Active Ankle Circumduction to Identify Mobility Deficits in Subacute Ankle Sprain Patients

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

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.

Athletes at late stage rehabilitation have persisting deficits in plantar- and dorsiflexion, and inversion (but not eversion) after ankle sprain

OBJECTIVES

Document reliability and normative data for a novel device measuring weight-bearing ankle range of motion after ankle injury.

DESIGN

Cross-sectional Cohort, two occasions one day apart.

SETTING

Sports medicine hospital.

PARTICIPANTS

87 ankle-injured male athletes at a late stage of their rehabilitation and 25 uninjured subjects. The injured athletes had met all criteria to return to functional, on-field rehabilitation.

MAIN OUTCOME MEASURES

Reliability (Intra-Class correlation Coefficient (ICC), and Minimum Detectable Change as a percent of the grand mean), weight-bearing range of motion (degrees) of dorsiflexion, plantarflexion, inversion, and eversion.

RESULTS

Good (dorsiflexion = 0.82[0.76-0.87] and inversion = 0.81[0.75-0.86]) and excellent (plantarflexion = 0.93[0.90-0.95]) reliability was documented, however reliability for the eversion measure showed only fair reliability (0.61[0.49-0.70]). Reduced range of motion in the injured leg was seen in all 4 directions, however with different magnitudes: Large differences were plantarflexion (-8.5°, ES = 0.80), medium for dorsiflexion (-5.2°, 0.57), small for inversion (-4.8°, 0.36), and trivial for eversion (-1.7°, 0.15).

CONCLUSION

The device demonstrated clinically useful reliability for measuring these ranges of motion in a functional, weight-bearing position. PF ROM showed the greatest reduction in range in these athletes at a late stage of their rehabilitation.