (T2). The primary outcome was the foot and ankle outcome score (FAOS). Ankle motor strength and spatiotemporal gait metrics were assessed as secondary outcomes. There were significant time and group interaction effects on the pain, symptoms, activities of daily living, sports activities, and quality of life (QOL) domains of the FAOS (P < 0.05, all). The patients in the intervention group showed larger improvements in all domains of the FAOS than did the control group at both T1 and T2 (P < 0.05, all). The time and group interaction effects on invertor and evertor strength were also significant (P = 0.047 and P = 0.044). Invertor and evertor strength improved significantly more in the intervention group than in the control group at T1 and T2 (P < 0.05, all). The preferred walking velocity, cadence, step length on the affected side, and double stance phase duration tended to improve over time. Postoperative hospital-based rehabilitation helped improve CAI pain, symptoms, independence in activities of daily living, sports activity levels, and QOL more effectively than did conventional rehabilitation at home.
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16
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Effects of TRX Suspension Training on Proprioception and Muscle Strength in Female Athletes with Functional Ankle Instability. Asian J Sports Med 2021. [DOI: 10.5812/asjsm.107042] [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: 11/16/2022] Open
Abstract
Background: Functional ankle instability (FAI) is a common consequence of ankle sprain injury, especially in high-impact sports. Objectives: To investigate the effect of six weeks of suspension training with total resistance exercises (TRX) on proprioception and muscle strength in female athletes with FAI. Methods: Thirty female athletes with FAI (age: 21.9 ± 2.2 years, height: 169.3 ± 4.2 cm, and weight: 59.8 ± 6.1 kg) were randomly assigned to two equally numbered groups: TRX training and controls based on inclusion and exclusion criteria. In the pre-test, the anthropometric variables and also proprioception accuracy and muscle strength of subjects were evaluated by joint angle reset test (JART) and manual muscle testing (MMT) in both dorsiflexion and plantarflexion motions. The training group completed three sessions per week with progressive load for six weeks, and each training session lasted 15 - 20 minutes, whilst control subjects continued with their normal activity without special sport activities. After six weeks of training, all tests performed in the pre-test phase were also performed in the post-test phase. The t-test was used for statistic analysis (α ≤ 0.05). Results: The findings showed that TRX training significantly improved the proprioception accuracy (P ≤ 0.001) and muscle strength (P ≤ 0.001) in the training group rather than the control group. No statistically significant difference was found in any of the tests between pre-test and post-test for the control group (P > 0.05). Conclusions: Six weeks of TRX suspension training had a positive effect on strength and proprioception accuracy in female athletes with FAI.
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17
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Halabchi F, Hassabi M. Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World J Orthop 2020; 11:534-558. [PMID: 33362991 PMCID: PMC7745493 DOI: 10.5312/wjo.v11.i12.534] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/04/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023] Open
Abstract
Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40% of all sports-related injuries. It is especially common in basketball, American football, and soccer. The majority of sprains affect the lateral ligaments, particularly the anterior talofibular ligament. Despite its high prevalence, a high proportion of patients experience persistent residual symptoms and injury recurrence. A detailed history and proper physical examination are diagnostic cornerstones. Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules. Several interventions have been recommended in the management of acute ankle sprains including rest, ice, compression, and elevation, analgesic and anti-inflammatory medications, bracing and immobilization, early weight-bearing and walking aids, foot orthoses, manual therapy, exercise therapy, electrophysical modalities and surgery (only in selected refractory cases). Among these interventions, exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process. An exercise program should be comprehensive and progressive including the range of motion, stretching, strengthening, neuromuscular, proprioceptive, and sport-specific exercises. Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables, manual tests for stability, and functional performance testing. There are some common myths and mistakes in the management of ankle sprains, which all clinicians should be aware of and avoid. These include excessive imaging, unwarranted non-weight-bearing, unjustified immobilization, delay in functional movements, and inadequate rehabilitation. The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.
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Affiliation(s)
- Farzin Halabchi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Mohammad Hassabi
- Department of Sports and Exercise Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19979-64151, Iran
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18
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Chen Z. A novel staged wrist sensorimotor rehabilitation program for a patient with triangular fibrocartilage complex injury: A case report. J Hand Ther 2020; 32:525-534. [PMID: 30017412 DOI: 10.1016/j.jht.2018.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/07/2018] [Accepted: 04/01/2018] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Case report. INTRODUCTION Studies have highlighted the sensory innervations and stabilizing role of forearm muscles on wrist joint and implications to wrist sensorimotor rehabilitation. This case explored the novel incorporation of dart-throwing motion and proprioceptive neuromuscular facilitation in wrist sensorimotor rehabilitation. PURPOSE OF THE STUDY To describe and evaluate a staged wrist sensorimotor rehabilitation program for a patient with triangular fibrocartilage complex (TFCC) injury. METHODS The patient participated in the staged program for 9 sessions over a 3-month period. Treatment involved neuromuscular strengthening at the wrist and movement normalization of the upper extremity. Outcome measures were grip strength, visual analog scale, joint position sense, Quick Disabilities of the Arm, Shoulder and Hand, and patient-rated wrist evaluation. RESULTS The patient showed improvement in all outcome measures. Most outcomes exceeded the established minimal clinically important difference values. DISCUSSION The results suggest that dart-throwing motion and proprioceptive neuromuscular facilitation are beneficial in rehabilitation of TFCC injury. CONCLUSIONS This is the first study that incorporated dart-throwing motion and proprioceptive neuromuscular facilitation in the sensorimotor rehabilitation of TFCC injury and yielded promising results. There is a need to further evaluate the program in prospective randomized controlled trial recruiting a larger group of patients with TFCC injury.
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Affiliation(s)
- Zhiqing Chen
- Occupational Therapy Department, Singapore General Hospital, Singapore.
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19
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Ankle strength is not strongly associated with postural stability in patients awaiting surgery for chronic lateral ankle instability. Knee Surg Sports Traumatol Arthrosc 2020; 28:326-333. [PMID: 29704114 DOI: 10.1007/s00167-018-4960-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/23/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE (1) To describe ankle strength and postural stability in patients with chronic lateral ankle instability and (2) to analyse the correlation between deficits in ankle strength and postural stability. METHODS Results of preoperative isokinetic and balance tests in 203 patients whose contralateral ankle was normal were retrospectively reviewed. Isokinetic peak torque values of eversion and inversion at 2 angular velocities (30°/s and 120°/s) were measured in the injured and normal ankles. In the balance test, the percent differences of 3 actual scores (overall, anterior-posterior, and medial-lateral) between the injured and normal ankles were calculated. Additional statistical analyses were performed to evaluate weakness of ankle strength, postural stability deficits, and their correlation. RESULTS Significant differences in 4 peak torque values and 4 relative peak torque values (peak torque/body weight) were found between the injured and normal ankles. All 8 values were significantly lower in the injured ankles. Weakness was severe during inversion and at 30°/s. In the balance test, 49 subjects (24.1%) had significant deficits in postural stability and 109 (53.7%) had favourable results. No strong association was found between weakness of ankle strength and deficits in postural stability. CONCLUSIONS Strength measurement alone is insufficient to evaluate preoperative functional deficits, and other functional tests are required to measure postural stability. The results of this study provide further evidence for a rehabilitation programme consisting of proprioceptive training as well as strengthening. The proprioceptive training must be an integral part of the rehabilitation programme in addition to strengthening exercise. LEVEL OF EVIDENCE Case series, Level IV.
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20
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Chen ET, Borg-Stein J, McInnis KC. Ankle Sprains: Evaluation, Rehabilitation, and Prevention. Curr Sports Med Rep 2019; 18:217-223. [PMID: 31385837 DOI: 10.1249/jsr.0000000000000603] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ankle sprains affect athletic populations at high rates. Athletes who suffer an ankle sprain frequently go on to develop persistent symptoms, resulting in significant resources spent toward treatment, rehabilitation, and prevention. A thorough clinical evaluation is necessary to ensure an accurate diagnosis and appropriate treatment prescription. This narrative review aims to present an approach to evaluation of high and low ankle sprains for athletes of all levels. The authors review the current evidence for ankle sprain treatment and rehabilitation. Strategies for prevention of recurrent sprains and return to play considerations also are discussed.
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Affiliation(s)
- Eric T Chen
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.,Department of Physical Medicine and Rehabilitation, Newton Wellesley Hospital, Newton, MA
| | - Kelly C McInnis
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA.,Department of Orthopedics, Division of Sports Medicine, Massachusetts General Hospital, Boston, MA
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21
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MANAGEMENT OF ACUTE GRADE II LATERAL ANKLE SPRAINS WITH AN EMPHASIS ON LIGAMENT PROTECTION: A DESCRIPTIVE CASE SERIES. Int J Sports Phys Ther 2019; 14:445-458. [PMID: 31681503 DOI: 10.26603/ijspt20190445] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background and Purpose Lateral ankle sprain the most common injury in physically active populations. Individuals who sustain an acute lateral ankle sprain may not receive timely formal rehabilitation and are at an increased risk to have subsequent sprains which can lead to chronic pain and instability. Attention to essential factors for ligament protection and healing while preserving ankle movement, may result in a more stable yet mobile ankle offering improved outcomes. The purpose of this case series was to describe the methods and observe the outcomes associated with a comprehensive strategy for managing acute first episode grade II lateral ankle sprains. Study design Prospective case series. Case Descriptions and Interventions Ten patients (mean age 26.7 years, range 16-51 years, mean 2.3 days from injury) with acute grade II lateral ankle sprain were treated with an approach to protect the injured ligament, prevent impairments to movement, restore strength and proprioception, and progress to full function. Patient outcomes were assessed at four, eight and 12 weeks. Follow-up interviews at six and 12 months assessed injury recurrence. Outcomes Patients were treated for an average of eight sessions over a mean of seven weeks. Rapid change in self-reported function, ankle ROM, and pain were observed in the first four weeks of care. Clinically meaningful improvements in function and ankle ROM were also noted at eight weeks and maintained at 12-week follow-ups. All patients returned to desired physical activity with only a single re-sprain event within one year after injury. Conclusion The results of this prospective case series suggest that a treatment approach designed to protect the injured ligament, maintain and restore normal ankle motion, and provide a tailored functional pathway to return to run and sport demonstrated resolution of symptoms and improvement in reported functional outcomes in a group of patients following grade II acute primary ankle sprain. Level of Evidence Level IV, Case Series.
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22
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Cruz AL, Oliveira R, Silva AG. Exercise-based interventions for physically active individuals with functional ankle instability: a systematic review of the literature. J Sports Med Phys Fitness 2019; 59:666-675. [DOI: 10.23736/s0022-4707.18.08544-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lazarou L, Kofotolis N, Pafis G, Kellis E. Effects of two proprioceptive training programs on ankle range of motion, pain, functional and balance performance in individuals with ankle sprain. J Back Musculoskelet Rehabil 2018; 31:437-446. [PMID: 28946541 DOI: 10.3233/bmr-170836] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Following ankle sprain, residual symptoms are often apparent, and proprioceptive training is a treatment approach. Evidence, however, is limited and the optimal program has to be identified. OBJECTIVE To investigate the effects of two post-acute supervised proprioceptive training programs in individuals with ankle sprain. METHODS Participants were recruited from a physiotherapy center for ankle sprain rehabilitation. In a pre-post treatment, blinded-assessor design, 22 individuals were randomly allocated to a balance or a proprioceptive neuromuscular facilitation (PNF) group. Both groups received 10 rehabilitation sessions, within a six-week period. Dorsiflexion range of motion (ROM), pain, functional and balance performance were assessed at baseline, at the end of training and eight weeks after training. RESULTS Follow-up data were provided for 20 individuals. Eight weeks after training, statistically significant (p< 0.017) improvements were found in dorsiflexion ROM and most functional performance measures for both balance and PNF groups. Eight weeks after training, significant (p< 0.017) improvements in the frontal plane balance test and pain were observed for the balance group. CONCLUSIONS Balance and PNF programs are recommended in clinical practice for improving ankle ROM and functional performance in individuals with sprain. Balance programs are also recommended for pain relief.
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Melam G, Alhusaini A, Perumal V, Buragadda S, Albarrati A, Lochab R. Effect of weight-bearing overload using elastic tubing on balance and functional performance in athletes with chronic ankle instability. Sci Sports 2018. [DOI: 10.1016/j.scispo.2018.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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de Vasconcelos GS, Cini A, Sbruzzi G, Lima CS. Effects of proprioceptive training on the incidence of ankle sprain in athletes: systematic review and meta-analysis. Clin Rehabil 2018; 32:1581-1590. [PMID: 29996668 DOI: 10.1177/0269215518788683] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE: To investigate how dynamic neuromuscular control, postural sway, joint position sense, and incidence of ankle sprain are influenced by balance training in athletes compared with the control group in randomized clinical trials. DATA SOURCES: The search strategy included MEDLINE, Physical Therapy Evidence Database, Cochrane Central Register of Controlled Trials, and Latin American and Caribbean Center on Health Sciences Information. Randomized controlled trials (RCTs) were published by June of 2018. METHODS: RCTs that evaluate the effectiveness of proprioception in these outcomes: dynamic neuromuscular control, postural sway, joint position, and the incidence of ankle sprains in athletes aged between 18 and 35 years. Two reviewers independently screened the searched records, extracted the data, and assessed risk of bias. The treatment effect sizes were pooled in a meta-analysis using the RevMan 5.2 software. Internal validity was assessed through topics suggested by Cochrane Collaborations. RESULTS: Of the 12 articles included ( n = 1817), eight were in the meta-analysis ( n = 1722). The balance training reduced the incidence of ankle sprains in 38% compared with the control group ( RR: 0.62; 95% CI: 0.43-0.90). In relation to the dynamic neuromuscular control, the training showed increase in the distance of reach in the anterior (0.62 cm, 95% CI: 0.13-1.11), posterolateral (4.22 cm, 95% CI: 1.76-6.68), and posteromedial (3.65 cm, 95% CI: 1.03-6.26) through the Star Excursion Balance test. Furthermore, training seems to improve postural sway and joint position sense. CONCLUSION: Balance training reduces the incidence of ankle sprains and increases dynamic neuromuscular control, postural sway, and the joint position sense in athletes.
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Affiliation(s)
- Gabriela Souza de Vasconcelos
- Laboratório de Pesquisa do Exercício (LAPEX), Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Anelize Cini
- Laboratório de Pesquisa do Exercício (LAPEX), Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Graciele Sbruzzi
- Laboratório de Pesquisa do Exercício (LAPEX), Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Cláudia Silveira Lima
- Laboratório de Pesquisa do Exercício (LAPEX), Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Vuurberg G, Hoorntje A, Wink LM, van der Doelen BFW, van den Bekerom MP, Dekker R, van Dijk CN, Krips R, Loogman MCM, Ridderikhof ML, Smithuis FF, Stufkens SAS, Verhagen EALM, de Bie RA, Kerkhoffs GMMJ. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med 2018. [PMID: 29514819 DOI: 10.1136/bjsports-2017-098106] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury. The previous guideline provided evidence that the severity of ligament damage can be assessed most reliably by delayed physical examination (4-5 days post trauma). After correct diagnosis, it can be stated that even though a short time of immobilisation may be helpful in relieving pain and swelling, the patient with an acute lateral ankle ligament rupture benefits most from use of tape or a brace in combination with an exercise programme.New in this update: Participation in certain sports is associated with a heightened risk of sustaining a lateral ankle sprain. Care should be taken with non-steroidal anti-inflammatory drugs (NSAIDs) usage after an ankle sprain. They may be used to reduce pain and swelling, but usage is not without complications and NSAIDs may suppress the natural healing process. Concerning treatment, supervised exercise-based programmes preferred over passive modalities as it stimulates the recovery of functional joint stability. Surgery should be reserved for cases that do not respond to thorough and comprehensive exercise-based treatment. For the prevention of recurrent lateral ankle sprains, ankle braces should be considered as an efficacious option.
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Affiliation(s)
- Gwendolyn Vuurberg
- Department of Orthopedic Surgery, Orthopaedic Research Center Amsterdam, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), VUmc / AMC IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Amsterdam, The Netherlands
| | - Alexander Hoorntje
- Department of Orthopedic Surgery, Orthopaedic Research Center Amsterdam, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), VUmc / AMC IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Amsterdam, The Netherlands
| | - Lauren M Wink
- Department of Orthopedic Surgery, Orthopaedic Research Center Amsterdam, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,VU Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Brent F W van der Doelen
- Department of Orthopedic Surgery, Orthopaedic Research Center Amsterdam, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), VUmc / AMC IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Amsterdam, The Netherlands
| | | | - Rienk Dekker
- Dutch Society of Rehabilitation, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - C Niek van Dijk
- Department of Orthopedic Surgery, Orthopaedic Research Center Amsterdam, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), VUmc / AMC IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Amsterdam, The Netherlands
| | - Rover Krips
- Department of Orthopaedic Surgery, Flevoziekenhuis, Almere, The Netherlands
| | | | | | - Frank F Smithuis
- Department of Musculoskeletal Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Sjoerd A S Stufkens
- Department of Orthopedic Surgery, Orthopaedic Research Center Amsterdam, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Evert A L M Verhagen
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), VUmc / AMC IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Amsterdam, The Netherlands.,VU Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of of Public and Occupational Health VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Rob A de Bie
- Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery, Orthopaedic Research Center Amsterdam, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), VUmc / AMC IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Amsterdam, The Netherlands
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Bullock SA, Allen GM, Watson MS, Wilson DJ. Predicting poor outcome from simple ankle injuries: a prospective cohort study. Br J Radiol 2018; 91:20170213. [PMID: 29076746 PMCID: PMC5966200 DOI: 10.1259/bjr.20170213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/07/2017] [Accepted: 10/23/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Sprained ankles are common and when there are no signs or evidence of a fracture, conventional management is conservative. At present, there are no clinical markers to identify those that may develop persisting instability and disability that would require rehabilitation or surgery. OBJECTIVES To investigate the nature and extent of soft tissue ankle injuries, and to consider whether the anatomical severity of injury can predict functional outcome. METHODS Patients attending a local Accident and Emergency Department in Oxford with an acute ankle injury with no clinical requirement for radiographs, or where radiographs were normal, were invited into the study. Within 5 days, patients underwent a diagnostic ultrasound examination, a cone beam CT study and a disability assessment. Ultrasound and physiotherapy assessments were repeated at 3 and 6 months. RESULTS 100 patients were recruited and grouped based upon injuries. 58 had simple ankle injuries, 21 complex, 19 had significant fractures and 2 were excluded from further follow up analysis. There were no clinically significant differences in pain, disability or functional outcomes between the groups at all points of the study. CONCLUSION Medium to long term clinical outcomes were not solely determined by the severity of injury. Some patients with simple injuries were seen to have ongoing problems, whereas some with complex injuries recovered completely in a shorter period. Advances in knowledge: The severity of an ankle injury determined by radiological imaging does not necessarily dictate the severity of a patient's symptoms and the trajectory of their recovery.
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Lazarou L, Kofotolis N, Malliou P, Kellis E. Effects of two proprioceptive training programs on joint position sense, strength, activation and recurrent injuries after ankle sprains. ISOKINET EXERC SCI 2017. [DOI: 10.3233/ies-171146] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Lazaros Lazarou
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Kofotolis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Paraskevi Malliou
- Laboratory of Therapeutic Exercise and Rehabilitation, Department of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, Greece
| | - Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
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Fautrelle L, Kubicki A, Babault N, Paizis C. Immediate effects of shoes inducing ankle-destabilization around Henke's axis during challenging walking gaits: Gait kinematics and peroneal muscles activities. Gait Posture 2017; 54:259-264. [PMID: 28371739 DOI: 10.1016/j.gaitpost.2017.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 03/09/2017] [Accepted: 03/21/2017] [Indexed: 02/02/2023]
Abstract
Due to its high frequency of occurrence, as well as possible residual symptoms, proper treatment of lateral ankle sprains (LAS) is important. From a physiological point of view, increasing the quantity of electromyographic (EMG) activity in the peroneal muscles will mechanically improve the functional stability of the ankle joint. The present study investigated the immediate effects of an ankle destabilization device (ADD) specifically designed to induce imbalances along the Henke's axis during 3 challenging walking tasks. As the effects of such a device have to be tested on healthy participants before being implemented in rehabilitation programs, 12 healthy participants performed 3 different types of walking (normal, aligned, and jumping walking) while the EMG activities in four peroneal muscles and the main gait kinematics parameters were recorded. Our results clearly demonstrated that wearing the ADD during these different walking tasks significantly increased EMG activities in the four peroneal muscles (increases from 9 to 33% on average depending on the muscle and the walking condition) while maintaining previous gait kinematic patterns. Our study shows that an ADD coupled with walking or jumping tasks is able to improve neuromuscular activity. It should therefore be useful for ankle rehabilitation therapy and the prevention of LAS.
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Affiliation(s)
- Lilian Fautrelle
- Institut National de la Santé et de la Recherche Médicale, Unité 1093, Cognition, Action et Plasticité Sensori-Motrice, F-21078 Dijon, France; Laboratoire EA 2931 CeRSM, Centre de Recherches sur le Sport et le Mouvement, UFR STAPS, 200 Avenue de la République, 92000 Nanterre, France; Université de Paris Ouest, Nanterre La Défense, Unité de Formation et de Recherche en Sciences et Techniques des Activités Physiques et Sportives, 200 Avenue de la République, 92001 Nanterre, France.
| | - Alexandre Kubicki
- Institut National de la Santé et de la Recherche Médicale, Unité 1093, Cognition, Action et Plasticité Sensori-Motrice, F-21078 Dijon, France
| | - Nicolas Babault
- Institut National de la Santé et de la Recherche Médicale, Unité 1093, Cognition, Action et Plasticité Sensori-Motrice, F-21078 Dijon, France; Centre d'Expertise de la Performance G. Cometti, Faculté des Sciences du Sport, Université de Bourgogne Franche-Comté, BP 27887, 21078, Dijon Cedex, France
| | - Christos Paizis
- Institut National de la Santé et de la Recherche Médicale, Unité 1093, Cognition, Action et Plasticité Sensori-Motrice, F-21078 Dijon, France; Centre d'Expertise de la Performance G. Cometti, Faculté des Sciences du Sport, Université de Bourgogne Franche-Comté, BP 27887, 21078, Dijon Cedex, France
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Hincapie OL, Elkins JS, Vasquez-Welsh L. Proprioception retraining for a patient with chronic wrist pain secondary to ligament injury with no structural instability. J Hand Ther 2017; 29:183-90. [PMID: 27264903 DOI: 10.1016/j.jht.2016.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 02/26/2016] [Accepted: 03/03/2016] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Case report. INTRODUCTION Previously published studies demonstrate the importance of the sensory innervation of the carpal ligaments and the implication for the sensorimotor control of the wrist. In addition, this case considers key rehabilitation concepts to include the dart-throwing motion and the stabilizing effect of the forearm muscles. PURPOSE OF THE STUDY To describe the rehabilitation program for a patient with chronic wrist pain, diagnosed with a partial tear of the dorsal intercarpal ligament and a sprain of the scapholunate ligament of the right wrist. METHODS The patient participated in a staged treatment plan over a 3-month period (20 sessions), which began with a focus on proprioceptive awareness and joint position sense retraining. The treatment progressed to strengthening of specific muscles to enhance stability of the wrist joint. The patient completed the Quick Disabilities of the Arm, Shoulder and Hand and the patient-rated wrist evaluation on initial evaluation, re-evaluation at ninth session, and discharge at 20th session. RESULTS Raw scores in the Quick Disabilities of the Arm, Shoulder and Hand and the patient-rated wrist evaluation improved from 33 and 61.5 on initial evaluation to 18 and 17.5 on discharge, respectively. CONCLUSIONS Sensorimotor techniques including proprioceptive retraining may improve pain, neuromuscular control, and functional outcomes in patients with chronic wrist pain due to ligament injury. The effectiveness of proprioceptive retraining needs to be evaluated in a well-designed randomized controlled trial recruiting this patient population. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Olga L Hincapie
- NYU Langone Medical Center, Center for Musculoskeletal Care, Hand Therapy Service, New York, NY, USA.
| | - Jeananne S Elkins
- Northeastern University, College of Professional Studies, Boston, MA, USA
| | - Laura Vasquez-Welsh
- NYU Langone Medical Center, Center for Musculoskeletal Care, Hand Therapy Service, New York, NY, USA
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Adebayo OW, Gonzalez-Guarda RM. Factors Associated With HIV Testing in Youth in the United States: An Integrative Review. J Assoc Nurses AIDS Care 2016; 28:342-362. [PMID: 27993497 DOI: 10.1016/j.jana.2016.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
We used an integrative review to synthesize existing literature on the factors associated with HIV testing by youth ages 13 to 24 years in the United States. PubMed, CINAHL, PsycINFO, and Google Scholar were systematically searched and 44 original research studies met our criteria. A directed qualitative content analysis was conducted to integrate findings according to the personal, relationship, community, and society levels of the social-ecological model. Female gender, African American race, age, and physical illness were some of the factors more consistently associated with HIV testing. Modifiable factors such as fear, drug use, poor condom use, partner communication, and multiple sexual partners were also noted as influencing HIV testing in youth. Our integrative review revealed gaps in the literature that need further exploration, particularly in the area of community and society influences on HIV testing for youth. Implications for research, practice, and policy are discussed.
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Doherty C, Bleakley C, Delahunt E, Holden S. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med 2016; 51:113-125. [PMID: 28053200 DOI: 10.1136/bjsports-2016-096178] [Citation(s) in RCA: 177] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ankle sprains are highly prevalent with high risk of recurrence. Consequently, there are a significant number of research reports examining strategies for treating and preventing acute and recurrent sprains (otherwise known as chronic ankle instability (CAI)), with a coinciding proliferation of review articles summarising these reports. OBJECTIVE To provide a systematic overview of the systematic reviews evaluating treatment strategies for acute ankle sprain and CAI. DESIGN Overview of intervention systematic reviews. PARTICIPANTS Individuals with acute ankle sprain/CAI. MAIN OUTCOME MEASUREMENTS The primary outcomes were injury/reinjury incidence and function. RESULTS 46 papers were included in this systematic review. The reviews had a mean score of 6.5/11 on the AMSTAR quality assessment tool. There was strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence of an ankle sprain. For the combined outcomes of pain, swelling and function after an acute sprain, there was strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques. There was conflicting evidence regarding the efficacy of surgery and acupuncture for the treatment of acute ankle sprains. There was insufficient evidence to support the use of ultrasound in the treatment of acute ankle sprains. CONCLUSIONS For the treatment of acute ankle sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques, for pain, swelling and function. Exercise therapy and bracing are supported in the prevention of CAI.
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Affiliation(s)
- Cailbhe Doherty
- Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland
| | - Chris Bleakley
- Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, UK
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Sinead Holden
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Plaza-Manzano G, Vergara-Vila M, Val-Otero S, Rivera-Prieto C, Pecos-Martin D, Gallego-Izquierdo T, Ferragut-Garcías A, Romero-Franco N. Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial. ACTA ACUST UNITED AC 2016; 26:141-149. [PMID: 27598553 DOI: 10.1016/j.math.2016.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/06/2016] [Accepted: 08/22/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Recurrent ankle sprains often involve residual symptoms for which subjects often perform proprioceptive or/and strengthening exercises. However, the effectiveness of mobilization to influence important nerve structures due to its anatomical distribution like tibial and peroneal nerves is unclear. OBJETIVES To analyze the effects of proprioceptive/strengthening exercises versus the same exercises and manual therapy including mobilizations to influence joint and nerve structures in the management of recurrent ankle sprains. STUDY DESIGN A randomized single-blind controlled clinical trial. METHOD Fifty-six patients with recurrent ankle sprains and regular sports practice were randomly assigned to experimental or control group. The control group performed 4 weeks of proprioceptive/strengthening exercises; the experimental group performed 4 weeks of the same exercises combined with manual therapy (mobilizations to influence joint and nerve structures). Pain, self-reported functional ankle instability, pressure pain threshold (PPT), ankle muscle strength, and active range of motion (ROM) were evaluated in the ankle joint before, just after and one month after the interventions. RESULTS The within-group differences revealed improvements in all of the variables in both groups throughout the time. Between-group differences revealed that the experimental group exhibited lower pain levels and self-reported functional ankle instability and higher PPT, ankle muscle strength and ROM values compared to the control group immediately after the interventions and one month later. CONCLUSIONS A protocol involving proprioceptive and strengthening exercises and manual therapy (mobilizations to influence joint and nerve structures) resulted in greater improvements in pain, self-reported functional joint stability, strength and ROM compared to exercises alone.
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Affiliation(s)
- Gustavo Plaza-Manzano
- Departamento de Medicina Física y Rehabilitación, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Spain.
| | - Marta Vergara-Vila
- Community Health Centre Maria Wolff, Madrid, Spain; Physiotherapy Department, University of Alcalá, E-28871, Madrid, Spain.
| | - Sandra Val-Otero
- Physiotherapy Department, University of Alcalá, E-28871, Madrid, Spain.
| | | | | | | | | | - Natalia Romero-Franco
- Physiotherapy and Nursery Department, University of the Balearic Islands, E-07122, Mallorca, Spain.
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Vriend I, Gouttebarge V, van Mechelen W, Verhagen EALM. Neuromuscular training is effective to prevent ankle sprains in a sporting population: a meta-analysis translating evidence into optimal prevention strategies. J ISAKOS 2016. [DOI: 10.1136/jisakos-2016-000062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Efficacy of Proprioceptive Exercises in Patients with Subacromial Impingement Syndrome: A Single-Blinded Randomized Controlled Study. Am J Phys Med Rehabil 2016; 95:169-82. [PMID: 26098920 DOI: 10.1097/phm.0000000000000327] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the effectiveness of proprioceptive exercises on shoulder proprioception, range of motion, pain, muscle strength, and function in patients with subacromial impingement syndrome. DESIGN Sixty-one patients with subacromial impingement syndrome participated in this prospective, single-blind randomized controlled trial. All patients were randomly divided into two groups: control group (conventional physiotherapy, n = 30) and intervention group (proprioceptive exercise and conventional physiotherapy, n = 31). The primary outcome measures were sense of kinesthesia and active and passive repositioning for proprioception at 0 degrees and 10 degrees external rotation at 12 wks. The secondary outcome measures were pain at rest, at night, and during activities of daily living with the visual analog scale (0-10 cm), the Western Ontario Rotator Cuff index, the American Shoulder and Elbow Surgeons index, range of motion, and isometric muscle strength at both 6 and 12 wks. RESULTS After treatment, significant improvement was found in range of motion, pain, isometric muscle strength, kinesthesia at 0 degrees external rotation, and functional tests in both groups. The intervention group showed a significant improvement in kinesthesia at 10 degrees external rotation and active and passive repositioning at 10 degrees external rotation. When groups were compared, there were no statistically significant differences in any of the parameters at 12 wks. CONCLUSIONS Although proprioceptive exercises may provide better proprioceptive acuity, no additional positive effect on other clinical parameters was observed.
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36
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Prevalence and profile of musculoskeletal injuries in ballet dancers: A systematic review and meta-analysis. Phys Ther Sport 2016; 19:50-6. [DOI: 10.1016/j.ptsp.2015.12.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/13/2015] [Accepted: 12/25/2015] [Indexed: 12/14/2022]
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Pearce CJ, Tourné Y, Zellers J, Terrier R, Toschi P, Silbernagel KG. Rehabilitation after anatomical ankle ligament repair or reconstruction. Knee Surg Sports Traumatol Arthrosc 2016; 24:1130-9. [PMID: 26905066 DOI: 10.1007/s00167-016-4051-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 02/05/2016] [Indexed: 01/08/2023]
Abstract
The selection, implementation of and adherence to a post-operative regimen are all essential in order to achieve the best outcomes after ankle ligament surgery. The purpose of this paper is to present a best-evidence approach to this, with grounding in basic science and a consensus opinion from the members of the ESSKA-AFAS Ankle Instability Group. Basic science and clinical evidence surrounding tissue healing after surgical repair or reconstruction of the ligaments as well as around the re-establishment of sensorimotor control are reviewed. A consensus opinion based on this evidence as to the recommended rehabilitation protocol after ankle ligament surgery was then obtained from the members of the ESSKA-AFAS Ankle Instability Group. Rehabilitation recommendations are presented for the initial post-operative period, the early recovery phase and a goal-orientated late rehabilitation and return-to-sport phase. This paper presents practical, evidenced-based guidelines for rehabilitation and return to activity after lateral ankle ligament surgery.
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Affiliation(s)
| | - Yves Tourné
- Centre Osteo-Articulaire des Cèdres, Parc Galaxie SUD, 5 rue des tropiques, 38130, Echirolles, France
| | - Jennifer Zellers
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Romain Terrier
- Laboratoire de Physiologie de l'Exercice (EA 4338), Université Savoie Mont-Blanc, 73377, Le Bourget du Lac, France
| | - Pascal Toschi
- CEVRES Santé Savoie Technolac, 30 allée du lac d' Aiguebelette, BP 322, 73377, Le Bourget du Lac, France
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Pearce CJ, Tourné Y, Zellers J, Terrier R, Toschi P, Silbernagel KG. Rehabilitation after anatomical ankle ligament repair or reconstruction. KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY : OFFICIAL JOURNAL OF THE ESSKA 2016. [PMID: 26905066 DOI: 10.1007/s00167-016-4051-z.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The selection, implementation of and adherence to a post-operative regimen are all essential in order to achieve the best outcomes after ankle ligament surgery. The purpose of this paper is to present a best-evidence approach to this, with grounding in basic science and a consensus opinion from the members of the ESSKA-AFAS Ankle Instability Group. Basic science and clinical evidence surrounding tissue healing after surgical repair or reconstruction of the ligaments as well as around the re-establishment of sensorimotor control are reviewed. A consensus opinion based on this evidence as to the recommended rehabilitation protocol after ankle ligament surgery was then obtained from the members of the ESSKA-AFAS Ankle Instability Group. Rehabilitation recommendations are presented for the initial post-operative period, the early recovery phase and a goal-orientated late rehabilitation and return-to-sport phase. This paper presents practical, evidenced-based guidelines for rehabilitation and return to activity after lateral ankle ligament surgery.
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Affiliation(s)
| | - Yves Tourné
- Centre Osteo-Articulaire des Cèdres, Parc Galaxie SUD, 5 rue des tropiques, 38130, Echirolles, France
| | - Jennifer Zellers
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Romain Terrier
- Laboratoire de Physiologie de l'Exercice (EA 4338), Université Savoie Mont-Blanc, 73377, Le Bourget du Lac, France
| | - Pascal Toschi
- CEVRES Santé Savoie Technolac, 30 allée du lac d' Aiguebelette, BP 322, 73377, Le Bourget du Lac, France
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Riva D, Bianchi R, Rocca F, Mamo C. Proprioceptive Training and Injury Prevention in a Professional Men's Basketball Team: A Six-Year Prospective Study. J Strength Cond Res 2016; 30:461-75. [PMID: 26203850 PMCID: PMC4750505 DOI: 10.1519/jsc.0000000000001097] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Single limb stance instability is a risk factor for lower extremity injuries. Therefore, the development of proprioception may play an important role in injury prevention. This investigation considered a professional basketball team for 6 years, integrating systematic proprioceptive activity in the training routine. The purpose was to assess the effectiveness of proprioceptive training programs based on quantifiable instability, to reduce ankle sprains, knee sprains, and low back pain through developing refined and long-lasting proprioceptive control. Fifty-five subjects were studied. In the first biennium (2004-2006), the preventive program consisted of classic proprioceptive exercises. In the second biennium (2006-2008), the proprioceptive training became quantifiable and interactive by means of electronic proprioceptive stations. In the third biennium (2008-2010), the intensity and the training volume increased while the session duration became shorter. Analysis of variance was used to analyze the differences in proprioceptive control between groups, years, and bienniums. Injury rates and rate ratios of injury during practices and games were estimated. The results showed a statistically significant reduction in the occurrence of ankle sprains by 81% from the first to the third biennium (p < 0.001). Low back pain showed similar results with a reduction of 77.8% (p < 0.005). The reduction in knee sprains was 64.5% (not significant). Comparing the third biennium with the level of all new entry players, proprioceptive control improved significantly by 72.2% (p < 0.001). These findings indicate that improvements in proprioceptive control in single stance may be a key factor for an effective reduction in ankle sprains, knee sprains, and low back pain.
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Affiliation(s)
- Dario Riva
- International Society of Proprioception and Posture, Turin, Italy
- Proprioception Center, Turin, Italy
| | - Roberto Bianchi
- International Society of Proprioception and Posture, Turin, Italy
- Cantù Basketball Team, Cantù, Italy; and
| | - Flavio Rocca
- International Society of Proprioception and Posture, Turin, Italy
- Proprioception Center, Turin, Italy
| | - Carlo Mamo
- Epidemiology Unit, Local Health Unit TO3, Piemonte Region, Grugliasco, Italy
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Porter T, Rushton A. The efficacy of exercise in preventing injury in adult male football: a systematic review of randomised controlled trials. SPORTS MEDICINE - OPEN 2015; 1:4. [PMID: 27747841 PMCID: PMC4532702 DOI: 10.1186/s40798-014-0004-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 10/21/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Injury prevention measures might reduce the impact of injury on footballers and football clubs. Increasing research has evaluated the use of exercise for injury prevention. However, research has focused on adolescent females. No high-quality systematic reviews have evaluated the efficacy of all forms of exercise on preventing injury in adult male football. OBJECTIVE Our objective was to conduct a systematic review to evaluate the efficacy of exercise in preventing injury in adult male football. DATA SOURCES Comprehensive searches of electronic databases CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, Embase, AMED (The Allied and Complementary Medicine Database), the Cochrane Central Register of Controlled Trials, PEDro (The Physiotherapy Evidence Database), SPORTDiscus™, the National Research Register, Current Controlled Trials website (York), and http://www.ClinicalTrials.gov were conducted using predefined search terms to identify relevant studies published up to 1 March 2013. Screening of references, searches of grey literature, and hand searches of relevant journals were also employed. STUDY SELECTION Included studies were randomized controlled trials using injury incidence as an outcome measure to evaluate the efficacy of an exercise intervention on uninjured male footballers aged 16 years and over. Articles not written in English were excluded. DATA EXTRACTION Two researchers independently searched data sources, screened studies for eligibility, evaluated risk of bias, and extracted data using predefined criteria. STUDY APPRAISAL AND SYNTHESIS METHODS Risk of bias of included trials was assessed using the Cochrane Collaboration's tool for assessing risk of bias. There was insufficient trial comparability (outcome measures, interventions, injury type) for meta-analysis, and a qualitative analysis was performed. RESULTS Eight trials (n = 3,355) from five countries met the inclusion criteria. All trials were assessed as having a high risk of bias. Two trials reported statistically significant reductions in hamstring injuries with eccentric exercise, and two reported statistically significant reductions in recurrent ankle sprains with proprioceptive exercise. Four trials showed no statistically significant difference in injury incidence with exercise interventions targeting a range of injuries. LIMITATIONS Notable limitations of included trials included poor reporting and limited blinding. A high risk of bias and insufficient comparability across trials prevented quantitative data synthesis. CONCLUSIONS Limitations in the context of study quality and heterogeneity resulted in an inability to reach a clear conclusion regarding efficacy of exercise for injury prevention in adult male football. Future low risk of bias, properly powered, and comprehensively reported trials are warranted to evaluate the efficacy of exercise on injury prevention. The use of eccentric hamstring exercise for hamstring injury prevention and proprioceptive training for recurrent ankle sprain prevention might be a good focus for future trials, as existing trials with a high risk of bias suggest an effect.
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Affiliation(s)
- Tom Porter
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT UK
| | - Alison Rushton
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT UK
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Lubetzky-Vilnai A, McCoy SW, Price R, Ciol MA. Young Adults Largely Depend on Vision for Postural Control When Standing on a BOSU Ball but Not on Foam. J Strength Cond Res 2015; 29:2907-18. [DOI: 10.1519/jsc.0000000000000935] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ross SE, Linens SW, Wright CJ, Arnold BL. Noise-Enhanced Eversion Force Sense in Ankles With or Without Functional Instability. J Athl Train 2015; 50:819-24. [PMID: 26090711 DOI: 10.4085/1062-6050-50.5.06] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Force sense impairments are associated with functional ankle instability. Stochastic resonance stimulation (SRS) may have implications for correcting these force sense deficits. OBJECTIVE To determine if SRS improved force sense. DESIGN Case-control study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Twelve people with functional ankle instability (age = 23 ± 3 years, height = 174 ± 8 cm, mass = 69 ± 10 kg) and 12 people with stable ankles (age = 22 ± 2 years, height = 170 ± 7 cm, mass = 64 ± 10 kg). INTERVENTION(S) The eversion force sense protocol required participants to reproduce a targeted muscle tension (10% of maximum voluntary isometric contraction). This protocol was assessed under SRSon and SRSoff (control) conditions. During SRSon, random subsensory mechanical noise was applied to the lower leg at a customized optimal intensity for each participant. MAIN OUTCOME MEASURE(S) Constant error, absolute error, and variable error measures quantified accuracy, overall performance, and consistency of force reproduction, respectively. RESULTS With SRS, we observed main effects for force sense absolute error (SRSoff = 1.01 ± 0.67 N, SRSon = 0.69 ± 0.42 N) and variable error (SRSoff = 1.11 ± 0.64 N, SRSon = 0.78 ± 0.56 N) (P < .05). No other main effects or treatment-by-group interactions were found (P > .05). CONCLUSIONS Although SRS reduced the overall magnitude (absolute error) and variability (variable error) of force sense errors, it had no effect on the directionality (constant error). Clinically, SRS may enhance muscle tension ability, which could have treatment implications for ankle stability.
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Affiliation(s)
| | | | | | - Brent L Arnold
- School of Health and Rehabilitation Sciences, Indiana University, Indianapolis
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Schiftan GS, Ross LA, Hahne AJ. The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: A systematic review and meta-analysis. J Sci Med Sport 2015; 18:238-44. [DOI: 10.1016/j.jsams.2014.04.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/08/2014] [Accepted: 04/18/2014] [Indexed: 12/26/2022]
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Salom-Moreno J, Ayuso-Casado B, Tamaral-Costa B, Sánchez-Milá Z, Fernández-de-las-Peñas C, Alburquerque-Sendín F. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:790209. [PMID: 26064172 PMCID: PMC4430654 DOI: 10.1155/2015/790209] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 01/31/2023]
Abstract
Objective. To compare the effects of combined trigger point dry needling (TrP-DN) and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods. Twenty-seven (44% female, mean age: 33 ± 3 years) individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM) and ankle pain intensity assessed with a numerical pain rate scale (NPRS). They were captured at baseline and 1-month follow-up after the intervention. Results. The ANOVAs found significant Group ∗ Time Interactions for both subscales of the FAAM (ADL: F = 8.211; P = 0.008; SPORTS: F = 13.943; P < 0.001) and for pain (F = 44.420; P < 0.001): patients receiving TrP-DN plus proprioceptive/strengthening exercises experienced greater improvements in function and pain than those receiving the exercise program alone. Between-groups effect sizes were large in all outcomes (SMD > 2.1) in favor of the TrP-DN group. Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability.
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Affiliation(s)
- Jaime Salom-Moreno
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
- Grupo de Excelencia Investigadora URJC-Banco de Santander: Investigación Traslacional en el Proceso de Salud-Enfermedad (ITPSE), Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
| | - Blanca Ayuso-Casado
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
| | - Beatriz Tamaral-Costa
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
- Grupo de Excelencia Investigadora URJC-Banco de Santander: Investigación Traslacional en el Proceso de Salud-Enfermedad (ITPSE), Avenida de Atenas s/n, Alcorcón, 28922 Madrid, Spain
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Ankle Muscular Proprioceptive Signals’ Relevance for Balance Control on Various Support Surfaces. Am J Phys Med Rehabil 2015; 94:20-7. [DOI: 10.1097/phm.0000000000000137] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Manual physical therapy and exercise versus supervised home exercise in the management of patients with inversion ankle sprain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther 2014; 43:443-55. [PMID: 23628755 DOI: 10.2519/jospt.2013.4792] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Randomized clinical trial. OBJECTIVE To compare the effectiveness of manual therapy and exercise (MTEX) to a home exercise program (HEP) in the management of individuals with an inversion ankle sprain. BACKGROUND An in-clinic exercise program has been found to yield similar outcomes as an HEP for individuals with an inversion ankle sprain. However, no studies have compared an MTEX approach to an HEP. METHODS Patients with an inversion ankle sprain completed the Foot and Ankle Ability Measure (FAAM) activities of daily living subscale, the FAAM sports subscale, the Lower Extremity Functional Scale, and the numeric pain rating scale. Patients were randomly assigned to either an MTEX or an HEP treatment group. Outcomes were collected at baseline, 4 weeks, and 6 months. The primary aim (effects of treatment on pain and disability) was examined with a mixed-model analysis of variance. The hypothesis of interest was the 2-way interaction (group by time). RESULTS Seventy-four patients (mean ± SD age, 35.1 ± 11.0 years; 48.6% female) were randomized into the MTEX group (n = 37) or the HEP group (n = 37). The overall group-by-time interaction for the mixed-model analysis of variance was statistically significant for the FAAM activities of daily living subscale (P<.001), FAAM sports subscale (P<.001), Lower Extremity Functional Scale (P<.001), and pain (P ≤.001). Improvements in all functional outcome measures and pain were significantly greater at both the 4-week and 6-month follow-up periods in favor of the MTEX group. CONCLUSION The results suggest that an MTEX approach is superior to an HEP in the treatment of inversion ankle sprains. Registered at clinicaltrials.gov (NCT00797368). LEVEL OF EVIDENCE Therapy, level 1b-.
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Smith TO, Easton V, Bacon H, Jerman E, Armon K, Poland F, Macgregor AJ. The relationship between benign joint hypermobility syndrome and psychological distress: a systematic review and meta-analysis. Rheumatology (Oxford) 2013; 53:114-22. [DOI: 10.1093/rheumatology/ket317] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Smith TO, Bacon H, Jerman E, Easton V, Armon K, Poland F, Macgregor AJ. Physiotherapy and occupational therapy interventions for people with benign joint hypermobility syndrome: a systematic review of clinical trials. Disabil Rehabil 2013; 36:797-803. [DOI: 10.3109/09638288.2013.819388] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Rehabilitation is easy to do badly and difficult to do well. Many people are involved in the process, and must act as a team to support the patient with good communication and teamwork. The whole process can be satisfying to all concerned when dealing with motivated and enthusiastic patients. Measuring the process is achievable and gives credibility and support to the initial hypothesis of the individual's rehabilitation program. Rehabilitation involves creativity using science and art, with the end result being the patient's return to a normal life or ability to excel within their sport.
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Affiliation(s)
- Bryan English
- The Fortius Clinic, 17 Fitzhardinge Street, London, W1H 6EQ, UK.
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Aguilera Eguía R, Espinoza Salinas A, Zafra Santos E, Aguilera Eguía T. Proprioceptive exercises for ankle ligament injury: a CAT. Medwave 2013. [DOI: 10.5867/medwave.2013.05.5683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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