Koldenhoven RM, Fraser JJ, Saliba SA, Hertel J. Ultrasonography of Gluteal and Fibularis Muscles During Exercises in Individuals With a History of Lateral Ankle Sprain.
J Athl Train 2019;
54:1287-1295. [PMID:
31584853 DOI:
10.4085/1062-6050-406-18]
[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: 12/29/2022]
Abstract
CONTEXT
Individuals with a history of lateral ankle sprains (LASs) have ankle and hip neuromuscular changes compared with those who do not have a history of LAS.
OBJECTIVE
To compare gluteus maximus (GMax), gluteus medius (GMed), and fibularis longus and brevis muscle activation using ultrasound imaging during tabletop exercises and lateral resistance-band walking in individuals with or without a history of LAS or chronic ankle instability (CAI).
DESIGN
Cross-sectional study.
PATIENTS OR OTHER PARTICIPANTS
Sixty-seven young adults (27 males, 40 females). Groups were healthy = 16, coper = 17, LAS = 15, CAI = 19. The number of previous sprains was 0 ± 0 in the healthy group, 1.1 ± 0.3 in the coper group, 2.9 ± 2.4 in the LAS group, and 5.3 ± 5.9 in the CAI group.
MAIN OUTCOME MEASURE(S)
Ultrasound imaging measures of fibularis cross-sectional area (CSA) were collected during nonresisted and resisted ankle eversion. Gluteal muscle thicknesses were imaged during nonresisted and resisted side-lying abduction and during lateral resistance-band walking exercises (lower leg and forefoot band placement). Separate 4 × 2 repeated-measures analyses of variance and post hoc Fisher least significant difference tests were used to assess activation across groups and resistance conditions.
RESULTS
All groups demonstrated 3.2% to 4.1% increased fibularis CSA during resisted eversion compared with nonresisted. During side-lying abduction, the LAS and CAI groups displayed increased GMax thickness (6.4% and 7.2%, respectively), and all but the CAI group (-0.4%) increased GMed thickness (5.3%-11.8%) with added resistance in hip abduction. During band walking, the healthy and LAS groups showed increased GMax thickness (4.8% and 8.1%, respectively), and all groups had increased GMed thickness (3.0%-5.8%) in forefoot position compared with the lower leg position. Although the values were not different, copers exhibited the greatest amount of GMed thickness during band-walking activities (copers = 23%-26%, healthy = 17%-23%, LAS = 11%-15%, CAI = 15%-19%).
CONCLUSIONS
All groups had increased fibularis CSA with resisted eversion. In side-lying hip abduction, individuals with CAI had greater GMax thickness than GMed thickness. Ultrasound imaging of fibularis CSA and gluteal muscle thickness may be clinically useful in assessing and treating patients with LAS or CAI.
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