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Tang F, Yin S, Gao P, Chen L. The effect of joint mobilization of Maitland on chronic ankle instability: A randomized trial. Medicine (Baltimore) 2024; 103:e39100. [PMID: 39121319 PMCID: PMC11315491 DOI: 10.1097/md.0000000000039100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The aim of study was to observe the therapeutic effect of joint mobilization of Maitland on subjects with chronic ankle instability (CAI). METHODS 76 subjects with CAI were recruited for this randomized, single-blinded trial and randomized divided into experimental group (EG) and control group (CG). The CG was received conventional rehabilitation, and the EG added 8-weeks treatment of Maitland technology based on the CG. The visual analogue scale, ankle range of motion, Y-balance test, and Foot and Ankle Ability Measure scores (the daily living part of Foot and Ankle Ability Measure scores and the sport part of Foot and Ankle Ability Measure scores) were measured before and 8 weeks after the intervention respectively. RESULTS There was no significant difference on outcomes between the 2 groups before treatment (P > .05). After 8 weeks of intervention, the visual analogue scale, ankle range of motion (dorsiflexion, plantar flexion, and varus), the value of Y-balance test (forward extension distance, inner extension distance, and posterior extension distance), the daily living part of Foot and Ankle Ability Measure scores, and the sport part of Foot and Ankle Ability Measure scores of the 2 groups were significantly improved (P < .01), and the improvement of the EG showed remarkable than CG (P < .01). CONCLUSION Maitland therapy is effective in the treatment of CAI. Conventional rehabilitation assisted by Maitland therapy were beneficial to improve pain and functional state in patients with CAI than only routine rehabilitation.
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Affiliation(s)
- Fang Tang
- College of Physical Education, Anqing Normal University, Anqing, China
- Department of Rehabilitation and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Shanshan Yin
- Public Physical Education Department, Taizhou University, Taizhou, China
| | - Pincao Gao
- College of Physical Education, Anqing Normal University, Anqing, China
- Department of Rehabilitation and Healthcare, Hunan University of Medicine, Huaihua, China
| | - Lin Chen
- Guilin Vocational College of life and health, Guilin, China
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Karabay D, Yeşilyaprak SS, Erduran M, Ozcan C. Effects of Eccentric Versus Concentric Strengthening in Patients With Subacromial Pain Syndrome: A Randomized Controlled Trial. Sports Health 2024:19417381241236817. [PMID: 38532530 DOI: 10.1177/19417381241236817] [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: 03/28/2024] Open
Abstract
BACKGROUND Subacromial pain syndrome (SPS) is the most common cause of shoulder pain. Therapeutic exercise is the first-line treatment for SPS; however, the ideal exercise type remains unclear. Here, we compared the effects of eccentric and concentric strengthening in patients with SPS. HYPOTHESIS Adding isolated eccentric strengthening to a multimodal physiotherapy program (MPP) would lead to greater improvements in outcomes compared with either MPP alone or adding isolated concentric strengthening to the MPP. STUDY DESIGN Randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS A total of 45 patients were randomized to eccentric strengthening (ESG), concentric strengthening (CSG), and control (CG) groups; all groups received the MPP. The strengthening groups also performed group-specific strengthening. Shoulder pain, abduction and external rotation (ER) strength, joint position sense (JPS), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand score were collected at baseline, after 12 weeks of treatment, and at week 24. RESULTS For CMS, ESG exhibited a greater, but not clinically meaningful, improvement than CSG and CG (P < 0.05). Eccentric abduction strength increased in ESG compared with CG. From baseline to follow-up, abduction strength increased in ESG compared with CSG and CG. Eccentric abduction strength increased in CSG compared with CG. JPS at abduction improved in the ESG compared with CG. Other between-group comparisons were not significant (P > 0.05). CONCLUSION In SPS, eccentric strengthening provided added benefits, improving shoulder abduction strength and JPS at abduction, and was superior to concentric strengthening for improving shoulder abduction strength. Neither strengthening approach had an additional effect on shoulder function, pain, ER strength, or rotational JPS. CLINICAL RELEVANCE Clinicians could implement eccentric strengthening as a motor control retraining for strength and proprioception gain rather than for pain relief and reducing disability.
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Affiliation(s)
- Damla Karabay
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Izmir Katip Celebi University, Izmir, Turkey
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Sevgi Sevi Yeşilyaprak
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Bakircay University, Izmir, Turkey
| | - Mehmet Erduran
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Cem Ozcan
- Department of Orthopedics and Traumatology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
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Seo HG, Yun SJ, Farrens A, Johnson C, Reinkensmeyer DJ. A Systematic Review of the Learning Dynamics of Proprioception Training: Specificity, Acquisition, Retention, and Transfer. Neurorehabil Neural Repair 2023; 37:744-757. [PMID: 37864458 PMCID: PMC10847967 DOI: 10.1177/15459683231207354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
OBJECTIVE We aimed to identify key aspects of the learning dynamics of proprioception training including: 1) specificity to the training type, 2) acquisition of proprioceptive skills, 3) retention of learning effects, and 4) transfer to different proprioceptive skills. METHODS We performed a systematic literature search using the database (MEDLINE, EMBASE, Cochrane Library, and PEDro). The inclusion criteria required adult participants who underwent any training program that could enhance proprioceptive function, and at least 1 quantitative assessment of proprioception before and after the intervention. We analyzed within-group changes to quantify the effectiveness of an intervention. RESULTS In total, 106 studies with 343 participant-outcome groups were included. Proprioception-specific training resulted in large effect sizes with a mean improvement of 23.4 to 42.6%, nonspecific training resulted in medium effect sizes with 12.3 to 22% improvement, and no training resulted in small effect sizes with 5.0 to 8.9% improvement. Single-session training exhibited significant proprioceptive improvement immediately (10 studies). For training interventions with a midway evaluation (4 studies), trained groups improved by approximately 70% of their final value at the midway point. Proprioceptive improvements were largely maintained at a delayed follow-up of at least 1 week (12 studies). Finally, improvements in 1 assessment were significantly correlated with improvements in another assessment (10 studies). CONCLUSIONS Proprioceptive learning appears to exhibit several features similar to motor learning, including specificity to the training type, 2 time constant learning curves, good retention, and improvements that are correlated between different assessments, suggesting a possible, common mechanism for the transfer of training.
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Affiliation(s)
- Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Mechanical and Aerospace Engineering, University of California at Irvine, California, USA
| | - Seo Jung Yun
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Human System Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Andria Farrens
- Department of Mechanical and Aerospace Engineering, University of California at Irvine, California, USA
| | - Christopher Johnson
- Department of Biomedical Engineering, University of California at Irvine, California, USA
| | - David J. Reinkensmeyer
- Department of Mechanical and Aerospace Engineering, University of California at Irvine, California, USA
- Department of Biomedical Engineering, University of California at Irvine, California, USA
- Department of Anatomy and Neurobiology, University of California at Irvine, California, USA
- Department of Physical Medicine and Rehabilitation, University of California at Irvine, California, USA
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Yin Y, Yu Z, Wang J, Sun J. Effectiveness of the Rehabilitation Training Combined with Maitland Mobilization for the Treatment of Chronic Ankle Instability: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15328. [PMID: 36430049 PMCID: PMC9690276 DOI: 10.3390/ijerph192215328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
The study aims to determine whether routine rehabilitation training combined with the Maitland mobilization is more effective than routine rehabilitation training alone in patients with chronic ankle instability, intending to provide a novel rehabilitation strategy for chronic ankle instability. A total of 48 subjects were divided into three groups: EG (Maitland mobilization and routine rehabilitation), CG (routine rehabilitation), and SG (sham mobilization and routine rehabilitation). The intervention was performed three times each week for 4 weeks, for a total of 12 sessions. Before and after the intervention, the muscle strength, star excursion balance test (SEBT), weight-bearing dorsiflexion range of motion (WB-DFROM), ankle range of movement, Cumberland ankle instability tool (CAIT), self-comfort visual analog scale (SCS-VAS), and self-induced stability scale (SISS-VAS) were assessed. The results showed that the improvement of SEBT, WB-DFROM, and active ankle range of movement without the pain in EG was more obvious than CG and SG, but the improvement of the self-report of ankle severity and muscle strength was not. Compared with routine rehabilitation training alone, routine rehabilitation training combined with Maitland mobilization for patients with chronic ankle instability may provide more benefit in terms of balance and ankle range of movement than routine rehabilitation alone, but the improvement in muscle strength was not evident enough.
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Affiliation(s)
- Yikun Yin
- College of Physical and Health Education, Guangxi Normal University, Guilin 541006, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Zhengze Yu
- College of Physical and Health Education, Guangxi Normal University, Guilin 541006, China
| | - Jialin Wang
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Junzhi Sun
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
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Winter L, Huang Q, Sertic JVL, Konczak J. The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:830166. [PMID: 36188962 PMCID: PMC9397687 DOI: 10.3389/fresc.2022.830166] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 01/13/2023]
Abstract
Objective Proprioceptive training is any intervention aiming to improve proprioceptive function with the ultimate goal to enhance motor function and performance. It has been promoted as an approach to enhance athletic performance and as a tool for sensorimotor rehabilitation. Numerous studies sought to provide evidence on the effectiveness of the approach. However, many different training regimes claiming to train proprioception report a variety of sensorimotor measures that are not directly comparable. This, in turn, makes it difficult to assess effectiveness across approaches. It is the objective of this study to systematically review recent empirical evidence to gain an understanding of which outcome measures are most sensitive, which populations may benefit most from proprioceptive training, and what are the effects on proprioceptive and motor systems. Methods Four major databases were searched. The following inclusion criteria were applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function and not confounded by information from other sensory modalities. 4) The study reported of at least one quantified measure of motor performance. Results Of the 3,297 articles identified by the database search, 70 studies met the inclusion criteria and were included for further review. Across studies, proprioceptive training led to comparable gains in both proprioceptive (+46%) and motor performance (+45%). The majority of studies (50/70) applied active movement interventions. Interventions applying somatosensory stimulation were most successful in clinical populations. Joint position sense error (JPSE) was the most commonly used proprioceptive measure and presents a reliable and feasible measure for clinical use. Conclusion Proprioceptive training can lead to significant improvements in proprioceptive and motor function across a range healthy and clinical populations. Regimens requiring active movement of the trainee tended to be most successful in improving sensorimotor performance. Conclusive evidence on how long training gains are retained is still lacking. There is no solid evidence about the underlying long-term neuroplastic changes associated proprioceptive training.
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Affiliation(s)
- Leoni Winter
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Leoni Winter
| | - Qiyin Huang
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
| | - Jacquelyn V. L. Sertic
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
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Li Y, Liu X, Luo X, Guo C. Effect of Tai Chi combined with Kinesio taping on posture control of football players with FAI: protocol for a randomized controlled trial. Trials 2022; 23:162. [PMID: 35183232 PMCID: PMC8858540 DOI: 10.1186/s13063-022-06083-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 02/04/2022] [Indexed: 12/26/2022] Open
Abstract
Background Functional ankle instability (FAI) of college football players is an important risk factor affecting their training and competition. Physical therapy and appropriate sports intervention can improve the stability of FAI patients. Previous studies have shown that Tai Chi (TC) and Kinesio taping (KT) can improve the posture control ability of FAI patients. However, whether Tai Chi combined with Kinesio taping effect patch can be used as an effective exercise for rehabilitation of college football players with FAI is not yet proven. Methods/design Fifty-three FAI college football players were randomly assigned to 3 groups: TC+KT (n = 20); TC+KTp (placebo Kinesio taping, KTp, placebo) (n = 17), and KT (n = 16). The TC+KT group received TC and KT functional correction technical intervention, the TC+KTp group received TC and placebo KT technical intervention, and the KT group received KT functional correction technical intervention. Each of the three groups received 30 min each time, 3 times a week, for a total of 6 weeks of intervention training. Star Excursion Balance Test (SEBT) and UniPedal Stance Test (UST) at baseline (before), 4 weeks after intervention (middle), and 6 weeks after intervention (after) and Toe Touch Test (TTT) were evaluated. Discussion For the first time in this trial, the impact will be evaluated. If the results are the same as expected, they will provide evidence that Tai Chi combined with Kinesio taping sticking intervention can promote the posture control of college football players with FAI. Trial registration Chinese Clinical Trial Registry ChiCTR1900027253. Registered on 6 November 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06083-5.
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Effect of Virtual Reality on Functional Ankle Instability Rehabilitation: A Systematic Review. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7363403. [PMID: 34880979 PMCID: PMC8648442 DOI: 10.1155/2021/7363403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 11/25/2022]
Abstract
Objective To systematically evaluate the effectiveness of virtual reality (VR) in the rehabilitation of patients with functional ankle instability (FAI). Methods Nine databases were researched, including PubMed, Cochrane Library, Web of Science, Embase, OVID, CNKI, VIP, WanFang, SinoMed, ResearchGate, and WorldWildScience. The publication date deadline was May 22, 2021. To analyze the effect of VR rehabilitation of FAI, we systematically reviewed the literature using the RevMan 5.4 software. Main Results. Five randomized controlled trials (RCTs) were included in the analysis, consisting of 137 patients with FAI; 68 of them were in the experimental group, 69 were in the control group, and all were university students. A comparison study was conducted between the two groups in terms of balance function, muscle performance, and proprioception. VR rehabilitation in the treatment of FAI was found to be significantly more effective using a 30-second single-leg standing test than conventional rehabilitation. The angular offset index of VR rehabilitation training was significantly lower than that of conventional balance training (0.66 ± 0.18 vs. 0.95 ± 0.21; P = 0.005). Conclusion VR rehabilitation is effective at treating FAI. However, RCTs with higher homogeneity are needed to provide a more reliable evidence-based foundation for clinical rehabilitation.
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Migel KG, Wikstrom EA. Immediate effects of vibration biofeedback on ankle kinematics in people with chronic ankle instability. Clin Biomech (Bristol, Avon) 2021; 90:105495. [PMID: 34601325 DOI: 10.1016/j.clinbiomech.2021.105495] [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: 03/26/2021] [Revised: 08/30/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND People with chronic ankle instability are more inverted during initial contact and loading response which may increase the risk of subsequent ankle injuries. Vibration feedback gait retraining causes medial center of pressure shifts but its impact on ankle kinematics remains unknown. The purpose of this study was to understand kinematic ankle changes in people with chronic ankle instability following vibration feedback gait retraining. METHODS Nineteen participants with chronic ankle instability walked with vibration feedback for 10 min on a treadmill and for one mile in the real-world. A vibration stimulus occurred at the lower leg when pressure under the 5th metatarsal exceeded a threshold. Three-dimensional kinematics of the ankle were recorded in the lab before and after training. Paired t-tests compared baseline and posttest ankle, hindfoot, and forefoot positions during initial contact and loading response for the lab and real-world conditions. FINDINGS After lab training the ankle (mean difference:-1.68 ± 1.62°, effect size:0.95) and forefoot (mean difference:-1.68 ± 1.67°, effect size:0.92) were more abducted. After real-world training, the ankle (mean difference:-1.19 ± 2.12°, effect size:0.54) and forefoot (mean difference:-1.87 ± 3.00°, effect size:0.63) were more everted. Similarly the ankle (mean difference:-2.37 ± 4.79°, effect size:0.46) and forefoot (mean difference:-2.78 ± 4.91°, effect size:0.51) were more abducted after real-world training. INTERPRETATION Vibration feedback decreases inversion and adduction during loading response. However, RW compared to lab training may have more beneficial frontal plane changes for people with chronic ankle instability.
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Affiliation(s)
- Kimmery G Migel
- MOTION Science Institute, University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB8700, Chapel Hill, NC 27599, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, CB8700, Chapel Hill, NC 27599, USA.
| | - Erik A Wikstrom
- MOTION Science Institute, University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB8700, Chapel Hill, NC 27599, USA.
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Park DJ, Kim BJ, Kim YH, Park SY. A three-week intervention emphasized diagonal eccentric contraction on balance and joint position sense and ankle strength in subjects with ankle instability: A randomized controlled trial. J Back Musculoskelet Rehabil 2021; 34:95-101. [PMID: 33104016 DOI: 10.3233/bmr-200058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Problems related to ankle instability, decreased proprioceptive sensation, altered static and dynamic balance abilities are suggested as major representative factors that contribute to the recurrence of ankle sprains. OBJECTIVE To assess the effect of a three-week intervention (intervention emphasizing diagonal eccentric contraction (IEDEC) and intervention of general exercise (IGE)) on static and dynamic balance abilities, ankle strength and joint position sense at pre- and post-intervention, and at two- and three-week post-intervention. METHODS Twenty-five participants with ankle instability, including a history of ankle sprain and recurrent episodes of giving way, were enrolled in the study. They were randomly classified into the IEDEC group (n= 12) and the IGE group (n= 13). Dynamic balance was examined using the Y Balance Test, four-way ankle strength was measured, and the static balance was evaluated using the total displacement of the center of pressure (COP). To identify the joint position error, eversion and inversion of the ankle angle were measured. RESULTS The results revealed significant increases in ankle dynamic stability and strength at two and three weeks post-intervention (p< 0.05). Similarly, the total displacement of the COP differed significantly over time, with a higher COP during the initial measurement than at two and three weeks intervention (p< 0.05) General balance training with IEDEC can improve position sense during ankle inversion (p< 0.05). CONCLUSION General balance training with IEDEC improved the position sense of the inversion. Combined therapeutic intervention, such as with the manual technique, could be a beneficial approach to maximize the treatment effects.
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Affiliation(s)
- Du-Jin Park
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea
| | - Byeong-Jo Kim
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dongeui University, Busan, Korea
| | - Yong-Hun Kim
- Department of Physical Therapy, College of Biomedical Science, Masan University, Changwon, Korea
| | - Se-Yeon Park
- Department of Physical Therapy, College of Biomedical Science, Kaya University, Gimhae, Korea
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Kalaycioglu T, Apostolopoulos NC, Yurt Y, Tunay VB. The effectiveness of different ankle strengthening training programs on performance. J Sports Med Phys Fitness 2021; 62:435-447. [PMID: 33768775 DOI: 10.23736/s0022-4707.21.12130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the effectiveness of different ankle strengthening training programs: eccentric, concentric, and resistance bands, on performance of university level sedentary males. METHODS Sixty-three males between the ages of 18 and 26 years were randomized to either eccentric isokinetic (n=21), concentric isokinetic (n=21), and resistance bands ankle strengthening groups (n=21). Training was performed three days a week, for eight weeks for both sides of ankle. Each program was made progressively harder by increasing the number of repetitions or sets. Measurements evaluating strength, balance and jumping performance were repeated pre, post and at one month (follow-up) after training. RESULTS Statistical significance was observed for concentric evertor strength for both sides of the ankle for all groups after training (p<0.05). In addition, statistically significant increases were seen in jumping performance for all groups and dynamic balance for eccentric and concentric groups (p<0.05), with the concentric being statistically higher compared to the resistance bands group for all parameters (p<0.05). CONCLUSIONS Ankle isokinetic strength (eccentric, concentric) training is more effective than resistance bands regarding improvement on strength, explosive strength, and dynamic balance. Ankle isokinetic strength training, which includes evertor and invertor muscles, improves performance, especially when applied concentrically. Therefore, the proper strengthening of ankle muscles will prevent the re-injury of ankles with individuals returning to activities.
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Affiliation(s)
- Tugce Kalaycioglu
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Cyprus Health and Social Sciences University, Morphou, North Cyprus via Mersin, Turkey -
| | - Nikos C Apostolopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Yasin Yurt
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus via Mersin, Turkey
| | - Volga B Tunay
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Xue X, Ma T, Li Q, Song Y, Hua Y. Chronic ankle instability is associated with proprioception deficits: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:182-191. [PMID: 33017672 PMCID: PMC7987558 DOI: 10.1016/j.jshs.2020.09.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/11/2020] [Accepted: 08/10/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Acute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability (CAI). We aimed to explore whether deficits of proprioception, including kinesthesia and joint position sense (JPS), exist in patients with CAI when compared with the uninjured contralateral side and healthy people. We hypothesized that proprioception deficits did exist in patients with CAI and that the deficits varied by test methodologies. METHODS The study was a systematic review and meta-analysis. We identified studies that compared kinesthesia or JPS in patients with CAI with the uninjured contralateral side or with healthy controls. Meta-analyses were conducted for the studies with similar test procedures, and narrative syntheses were undertaken for the rest. RESULTS A total of 7731 studies were identified, of which 30 were included for review. A total of 21 studies were eligible for meta-analysis. Compared with the contralateral side, patients with CAI had ankle kinesthesia deficits in inversion and plantarflexion, with a standardized mean difference (SMD) of 0.41 and 0.92, respectively, and active and passive JPS deficits in inversion (SMD = 0.92 and 0.72, respectively). Compared with healthy people, patients with CAI had ankle kinesthesia deficits in inversion and eversion (SMD = 0.64 and 0.76, respectively), and active JPS deficits in inversion and eversion (SMD = 1.00 and 4.82, respectively). Proprioception deficits in the knee and shoulder of patients with CAI were not statistically significant. CONCLUSION Proprioception, including both kinesthesia and JPS, of the injured ankle of patients with CAI was impaired, compared with the uninjured contralateral limbs and healthy people. Proprioception varied depending on different movement directions and test methodologies. The use of more detailed measurements of proprioception and interventions for restoring the deficits are recommended in the clinical management of CAI.
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Affiliation(s)
- Xiao'ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Tengjia Ma
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yujie Song
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
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12
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Geist KT, Frierson EM, Goudiss HL, Kitchen H, Wilkins M, Pruszynski D, Carter VM. Short-term effects of dry needling at a spinal and peripheral site on functional outcome measures, strength, and proprioception among individuals with a lateral ankle sprain. J Bodyw Mov Ther 2021; 26:158-166. [PMID: 33992238 DOI: 10.1016/j.jbmt.2020.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The purpose of the study was to compare the effects of spinal and peripheral dry needling with peripheral dry needling alone, in addition to a strength and proprioception home exercise program, on pain, balance, strength, proprioception, and functional limitations among individuals with a history of a lateral ankle sprain. METHODS The study design is a single-blinded, repeated measures randomized clinical trial. Thirty-four participants, aged 18-50, with a history of a lateral ankle sprain within the last twelve months were randomly assigned into a peripheral dry needling (PDN) group or a spinal and peripheral dry needling (SPDN) group. Outcome measures included a pain assessment, strength testing, Modified Clinical Test of Sensory Integration and Balance, physical performance on hop tests, Cumberland Ankle Instability Tool and the Foot and Ankle Disability Index assessed at baseline, one week, and at four to six weeks. RESULTS The mixed model ANOVAs showed significant side by time interaction (p < 0.05) for inverter/dorsiflexion strength and significant improvements in side, time, and side by time (p < 0.05) for the CAIT. CONCLUSION Trigger point dry needling demonstrated short-term improvements in strength of the inverters/dorsiflexors and the CAIT scores on the involved side at one week and at four to six weeks irrespective of a PDN or SPDN approach. DISCUSSION These results suggest that improvements in strength and function can be achieved with PDN without additional needling at the corresponding spinal level.
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Affiliation(s)
- Kathleen T Geist
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA.
| | | | - Harrison L Goudiss
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Hope Kitchen
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Maggie Wilkins
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - David Pruszynski
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Vincent M Carter
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
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THE RELATIONSHIP BETWEEN SINGLE LEG BALANCE AND ISOMETRIC ANKLE AND HIP STRENGTH IN A HEALTHY POPULATION. Int J Sports Phys Ther 2020; 15:712-721. [PMID: 33110690 DOI: 10.26603/ijspt20200712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Impaired balance and strength commonly affect athletes with conditions like chronic ankle instability (CAI). Yet, clinical research surrounding the relationship between balance, strength, and CAI is still growing. Deeper investigation of these relationships is warranted to better inform clinical practice patterns when managing athletes with balance deficits. Purpose To investigate the relationship between single leg balance, ankle strength, and hip strength in healthy, active adults. Study Design Observational study. Methods Forty healthy participants (age 23.7 ± 4.9 years) were assessed for static balance, using a modified version of the Balance Error Scoring System (mBESS), as well as isometric strength of ankle and hip musculature via handheld dynamometry. Pearson's correlations were used to analyze relationships between balance and strength measures. Paired t-tests were utilized to compare dominant and non-dominant limb performance. Results Negligible to low, negative correlations were found between balance scores and hip extension strength (r = -0.24 to -0.38, p<0.05). High, positive correlations were found between ankle and hip strength measures (r = 0.75 to 0.84, p<0.05). When comparing dominant to non-dominant limbs, only minimal differences were noted in ankle eversion strength (mean difference = 6.0%, p<0.01) and hip extension strength (mean difference = 5.5%, p<0.01). Conclusions Minimal relationships were identified between static balance and isometric ankle and hip strength. Comparison of dominant and non-dominant limbs suggests that clinicians should expect relative symmetry in balance and strength in healthy adults. Thus, asymmetries found during clinical examination should raise suspicion of specific impairments that may lead to dysfunction. Level of Evidence 2c.
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Three-Dimensional Ankle Exercise with Combined Isotonic Technique for an Obese Subject with Plantar Fasciitis: A Case Study. ACTA ACUST UNITED AC 2020; 56:medicina56040190. [PMID: 32326179 PMCID: PMC7230447 DOI: 10.3390/medicina56040190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 01/13/2023]
Abstract
Background and objectives: Obese people have many foot-related disorders and plantar fasciitis (PF) is the most common disorder among them. However, research on the role of therapeutic exercises in PF is lacking and there is no evidence to suggest its benefits. As such, a further insight into therapeutic exercises is needed within this group. This case study investigated the effect of three-dimensional (3D) ankle exercises using a combined isotonic (CI) technique on function and balance in an obese subject with PF. Material and methods: The subject in this study was a 28-year-old obese woman who was diagnosed with PF by an orthopedic surgeon. A 3D ankle exercise program was commenced three times a week for 15 min over 4 weeks. The evaluations were conducted at five intervals: pre-test, and at 1, 2, 3 and 4 weeks from the initiation of the intervention. The tests were conducted in the following order: the patient-specific functional scale test (PSFS), an ultrasound of the plantar fascia, the heel pressure and balance test, the pressure pain threshold (PPT), and the 4-way ankle strength test. Results: The mean score of the PSFS test reduced by 70.55% after 4 weeks of the intervention. The thickness of the plantar fascia and heel pressure measured during single-leg standing decreased by 6.67% and 10.37%, respectively, after 4 weeks of the intervention. The anteroposterior and medial-lateral balance ability showed improvements of 8.29% and 8.61%, respectively, after 4 weeks of the intervention. The PPT improved by 38.01% after 4 weeks of the intervention. In the 4-way ankle strength test, dorsiflexion, plantar flexion, inversion, and eversion increased by 14.46%, 9.63%, 4.3% and 13.25%, respectively, after 4 weeks of the intervention. Conclusion: 3D ankle exercises utilizing the CI technique were shown to be effective in improving foot function, pressure pain, and muscle strength in dorsiflexion and inversion in an obese patient with PF.
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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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Bonetti LV, Grisa NC, Palandi J, Finger ALT, Marchi TD, Tadiello GS. Isokinetic performance of ankle evertor and invertor muscles in adolescent female volleyball athletes. MOTRIZ: REVISTA DE EDUCACAO FISICA 2018. [DOI: 10.1590/s1980-657420180003e005018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Characterizing Lower Extremity Movement Scores Before and After Fatigue in Collegiate Athletes With Chronic Ankle Instability. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2018. [DOI: 10.1123/ijatt.2017-0029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sensorimotor function is impaired in chronic ankle instability (CAI) patients. CAI patients have an increased sensitivity to fatigue relative to controls. Few investigations have quantified functional movement scores in CAI patients or the effect of fatigue on such scores. Therefore, we characterized functional movement scores before and after fatigue in 40 collegiate athletes with CAI. Three movement patterns (double-limb squat, double-limb squat with heel lift, and single-limb squat) were completed before and after fatigue and scored using Fusionetics®. All Fusionetics scores were higher (worse) after fatigue. The results demonstrate that functional movement scores were sensitive to fatigue.
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