1
|
Hao Z, Cheng X, Jiang H, Yang J, Li Y, Ambrose Lo WL, Yu Q, Wang C. The associations between lumbar proprioception and postural control during and after calf vibration in people with and without chronic low back pain. Front Bioeng Biotechnol 2024; 12:1329437. [PMID: 38572361 PMCID: PMC10987701 DOI: 10.3389/fbioe.2024.1329437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/19/2024] [Indexed: 04/05/2024] Open
Abstract
The relationships of lumbar proprioception with postural control have not been clarified in people with chronic low back pain. This study aimed to compare the associations between lumbar proprioception and postural control in response to calf vibration in individuals with and without chronic low back pain. In this study, we recruited twenty patients with chronic low back pain (CLBP group) and twenty healthy control subjects (HC group) aged between 18 and 50 years. This study was a cross-sectional study and completed from May 2022 to October 2022. The passive joint repositioning sense (PJRS) test for two positions (15° and 35°) were used to assess lumbar proprioception and expressed as the mean of reposition error (RE). Postural control was tested by adding and removing calf vibration while standing on a stable force plate with eyes closed. The sway velocity in the anterior-posterior (AP) direction of center of pressure (COP) data with a window of 15s epoch at baseline, during and after calf vibration was used to evaluate postural control. Mann-Whitney U-tests were used to compare the difference of lumbar proprioception between two groups, and the independent t-tests were used to compare the difference of postural control at baseline and during vibration, and a mixed design ANOVA was used to compare the difference of postural control during post-perturbation. In addition, to explore the association between postural control and lumbar proprioception and pain intensity, Spearman's correlations were used for each group. The major results are: (1) significantly higher PJRS on RE of 15° (CLBP: 95% CI [2.03, 3.70]; HC: 95% CI [1.03, 1.93]) and PJRS on RE of 35° (CLBP: 95% CI [2.59, 4.88]; HC: 95% CI [1.07, 3.00]) were found in the CLBP group; (2) AP velocity was not different between the CLBP group and the HC group at baseline and during calf vibration. However, AP velocity was significantly larger in the CLBP group compared with the HC group at epoch 2-14 after calf vibration, and AP velocity for the CLBP group took a longer time (23 epochs) to return to the baseline after calf vibration compared with the HC group (9 epochs); (3) lumbar proprioception represented by PJRS on RE of 15°correlated negatively with AP velocity during and after vibration for the HC group. Within the CLBP group, no significant relationships between PJRS on RE for two positions (15° and 35°) and AP velocity in any postural phases were found. In conclusion, the CLBP group has poorer lumbar proprioception, slower proprioceptive reweighting and impaired postural control after calf vibration compared to the HC group. Lumbar proprioception offers different information on the control strategy of standing control for individuals with and without CLBP in the situations with proprioceptive disturbance. These results highlight the significance of assessing lumbar proprioception and postural control in CLBP patients.
Collapse
Affiliation(s)
- Zengming Hao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xue Cheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haimei Jiang
- Department of Rehabilitation Medicine, The 10th Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan, China
| | - Jiajia Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
2
|
Zhang X, Ogasawara I, Konda S, Matsuo T, Uno Y, Miyakawa M, Nishizawa I, Arita K, Liu J, Nakata K. Absorption function loss due to the history of previous ankle sprain explored by unsupervised machine learning. Gait Posture 2024; 109:56-63. [PMID: 38277765 DOI: 10.1016/j.gaitpost.2024.01.021] [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: 08/18/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Ankle sprains are common and cause persistent ankle function reduction. To biomechanically evaluate the ankle function after ankle sprains, the ground reaction force (GRF) measurement during the single-legged landing had been used. However, previous studies focused on discrete features of vertical GRF (vGRF), which largely ignored vGRF waveform features that could better identify the ankle function. PURPOSE To identify how the history of ankle sprain affect the vGRF waveform during the single-legged landing with unsupervised machine learning considering the time-series information of vGRF. METHODS Eighty-seven currently healthy basketball athletes (12 athletes without ankle sprain, 49 athletes with bilateral, and 26 athletes with unilateral ankle sprain more than 6 months before the test day) performed single-legged landings from a 20 centimeters (cm) high box onto the force platform. Totally 518 trials vGRF data were collected from 87 athletes of 174 ankles, including 259 ankle sprain trials (from previous sprain ankles) and 259 non-ankle sprain trials (from without sprain ankles). The first 100 milliseconds (ms) vGRF waveforms after landing were extracted. Principal component analysis (PCA) was applied to the vGRF data, selecting 8 principal components (PCs) representing 96% of the information. Based on these 8 PCs, k-means method (k = 3) clustered the 518 trials into three clusters. Chi-square test assessed significant differences (p < 0.01) in the distribution of ankle sprain and non-ankle sprain trials among clusters. FINDINGS The ankle sprain trials accounted for a significantly larger percentage (63.9%) in Cluster 3, which exhibited rapidly increased impulse vGRF waveforms with larger peaks in a short time. SIGNIFICANCE PCA and k-means method for vGRF waveforms during single-legged landing identified that the history of previous ankle sprains caused a loss of ankle absorption ability lasting at least 6 months from an ankle sprain.
Collapse
Affiliation(s)
- Xuemei Zhang
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Issei Ogasawara
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan; Department Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Shoji Konda
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan; Department Sports Medical Biomechanics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tomoyuki Matsuo
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuki Uno
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Motoi Miyakawa
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Izumi Nishizawa
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazuki Arita
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Jianting Liu
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ken Nakata
- Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| |
Collapse
|
3
|
Ma T, Liu C, Li H, Xu X, Wang Y, Tao W, Xue X, Li Q, Zhao R, Hua Y. Rehabilitation increases cortical activation during single-leg stance in patients with chronic ankle instability. Asia Pac J Sports Med Arthrosc Rehabil Technol 2024; 35:65-70. [PMID: 38235498 PMCID: PMC10792568 DOI: 10.1016/j.asmart.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024] Open
Abstract
Background Chronic ankle instability (CAI) has been considered a neurophysiological disease, having as symptoms dysfunction in somatosensory and motor system excitability. Rehabilitation has been considered an effective treatment for CAI. However, few studies have explored the effects of rehabilitation on neuroplasticity in the CAI population. Objective The purpose of this study was to investigate the effects of rehabilitation on cortical activities for postural control in CAI patients and to find the correlation between the change in cortical activities and patient-reported outcomes (PROs). Methods Thirteen participants with CAI (6 female, 7 male, age = 33.8 ± 7.7 years, BMI = 24.7 ± 4.9 kg/m2) received a home exercise program for about 40 min per day, four days per week and six weeks, including ankle range-of-motion exercise, muscle strengthening, and balance activities. Cortical activation, PROs and Y-balance test outcomes were assessed and compared before and after rehabilitation. Cortical activation was detected via Functional near-infrared spectroscopy (fNIRS) while the participants performed single-leg stance tasks. Results The participants had better PROs and Y balance test outcomes after rehabilitation. Greater cortical activation was observed in the primary somatosensory cortex (S1, d = 0.66, p = 0.035), the superior temporal gyrus (STG, d = 1.06, p = 0.002) and the middle temporal gyrus (MTG, d = 0.66, p = 0.035) in CAI patients after rehabilitation. Moreover, significant positive correlations were observed between the recovery of ankle symptoms and the change of cortical activation in S1 (r = 0.74, p = 0.005) and STG (r = 0.72, p = 0.007) respectively. Conclusion The current study reveals that six weeks of rehabilitation can cause greater cortical activation in S1, STG and MTG. This increase in cortical activation suggested a better ability to perceive somatosensory stimuli and may have a compensatory role in function improvement.
Collapse
Affiliation(s)
- Tengjia Ma
- Orthopedic and Sports Medicine Department, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, Liaoning, China
| | - Chang Liu
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Haozheng Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiaoyun Xu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Yiran Wang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Weichu Tao
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Xiao'ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Rongshan Zhao
- Shanghai Lixin University of Accounting and Finance, Shanghai, 201209, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| |
Collapse
|
4
|
Ma T, Xu X, Li M, Li Y, Wang Y, Li Q, Xue X, Tao W, Hua Y. Cortical Activation During Single-Legged Stance in Patients With Chronic Ankle Instability. J Athl Train 2023; 58:927-933. [PMID: 36827609 PMCID: PMC10784888 DOI: 10.4085/1062-6050-0363.22] [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] [Indexed: 02/26/2023]
Abstract
CONTEXT Chronic ankle instability (CAI) has been considered a neurophysiological condition, with dysfunctional somatosensory and motor system excitability. However, few researchers have explored the changes in cortical activation during balance tasks of patients with CAI. OBJECTIVE To compare the cortical activity during single-legged stance among CAI, copers, and uninjured control participants and to compare dynamic balance across groups. DESIGN Cross-sectional study. SETTING Biomechanics laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 22 participants with CAI (median [interquartile range]; age = 34.5 [11.0] years, height = 170.0 [15.8] cm, mass = 67.0 [16.2] kg), 17 copers (age = 27.0 [14.0] years, height = 170.0 [9.5] cm, mass = 66.5 [16.5] kg), and 21 uninjured control participants (age = 25.0 [10.5] years, height = 170.0 [11.0] cm, mass = 64.0 [16.5] kg). MAIN OUTCOME MEASURE(S) Participants performed single-legged stance while cortical activation was tested with functional near-infrared spectroscopy. The peak oxyhemoglobin response of the activated cortex was calculated and compared across groups. The Y-Balance test outcomes and patient-reported outcomes were assessed and compared across groups. RESULTS The CAI group had worse Y-balance test and patient-reported outcomes than the coper and uninjured control groups. Differences in the peak oxyhemoglobin response were observed for the primary somatosensory cortex (S1; F2,57 = 4.347, P = .017, ηp2 = 0.132) and superior temporal gyrus (STG; F2,57 = 4.548, P = .015, ηp2 = 0.138). Specifically, copers demonstrated greater activation in S1 and STG than the CAI (d = 0.73, P = .034, and d = 0.69, P = .043, respectively) and uninjured control (d = 0.77, P = .036, and d = 0.88, P = .022, respectively) groups. No differences were found in the cortical activation between CAI and uninjured control participants. CONCLUSIONS Copers displayed greater cortical activation in S1 and STG than CAI and uninjured control participants. Greater activation in S1 and STG suggested a better ability to perceive somatosensory stimuli and may represent a compensatory mechanism that allows copers to maintain good functional ability after the initial severe ankle sprain.
Collapse
Affiliation(s)
- Tengjia Ma
- Department of Joint and Sports Medicine, The Second Hospital of Dalian Medical University, Liaoning, China
| | - Xiaoyun Xu
- School of Kinesiology, Shanghai University of Sport, China
| | - Moxin Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yunxia Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiran Wang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao’ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Weichu Tao
- School of Kinesiology, Shanghai University of Sport, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
5
|
Wang X, Qiu J, Fong DT. The applications of wearable devices in the rehabilitation of ankle injuries: A systematic review and meta-analysis. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2023. [DOI: 10.1016/j.medntd.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
|
6
|
Efstathiou MA, Giannaki CD, Roupa Z, Hadjisavvas S, Stefanakis M. Evidence of distorted proprioception and postural control in studies of experimentally induced pain: a critical review of the literature. Scand J Pain 2022; 22:445-456. [PMID: 35470647 DOI: 10.1515/sjpain-2021-0205] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Deficits in proprioception and postural control are common in patients with different musculoskeletal pain syndromes. It has been proposed that pain can negatively affect proprioception and postural control at a peripheral level, however research is limited to animal studies. Human studies have shown that it is more likely, that the link between pain and proprioceptive deficits, lies within changes in the central nervous system where noxious and non-noxious stimuli may overlap. In clinical studies, causality cannot be determined due to other factors which could confound the assessment such as pathophysiological features of the underlying musculoskeletal disorder and different psycho-social influences especially in patients with chronic pain. On the other hand, experimentally induced pain in healthy participants is able to control most of these confounding factors and perhaps offers an assessment of the effects of pain on proprioception and postural control. The aim of this paper is to critically appraise the literature related to the effect of experimentally induced pain on proprioception and postural control. Results from these studies are discussed and limitations are highlighted for future research. METHODS A search of databases (Medline, Scopus, PubMed) was conducted as well as reference check from relevant articles published since 2000. Fifteen studies which explored the effect of experimentally induced pain on postural control and ten studies which explored the effect of experimentally induced pain on proprioception were included. RESULTS We found that in the majority of the studies, postural control was negatively affected by experimentally induced pain. Results for proprioception were mixed depending on the body region and the way the painful stimuli were delivered. Kinesthesia was negatively affected in two studies, while in one study kinesthesia was enhanced. Joint position sense was not affected in four out of five studies. Finally, force sense was affected in three out of four studies. CONCLUSIONS From a clinical point of view, findings from the available literature suggest that experimentally induced pain impairs postural control and could potentially increases the risk for falls in patients. Interventions aiming to reduce pain in these patients could lead to preservation or improvement of their balance. On the other hand, the same conclusion cannot be drawn for the effect of experimentally induced pain on kinesthesia and joint position sense due to the limited number of studies showing such an effect.
Collapse
Affiliation(s)
| | | | - Zoe Roupa
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Stelios Hadjisavvas
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Manos Stefanakis
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| |
Collapse
|
7
|
Lee SH, Yang JH, Kim I. Nonanatomic All-Inside Arthroscopic Anterior Talofibular Ligament Repair With a High-Position Anchor versus Anatomic Repair: An Analysis Based on 3D CT. Am J Sports Med 2022; 50:2134-2144. [PMID: 35612848 DOI: 10.1177/03635465221097119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND In patients with chronic ankle instability, it is important to repair the anterior talofibular ligament (ATFL) at the anatomic origin site. However, there are limited reports on the clinical outcomes according to anatomic ATFL repair. PURPOSE To compare the clinical outcomes after arthroscopic ATFL repair according to whether the anchor is fixed at an anatomic position. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS We performed a retrospective review of consecutive patients who underwent arthroscopic ATFL repair for chronic ankle instability and were available for a minimum 2-year follow-up. The patients were divided into 3 groups according to the anchor position at the distal fibula on 3-dimensional computed tomography: anatomic arthroscopic ATFL repair (anatomic group), subanatomic arthroscopic ATFL repair (subanatomic group), and nonanatomic arthroscopic ATFL repair (nonanatomic group). The visual analog scale for pain, Foot and Ankle Outcome Score (FAOS), and Karlsson ankle functional score were measured as subjective outcomes. Posturographic analysis and radiologic evaluation using stress radiographs and axial view magnetic resonance imaging were performed as objective outcomes. RESULTS Of 96 patients, 16 were excluded per the exclusion criteria, and 80 were evaluated (anatomic group, n = 24; subanatomic group, n = 42; nonanatomic group, n = 14). The mean age of the patients was 34.5 years, and the mean follow-up period was 27.4 months. A between-group comparison revealed significant differences in FAOS, Karlsson score, and fall risk evaluated by posturography at the final follow-up. Post hoc analysis revealed that the anatomic group had better clinical scores on the FAOS than did the nonanatomic group in all 5 domains (all P < .017). Patients in the anatomic and subanatomic groups had better Karlsson scores and fall risk than those in the nonanatomic group (P = .004 and P = .013, respectively). In terms of objective outcomes, patients in the anatomic and subanatomic groups had better outcomes in fall risk than did those in the nonanatomic group (both P = .001). There were no differences in clinical scores and objective outcomes between the anatomic and subanatomic groups. CONCLUSION Nonanatomic ATFL repair showed inferior outcomes when compared with anatomic ATFL repair. When arthroscopic ATFL repair is performed, the anchor should be fixed in the anatomic position to improve prognosis.
Collapse
Affiliation(s)
- Sung Hyun Lee
- Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, South Korea
| | - Je Heon Yang
- Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, South Korea
| | - Isac Kim
- Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, South Korea
| |
Collapse
|
8
|
Mayes M, Salesky M, Lansdown DA. Throwing Injury Prevention Strategies with a Whole Kinetic Chain-Focused Approach. Curr Rev Musculoskelet Med 2022; 15:53-64. [PMID: 35389192 PMCID: PMC9076771 DOI: 10.1007/s12178-022-09744-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/14/2022]
Abstract
Purpose of Review This review examines the relationship between the baseball pitching motion and the kinetic chain. The goal was to determine the underlying causes of a deficiency in throwing mechanics throughout a throwing motion, and to provide an evidence-based approach on how to prevent injuries caused by a lack of proper mechanics. In doing so, we sought to provide a warm-up strategy that can be added to every baseball player’s daily on-field routine that is tailored to each phase of the throwing motion. Recent Findings To help minimize the risk of injury to overhead throwing athletes, a thorough understanding of the throwing motion is critical. Throwing a ball places extreme stress on the body, notably the shoulder and elbow joints. With a clear understanding of the biomechanics of throwing, we can develop an injury prevention routine to minimize unnecessary stresses throughout the kinetic chain. Summary The throwing cycle is a complex motion that places various stresses throughout the thrower’s body, from the ankle to the core, and from the back to the shoulder and elbow. A thorough understanding of the mechanics of this motion, along with specific exercises to target the specific actions of each phase, may allow for throwers, regardless of their age and experience, to minimize injury risk.
Collapse
Affiliation(s)
- Michael Mayes
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA
| | - Madeleine Salesky
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA
| | - Drew A Lansdown
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA.
| |
Collapse
|
9
|
Alteration of ankle proprioceptive threshold during gait in the presence of acute experimental pain. PLoS One 2022; 17:e0263161. [PMID: 35078205 PMCID: PMC8789182 DOI: 10.1371/journal.pone.0263161] [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: 10/05/2021] [Accepted: 01/12/2022] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Human gait requires complex somatosensory processing of various inputs such as proprioception. Proprioception can be altered in the presence of pain. This has been shown mostly during controlled tasks, thereby limiting the influence of external perturbations. While controlling the environment is sometimes warranted, it limits the ecological validity of the data. Using robotic orthoses to apply perturbations during movements seems a promising tool to functionally assess proprioception, where the complex somatosensory processing required in real-life situations is at play. The main objective of this study was to compare the proprioceptive threshold of healthy participants during gait in the presence and absence of an acute experimental pain. METHODS 36 healthy participants walked on a treadmill while wearing a robotized ankle-foot orthosis (rAFO) around their right ankle. The rAFO applied torque perturbations of graded magnitudes during the swing phase of gait. Participants had to report the presence/absence of such perturbations, as a measure of proprioceptive threshold. Following initial assessment, they were randomly assigned to one of three experimental groups: Control (no stimulation), Painless (non-nociceptive stimulation) and Painful (nociceptive stimulation). Electrodes placed on the right lateral malleolus delivered an electrical stimulation during the second assessment for Painless and Painful groups. A Kruskal-Wallis was used to compare the percentage of change of the three groups between the two assessments. RESULTS A 31.80±32.94% increase in proprioceptive threshold, representing an increase of 1.3±1.2 Nm in the detection threshold, was observed for the Painful group only (p<0.005), with an effect size of 1.6. CONCLUSION Findings show that the presence of pain at the ankle can alter participants' proprioceptive threshold during gait. Clinical assessment of proprioception should therefore carefully consider the presence of pain when evaluating a patient's performance using clinical proprioceptive test and consider the negative effect of pain on proprioceptive threshold for test interpretation.
Collapse
|
10
|
An YW, Kang Y, Jun HP, Chang E. Anterior Cruciate Ligament Reconstructed Patients Who Recovered Normal Postural Control Have Dissimilar Brain Activation Patterns Compared to Healthy Controls. BIOLOGY 2022; 11:biology11010119. [PMID: 35053116 PMCID: PMC8773195 DOI: 10.3390/biology11010119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 11/21/2022]
Abstract
Simple Summary We report that patients with anterior cruciate ligament reconstruction have similar postural control but different cortical activation patterns in several regions of the brain when compared to healthy controls. This is significant because dissimilar cortical activation patterns indicate that neural adaptation in the brain is responsible for motor coordination, possibly due to altered proprioception, despite having a surgical reconstruction after an anterior cruciate ligament injury. Such neuroplasticity in ACLR patients may imply compensatory neural protective mechanisms in order to sustain postural control, which is a fundamental functional skill in daily activities. We believe that our findings will elucidate other researchers and clinicians about the effects of a peripheral joint injury on the brain’s function during postural control. Abstract Postural control, which is a fundamental functional skill, reflects integration and coordination of sensory information. Damaged anterior cruciate ligament (ACL) may alter neural activation patterns in the brain, despite patients’ surgical reconstruction (ACLR). However, it is unknown whether ACLR patients with normal postural control have persistent neural adaptation in the brain. Therefore, we explored theta (4–8 Hz) and alpha-2 (10–12 Hz) oscillation bands at the prefrontal, premotor/supplementary motor, primary motor, somatosensory, and primary visual cortices, in which electrocortical activation is highly associated with goal-directed decision-making, preparation of movement, motor output, sensory input, and visual processing, respectively, during first 3 s of a single-leg stance at two different task complexities (stable/unstable) between ACLR patients and healthy controls. We observed that ACLR patients showed similar postural control ability to healthy controls, but dissimilar neural activation patterns in the brain. To conclude, we demonstrated that ACLR patients may rely on more neural sources on movement preparation in conjunction with sensory feedback during the early single-leg stance period relative to healthy controls to maintain postural control. This may be a compensatory protective mechanism to accommodate for the altered sensory inputs from the reconstructed knee and task complexity. Our study elucidates the strategically different brain activity utilized by ACLR patients to sustain postural control.
Collapse
Affiliation(s)
- Yong Woo An
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA 90045, USA;
| | - Yangmi Kang
- Department of Kinesiology, New Mexico State University, Las Cruces, NM 88003, USA;
| | - Hyung-Pil Jun
- Department of Physical Education, Dong-A University, Busan 03722, Korea;
| | - Eunwook Chang
- Department of Kinesiology, Inha University, Incheon 22212, Korea
- Correspondence: ; Tel.: +82-32-860-8185; Fax: +82-32-860-8188
| |
Collapse
|
11
|
Lapanantasin S, Thongloy N, Samsee M, Wonghirunsombat N, Nuangpulsarp N, Ua-areejit C, Phattaraphanasakul P. Comparative Effect of Walking Meditation and Rubber-band Exercise on Ankle Proprioception and Balance Performance Among Persons With Chronic Ankle Instability: A Randomized Controlled Trial. Complement Ther Med 2022; 65:102807. [DOI: 10.1016/j.ctim.2022.102807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/03/2022] Open
|
12
|
The effects of visual feedback disruption on postural control with chronic ankle instability. J Sci Med Sport 2021; 25:53-57. [PMID: 34393051 DOI: 10.1016/j.jsams.2021.07.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The purpose of this study was to identify the effects of reduced visual feedback via stroboscopic glasses on dynamic postural control among chronic ankle instability (CAI), lateral ankle sprain (LAS) coper and uninjured control participants. DESIGN Controlled trial in a laboratory setting. METHODS Twenty CAI patients, 20 copers, and 20 controls participated in this study. Each participant performed a single-leg hop stabilization test with eyes open (EO) and stroboscopic vision (SV). Two-way ANOVAs (group × condition) were used to examine the differences between group (CAI, coper, and control) and condition (EO and SV). RESULTS There was a significant group by condition interaction for DPSI scores. CAI patients displayed increased DPSI scores with SV compared to EO (p < 0.01), and CAI patients had increased DPSI scores only with SV when compared with controls. All participants displayed decreased dynamic postural control under the SV condition compared to the EO condition (p < 0.01) regardless of ankle group. CONCLUSIONS CAI patients rely more on visual feedback during dynamic postural control than copers and controls. However, they may not be as able to compensate for the disrupted visual feedback during a dynamic task. Regardless of ankle injury history, stroboscopic glasses could be cost-effective visual disruption devices during a dynamic balance task.
Collapse
|
13
|
Pereira BS, Andrade R, Espregueira-Mendes J, Marano RPC, Oliva XM, Karlsson J. Current Concepts on Subtalar Instability. Orthop J Sports Med 2021; 9:23259671211021352. [PMID: 34435065 PMCID: PMC8381447 DOI: 10.1177/23259671211021352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conservative or surgical treatment and result in chronic ankle instability. Understanding the accurate anatomy and biomechanics of the subtalar joint, their interplay, and the contributions of the different subtalar soft tissue structures is fundamental to correctly diagnose and manage subtalar instability. An accurate diagnosis is crucial to correctly identify those patients with instability who may require conservative or surgical treatment. Many different nonsurgical and surgical approaches have been proposed to manage combined or isolated subtalar instability, and the clinician should be aware of available treatment options to make an informed decision. In this current concepts narrative review, we provide a comprehensive overview of the current knowledge on the anatomy, biomechanics, clinical and imaging diagnosis, nonsurgical and surgical treatment options, and outcomes after subtalar instability treatment.
Collapse
Affiliation(s)
- Bruno S. Pereira
- Facultad de Medicina, University of Barcelona, Casanova, 143, 08036
Barcelona, Spain
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Hospital Privado de Braga, Lugar da Igreja Nogueira, Braga,
Portugal
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports,
University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto,
Porto, Portugal
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto,
Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, Minho University, Braga, Portugal
- 3B’s–PT Government Associate Laboratory, Braga/Guimarães,
Portugal
- 3B’s Research Group– Biomaterials, Biodegradables and Biomimetics,
University of Minho, Headquarters of the European Institute of Excellence on Tissue
Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
| | | | - Xavier Martin Oliva
- Facultad de Medicina, University of Barcelona, Casanova, 143, 08036
Barcelona, Spain
- Orthopedic Surgery Department, Clínica Ntra. Sra. Del Remei,
Barcelona, Spain
| | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, Sahlgrenska
University Hospital, Gothenburg University, Gothenburg, Sweden
| |
Collapse
|
14
|
Lee SH, Cho HG, Yang JH. Additional Inferior Extensor Retinaculum Augmentation After All-Inside Arthroscopic Anterior Talofibular Ligament Repair for Chronic Ankle Instability Is Not Necessary. Am J Sports Med 2021; 49:1721-1731. [PMID: 33886379 DOI: 10.1177/03635465211008097] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although several arthroscopic surgical techniques for the treatment of chronic ankle instability (CAI) have been introduced recently, the effect of inferior extensor retinaculum (IER) augmentation remains unclear. PURPOSE To compare the clinical outcomes after arthroscopic anterior talofibular ligament (ATFL) repair according to whether additional IER augmentation was performed or not. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS We performed a retrospective review of consecutive patients who underwent arthroscopic ATFL repair surgery for CAI between 2016 and 2018. The mean age of the patients was 35.2 years (range, 19-51 years), and the mean follow-up period was 32.6 months (range, 24-48 months). Patients were divided into 2 groups according to the surgical technique used for CAI: arthroscopic ATFL repair (group A; n = 37) and arthroscopic ATFL repair with additional IER augmentation (group R; n = 45). The pain visual analog scale, American Orthopaedic Foot & Ankle Society score, Foot and Ankle Outcome Score, and the Karlsson Ankle Function Score were measured as subjective outcomes, and posturographic analysis was performed using a Tetrax device as an objective outcome. Radiologic outcome evaluations were performed preoperatively and at 2 years postoperatively using stress radiographs and axial view magnetic resonance imaging (MRI). RESULTS Out of 101 patients, 19 (18.5%) were excluded per the exclusion criteria, and 82 were evaluated. We identified 6 retears (7.3%) based on postoperative MRI evaluation. All patients who had ATFL retear on MRI (8.1% [3/37] in group A and 6.7% [3/45] in group R) demonstrated recurrent CAI with functional discomfort and anterior displacement >3 mm as compared with the intact contralateral ankle. All clinical scores and posturography results were improved after surgery in both groups (P < .001). However, there were no significant differences in the clinical results and radiologic findings between the groups. CONCLUSION The clinical and radiologic outcomes of patients with CAI improved after all-inside arthroscopic ATFL repair. However, additional IER augmentation after arthroscopic ATFL repair did not guarantee better clinical outcomes.
Collapse
Affiliation(s)
- Sung Hyun Lee
- Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Hyung Gyu Cho
- Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, Republic of Korea
| | - Je Heon Yang
- Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, Republic of Korea
| |
Collapse
|
15
|
Is Thumb Proprioception Decreased in Patients With Trapeziometacarpal Joint Osteoarthritis? Ann Plast Surg 2021; 85:379-383. [PMID: 32501842 DOI: 10.1097/sap.0000000000002422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Proprioception is thought to be essential for normal joint homeostasis, and its decreased function has been associated with an increased risk of joint diseases. However, only a few studies have been performed on the association between proprioceptive function in the trapeziometacarpal joint (TMCJ) and osteoarthritis. The purpose of this study was to compare TMCJ proprioceptive function in elderly women with radiographic TMCJ osteoarthritis relative to age-matched control women without osteoarthritis. We enrolled 19 women (mean age, 66 years) with symptomatic, radiographic Eaton and Littler grade 2, 3, and 4 TMCJ osteoarthritis and 19 age-matched control women without osteoarthritis. We evaluated thumb proprioception by using a joint-position reproduction test and compared the reposition error (RE) between the groups. We carried out a multivariate analysis for factors potentially associated with increased RE, such as age, body mass index, hand dominance, the presence of diabetes, pain level, and the presence of osteoarthritis. Also, a logistic regression analysis was performed for factors associated with the occurrence of TMCJ osteoarthritis. Patients with TMCJ osteoarthritis had greater RE than did the control patients in the joint-position reproduction test at 20°, 30°, and 40° of thumb palmar abduction. The multivariate analysis indicated that increased RE was associated with the presence of osteoarthritis, but not with the other factors assessed. The occurrence of TMCJ osteoarthritis was associated with increased RE at 20°, 30°, and 40° of thumb palmar abduction. This study showed that decreased proprioceptive function was associated with the presence of osteoarthritis in the TMCJ, although the causality remains unknown. Further studies on the role of proprioception in the pathogenesis of TMCJ osteoarthritis and the potential role of its training for disease prevention or treatment are required.
Collapse
|
16
|
Abstract
OBJECTIVE Static balance, postural stability, and reaction time are commonly impaired after a sport-related concussion. The Sway Balance System assesses postural sway (ie, stability) and simple reaction time using the triaxial accelerometer built into iOS mobile devices. The purpose of this study was to provide normative data for children and adolescents and to examine for age and sex differences on the Sway Balance System. DESIGN Cross-sectional study. SETTING Middle and high schools across the United States. PARTICIPANTS Participants were 3763 youth aged 9 to 21 years who completed the Sway Balance System Sports protocol in accordance with the company's recommended methods (ie, 1 acclimation trial and 2-3 baseline tests). INDEPENDENT VARIABLES Age and sex. MAIN OUTCOME MEASURES Sway Balance score (0-100) and Sway Reaction Time score (0-100). STATISTICAL ANALYSIS A multivariate analysis of variance examined the effects of age and sex on balance and reaction time scores. RESULTS Sway Balance and Reaction Time scores significantly differed by age [F(10, 7494) = 39.68, P < 0.001, V = 0.10, = 0.05] and sex [F(4, 7494) = 55.29, P < 0.001, V = 0.06, = 0.03]. Post hoc analyses revealed that older groups generally had better scores than younger groups on all balance comparisons (ps < 0.001) and many reaction time comparisons. Girls performed better than boys on balance [F(2, 3747) = 53.79, P < 0.001, = 0.03] and boys had faster reaction times [F(2, 3747) = 37.11, P < 0.001, = 0.02]. CONCLUSIONS Age and sex are important factors to consider when assessing Balance and Reaction Time scores using the Sway Balance System's Sports protocol in youth. We provide age- and sex-based normative values for the Sway Balance System, which will likely be helpful when using this technology to assess and manage concussions.
Collapse
|
17
|
Alghadir AH, Iqbal ZA, Iqbal A, Ahmed H, Ramteke SU. Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5318. [PMID: 32718066 PMCID: PMC7432694 DOI: 10.3390/ijerph17155318] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022]
Abstract
Background: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including pain, episodes of giving way, compromised proprioception and neuromuscular control, and re-injury leading to chronic ankle instability. The aim of this study was to see the effect of chronic ankle sprain on pain, range of motion, proprioception, and, static and dynamic balance among athletes. Methods: A total of 80 athletes, aged 18 to 25 years, involved in track-and-field sports were invited to participate in this study. They were divided in two groups. Athletes with history of grade 1 or 2 ankle sprain on either side requiring medical care who reported at least three episodes of ankle giving way in past 12 months were included in group A. An equal number of healthy athletes without any history of ankle sprain or injury in the lower limbs in the past one year matched by sex, age, height, weight, and limb dominance, were included in group B (control). Outcome measures: Participant's pain, range of motion, proprioception and balance (static and dynamic) was measured using visual analog scale, half circle goniometer, degree of foot position sense, single leg stance time and Y-balance test respectively. Results: Although there were no differences in the active ankle joint range of motion (p > 0.05) in comparison to the control group, athletes with chronic ankle sprain reported mild pain and statistically significant (p < 0.05) deficits in foot proprioception, static and dynamic balance. Conclusions: Deficits in foot proprioception, static and dynamic balance even one year after the ankle sprain could be the reason for limitations in the dynamic defense system of the joint that predisposes to recurrent injury and instability. It is essential to understand the normal clinical course and risk factors for athletes who sustain sprain before devising a long term comprehensive rehabilitation program that focuses on mechanical and functional insufficiencies in order to improve their functional performance and prevent the risk of recurrent sprain.
Collapse
Affiliation(s)
- Ahmad H. Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Zaheen A. Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Amir Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Hashim Ahmed
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia;
| | - Swapnil U. Ramteke
- Department of Musculoskeletal & Sports Physiotherapy, Sancheti Institute College of Physiotherapy, Shivaji Nagar, Pune 411005, Maharashtra, India;
| |
Collapse
|
18
|
Bertrand-Charette M, Dambreville C, Bouyer LJ, Roy JS. Systematic review of motor control and somatosensation assessment tests for the ankle. BMJ Open Sport Exerc Med 2020; 6:e000685. [PMID: 32655878 PMCID: PMC7342858 DOI: 10.1136/bmjsem-2019-000685] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 12/26/2022] Open
Abstract
Background/Aim Ankle sprains are frequent musculoskeletal injuries that can lead to sensorimotor deficits provoking long-term instability at the ankle joint. A broad variety of clinical tests currently exist to assess sensorimotor processing, and are commonly clinically referred to as proprioceptive tests. However, there is a discrepancy in the use of the term proprioception when looking at the main outcome of these tests. As identifying specific deficits is important for motor recovery, it is critical for clinicians to select the most appropriate tests. Methods A systematic review of four databases was performed to provide an up-to-date review of the psychometric properties of available tests referred to as proprioceptive tests. Seventy-nine articles on eight ankle proprioceptive tests were included and critically appraised. Data on validity, reliability and responsiveness were extracted from the included articles and synthesised. The tests reviewed were then divided into two categories based on their main outcome: motor control or somatosensation. Results Strong evidence showed that the Star Excursion Balance Test, a motor control test, is capable of differentiating between stable and unstable ankles. Moderate evidence suggests that somatosensation tests, such as Joint Position Sense, are also valid and reliable, but their responsiveness has yet to be evaluated. Conclusions Together, these findings indicate that the Star Excursion Balance Test can be used in the clinic to assess motor control based on its excellent psychometric properties. However, as ankle stability control involves complex sensorimotor interactions, care has to be taken regarding the use of this test as a specific tool for proprioception assessment.
Collapse
Affiliation(s)
- Michaël Bertrand-Charette
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
| | - Charline Dambreville
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
| | - Laurent J Bouyer
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
| |
Collapse
|
19
|
Lin CC, Chen SJ, Lee WC, Lin CF. Effects of Different Ankle Supports on the Single-Leg Lateral Drop Landing Following Muscle Fatigue in Athletes with Functional Ankle Instability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103438. [PMID: 32423151 PMCID: PMC7277185 DOI: 10.3390/ijerph17103438] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/30/2020] [Accepted: 05/09/2020] [Indexed: 12/26/2022]
Abstract
Background: Ankle support has been utilized for athletes with functional ankle instability (FAI), however, its effect on the landing performance during muscle fatigue is not well understood. This study aimed to examine the effects of ankle supports (ankle brace vs. Kinesio tape) on athletes with FAI following fatigued single-leg landing. Methods: Thirty-three young FAI athletes (CAIT scores < 24) were randomly allocated to control (Cn), ankle brace (AB) and Kinesio tape (KT) groups. All athletes performed single-leg lateral drop landings following ankle fatigue protocol. The fatigue-induced changes in kinetic parameters were measured among three groups. Results: A significant increase in peak vertical ground reaction force (vGRF) was found in the AB group (0.12% body weight (BW)) compared to that of the KT (0.02% BW) and Cn (median = 0.01% BW) groups. Significant decrease in both COP medial-lateral (ML) and anterior-posterior (AP) ranges were also found in the KT group (median = −0.15% foot width (FW) & median = −0.28% foot length (FL)) than those of the Cn group (median = 0.67% FW& median = 0.88% FL). Conclusions: Ankle braces might hamper the ability to absorb the impact force during landing. On the other hand, Kinesio tape might be beneficial for the postural control during landing.
Collapse
Affiliation(s)
- Cheng-Chieh Lin
- Department of Physical Therapy, Tzu Hui Institute of Technology, Pingtung 926001, Taiwan;
| | - Shing-Jye Chen
- Department of Product Design, College of Design, Tainan University of Technology, Tainan 71002, Taiwan;
| | - Wan-Chin Lee
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Cheng-Feng Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 5911)
| |
Collapse
|
20
|
Individuals with recurrent ankle sprain demonstrate postural instability and neuromuscular control deficits in unaffected side. Knee Surg Sports Traumatol Arthrosc 2020; 28:184-192. [PMID: 30291398 DOI: 10.1007/s00167-018-5190-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 10/01/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE To compare proprioception, postural stability, and neuromuscular control between patients with mechanical laxity and recurrent ankle sprain. METHODS Among 86 patients with ankle instability, 45 patients had mechanical laxity (mean age 27.2 ± 7.0 years) and 41 had recurrent ankle sprain (mean age 25.1 ± 9.2 years). Both the affected and unaffected ankles of each patient were evaluated. Proprioception and neuromuscular control tests were conducted using an isokinetic machine, and postural stability was tested using a postural stabilometry system. RESULTS Proprioception was not significantly different between the unaffected or affected ankles of the mechanical laxity group compared with those of the recurrent ankle sprain group (n.s). Static and dynamic postural stability and neuromuscular control were similar in the affected ankles between the two groups (n.s). However, postural stability (static, overall: p = 0.009, anterior-posterior: p = 0.028, medial-lateral: p = 0.022; dynamic, overall: p = 0.012, anterior-posterior: p = 0.004, medial-lateral: p = 0.001) and neuromuscular control (inversion: p = 0.031, eversion: p = 0.039, dorsiflexion: p = 0.029, plantarflexion: p = 0.035) were significantly decreased in the unaffected ankles of the recurrent ankle sprain group compared with those of the mechanical laxity group. CONCLUSION The unaffected ankles of the recurrent ankle sprain group showed significant decreases in both postural stability and neuromuscular control compared with the mechanical laxity group. Clinicians and therapists should consider unaffected ankle rehabilitation in patients with recurrent ankle sprain to prevent future sprain events. LEVEL OF EVIDENCE Case-control study, III.
Collapse
|
21
|
Huynh B, Tacker R, Hung YJ. Active ankle position sense and single-leg balance in runners versus non-runners. Physiother Theory Pract 2019; 37:1429-1437. [PMID: 31793354 DOI: 10.1080/09593985.2019.1698084] [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: 10/25/2022]
Abstract
Introduction: Ankle sprain is one of the most common injuries in collegiate athletes, including runners. The purpose of the study was to examine whether runners exhibited compromised ankle stability, ankle position sense, and single-leg balance.Methods: Thirty-seven individuals (21 non-runners and 16 runners) participated in the study. To be included in the runner group, subjects were required to run greater than 150 minutes per week for the past three months. We used the Cumberland Ankle Instability Tool (CAIT) to categorize ankle stability, and we used a dual-axis electronic goniometer to examine active ankle position sense. We examined single-leg balance with the Athletic Single Leg Stability Test of the Biodex Balance System using three different protocols: 1) default setting, 2) no extrinsic visual feedback, and 3) no extrinsic feedback with a cognitive demand.Results: Runners and non-runners had similar ankle stability (CAIT = 26.88 and 26.45 respectively; p = .666). Although runners had significantly larger ankle position errors than non-runners overall (2.56° vs. 1.68°; p = .004), they had better single-leg balance than non-runners without extrinsic visual feedback (Stability Index 1.67 vs. 4.39; p < .001), even with an added cognitive loading (Stability Index 2.18 vs. 4.32; p < .001).Conclusions: For runners, having worse ankle position sense did not compromise ankle stability, nor contribute to single-leg balance deficits. Runners may have established better motor control to maintain their single-leg balance and ankle stability.
Collapse
Affiliation(s)
- Brian Huynh
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - Ryan Tacker
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - You-Jou Hung
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| |
Collapse
|
22
|
Vuurberg G, Altink N, Rajai M, Blankevoort L, Kerkhoffs GMMJ. Weight, BMI and stability are risk factors associated with lateral ankle sprains and chronic ankle instability: a meta-analysis. J ISAKOS 2019; 4:313-327. [PMID: 33835938 DOI: 10.1136/jisakos-2019-000305] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/29/2019] [Accepted: 09/06/2019] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Lateral ankle sprains (LAS) are common in the general population and may lead to chronic ankle instability (CAI). If patients at risk could be identified, they could receive adequate and on-time treatment. OBJECTIVE The purpose of the current review was to identify all reported intrinsic factors associated with sustaining a LAS or progressing to CAI after an initial sprain. EVIDENCE REVIEW PubMed, Embase, MEDline, Cochrane and PEDro were searched for studies published until July 2019. Articles were selected if they included intrinsic factors related to LAS or CAI, subjects of at least 16 years old, and contained a minimum of 10 patients and 10 controls. Studies were excluded if they concerned reviews or case reports, included patients with previous surgical interventions, concomitant injuries or joint pathology other than ankle instability. Quality of included studies was assessed using the Quality in Prognostic Studies tool and quality of evidence was assessed using the GRADEpro tool. In case outcomes were described by at least three studies, data were pooled and assessed by performing a meta-analysis. Based on the pooled data, either a fixed-effects model or random-effects model was selected to correct for the degree of heterogeneity. FINDINGS The search resulted in a total of 4154 studies. After title and abstract screening and subsequent full-text screening, 80 relevant studies were included. Results of the meta-analyses indicated that, compared with healthy controls, patients with LAS had a higher mean body mass index (BMI). In patients with CAI, a higher weight and a longer time to stabilise after performing a task (eg, jumping) were found compared with healthy controls. Other outcomes could not be compared using a meta-analysis due to heterogeneity in outcome measurement and the great number of different outcomes reported. Identification of the risk factors when patients present themselves after a LAS may help to determine which patients are at risk of recurrent sprains or developing CAI. CONCLUSIONS AND RELEVANCE Based on the findings in this review, a higher BMI, and a higher weight and neuromuscular stability deficits may be regarded risk factors for sustaining a LAS or developing CAI, respectively. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Gwendolyn Vuurberg
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands .,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Nienke Altink
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Morteza Rajai
- Orthopaedic surgery, Iran University of Medical Sciences, Tehran, the Islamic Republic of Iran
| | - Leendert Blankevoort
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Gino M M J Kerkhoffs
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Navarro-Santana MJ, Albert-Lucena D, Gómez-Chiguano GF, Plaza-Manzano G, Fernández-de-Las-Peñas C, Cleland J, Pérez-Silvestre Á, Asín-Izquierdo I. Pressure pain sensitivity over nerve trunk areas and physical performance in amateur male soccer players with and without chronic ankle instability. Phys Ther Sport 2019; 40:91-98. [PMID: 31505432 DOI: 10.1016/j.ptsp.2019.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Chronic ankle instability (CAI) is reported after ankle sprain. Our aim was to assess differences in mechanical pain sensitivity of lower extremity nerve trunks and physical performance between amateur soccer players with and without CAI. DESIGN A cross-sectional case-control study. SETTING Amateur soccer teams. PARTICIPANTS Fifty-five male soccer players, 28 with and 27 without CAI participated. MAIN OUTCOME MEASURES The perceived instability was assessed with the Cumberland Ankle Instability Tool (CAIT). Pressure pain thresholds (PPTs) on the common peroneal and tibialis nerve trunks, vertical jump, lateral step-down test and joint position sense of the knee were assessed by a blinded assessor. RESULTS Soccer players with CAI showed lower PPTs over the common peroneal nerve than those without CAI (between-groups mean difference: 1.0 ± 0.8 kg/cm2, P < 0.001). No differences for PPT over the tibialis posterior (P = 0.078) or any physical performance outcome (knee joint positioning sense [P = 0.798], lateral step-down test [P = 0.580] and vertical jump variables [all, P > 0.310]) were found. PPT over the common peroneal nerve exhibited a significant moderate correlation with the CAIT score (r = 0.528, P < 0.001). CONCLUSION Amateur soccer players with CAI have higher pressure pain sensitivity over the common peroneal nerve but exhibit similar physical performance to amateur soccer players without CAI.
Collapse
Affiliation(s)
- Marcos J Navarro-Santana
- Health and Rehabilitation Center San Fernando (Centro Médico Rehabilitación San Fernando), Madrid, Spain
| | | | | | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria Del Hospital Clínico San Carlos, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - Joshua Cleland
- Department of Physical Therapy, Franklin Pierce University, Manchester, NH, USA; Rehabilitation Services, Concord Hospital, NH, USA; Manual Therapy Fellowship Program, Regis University, Denver, CO, USA
| | - Ángel Pérez-Silvestre
- Centre for Sports Medicine, Spanish Agency for Health Protection in Sports (AEPSAD in its Spanish acronym), Madrid, Spain
| | | |
Collapse
|
24
|
Moré-Pacheco A, Meyer F, Pacheco I, Candotti CT, Sedrez JA, Loureiro-Chaves RF, Loss JF. ANKLE SPRAIN RISK FACTORS: A 5-MONTH FOLLOW-UP STUDY IN VOLLEY AND BASKETBALL ATHLETES. REV BRAS MED ESPORTE 2019. [DOI: 10.1590/1517-869220192503208053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
ABSTRACT Introduction Ankle sprain is a frequent sports injury among volley and basketball players, and identifying risk factors is necessary to prevent injuries and prolong their careers. Objective To identify intrinsic and extrinsic factors in basketball and volleyball players related to the risk of ankle sprain injury over a five-month follow-up period. Methods Ninety-four Brazilian young competitive athletes (15.8±1.7 years, 47 basketball and 47 volleyball players) participated in this study. They were evaluated for intrinsic risk factors (previous history of ankle sprain, dominant lower limb, ankle ligament laxity, range of motion of the ankle-foot complex, electromyographic response time of ankle evertors, postural control and muscular torque of ankle invertors and evertors) and extrinsic risk factors (type of shoes worn, use of orthosis, previous injuries while training or competing, and the players’ position). Results During the study period, 18 (19%) athletes suffered unilateral sprains. Multivariate logistic regression analysis gave a final regression with four factors: dominant leg (p=0.161), type of shoes worn (p=0.049), player’s position (p=0.153), and peroneus brevis muscle reaction time (p=0.045). There was an 86.1% probability of an ankle sprain if the athlete had a left dominant leg, wore shoes without vibration dampeners, or played in the small forward, wing/hitter spiker, middle blocker, or opposite spiker positions, and had a peroneus muscle reaction time longer than 80ms. However, only the player’s position was significantly (p=0.046) associated with lesion occurrence. Conclusion The player’s position appeared to be a risk factor in both sports, and this result may help professionals to prevent ankle sprains. Level of Evidence I; High quality randomized clinical trial with or without statistically significant difference but with narrow confidence intervals.
Collapse
Affiliation(s)
| | - Flávia Meyer
- Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | | | | | | |
Collapse
|
25
|
Chang HY, Chang YC, Cheng SC, Wang CH. The effectiveness of rearfoot medial wedge intervention on balance for athletes with chronic ankle instability. Medicine (Baltimore) 2019; 98:e16217. [PMID: 31261576 PMCID: PMC6617356 DOI: 10.1097/md.0000000000016217] [Citation(s) in RCA: 5] [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] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Athletes with chronic ankle instability (CAI) often develop complications such as pain, instability, and reduced postural control and balance stability, all of which affect athletic performance. This study investigated the effects of a 4° medal wedge intervention on static and dynamic balance in athletes with CAI. METHODS The participants were 24 healthy and 25 CAI athletes. Participants received a 4° medial wedge applied at the rear foot insole and completed the experiment measurements before and after the wedge intervention. The main outcome measures included the area and path length of the center of pressure when participants performed single-leg standing balance in the closed eye condition and the dynamic balance scores of a multiple single-leg hop stabilization test. RESULTS The single-leg standing balance significantly improved in CAI (P = .027) and control groups (P = .005) after the medial wedge intervention. The dynamic balance scores significantly decreased from 53.00 ± 25.22 to 41.24 ± 21 48 (P = .015) in CAI group after medial wedge intervention. CONCLUSION Wearing a 4° medial wedge applied at the rear foot insole improved static and dynamic balance immediately in athletes with CAI. We suggest that clinicians may provide the foot insole to improve balance deficit in athletes having CAI.
Collapse
Affiliation(s)
- Hsiao-Yun Chang
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan
| | - Yun-Chi Chang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei
| | - Shih-Chung Cheng
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan
| | - Chun-Hou Wang
- Department of Physical Therapy, Chung Shan Medical University, and Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
26
|
Li L, Zhang S, Dobson J. The contribution of small and large sensory afferents to postural control in patients with peripheral neuropathy. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:218-227. [PMID: 31193300 PMCID: PMC6523875 DOI: 10.1016/j.jshs.2018.09.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/24/2018] [Accepted: 09/14/2018] [Indexed: 05/13/2023]
Abstract
Peripheral neuropathy (PN) is a multifarious disorder that is caused by damage to the peripheral nerves. Although the symptoms of PN vary with the etiology, most cases are characterized by impaired tactile and proprioceptive sensation that progresses in a distal to proximal manner. Balance also tends to deteriorate as the disorder becomes more severe, and those afflicted are substantially more likely to fall while walking compared with those who are healthy. Most patients with PN walk more cautiously and with greater stride variability than age-matched controls, but the majority of their falls occur when they must react to a perturbation such as a slippery or uneven surface. The purpose of this study was to first describe the role of somatosensory feedback in the control of posture and then discuss how that relationship is typically affected by the most common types of PN. A comprehensive review of the scientific literature was conducted using MEDLINE, and the relevant information was synthesized. The evidence indicates that the proprioceptive feedback that is conveyed primarily through larger type I afferents is important for postural control. However, the evidence indicates that the tactile feedback communicated through smaller type II afferents is particularly critical to the maintenance of balance. Many forms of PN often lead to chronic tactile desensitization in the soles of the feet and, although the central nervous system seems to adapt to this smaller type II afferent dysfunction by relying on more larger type I afferent reflex loops, the result is still decreased stability. We propose a model that is intended both to help explain the relationship between stability and the smaller type II afferent and the larger type I afferent feedback that may be impaired by PN and to assist in the development of pertinent rehabilitative interventions.
Collapse
Affiliation(s)
- Li Li
- College of Physical Education, Hunan Normal University, Changsha 410012, China
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA
- Corresponding author.
| | - Shuqi Zhang
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL 60115, USA
| | - John Dobson
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA
| |
Collapse
|
27
|
Laessoe U, Svendsen AW, Christensen MN, Rasmussen JR, Gaml AS. Evaluation of functional ankle instability assessed by an instrumented wobble board. Phys Ther Sport 2018; 35:133-138. [PMID: 30554122 DOI: 10.1016/j.ptsp.2018.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Ankle sprains often lead to a history of recurrent injuries and functional joint instability. This study evaluated a new method for assessing functional impairment in patients with chronic ankle instability. DESIGN Case-control study for construct validation purpose. SETTING The participants were tested during one-leg standing for 20 s on an instrumented wobble board and on a balance platform. PARTICIPANTS Twenty-five young people with previous ankle sprain and an instability score >11 in the "Identification of Functional Ankle Instability questionnaire" and an age-matched control group of 25 healthy individuals. MAIN OUTCOME MEASURES Wobble board variation of tilt angle measured by two accelerometers placed horizontally in the board. RESULTS The variation in angular tilt of the wobble board in the medio-lateral direction (standard deviation of tilt angle) was higher in the group with perceived ankle instability than in the control group: 1.5 (0.7) versus 1.1 (0.3). ICC for intra-tester reliability: 0.87 and correlation with COP area measures from the stable balance platform: 0.64. CONCLUSIONS People with functional ankle instability display poorer postural stability in the medio-lateral direction when challenged on an unstable surface. The instrumented wobble board may serve as a relevant tool in the clinical evaluation of functional ankle stability.
Collapse
Affiliation(s)
- Uffe Laessoe
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark; Department of Research and Development, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark.
| | - Anne Weinreich Svendsen
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
| | - Mads Norre Christensen
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
| | - Jacob Rosenkrans Rasmussen
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
| | - Alexander Scharf Gaml
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
| |
Collapse
|
28
|
Factors Contributing to Chronic Ankle Instability: A Systematic Review and Meta-Analysis of Systematic Reviews. Sports Med 2018; 48:189-205. [PMID: 28887759 DOI: 10.1007/s40279-017-0781-4] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Many factors are thought to contribute to chronic ankle instability (CAI). Multiple systematic reviews have synthesised the available evidence to identify the primary contributing factors. However, readers are now faced with several systematic reviews that present conflicting findings. OBJECTIVE The aim of this systematic review and meta-analysis was to establish the statistical significance and effect size of primary factors contributing to CAI and to identify likely reasons for inconsistencies in the literature. METHODS Relevant health databases were searched: CINAHL, MEDLINE, PubMed, Scopus and SPORTDiscus. Systematic reviews were included if they answered a focused research question, clearly defined the search strategy criteria and study selection/inclusion and completed a comprehensive search of the literature. Included reviews needed to be published in a peer-reviewed journal and needed to review observational studies of factors and/or characteristics of persons with CAI, with or without meta-analysis. There was no language restriction. Studies using a non-systematic review methodology (e.g. primary studies and narrative reviews) were excluded. Methodological quality of systematic reviews was assessed using the modified R-AMSTAR tool. Meta-analysis on included primary studies was performed. RESULTS Only 17% of primary studies measured a clearly defined CAI population. There is strong evidence to support the contribution of dynamic balance, peroneal reaction time and eversion strength deficits and moderate evidence for proprioception and static balance deficits to non-specific ankle instability. CONCLUSIONS Evidence from previous systematic reviews does not accurately reflect the CAI population. For treatment of non-specific ankle instability, clinicians should focus on dynamic balance, reaction time and strength deficits; however, these findings may not be translated to the CAI population. Research should be updated with an adequately controlled CAI population. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2016, CRD42016032592.
Collapse
|
29
|
Kim K, Choi B, Lim W. The efficacy of virtual reality assisted versus traditional rehabilitation intervention on individuals with functional ankle instability: a pilot randomized controlled trial. Disabil Rehabil Assist Technol 2018; 14:276-280. [PMID: 29385840 DOI: 10.1080/17483107.2018.1429501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Virtual reality (VR) training, a virtual environment commonly generated by computer systems, may enhance the therapeutic efficacy of functional rehabilitation programmes. The aim of this study was to investigate the efficacy of a VR assisted intervention (VRAI) versus traditional rehabilitation intervention (TRI) on functional ankle instability (FAI). METHODS A single-blind randomized controlled study was conducted with 10 subjects for each group. The VRAI was conducted with the Nintendo Wii Fit Plus, whilst the TRI was conducted with a series of exercises with theraband. The muscle strength change of the two groups and the difference between pre and post interventions for each group were compared. RESULTS The VRAI group had less improvement in the muscle strength of all ankle motions than did the TRI group (p > .05). The VRAI group had a greater improvement in muscle strength of plantar flexion than other motions, whilst the TRI group had an improvement in muscle strength of all ankle motions (p < .05). CONCLUSIONS The effects of VR training for the condition of FAI were not comparable to conventional training. However, VR training may be added to the conventional training programme as an optional for the condition of FAI. Implications for Rehabilitation Functional ankle instability (FAI) is subjective feelings of ankle instability resulting from proprioceptive and neuromuscular deficits in which individuals may experience "giving way" condition of the ankle. Therapeutic applications of virtual reality (VR) may be comparable to traditional rehabilitation interventions (TRI) in the rehabilitation of individuals with FAI. However, there is no definitive evidence for the issue. Integrating low-cost VR into functional rehabilitation programme can provide insight into an issue of whether it can be replaced with traditional therapeutic approaches. Although, the efficacy of VR application on strengthening muscles is unable to compare to traditional strengthening programmes, it may be considered an optional treatment based on the proprioceptive improvements.
Collapse
Affiliation(s)
- Kijong Kim
- a Department of Physical Therapy , Cheongam College , Suncheon , Republic of Korea
| | - Bongsam Choi
- b Department of Physical Therapy, College of Health and Welfare , Woosong University , Daejeon , Republic of Korea.,c Advanced Institute of Convergence Sports Rehabilitation , Woosong University , Daejeon , Republic of Korea
| | - Wootaek Lim
- b Department of Physical Therapy, College of Health and Welfare , Woosong University , Daejeon , Republic of Korea.,c Advanced Institute of Convergence Sports Rehabilitation , Woosong University , Daejeon , Republic of Korea
| |
Collapse
|
30
|
Dedieu P, Chamoun R, Lacaud G, Moulinat T, Queron M, Zanone PG. Does a not-so-recent ankle sprain influence interjoint coordination during walking? Clin Biomech (Bristol, Avon) 2017; 50:114-121. [PMID: 29100184 DOI: 10.1016/j.clinbiomech.2017.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 10/15/2017] [Accepted: 10/18/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ankle sprains are common joint injuries in daily and sports activities, whose underlying mechanisms have been amply studied. If joint structures are directly damaged, neuromuscular activity can be affected, particularly in the time domain. This study aims to establish whether previous ankle injury correlates with changes in the inter-joint synergy of the entire lower limb and in the muscle activity pattern during walking. METHODS Three-dimensional walking-gait analysis was conducted on twenty-four adults. Ten of them had never suffered from ankle sprain; fourteen had suffered from ankle sprain at least once during the three preceding years. Continuous Relative Phase (CRP) between the moving limbs assessed inter-joint coordination, and muscular activity was recorded by EMG. FINDINGS CRP between ankle and knee and between ankle and hip indicates that both joints moved in tight synchronization in the same direction on the injured side, whereas there was a time lag between joints on the healthy side for each sprained participants or on both side for the control group. Start-time and/or duration of muscular activity of tibialis anterior, soleus and peroneus longus occurred earlier and were longer on the injured side, respectively. INTERPRETATION Our findings suggest that ankle sprain modifies inter-joint coordination and muscular activity of the injured limb, inducing not an entirely new pattern of coordination but an alteration of the existing pattern. CRP revealed slight modifications in the extant inter-joint coordination which may not be captured by other kinematic variables, which opens perspectives on therapy and relapse prevention.
Collapse
Affiliation(s)
- Philippe Dedieu
- IRFSS, Croix-Rouge française - 25, rue Sismondi, 87000 Limoges, France.
| | - Rima Chamoun
- The Lebanese University, Faculty of Public Health (section 2), Department of Physiotherapy, Beyrouth, Lebanon
| | - Guilhaume Lacaud
- IRFSS, Croix-Rouge française - 25, rue Sismondi, 87000 Limoges, France
| | - Thibault Moulinat
- IRFSS, Croix-Rouge française - 25, rue Sismondi, 87000 Limoges, France
| | - Maxime Queron
- IRFSS, Croix-Rouge française - 25, rue Sismondi, 87000 Limoges, France
| | - Pier-Giorgio Zanone
- UMR 5549 CERCO CNRS University of Toulouse, UPS, 118 route de Narbonne, 31000 Toulouse, France
| |
Collapse
|
31
|
Jung YJ, Yi CH, Baek YJ, Son JI, Lim OB. Comparison of functional exercises on lower limb and trunk muscle activation in people with chronic ankle instability. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.10.435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ye-ji Jung
- Graduate student, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Chung-hwi Yi
- Professor, Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Republic of Korea
| | - Yun-jeong Baek
- Graduate student, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Jae-ik Son
- Graduate student, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Republic of Korea
| | - One-bin Lim
- Physical therapist, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju; Department of Physical Therapy, Rehabilitation Hospital, National Rehabilitation Center, Seoul, Republic of Korea
| |
Collapse
|
32
|
Chang YW, Wu HW. Effect of cryotherapy on ankle proprioception and balance in subjects with chronic ankle instability. ISOKINET EXERC SCI 2017. [DOI: 10.3233/ies-170657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Yi-Wen Chang
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - Hong-Wen Wu
- Department of Physical Education, National Taiwan University of Sport, Taichung, Taiwan
| |
Collapse
|
33
|
Tenenbaum S, Chechik O, Bariteau J, Bruck N, Beer Y, Falah M, Segal G, Mor A, Elbaz A. Gait abnormalities in patients with chronic ankle instability can improve following a non-invasive biomechanical therapy: a retrospective analysis. J Phys Ther Sci 2017; 29:677-684. [PMID: 28533609 PMCID: PMC5430272 DOI: 10.1589/jpts.29.677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/10/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the changes in gait patterns and clinical outcomes of patients with chronic ankle instability (CAI) following treatment with a home-based non-invasive biomechanical device. [Subjects and Methods] Thirty-three patients with CAI were compared with 43 healthy controls. Patients underwent a spatiotemporal gait assessment before and three months following treatment. Clinical evaluation was recorded with SF-36 Health Survey and the Foot and Ankle Outcome Score (FAOS). [Results] Significant baseline differences were found between groups. Patients with CAI showed a statistically significant improvement in velocity, cadence, symptomatic limb step length and single limb support over time. Significant improvements in SF-36 PCS and FAOS outcome scores were found in patients with CAI. [Conclusion] Patients with CAI have baseline spatiotemporal gait abnormalities as compared with healthy controls. However, clinical and gait metrics improvement can be expected after 12 weeks of perturbation training using a non-invasive biomechanical device.
Collapse
Affiliation(s)
- Shay Tenenbaum
- Department of Orthopedic Surgery, Chaim Sheba Medical
Center at TEL: Hashomer, affiliated to the Sackler Faculty of Medicine TEL: Aviv
University, Israel
| | - Ofir Chechik
- Department of Orthopedic Surgery, Sourasky Medical Center,
Israel
| | - Jason Bariteau
- Department of Orthopedics, Emory University School of
Medicine, USA
| | - Nathan Bruck
- Department of Orthopedic Surgery, Chaim Sheba Medical
Center at TEL: Hashomer, affiliated to the Sackler Faculty of Medicine TEL: Aviv
University, Israel
| | - Yiftah Beer
- Department of Orthopedic Surgery, Assaf Harofeh Medical
Center, Israel
| | - Mazen Falah
- Department of Orthopedic Surgery, Rambam Health Care
Campus, Israel
| | | | - Amit Mor
- AposTherapy Research Group, Israel
| | | |
Collapse
|
34
|
Sousa ASP, Leite J, Costa B, Santos R. Bilateral Proprioceptive Evaluation in Individuals With Unilateral Chronic Ankle Instability. J Athl Train 2017; 52:360-367. [PMID: 28318316 DOI: 10.4085/1062-6050-52.2.08] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Despite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. OBJECTIVE To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. DESIGN Cohort study. SETTING Research laboratory center in a university. PATIENTS OR OTHER PARTICIPANTS Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. MAIN OUTCOME MEASURE(S) Ankle active and passive joint position sense, kinesthesia, and force sense. RESULTS We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P < .001): the FAI group demonstrated increased error versus the control group (injured limb: P < .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). CONCLUSIONS Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense.
Collapse
Affiliation(s)
- Andreia S P Sousa
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
| | - João Leite
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
| | - Bianca Costa
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
| | - Rubim Santos
- Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana, Instituto Politécnico do Porto, Portugal
| |
Collapse
|
35
|
Paquette MR, Schilling BK, Bravo JD, Peel SA, Li Y, Townsend RJ. Computerized Agility Training Improves Change-of-Direction and Balance Performance Independently of Footwear in Young Adults. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2017; 88:44-51. [PMID: 27902891 DOI: 10.1080/02701367.2016.1252031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. PURPOSE This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. METHOD Thirty recreationally active young adults (Mage = 22.8 ± 3.1 years; Mheight = 1.71 ± 0.7 m; Mbodymass = 73.4 ± 10.3 kg) were randomly assigned to a 6-week computerized agility training intervention in 1 of 3 footwear groups (n = 10/group): barefoot, minimal footwear, or traditional shoes. Participants had no previous barefoot or minimal-footwear training experience. Dependent variables included change-of-direction test time to completion, Star Excursion Balance Test, and single-leg stability evaluation. Testing was performed at the start of the training program, after 2 weeks, after 4 weeks, and at the end of the training program. RESULTS No group or time interactions were found for any of the dependent variables. Time main effects were observed for the performance measures of change of direction, Star Excursion, and single-leg-with-eyes-open stability evaluation. Participants improved in all 3 tests as early as 2 weeks into the intervention, with improvements continuing through the entire 6-week intervention. CONCLUSIONS The lack of interaction and footwear effects suggests that agility and balance improvements during foot agility training are independent of footwear in a recreationally active young-adult population. Computerized agility training improves change-of-direction and balance performance within 2 weeks of training implementation. Future studies should consider footwear training effects in different populations, including frail older adults and athletes.
Collapse
|
36
|
Hung YJ, Miller J. Extrinsic visual feedback and additional cognitive/physical demands affect single-limb balance control in individuals with ankle instability. World J Orthop 2016; 7:801-807. [PMID: 28032032 PMCID: PMC5155255 DOI: 10.5312/wjo.v7.i12.801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/06/2016] [Accepted: 10/09/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the impact of extrinsic visual feedback and additional cognitive/physical demands on single-limb balance in individuals with ankle instability.
METHODS Sixteen subjects with ankle instability participated in the study. Ankle instability was identified using the Cumberland Ankle Instability Tool (CAIT). The subject’s unstable ankle was examined using the Athletic Single Leg Stability Test of the Biodex Balance System with 4 different protocols: (1) default setting with extrinsic visual feedback from the monitor; (2) no extrinsic visual feedback; (3) no extrinsic visual feedback with cognitive demands; and (4) no extrinsic visual feedback with physical demands. For the protocol with added cognitive demands, subjects were asked to continue subtracting 7 from a given number while performing the same test without extrinsic visual feedback. For the protocol with added physical demands, subjects were asked to pass and catch a basketball to and from the examiner while performing the same modified test.
RESULTS The subject’s single-limb postural control varied significantly among different testing protocols (F = 103; P = 0.000). Subjects’ postural control was the worst with added physical demands and the best with the default condition with extrinsic visual feedback. Pairwise comparison shows subjects performed significantly worse in all modified protocols (P < 0.01 in all comparisons) compared to the default protocol. Results from all 4 protocols are significantly different from each other (P < 0.01) except for the comparison between the “no extrinsic visual feedback” and “no extrinsic visual feedback with cognitive demands” protocols. Comparing conditions without extrinsic visual feedback, adding a cognitive demand did not significantly compromise single-limb balance control but adding a physical demand did. Scores from the default protocol are significantly correlated with the results from all 3 modified protocols: No extrinsic visual feedback (r = 0.782; P = 0.000); no extrinsic visual feedback with cognitive demands (r = 0.569; P = 0.022); no extrinsic visual feedback with physical demands (r = 0.683; P = 0.004). However, the CAIT score is not significantly correlated with the single-limb balance control from any of the 4 protocols: Default with extrinsic visual feedback (r = -0.210; P = 0.434); no extrinsic visual feedback (r = -0.450; P = 0.081); no extrinsic visual feedback with cognitive demands (r = -0.406; P = 0.118); no extrinsic visual feedback with physical demands (r = -0.351; P = 0.182).
CONCLUSION Single-limb balance control is worse without extrinsic visual feedback and/or with cognitive/physical demands. The balance test may not be a valid tool to examine ankle instability.
Collapse
|
37
|
Gorgy O, Vercher JL, Coyle T, Buloup F. Coordination of Upper and Lower Body during Balance Recovery following a Support Translation. Percept Mot Skills 2016; 105:715-32. [DOI: 10.2466/pms.105.3.715-732] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Strategies for recovery of posture were studied after lateral mechanical perturbations. 11 participants standing in tandem stance were unexpectedly submitted to lateral support translations with the eyes open or closed at two translation amplitudes. The trajectories of the center of mass of the upper and lower body and muscle activities allowed identification of three strategies, involving either the ankle or the hip only, or both. Hip use increased with vision and with amplitude of perturbation. Short-to-medium latency electromyographic activities were observed in leg and trunk muscles, and long-latency responses in the back leg muscles. Vision increased the activity of both leg and trunk muscles but did not influence the onset of the muscular responses. These data suggest a hierarchy in the selection of these different strategies: the hip is mobilized when the perturbation is more destabilizing but this strategy has a cost and needs specific sensory information supplied by vision.
Collapse
Affiliation(s)
| | | | - Thelma Coyle
- CNRS, University of the Mediterranean, Marseille
| | | |
Collapse
|
38
|
Postural stabilization after single-leg vertical jump in individuals with chronic ankle instability. Phys Ther Sport 2016; 22:88-93. [DOI: 10.1016/j.ptsp.2016.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/26/2016] [Accepted: 07/29/2016] [Indexed: 11/30/2022]
|
39
|
Eccentric Training Improves Ankle Evertor and Dorsiflexor Strength and Proprioception in Functionally Unstable Ankles. Am J Phys Med Rehabil 2016; 95:448-58. [DOI: 10.1097/phm.0000000000000421] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
40
|
Individuals with chronic ankle instability compensate for their ankle deficits using proximal musculature to maintain reduced postural sway while kicking a ball. Hum Mov Sci 2015; 43:33-44. [DOI: 10.1016/j.humov.2015.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 11/19/2022]
|
41
|
Hung YJ. Neuromuscular control and rehabilitation of the unstable ankle. World J Orthop 2015; 6:434-438. [PMID: 26085985 PMCID: PMC4458494 DOI: 10.5312/wjo.v6.i5.434] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/21/2015] [Accepted: 05/11/2015] [Indexed: 02/06/2023] Open
Abstract
Lateral ankle sprain is a common orthopedic injury with a very high recurrence rate in athletes. After decades of research, it is still unclear what contributes to the high recurrence rate of ankle sprain, and what is the most effective intervention to reduce the incident of initial and recurrent injuries. In addition, clinicians often implement balance training as part of the rehabilitation protocol in hopes of enhancing the neuromuscular control and proprioception of the ankle joint. However, there is no consensus on whether the neuromuscular control and proprioception are compromised in unstable ankles. To reduce the prevalence of ankle sprains, the effectiveness of engaging balance training to enhance the neuromuscular control and proprioception of the ankle joint is also questionable.
Collapse
|
42
|
Zhang S, Manor B, Li L. H-index is important for postural control for people with impaired foot sole sensation. PLoS One 2015; 10:e0121847. [PMID: 25807534 PMCID: PMC4373754 DOI: 10.1371/journal.pone.0121847] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 02/18/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION People with Peripheral Neuropathy (PN), especially those with impaired sensory inputs through the small-afferent fiber (type II afferent fibers) reflex loop (SAF), might depend more on the large-afferent fiber (type I afferent fibers) reflex loop (LAF) for postural control. PURPOSE To examine whether the function of the LAF reflex loop, reflected by the H-reflex and ankle joint proprioception, influences postural control when the SAF reflex loop is impaired, as indicated by reduced foot sole cutaneous sensation. METHODS Thirteen participants (8 women, 5 men) diagnosed with PN and 12 age-matched controls (7 women, 5 men) completed the testing protocol. Measures of interest included the H-index, active (AAP) and passive (PAP) ankle proprioception, plantar pressure sensitivity (PPS), average sway velocity (VAVG) and area (A95) during 30 seconds eyes-closed standing, 6-minute walk distance (6MWD) and timed up-and-go duration (TUG). RESULTS Statistically significant group-dependent regression was observed between VAVG and H-index. Compared to the control group, the PN group demonstrated reduced PPS (2.0 ± 1.9 vs. 4.2 ± 1.2, P < .05) and H-index (63.6 ± 10.9 vs. 76.4 ± 16.0, P < .05), greater VAVG (3.5 ± 2.1 vs. 1.6 ± 0.6 cm/s, P < .05) and A95 (10.0 ± 10.1 vs. 2.5 ± 1.5 cm2, P < .05), shorter 6MWD (442.2 ± 93.0 vs. 525.3 ± 68.2 m, P < .05), and longer TUG (9.4 ± 1.6 vs. 6.5 ± 1.3 s, P < .05). Within the PN group, but not the control group, the H-index was correlated with VAVG (r = -.56, P < .05). Moreover, within the PN group only, PAP scores were correlated with 6MWD (r = -.68, P < .05) and TUG (r = -.59, P < .05) performance. No other statistically significant group difference, correlation or group-dependent regression was observed. CONCLUSION VAVG, 6MWD, and TUG correlated with LAF reflex loop function observed among those with impaired functioning of the SAF reflex loop. This observation suggests that the LAF reflex loop may be critical to the control of balance in those individuals suffering from small-fiber PN.
Collapse
Affiliation(s)
- Shuqi Zhang
- Louisiana State University, Baton Rouge, LA, United States of America
- Georgia Southern University, Statesboro, GA, United States of America
| | - Brad Manor
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States of America
| | - Li Li
- Georgia Southern University, Statesboro, GA, United States of America
- Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
43
|
Kobayashi T, Saka M, Suzuki E, Yamazaki N, Suzukawa M, Akaike A, Shimizu K, Gamada K. The effects of a semi-rigid brace or taping on talocrural and subtalar kinematics in chronic ankle instability. Foot Ankle Spec 2014; 7:471-7. [PMID: 25053794 DOI: 10.1177/1938640014543357] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND A semi-rigid brace or taping is often used to prevent giving-ways in the joint with chronic ankle instability (CAI). However, it remains unknown whether the application of a semi-rigid brace or taping modifies abnormal kinematics in CAI joints. The objective of this study was to determine if the application of a semi-rigid brace or taping of the ankle normalizes abnormal weight-bearing kinematics in CAI joints during ankle internal rotation in plantar flexion. METHODS A total of 14 male patients with unilateral CAI (mean age 21.1 ± 2.5 years) were enrolled. Three-dimensional bone models created from the computed tomography images were matched to the fluoroscopic images to compute the 6 degrees-of-freedom talocrural, subtalar, and ankle joint complex (AJC) kinematics for the healthy and contralateral CAI joints, as well as for CAI joints with a brace or taping. Selected outcome measures were talocrural anterior translation, talocrural internal rotation, and subtalar internal rotation. RESULTS There was no significant difference in talocrural anterior translation and internal rotation induced by applying either a semi-rigid brace or taping (P > .05). For subtalar internal rotation, there was a tendency toward restoration of normal kinematics in CAI joints after applying a semi-rigid brace or taping. However, the difference was not significant (P > .05). DISCUSSION Application of a semi-rigid brace or taping had limited effects on the CAI joint during weight-bearing ankle internal rotation in plantar flexion. Further studies using a variety of testing conditions should be conducted in the future. LEVELS OF EVIDENCE Therapeutic, Level IV: Cross-Sectional Case Series.
Collapse
Affiliation(s)
- Takumi Kobayashi
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| | - Masayuki Saka
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| | - Eiichi Suzuki
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| | - Naohito Yamazaki
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| | - Makoto Suzukawa
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| | - Atsushi Akaike
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| | - Kuniaki Shimizu
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| | - Kazuyoshi Gamada
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan (Masayuki Saka, KG)Department of Orthopaedics, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (ES)Department of Medical Radiation, Kanagawa Prefectural Shiomidai Hospital, Kanagawa, Japan (NY)Department of Rehabilitation, Yokohama Sports Medical Center, Kanagawa, Japan (Makoto Suzukawa)Department of Orthopaedics, Yokohama Sports Medical Center, Kanagawa, Japan (AA, KS)
| |
Collapse
|
44
|
Abstract
UNLABELLED Many studies investigated the contributing factors of chronic ankle instability, but a consensus has not yet been obtained. The objective of this critical review is to provide recent scientific evidence on chronic ankle instability, including the epidemiology and pathology of lateral ankle sprain as well as the causative factors of chronic ankle instability. We searched MEDLINE from 1964 to December 2013 using the terms ankle, sprain, ligament, injury, chronic, functional, mechanical, and instability. Lateral ankle sprain shows a very high recurrence rate and causes considerable economic loss due to medical care, prevention, and secondary disability. During the acute phase, patients with ankle sprain demonstrate symptoms such as pain, range of motion deficit, postural control deficit, and muscle weakness, and these symptoms may persist, leading to chronic ankle instability. Although some agreement regarding the effects of chronic ankle instability with deficits in postural control and/or concentric eversion strength exists, the cause of chronic ankle instability remains controversial. LEVELS OF EVIDENCE Therapeutic Level IV: Review of Level IV studies.
Collapse
Affiliation(s)
- Takumi Kobayashi
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Department of Rehabilitation, Hiroshima International University, Hiroshima, Japan (KG)
| | - Kazuyoshi Gamada
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan (TK)Department of Rehabilitation, Hiroshima International University, Hiroshima, Japan (KG)
| |
Collapse
|
45
|
Marchetti PH, Orselli MIV, Martins LMS, Duarte M. Effects of a full season on stabilometric Parameters of team handball elite athletes. MOTRIZ: REVISTA DE EDUCACAO FISICA 2014. [DOI: 10.1590/s1980-65742014000100011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
It is unclear whether athletes change their postural control over the course of a full sport season, or become more asymmetrical with respect to their neuromuscular performance over the same period. The aim of this study was to investigate the effects of a full sport season on the postural control of team handball elite athletes. Ten healthy, elite male team handball players performed bipodal standing (BP) and right and left unipodal standing (UP) during 30s. We used the RMS and speed of the center of pressure to describe postural sway. For the BP task, the sway was lower at the end of the season (p<0.005). For the UP tasks, the sway was lower at the end of the season only for the non-dominant limb (p<0.001). Differences between limbs were observed only at the end of the season (p<0.03). In conclusion, a full team handball season did not lead to deterioration of the athletes' postural control, but by the end of the season, the athletes were more asymmetrical.
Collapse
|
46
|
Kawasaki T, Yasuda K, Fukuhara K, Higuchi T. Relationship between Mental Rotation of Body Parts and Postural Stability during Quiet Stance. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/jirspa-2014-0001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractThe present study was designed to investigate a relationship between the ability to quickly perform a mental rotation (MR) task using body (particularly foot) stimuli and postural stability during unipedal and bipedal quiet stance. Twenty-four healthy young adults participated in this study to measure reaction times for the MR (stimuli: foot, hand, and car), postural sway values during unipedal and bipedal standings, and lower extremity functions. Results showed significant correlations between the reaction time for the MR of the foot stimuli (but not for hand and car stimuli) and some of postural sway values (total length of sway and mean velocity in the anterior–posterior direction) during unipedal standing (but not for bipedal standing). Consistently, participants who performed the MR task quickly showed significantly smaller sway values during unipedal standing than those who performed the task slowly. These findings suggest that the ability to mentally imagine the foot movement is likely to relate to postural stability, while involving a challenging postural task, such as unipedal standing. The reaction time for the MR of foot stimuli was also correlated with two-point discrimination (TPD) distance on the plantar skin. Given that the TPD distance not only represents cutaneous acuity but also reflects participants’ body image relating to their feet, MR performance may have been related to postural stability because both involve cognitive processes used for both motor imagery and motor execution of the foot movement.
Collapse
|
47
|
Asimenia G, Paraskevi M, Polina S, Anastasia B, Kyriakos T, Georgios G. Aquatic training for ankle instability. Foot Ankle Spec 2013; 6:346-51. [PMID: 23811948 DOI: 10.1177/1938640013493461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
UNLABELLED The aim of the present study was to evaluate balance deficits after an ankle sprain in collegiate students and to examine the effectiveness of 2 different balance rehabilitation programs on balance ability. Thirty collegiate students with functional ankle instability were randomly divided into 2 groups. Both groups followed an intervention balance program for 6 weeks, 3 times per week, 20 minutes per session, using balance boards. One of the 2 training groups performed the exercises on the ground-the "Land" group (n = 15), and the other in a swimming pool-the "Aquatic" group (n = 15). Balance ability was assessed before and after the 6-week intervention program. Balance assessments included static (stability indices: total, anterior-posterior, medial-lateral) and dynamic (dynamic moving the cursor) stability tests on the Biodex Stability System (Biodex, Inc, Shirley, NY). The results showed that in both training groups balance ability of the injured leg was significantly improved after the training period. In the final measurements, no statistically significant differences between the injured and healthy limb were found. The present study indicates that the performance of balance exercises in or out of water by collegiate students with functional ankle instability improves their balance ability. LEVEL OF EVIDENCE Therapeutic, Level 1.
Collapse
Affiliation(s)
- Gioftsidou Asimenia
- 1Department of Physical Education and Sports Science, Democritus University of Thrace, Komotini, Greece (GA, MP,SP, BA, GG)
| | | | | | | | | | | |
Collapse
|
48
|
Kobayashi T, No Y, Yoneta K, Sadakiyo M, Gamada K. In vivo kinematics of the talocrural and subtalar joints with functional ankle instability during weight-bearing ankle internal rotation: a pilot study. Foot Ankle Spec 2013; 6:178-84. [PMID: 23439609 DOI: 10.1177/1938640013477452] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Functional ankle instability (FAI) may involve abnormal kinematics. However, reliable quantitative data for kinematics of FAI have not been reported. The objective of this study was to determine if the abnormal kinematics exist in the talocrural and subtalar joints in patients with FAI. Five male subjects with unilateral FAI (a mean age of 33.4 ± 13.2 years) were enrolled. All subjects were examined with stress radiography and found to have no mechanical ankle instability (MAI). Lateral radiography at weight-bearing ankle internal rotation of 0° and 20° was taken with the ankle at 30° dorsiflexion and 30° plantar flexion. Patients underwent computed tomography scan at 1.0 mm slice pitch spanning distal one third of the lower leg and the distal end of the calcaneus. Three-dimensional (3D) kinematics of the talocrural and subtalar joints as well as the ankle joint complex (AJC) were determined using a 3D-to-2D registration technique using a 3D-to-2D registration technique with 3D bone models and plain radiography. FAI joints in ankle dorsiflexion demonstrated significantly greater subtalar internal rotation from 0° to 20° internal rotation. No statistical differences in plantar flexion were detected in talocrural, subtalar or ankle joint complex kinematics between the FAI and contralateral healthy joints. During ankle internal rotation in dorsiflexion, FAI joints demonstrated greater subtalar internal rotation. The FAI joints without mechanical instability presented abnormal kinematics. This suggests that abnormal kinematics of the FAI joints may contribute to chronic instability. FAI joints may involve unrecognized abnormal subtalar kinematics during internal rotation in ankle dorsiflexion which may contribute to chronic instability and frequent feelings of instability.
Collapse
Affiliation(s)
- Takumi Kobayashi
- Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Higashi Hiroshima, Japan
| | | | | | | | | |
Collapse
|
49
|
McKeon JMM, McKeon PO. Evaluation of joint position recognition measurement variables associated with chronic ankle instability: a meta-analysis. J Athl Train 2013; 47:444-56. [PMID: 22889661 DOI: 10.4085/1062-6050-47.4.15] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify the most precise and consistent variables using joint repositioning for identifying joint position recognition (JPR) deficits in individuals with chronic ankle instability (CAI). DATA SOURCES We conducted a computerized search of the relevant scientific literature from January 1, 1965, to July 31, 2010, using PubMed Central, CINAHL, MEDLINE, SPORTDiscus, and Web of Science. We also conducted hand searches of all retrieved studies to identify relevant citations. Included studies were written in English, involved human participants, and were published in peer-reviewed journals. STUDY SELECTION Studies were included in the analysis if the authors (1) had examined JPR deficits in patients with CAI using active or passive repositioning techniques, (2) had made comparisons with a group or contralateral limb without CAI, and (3) had provided means and standard deviations for the calculation of effect sizes. DATA EXTRACTION Studies were selected and coded independently and assessed for quality by the investigators. We evaluated 6 JPR variables: (1) study comparisons, (2) starting foot position, (3) repositioning method, (4) testing range of motion, (5) testing velocity, and (6) data-reduction method. The independent variable was group (CAI, control group or side without CAI). The dependent variable was errors committed during joint repositioning. Means and standard deviations for errors committed were extracted from each included study. DATA SYNTHESIS Effect sizes and 95% confidence intervals were calculated to make comparisons across studies. Separate meta-analyses were calculated to determine the most precise and consistent method within each variable. Between-groups comparisons that involved active repositioning starting from a neutral position and moving into plantar flexion or inversion at a rate of less than 5°/s as measured by the mean absolute error committed appeared to be the most sensitive and precise variables for detecting JPR deficits in people with CAI.
Collapse
Affiliation(s)
- Jennifer Medina M McKeon
- Department of Rehabilitation Sciences, University of Kentucky, CT Wethington Building, 900 S Limestone, Lexington, KY 40536, USA.
| | | |
Collapse
|
50
|
Cheing GLY, Chau RMW, Kwan RLC, Choi CH, Zheng YP. Do the biomechanical properties of the ankle-foot complex influence postural control for people with Type 2 diabetes? Clin Biomech (Bristol, Avon) 2013; 28:88-92. [PMID: 23021727 DOI: 10.1016/j.clinbiomech.2012.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 09/03/2012] [Accepted: 09/03/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The ankle-foot complex plays an important role in the mechanics of postural control. The objectives of this study were to compare the biomechanical properties of the ankle-foot complex of people with diabetes who had or did not have peripheral neuropathy with those healthy individuals; and to examine its correlation with postural control. METHODS A total of 64 individuals participated in this study: 9 people with diabetic peripheral neuropathy, 23 diabetes without neuropathy, and 32 healthy controls. A hand-held ultrasound indentation system was used to assess the soft tissue biomechanical properties of the ankle-foot complex. The Sensory Organization test was performed using The Smart EquiTest system to assess postural control. FINDINGS The soft tissue of the Achilles tendon was significantly thickened in all individuals with diabetes (P<0.001), and was associated with the vestibular ratio (r=0.40; P<0.05). The Young's modulus of the plantar soft tissue was significantly increased in the diabetic neuropathy group (all P<0.05). Also, the Young's modulus of the plantar soft tissue at the first metatarsal head was positively correlated with the somatosensory ratio (r=0.46; P<0.05) and visual ratio (r=0.39; P<0.05). INTERPRETATION Diabetic patients with or without neuropathy had a thicker Achilles tendon and stiffer plantar soft tissue than the healthy control. Changes in the biomechanical properties of the ankle-foot complex were correlated with the use of vestibular, somatosensory or visual inputs to maintain balance in individuals with diabetes.
Collapse
Affiliation(s)
- Gladys L Y Cheing
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR.
| | | | | | | | | |
Collapse
|