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Mohammadi A, Sakhtemani SE, Trimmel L, Petricsevics K, Makai A, Zsenak I, Melczer C, Tardi PS. Investigating the Combined Effects of Fascial Distortion Model Manual Therapy and Balance-Strength Training in Individuals with Chronic Ankle Instability. Sports (Basel) 2024; 12:33. [PMID: 38251307 PMCID: PMC10820242 DOI: 10.3390/sports12010033] [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: 11/02/2023] [Revised: 01/01/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Fascial Distortion Model (FDM) is a relatively new manual therapy approach in the field of musculoskeletal physical therapy, and its potential effectiveness in treating chronic ankle instability (CAI) remains unexplored. METHODS A randomized controlled trial with 23 participants was conducted. Patients were randomly assigned to either the FDM + balance-strength training (BST) group (n = 8), receiving extra FDM sessions weekly in addition to two sessions of BST, or the BST group (n = 7). Healthy controls (n = 8) did not receive any treatment and participated only in pre- and post-test measurements. Objective measurements including Y-Balance Test Lower Quarter (YBT-LQ), Flamingo Balance Test (FBT), Weight-Bearing Lunge Test (WBLT), ankle joint range of motion (ROM), and Cumberland Ankle Instability Tool (CAIT) were recorded at baseline and the end of the intervention. The results demonstrated significant differences between the FDM + BST and BST groups for supination ROM (p = 0.008) and similarly for WBLT (p = 0.041), FBT (p = 0.40), YBT-LQ (p = 0.023), and CAIT score (p = 0.008). Moreover, while both groups demonstrated significant improvement at the post-test compared with their pre-test for plantarflexion and pronation ROM, WBLT, and CAIT score, the FDM + BST group demonstrated significant improvements in supination ROM, FBT, and YBT-LQ. CONCLUSION Our study suggests that the addition of FDM concepts to a BST may lead to enhanced improvements in ankle ROM, static and dynamic balance, and self-reported outcomes in individuals with CAI compared to BST.
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Affiliation(s)
- Amin Mohammadi
- Faculty of Health Sciences, Institute of Physiotherapy and Sports Science, University of Pécs, 3 Vörösmarty Str., H-7621 Pecs, Hungary; (A.M.); (S.E.S.); (A.M.); (I.Z.); (C.M.)
| | - Seyed Ehsan Sakhtemani
- Faculty of Health Sciences, Institute of Physiotherapy and Sports Science, University of Pécs, 3 Vörösmarty Str., H-7621 Pecs, Hungary; (A.M.); (S.E.S.); (A.M.); (I.Z.); (C.M.)
| | | | | | - Alexandra Makai
- Faculty of Health Sciences, Institute of Physiotherapy and Sports Science, University of Pécs, 3 Vörösmarty Str., H-7621 Pecs, Hungary; (A.M.); (S.E.S.); (A.M.); (I.Z.); (C.M.)
| | - Istvan Zsenak
- Faculty of Health Sciences, Institute of Physiotherapy and Sports Science, University of Pécs, 3 Vörösmarty Str., H-7621 Pecs, Hungary; (A.M.); (S.E.S.); (A.M.); (I.Z.); (C.M.)
| | - Csaba Melczer
- Faculty of Health Sciences, Institute of Physiotherapy and Sports Science, University of Pécs, 3 Vörösmarty Str., H-7621 Pecs, Hungary; (A.M.); (S.E.S.); (A.M.); (I.Z.); (C.M.)
| | - Péter Sándor Tardi
- Faculty of Health Sciences, Institute of Physiotherapy and Sports Science, University of Pécs, 3 Vörösmarty Str., H-7621 Pecs, Hungary; (A.M.); (S.E.S.); (A.M.); (I.Z.); (C.M.)
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Kim KM, Needle AR, Kim JS, An YW, Cruz-Díaz D, Taube W. What interventions can treat arthrogenic muscle inhibition in patients with chronic ankle instability? A systematic review with meta-analysis. Disabil Rehabil 2024; 46:241-256. [PMID: 36650898 DOI: 10.1080/09638288.2022.2161643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 12/18/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify, critically appraise, and synthesize the existing evidence regarding the effects of therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability (CAI). MATERIALS AND METHODS Two reviewers independently performed exhaustive database searches in Web of Science, PubMed, Medline, CINAHL, and SPORTDiscus. RESULTS Nine studies were finally included. Five types of disinhibitory interventions were identified: focal ankle joint cooling (FAJC), manual therapy, fibular reposition taping (FRT), whole-body vibration (WBV), and transcranial direct current stimulation (tDCS). There were moderate effects of FAJC on spinal excitability in ankle muscles (g = 0.55, 95% CI = 0.03-1.08, p = 0.040 for the soleus and g = 0.54, 95% CI = 0.01-1.07, p = 0.046 for the fibularis longus). In contrast, manual therapy, FRT, WBV were not effective. Finally, 4 weeks of tDCS combined with eccentric exercise showed large effects on corticospinal excitability in 2 weeks after the intervention (g = 0.99, 95% CI = 0.14-1.85 for the fibularis longus and g = 1.02, 95% CI = 0.16-1.87 for the tibialis anterior). CONCLUSIONS FAJC and tDCS may be effective in counteracting AMI. However, the current evidence of mainly short-term studies to support the use of disinhibitory interventions is too limited to draw definitive conclusions.
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Affiliation(s)
- Kyung-Min Kim
- Department of Sport Science, Sungkyunkwan University, Suwon-si, Korea
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - Alan R Needle
- Department of Public Health & Exercise Science, Appalachian State University, Boone, NC, USA
- Department of Rehabilitation Sciences, Appalachian State University, Boone, NC, USA
| | - Joo-Sung Kim
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - Yong Woo An
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, USA
| | - David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
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Safari S, Mohsenifar H, Amiri A. The immediate effect of synergistic muscles kinesio taping on function and balance of volleyball players with functional ankle instability: A randomized controlled trial. Foot (Edinb) 2023; 57:102058. [PMID: 37939512 DOI: 10.1016/j.foot.2023.102058] [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: 04/09/2023] [Revised: 09/12/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To determine the immediate effect of synergistic muscles Kinesio taping (KT) on the function and balance of volleyball players with functional ankle instability (FAI). DESIGN Parallel, superiority randomized controlled trial. METHODS Twenty-six semi-professional volleyball players with FAI were randomly assigned to either the intervention or control group. All participants received KT of fibularis longus, gastrocnemius, and gluteus maximus muscles for one session. The intervention group received KT with 35 % tension, while the control group received KT without tension. The function was assessed using the side hop and single hop distance tests. Dynamic balance was assessed with the Y Balance test. The outcomes were measured at baseline, 20 min after KT, and 24 h after KT. Statistical analyses were performed using Mixed-model repeated measures analysis of variance (ANOVA) and one-way ANOVA. RESULTS The interactions of time*group for the outcomes of function using the single hop test and stability in the anterior direction of the Y Balance test were significant (p < 0.05). Within-group comparisons showed after KT, both groups experienced significant improvements in all outcomes compared to the baseline. Results of between-group comparisons revealed that the application of KT with tension compared to no tension significantly improved function and balance in the anterior of the Y Balance test. CONCLUSIONS Kinesio taping can be an effective treatment option to improve function and balance in FAI. Additionally, Kinesio taping with tension compared to KT without tension had superiority.
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Affiliation(s)
- Sahar Safari
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Holakoo Mohsenifar
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Amiri
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Luan L, Zhu M, Adams R, Witchalls J, Pranata A, Han J. Effects of acupuncture or similar needling therapy on pain, proprioception, balance, and self-reported function in individuals with chronic ankle instability: A systematic review and meta-analysis. Complement Ther Med 2023; 77:102983. [PMID: 37666474 DOI: 10.1016/j.ctim.2023.102983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVE Acupuncture or similar needling therapy has long been used to improve well-being, but its effectiveness in management of chronic ankle instability (CAI) is unclear. To investigate the efficacy of acupuncture or similar needling therapy on pain, proprioception, balance, and self-reported function in individuals with CAI. METHODS Nine databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, PEDro, CNKI, WanFang, and CQVIP) were systematically searched from inception to April 2023. This study included randomized controlled trials involving acupuncture or similar needling therapy as an intervention for individuals with CAI. Data were extracted independently by two assessors using a standardized form. Literature quality and risk bias were assessed by using the PEDro scale. RESULTS Twelve trials (n = 571) were found, of which the final meta-analysis was conducted with eight. Different studies employ varying treatments, including specific needle types, techniques, and therapeutic frameworks. Compared to control without acupuncture or similar needling therapy, acupuncture or similar needling intervention resulted in improved pain (WMD 1.33, 95 % CI 0.14-2.52, I²=90 %, p = 0.03), proprioception (active joint position sense, WMD 1.71, 95 % CI 0.95-2.48, I²=0 %, p < 0.0001), balance (SMD 0.54, 95 % CI 0.03-1.04, I²=46 %, p = 0.04), and self-reported function (Cumberland Ankle Instability Tool (WMD 2.92, 95 % CI 0.94-4.90, I²=78 %, p = 0.004); American Orthopedic Foot and Ankle Society (WMD 9.36, 95 % CI 6.57-12.15, I²=0 %, p < 0.001); Foot and Ankle Ability Measure: activities of daily living (WMD 5.09, 95 % CI 1.74-8.44, I²=0 %, p = 0.003)) for individuals with CAI. CONCLUSIONS The available evidence suggests that acupuncture or similar needling therapy may improve pain, proprioception, balance, and self-reported function in individuals with CAI, but more trials are needed to verify these findings. Furthermore, various needles and techniques using in different studies have resulted in methodologic limitations that should be addressed in the future.
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Affiliation(s)
- Lijiang Luan
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Mengda Zhu
- Department of Physiotherapy, Monash University, VIC, Australia
| | - Roger Adams
- School of Physiotherapy, The University of Sydney, NSW, Australia; Research Institute for Sport and Exercise, University of Canberra, ACT, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, ACT, Australia
| | - Adrian Pranata
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, VIC, Australia
| | - Jia Han
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China; College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China; Research Institute for Sport and Exercise, University of Canberra, ACT, Australia; Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, VIC, Australia.
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Singh AK, Singh MS, Makhija M. Role of interventions targeting plantar cutaneous receptors in improving postural control in chronic ankle instability: A systematic review with meta-analysis. Foot (Edinb) 2023; 56:102034. [PMID: 37236131 DOI: 10.1016/j.foot.2023.102034] [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: 12/15/2021] [Revised: 04/04/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Chronic ankle instability (CAI) is a disorder that occurs after one or more acute ankle sprains and is characterised by persistent symptoms which include episodes of ''giving way'' a sensation of instability, recurrent ankle sprains, and functional deficits. Despite of effective treatment strategies a comprehensive approach is needed that can break this continuum of disability and improve the postural control. A systematic review with meta-analysis assessing the effectiveness of interventions targeting plantar cutaneous receptors for improving postural control in individuals with chronic ankle instability. METHODS The systematic review with meta-analysis was performed following PRISMA guidelines. Outcome measure used to evaluate the improvement in which static postural control was assessed on SLBT (Single limb balance test) and COP (Centre of pressure) whereas dynamic postural control was assessed on SEBT (star excursion balance test) and scores expressed as mean ± SD and random-effects model were performed, and heterogeneity between the studies was calculated using the I2 statistic. RESULTS A total of 168 CAI populations were included among the 8 selected studies in the meta-analysis. In which,5 studies using Plantar massage and 3 studies using foot insole were assessed, with moderate to high quality on the Pedro scale (range 4-7). For single and six-sessions of plantar massage showed insignificant effect on SLBT COP and for the single session of custom moulded FO showed insignificant effect on SEBT. CONCLUSION The meta-analysis showed non-significant pooled results for plantar massage and foot orthotics on static and dynamic postural control when assessed on postural outcome measures. Further high-quality evidence-based trials would be required to highlight the importance of sensory targeted approaches to treat the postural instability in CAI patients.
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Affiliation(s)
- Anand Kumar Singh
- Department of Rehabilitation, Musculoskeletal Physiotherapist,Indian Spinal Injuries Centre, New Delhi, India
| | - Maninder Shah Singh
- Department of Orthopaedics, MBBS, MS Orthopaedic Indian Spinal Injuries Centre, New Delhi, India
| | - Meena Makhija
- Department of Rehabilitation, Associate Professor, Indian Spinal Injuries Centre, New Delhi, India.
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Shi X, Ganderton C, Tirosh O, Adams R, Ei-Ansary D, Han J. Test-retest reliability of ankle range of motion, proprioception, and balance for symptom and gender effects in individuals with chronic ankle instability. Musculoskelet Sci Pract 2023; 66:102809. [PMID: 37354602 DOI: 10.1016/j.msksp.2023.102809] [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: 01/07/2023] [Revised: 05/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To determine the reliability of the commonly used musculoskeletal assessments in individuals with chronic ankle instability (CAI). DESIGN Within and between-days test-retest reliability. SETTING University laboratory. PARTICIPANTS Twenty-four individuals with unilateral CAI. METHOD For both sides, ankle dorsiflexion range of motion (DFROM) was assessed by a goniometer and weight-bearing lunge test (WBLT), proprioception by the active movement extent discrimination apparatus (AMEDA), and balance by the Star Excursion Balance Test with anterior (SEBTA), posteromedial (SEBTPM) and posterolateral (SEBTPL) components. All measures were taken at enrollment, after 30 min and one week later. RESULTS For the asymptomatic side, all assessments demonstrated good to excellent reliability, with ICCs (3,1) between 0.8 and 0.96. On the symptomatic side, WBLT, SEBTA and SEBTPM showed excellent reliability, with ICCs (3,1) above 0.90, while SEBTPL, goniometer and AMEDA showed moderate reliability, with the 95% CI of the ICCs (3,1) crossing 0.5. Three-way repeated measures ANOVA showed a side main effect, with asymptomatic worse, for WBLT (F = 16.9, p < 0.001) and SEBTA (F = 5.4, p = 0.03); an overall improving time main effect for SEBTPL (F = 6.9, p = 0.02). Neither a gender main effect nor any interaction effect was found. CONCLUSIONS WBLT, SEBTA and SEBTPM can be strongly recommended for measuring ankle dorsiflexion mobility and dynamic balance for both sides of individuals with unilateral CAI, while only WBLT can be used for side-to-side comparison. The application of a goniometer to measure DFROM, SEBTPL or AMEDA should be done cautiously for this specific cohort, considering their poor to good reliability for the symptomatic side.
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Affiliation(s)
- Xiaojian Shi
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China.
| | - Charlotte Ganderton
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Oren Tirosh
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia
| | - Doa Ei-Ansary
- School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China; Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia.
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Rowe PL, Hinman RS, Bryant AL, Paterson KL. Health-seeking behaviors, management practices, and return to play decisions after an ankle sprain in netball: An international cross-sectional survey of 1592 non-elite netballers. J Sci Med Sport 2023; 26:415-420. [PMID: 37400287 DOI: 10.1016/j.jsams.2023.06.004] [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: 12/22/2022] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES Evaluate if non-elite netballers sought health care, treatments received, and return-to-play decisions after an ankle sprain, including intercountry differences. DESIGN Cross-sectional survey. METHODS Non-elite netballers aged >14 years were recruited from Australia, United Kingdom, and New Zealand. Participants completed an online survey regarding their last ankle sprain and were queried regarding health care sought, health professionals consulted, treatments received, time missed, and return-to-play clearance. Data were described using number (proportion) for the overall cohort and countries. Between-country differences in health care use were compared using chi-square tests. Descriptive statistics were presented for management practices. RESULTS We received 1592 responses from Australian (n = 846), United Kingdom (n = 454), and New Zealand (n = 292) netballers. Three in five (n = 951, 60 %) sought health care. Of those, most consulted a physiotherapist (n = 728, 76 %), received strengthening exercises (n = 771, 81 %), balance exercises (N = 665, 70 %) and taping (n = 636, 67 %). Few received return-to-play clearance (n = 362, 23 %). Comparing countries, fewer United Kingdom netballers sought health care than Australian and New Zealand netballers (Australia: 60 % vs United Kingdom: 53 % vs New Zealand: 68 %, p < 0.001), consulted a physiotherapist (Australia: 79 %, United Kingdom: 63 %, New Zealand: 87 %), received strengthening (Australia: 84 %, United Kingdom: 73 %, New Zealand: 84 %) or balance exercises (Australia: 71 %, United Kingdom: 60 %, New Zealand: 80 %) or taping (Australia: 74 %, United Kingdom: 39 %, New Zealand: 82 %). More Australian netballers returned to play within 1-7 days (Australia: 25 %, United Kingdom: 15 %, New Zealand: 21 %) and fewer United Kingdom netballers received return-to-play clearance (Australia: 28 %, United Kingdom: 10 %, New Zealand: 28 %). CONCLUSIONS Health-seeking behaviours are adopted by some, but not all netballers after an ankle sprain. For those who sought care, most consulted a physiotherapist and were prescribed exercise-based interventions and external ankle support, but few received return-to-play clearance. Comparing countries, United Kingdom netballers had lower health-seeking behaviours and received less best-practice management than Australian and New Zealand netballers.
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Affiliation(s)
- Patrick L Rowe
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia. https://twitter.com/patrickrowe94
| | - Rana S Hinman
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia. https://twitter.com/HinmanRana
| | - Adam L Bryant
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
| | - Kade L Paterson
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
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Wang X, Shao X, Yu R, Wang Y, Deng F, Adams R, Han J. Acute effects of kinesiology tape on dynamic balance control in chronic ankle instability: An exploratory study. Phys Ther Sport 2023; 62:65-70. [PMID: 37399706 DOI: 10.1016/j.ptsp.2023.06.005] [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: 04/06/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To investigate the acute effect of the four-strip kinesiology taping (KT) technique on dynamic balance control in the Y Balance Test (YBT), and to explore the relationship between the YBT and Cumberland Ankle Instability Tool (CAIT) scores in individuals with and without chronic ankle instability (CAI). METHODS 16 CAI and 16 non-CAI participants were involved. Two groups completed the YBT in the no-tape barefoot and the KT condition at random. The CAIT was completed on the first day. Bonferroni test was used to analyze YBT scores in three directions for post hoc analysis. Spearman's correlation was used to analyze the relationship between YBT scores in the no-tape barefoot condition and CAIT scores. RESULTS This KT application significantly improved YBT performance. The YBT scores in the anterior direction (YBT-A), posteromedial direction (YBT-PM), and posterolateral direction (YBT-PL) for the CAI group were significantly improved after taping. However, in the non-CAI group, only YBT-PM score was significantly improved after taping. Three YBT scores were all moderately correlated with the CAIT score. CONCLUSION This KT technique can immediately improve dynamic balance in CAI patients. Dynamic balance performance was moderately related to the degree of self-perceived instability in individuals with and without CAI.
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Affiliation(s)
- Xiaotian Wang
- Department of Orthopedics and Traumatology, Jinhua Hospital of Traditional Chinese Medicine, Jinhua, Zhejiang, China
| | - Xuerong Shao
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Ruoni Yu
- School of Medicine, Jinhua Polytechnic, Jinhua, Zhejiang, China
| | - Yudi Wang
- School of Physical Education and Nursing, Chengdu College of Arts and Sciences, Chengdu, Sichuan, China
| | - Fawei Deng
- Department of Rehabilitation, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Roger Adams
- Research Institute for Sports and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China; Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, ACT, Australia.
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Espí-López GV, Pavlu D, Arnal-Gómez A, Muñoz-Gómez E, Martinez-Millana A, Marqués-Sulé E. Short-Term Effects of Manual Therapy on Balance: A Multicenter, Randomized, Double-Blind Controlled Trial. J Manipulative Physiol Ther 2023; 46:162-170. [PMID: 38142378 DOI: 10.1016/j.jmpt.2023.11.003] [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: 05/16/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze short-term changes in dynamic and static balance after a manual therapy protocol in healthy participants and analyze any repercussions on mood and perception of change after applying articulatory techniques. METHODS A single-blind, randomized, multicenter clinical trial was conducted. Participants were allocated to either a manual therapy group (MTG) (n = 101) or a control group (CG) without intervention (n = 99), and measures were taken before treatment, after the intervention, and 1 week after treatment. Assessments included the Star Excursion Balance Test, Unipedal Stance Test (UPST), Profile of Mood States (POMS), and Patient Global Impression of Change (PGIC) scale. RESULTS Two hundred healthy participants completed the study (mean age, 22 [SD = 2.67]). There was a statistically significant interaction between groups and time measurements in the right leg for anterior (P = .003), posteromedial (P < .001), and posterolateral (P = .001) directions in favor of the MTG, as well as in the left leg for anterior (P < .001), posteromedial (P < .001), and posterolateral (P = .012) directions. The analysis failed to show statistically significant interactions between any of the factors for the UPST and POMS (P > .05). The MTG showed a significant improvement compared to the CG after treatment (P = .003) and at 1-week follow-up (P < .001) on the PGIC scale. CONCLUSION The results suggest the MT intervention was effective on dynamic balance in post-intervention in healthy participants, and some of the directions maintained the results at 1-week follow-up. Perception of change in post-treatment and 1-week follow-up also significantly improved. The protocol did not seem to produce changes in static balance and mood states. Positive changes after manual therapy were maintained in the short term.
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Affiliation(s)
- Gemma V Espí-López
- Exercise Intervention for Health (EXINH), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Dagmar Pavlu
- Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Anna Arnal-Gómez
- Physiotherapy in Motion, Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain.
| | - Elena Muñoz-Gómez
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | | | - Elena Marqués-Sulé
- Physiotherapy in Motion, Multispecialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
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Koshino Y, Kobayashi T. Effects of Conservative Interventions on Static and Dynamic Balance in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2022; 104:673-685. [PMID: 36417970 DOI: 10.1016/j.apmr.2022.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine which conservative interventions are effective for static and dynamic balance in patients with chronic ankle instability (CAI). DATA SOURCES PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to March 20, 2022. STUDY SELECTION Randomized controlled trials investigating the effects of conservative interventions on static and/or dynamic balance in patients with CAI compared with those of different conservative interventions or controls were included. DATA EXTRACTION Two independent reviewers extracted the data. Certainty of the evidence was assessed using the GRADE approach. DATA SYNTHESIS Forty-eight studies (1906 participants) were included. Whole-body vibration training (WBVT) was significantly more effective than controls for both static (standardized mean difference, 1.13; 95% confidence interval [CI], 0.58-1.68; moderate-certainty evidence) and dynamic balance (0.56; CI, 0.24-0.88; low-certainty evidence). Balance training (BT) and joint mobilization were significantly more effective than controls for dynamic balance (0.77; CI, 0.41-1.14; and 0.75; CI, 0.35-1.14, respectively), but not for static balance (very low to low-certainty evidence). Adding other interventions to BT had no significant effect on either type of balance compared with that of BT alone (moderate to low-certainty evidence). Strength training (ST) and taping had no significant effect on either type of balance (very low- to low-certainty evidence). Multimodal interventions were significantly effective in improving dynamic balance (0.76; CI, 0.32-1.20; low-certainty evidence). Adding transcranial direct current stimulation to ST was significantly more effective for dynamic balance than ST (0.81; CI, 0.08-1.53; moderate-certainty evidence). The effects on balance were not significantly different among BT, ST, and WBVT (very low- to low-certainty evidence). CONCLUSIONS The significantly effective interventions reviewed may be treatment options for balance impairments associated with CAI. However, interventions should be chosen carefully, as much of the certainty of evidence is very low to low.
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Affiliation(s)
- Yuta Koshino
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Takumi Kobayashi
- Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
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Ke XH, Huang DB, Li YY, Li XM, Guo JH, Guo MM, Yu SX, Ma SC, Jiang C, Lin ZH. Effects of 12 weeks of Tai Chi Chuan intervention on the postural stability and self-reported instability in subjects with functional ankle instability: Study protocol for a randomized controlled trial. Front Neurol 2022; 13:923669. [PMID: 36212637 PMCID: PMC9535359 DOI: 10.3389/fneur.2022.923669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Tai Chi Chuan (TCC) is a physical activity modality that originated in China and is now widely popular around the world. Although there are a series of articles reporting that TCC can improve balance and other functional symptoms in a variety of populations, including the elderly, patients with stroke, and patients with Parkinson's disease, its efficiency has not been scientifically and methodically evaluated in subjects with functional ankle instability (FAI). Moreover, there is no literature directly comparing TCC and conventional balance training (CBT) interventions for FAI. The objective of this study is to investigate the comparative effects of TCC intervention and CBT protocols in improving postural balance and subjective instability feelings in patients with FAI. Methods This study will be a single-center, parallel group, randomized controlled trial. Sixty-eight patients with FAI will be included and randomly assigned in a 1:1 ratio to either an intervention group (n =34) or a control group (n = 34). The participants in the intervention group will complete 12 weeks of TCC intervention (40 min/time, 3 times/week for 12 weeks) on the basis of health education treatment. The control group will receive health education and 36 CBT sessions during a 12-week period. Outcome measures include postural stability and self-reported feelings of instability at baseline, after the end of the intervention, and 3-month follow-up. The postural stability assessment of patients with FAI will be detected by performing static and dynamic postural tests, which will be carried out through a specific balance platform (TecnoBody ProKin). Self-reported feelings of instability will be assessed by Cumberland Ankle Instability Tool (CAIT), American Orthopedics Foot and Ankle Society's Ankle–Hindfoot Evaluation Scale (AOFAS-AHES), and the MOS item Short Form Health Survey (SF-36). Discussion This trial will demonstrate whether a 12-week TCC intervention positively affects postural stability and self-reported outcomes in patients with FAI. At the same time, the superiority of its clinical efficacy will also be compared with that of CBT. This study may also help to redefine the value of traditional Chinese exercises in the treatment of chronic ankle instability. Clinical trial registration Chinese Clinical Trial Registry: ChiCTR2100041790. Registration date: 22 March 2021. http://www.chictr.org.cn/edit.aspx?pid=119501&htm=4.
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Affiliation(s)
- Xiao-hua Ke
- Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Dun-bing Huang
- Rehabilitation Center, Zhejiang Hospital, Hangzhou, China
| | - Yin-yan Li
- General Outpatient Department, Fujian Academy of Chinese Medical Sciences, Fuzhou, China
| | - Xiao-mei Li
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Jin-hua Guo
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Miao-miao Guo
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Sheng-xian Yu
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Sheng-chao Ma
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Cai Jiang
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
- The Second Rehabilitation Department, Fujian Provincial Hospital, Fuzhou, China
- Fujian Institute of Clinical Geriatric, Fujian Provincial Hospital, Fuzhou, China
- *Correspondence: Cai Jiang
| | - Zhong-hua Lin
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
- The Second Rehabilitation Department, Fujian Provincial Hospital, Fuzhou, China
- Fujian Institute of Clinical Geriatric, Fujian Provincial Hospital, Fuzhou, China
- Zhong-hua Lin
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Han J, Luan L, Adams R, Witchalls J, Newman P, Tirosh O, Waddington G. Can therapeutic exercises improve proprioception in chronic ankle instability? a systematic review and network meta-analysis. Arch Phys Med Rehabil 2022; 103:2232-2244. [PMID: 35550140 DOI: 10.1016/j.apmr.2022.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/03/2022] [Accepted: 04/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To assess exercise therapies that aim to enhance proprioception in individuals with chronic ankle instability (CAI). DATA SOURCES Five databases (PubMed, Embase, Cochrane Library, Web of Science, and EBSCO) were searched in October 2021. STUDY SELECTION Randomized controlled trials involving exercise therapy conducted on individuals with CAI were included. DATA EXTRACTION Data were extracted by two independent reviewers using a standardized form. Methodological quality and risk of bias were assessed with the PEDro scale. DATA SYNTHESIS The end-trial weighted mean difference and standard deviations were analyzed, and the synthetic value for the improvement in error scores of ankle joint position sense (JPS) in multiple directions was evaluated. RESULTS Eleven trials with 333 participants were eligible for inclusion in this systematic review and were included in the Network Meta-Analysis. Foot and ankle muscle strengthening exercise showed the highest probability of being among the best treatments (surface under the cumulative ranking (SUCRA)=74.6%). The next two were static balance exercise only (SUCRA=67.9%) and corrective exercise (SUCRA=56.1%). The SUCRA values of proprioceptive exercise, dynamic balance exercise only, aquatic exercise, rehabilitation exercise with brace, mixed static/dynamic balance exercise, and control were at relatively low levels, and scored at 49.6%, 48.8%, 47.8%, 47.7%, 44.0%, and 13.5%, respectively. CONCLUSIONS Foot and ankle muscle strengthening exercise may have a good effect when used to improve JPS in individuals with CAI. Probably, the more complex balance exercise intervention becomes, the less effective the proprioceptive outcome. PROSPERO REGISTRATION NUMBER CRD42021240331.
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Affiliation(s)
- Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China; Department of Physiotherapy and Sports Rehabilitation, Shanghai University of Sport, Shanghai, China; Research Institute for Sport and Exercise, University of Canberra, Bruce ACT, Australia; Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn VIC, Australia.
| | - Lijiang Luan
- Department of Physiotherapy and Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Roger Adams
- School of Physiotherapy, University of Sydney, Lidcombe NSW, Australia; Research Institute for Sport and Exercise, University of Canberra, Bruce ACT, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Bruce ACT, Australia
| | - Phillip Newman
- Research Institute for Sport and Exercise, University of Canberra, Bruce ACT, Australia
| | - Oren Tirosh
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn VIC, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, Bruce ACT, Australia
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Izaola-Azkona L, Vicenzino B, Olabarrieta-Eguia I, Saez M, Lascurain-Aguirrebeña I. Effectiveness of Mobilization of the Talus and Distal Fibula in the Management of Acute Lateral Ankle Sprain. Phys Ther 2021; 101:6231218. [PMID: 33877325 DOI: 10.1093/ptj/pzab111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 01/20/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Distal fibular mobilization with movement (MWM), with and without a posterior gliding fibular tape, and anteroposterior mobilization of the talus (MOB) are widely used to treat acute lateral ankle sprains. The purpose of this study was to investigate the short-term and long-term relative effectiveness of these techniques. METHODS In this double-blind randomized controlled trial, 45 amateur soccer players with acute (<72 hours) lateral ankle sprain were randomly allocated to 6 sessions (3/wk within the first 2 weeks) of either MWM, MWM with tape (MWMtape), or MOB. All participants also received general advice, transcutaneous electrical nerve stimulation, edema draining massage, and a program of proprioception exercises. Participant ratings of function on the Foot and Ankle Ability Measure and Patient Global Impression of Improvement Scale were the primary outcomes measured over 52 weeks. Secondary outcomes were ankle pain, pressure pain threshold, range of motion, volume, and strength. RESULTS MWM and MWMtape were equally effective and participants demonstrated greater function on the Foot and Ankle Ability Measure at 12 and 52 weeks when compared with those receiving MOB; however, the latter demonstrated superior function at 2 weeks. No differences between groups were observed for Patient Global Impression of Improvement Scale or any of the secondary outcomes. CONCLUSION There are limited differences in the short term among techniques, with the exception of better sport function with MOB. Over the longer term, the distal fibular MWM is most effective to achieve activities of daily living and sport function when added to usual physical therapy care. The addition of a posterior gliding fibular tape provides no additional benefit. IMPACT Distal fibular mobilization with movement may be the most appropriate choice of treatment for acute lateral ankle sprain to achieve long-term activities of daily living and sport function. In the short term, anteroposterior mobilization of the talus offers greater improvement in sport function. The use of fibular tape provides no added benefit as an adjunct to a treatment that includes distal fibular mobilization with movement.
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Affiliation(s)
- Loitzun Izaola-Azkona
- Physiotherapy Department, University of Deusto, San Sebastian, Spain.,Mugi Fisioterapia, Sabino Arana 30, Sopelana, Spain
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, Department of Physiotherapy, University of Queensland, St Lucia, Queensland, Australia
| | | | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ion Lascurain-Aguirrebeña
- Physiotherapy, Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain
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14
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Luan L, Adams R, Witchalls J, Ganderton C, Han J. Does Strength Training for Chronic Ankle Instability Improve Balance and Patient-Reported Outcomes and by Clinically Detectable Amounts? A Systematic Review and Meta-Analysis. Phys Ther 2021; 101:6124780. [PMID: 33517464 DOI: 10.1093/ptj/pzab046] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/28/2020] [Accepted: 01/04/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Strength training as a form of exercise therapy has long been used to maintain or promote strength, but its effectiveness as a treatment intervention in chronic ankle instability (CAI) is not fully understood. The purpose of this study was to evaluate the effects of strength training compared with no exercise and neuromuscular control training on balance and self-reported function in people with CAI. METHODS Eight databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, PEDro, CNKI, and WanFang) were searched in June 2020. Randomized controlled trials (RCTs) involving strength training conducted on individuals with CAI were included. Data were extracted by 2 independent reviewers using a standardized form. Methodological quality and risk of bias were assessed by using the PEDro Scale. In addition, the GRADE evaluation system (Grading of Recommendations Assessment, Development and Evaluation) was used to determine the strength of evidence. A total of 554 studies were initially screened, resulting in a final selection of 11 RCTs involving 428 participants, and 8 RCTs were included in the final meta-analysis. Compared with no exercise, strength training demonstrated some benefits in the Star Excursion Balance Test (anterior: weighted mean difference [WMD] = 2.39, 95% CI = 0.60-4.18; posteromedial: WMD = 3.30, 95% CI = 0.24-6.35; posterolateral: WMD = 2.97, 95% CI = 0.37-5.57), but these intervention results did not reach the minimal detectable change values. CONCLUSION Available evidence showed that, compared with controls, strength training did not produce any minimal detectable changes on Star Excursion Balance Test or Foot and Ankle Ability Measure scores in individuals with CAI. Clinicians should use strength training cautiously for improving balance and symptoms in CAI. IMPACT The results of this study may have an impact on selecting effective physical therapy interventions for managing symptoms associated with CAI.
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Affiliation(s)
- Lijiang Luan
- Xiamen Qingdun Fitness Management Co., Ltd., Xiamen, Fujian, China
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT, Australia
| | | | - Charlotte Ganderton
- Faculty of Health, Arts and Design, Swinburne University of Technology, VIC, Australia
| | - Jia Han
- Research Institute for Sport and Exercise, University of Canberra, ACT, Australia.,Faculty of Health, Arts and Design, Swinburne University of Technology, VIC, Australia.,Department of Physiotherapy and Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
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Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG80. [PMID: 33789434 DOI: 10.2519/jospt.2021.0302] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.
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Han J, Yang Z, Adams R, Ganderton C, Witchalls J, Waddington G. Ankle inversion proprioception measured during landing in individuals with and without chronic ankle instability. J Sci Med Sport 2021; 24:665-669. [PMID: 33632662 DOI: 10.1016/j.jsams.2021.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/16/2021] [Accepted: 02/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Research evidence has suggested that a more sensitive ankle proprioceptive testing method with higher ecological validity is needed for assessing proprioceptive deficits in individuals with chronic ankle instability (CAI). OBJECTIVES (1) To determine the test-retest reliability of a novel ankle proprioception assessment tool, the Ankle Inversion Discrimination Apparatus for Landing (AIDAL); (2) To assess whether AIDAL scores were sufficiently sensitive to detect proprioceptive deficits in chronic ankle instability (CAI); and (3) To examine whether AIDAL scores correlated with Cumberland Ankle Instability Tool (CAIT) scores. DESIGN Cross-sectional study. METHODS The AIDAL was purpose-built to assess ankle discrimination in four positions of ankle inversion (10°, 12°, 14° and 16°) upon landing from a 10cm drop. Area Under the Receiver Operating Curve (AUC) was employed as the ankle proprioceptive discrimination score. Seven-day test-retest reliability was evaluated with 23 university students (12 CAI and 11 non-CAI), and another 36 university students (18 CAI and 18 non-CAI) were in the comparison study. RESULTS The test-retest reliability ICC score for the whole group was 0.763 (95% CI=0.519-0.892), which showed an excellent reliability level. ICC (3,1) was 0.701 for the non-CAI group (95%CI=0.210-0.910) and 0.804 for the CAI group (95%CI=0.451-0.939). The CAI group performed at a significantly lower level on the AIDAL assessment than the non-CAI group (0.777±0.05 vs. 0.815±0.05, F=5.107, p=0.03). The discriminative AUC value for the AIDAL test was 0.756 with a cut point of 0.819 (sensitivity=0.733, specificity=0.800). The MDC90 scores for CAI and non-CAI groups were both 0.04. Spearman's correlation showed that the CAIT scores were significantly correlated with the ankle proprioceptive discrimination scores (rho=0.401, p=0.015). CONCLUSION The AIDAL showed good test-retest reliability for both non-CAI and CAI groups. Measuring ankle inversion proprioception during landing may be important for assessing the outcomes of CAI rehabilitation, as proprioceptive performance obtained from the AIDAL was significantly correlated with severity of functional ankle instability CAIT scores.
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Affiliation(s)
- Jia Han
- Department of Physiotherapy and Sport Rehabilitation Shanghai University of Sport, China; Faculty of Health, Arts and Design, Swinburne University of Technology, Australia; Research Institute for Sport and Exercise, University of Canberra, Australia.
| | - Zonghan Yang
- Department of Physiotherapy and Sport Rehabilitation Shanghai University of Sport, China; Department of Physiotherapy, University of Melbourne, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Australia
| | - Charlotte Ganderton
- Faculty of Health, Arts and Design, Swinburne University of Technology, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, Australia
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Zhang L, Lu J, Cai B, Fan S, Jiang X. Quantitative assessments of static and dynamic balance performance in patients with chronic ankle instability. Medicine (Baltimore) 2020; 99:e19775. [PMID: 32332619 PMCID: PMC7220543 DOI: 10.1097/md.0000000000019775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/17/2020] [Accepted: 03/05/2020] [Indexed: 12/26/2022] Open
Abstract
Patients with chronic ankle instability (CAI) have postural-control deficits during center-of-pressure excursions than do healthy individuals. While an external analysis of center-of-pressure excursions in CAI has been performed, a quantitative analysis of center-of-gravity movements, to detect the balance deficits associated with CAI, has yet to be performed. Therefore, the aim of the study is to quantify the balance deficits in patients with unilateral CAI.Forty-four patients with unilateral CAI (24 men; age, 31.7 ± 5.5 years) and 26 uninjured volunteers (12 men; age, 28.6 ± 5.9 years) underwent Neurocom Balance Manager assessments of dynamic and static balance responses in limits of stability, unilateral stance, and forward lunge tests.In the limits of stability test, there were no significant group differences in the forward direction; however, reaction times were longer in the CAI group than in the control group in the backward (P = .037, effect size [ES] = 0.49) and rightward directions (P = .032, ES = 0.47). Furthermore, the CAI group showed more excursions in the rightward (P = .046, ES = 0.50) and leftward directions (P = .002, ES = 0.80), and less directional control in the leftward direction (P = .036, ES = 0.59). In the unilateral stance test, the center of gravity sway velocity was faster in the CAI group than in the control group, whether eyes were opened or closed (P < .05). There were no significant group differences in forward lunge-test outcomes.Patients with CAI have poor static and dynamic balance performance compared to that in healthy counterparts. Thus, balance retraining should be an essential component of rehabilitation programs for patients with CAI.
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