Effective Treatment for Chronic Ankle Instability During Lateral Step-Down-Kinesiology Tape, Resistance Exercise, or Both Accompanied With Heel Raise-Lower Exercise?

Diagnostic value of the posterior talofibular ligament area for chronic lateral ankle instability

An injured posterior talofibular ligament (PTFL) is one of the reasons for chronic lateral ankle instability (CLAI). Previous researches have demonstrated that the PTFL thickness (PTFLT) is associated with chronic ligament injuries. However, ligament hypertrophy is different from ligament thickness. Thus, we created the PTFL cross-sectional area (PTFLCSA) as a diagnostic image parameter to assess the hypertrophy of the whole PTFL. We assumed that the PTFLCSA is a key morphological diagnostic parameter in CLAI. PTFL data were obtained from 15 subjects with CLAI and from 16 normal individuals. The T1-weighted axial ankle-MR (A-MR) images were acquired at the level of PTFL. We measured the PTFLT and PTFLCSA at the posterior aspect of the ankle using our imaging analysis program. The PTFLT was measured as the thickness between point of anterior and posterior fiber of PTFL. The PTFLCSA was calculated as the whole cross-sectional PTFL area. The average PTFLT was 3.43 ± 0.52 mm in the healthy group and 4.89 ± 0.80 mm in the CLAI group. The mean PTFLCSA was 41.06 ± 12.18 mm 2 in the healthy group and 80.41 ± 19.14 mm 2 in the CLAI group. CLAI patients had significantly greater PTFLT ( P < .001) and PTFLCSA ( P < .001) than the healthy group. A receiver operating characteristic curve analysis demonstrated that the optimal cutoff score of the PTFLT was 4.19 mm, with 93.3% sensitivity, 93.7% specificity, and an area under the curve of 0.97. The most suitable cutoff value of the PTFLCSA was 61.15 mm 2 , with 93.3% sensitivity, 100% specificity, and area under the curve of 0.99. Even though the PTFLT and PTFLCSA were both significantly associated with CLAI, the PTFLCSA was a more exact morphological measurement parameter.

Reliability and usefulness of the single leg heel raise balance test in patients with chronic ankle instability

We aimed to analyze the differences in static (including conventional and modified [single-leg heel-raise balance]) and dynamic postural stability and muscle endurance between patients with chronic ankle instability (CAI) and healthy controls, and to determine the reliability and usefulness of the single-leg heel-raise balance test in patients with CAI. In total, 26 patients with CAI and 26 healthy controls were enrolled. Postural stability was assessed using a postural stabilometry system. Muscle endurance was measured in dorsiflexion and plantarflexion using an isokinetic device. Modified static postural stability (P < 0.001) and dynamic postural stability (P < 0.001) were significantly poorer in the affected ankles of patients with CAI than in the controls. Plantarflexion endurance was significantly lower in the affected ankles of the patients with CAI than in the controls (P = 0.023). Modified static postural stability significantly correlated with plantarflexion endurance in both groups (CAI group: r = - 0.470, P = 0.015; healthy controls group: r = - 0.413, P = 0.036). Plantarflexion endurance was a significant risk factor for modified static postural stability in both the CAI group (R² = 0.221, P = 0.015) and healthy controls (R² = 0.170, P = 0.036). Given the reliability of the modified static postural stability test, clinicians and therapists should consider using it to assess improvements in postural stability and muscle endurance in patients with CAI before and after rehabilitation.