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Kim KM, Kim JS, Needle AR. Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:559-568. [PMID: 38428732 PMCID: PMC11184308 DOI: 10.1016/j.jshs.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/20/2023] [Accepted: 11/27/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND Acute lateral ankle sprains (ALAS) are associated with long-term impairments and instability tied to altered neural excitability. Arthrogenic muscle inhibition (AMI) has been observed in this population; however, relationships with injury-related impairments are unclear, potentially due to the resting, prone position in which AMI is typically measured. Assessing AMI during bipedal stance may provide a better understanding of this relationship. METHODS AMI was assessed in 38 young adults (19 ALAS within 72 h of injury: 10 males, 21.4 ± 2.7 years; 19 healthy controls: 10 males, 21.9 ± 2.2 years; mean ± SD) using the Hoffmann reflex (H-reflex) during bipedal stance. Electrical stimulation was administered to identify the maximal H-reflex (Hmax) and maximal motor response (Mmax) from the soleus, fibularis longus, and tibialis anterior muscles. The primary outcome measure was the Hmax/Mmax ratio. Secondary outcomes included acute symptoms (pain and swelling), postural control during bipedal stance, and self-reported function. RESULTS No significant group-by-limb interactions were observed for any muscle. However, a significant group main effect was observed in the soleus muscle (F(1,35) = 6.82, p = 0.013), indicating significantly lower Hmax/Mmax ratios following ALAS (0.38 ± 0.20) compared to healthy controls (0.53 ± 0.16). Furthermore, lower Hmax/Mmax ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control. CONCLUSION This study supports previous evidence of AMI in patients with ALAS, providing insight into neurophysiologic impacts of musculoskeletal injury. Our results suggest that assessing AMI in a standing position following acute injury may provide valuable insight into how AMI develops and guide potential therapeutic options to curb and offset the formation of joint instability.
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Affiliation(s)
- Kyung-Min Kim
- Department of Sport Science, Sungkyunkwan University, Suwon-si 16419, Republic of Korea
| | - Joo-Sung Kim
- Department of Health and Human Performance, Texas State University, San Marcos, TX 78666, USA
| | - Alan R Needle
- Department of Public Health & Exercise Science, Appalachian State University, Boone, NC 28608, USA; Department of Rehabilitation Science, Appalachian State University, Boone, NC 28608, USA.
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Roberts DW. Treating mechanical joint dysfunction in children: a retrospective exploratory report of selected cases. J Man Manip Ther 2024; 32:325-334. [PMID: 35815625 PMCID: PMC11216240 DOI: 10.1080/10669817.2022.2099182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
AIMS The purpose of reporting on selected cases is to increase the recognition and treatment of mechanical joint dysfunction (restrictions in movement at the joint level) in pediatric patients. METHODS The selected cases demonstrate a variety of clinical outcomes that are possible using manual therapy to improve mechanical joint dysfunction and chronic pain. The techniques used for these patents were performed by a physical therapist without formal manual therapy training to encourage more physical therapists to use manual therapy as an intervention to improve outcomes in pediatric patients. RESULTS The hands-on treatment used to treat mechanical joint dysfunction improved participation and function in children of various ages with a variety of clinical issues. CONCLUSIONS : Recognizing and treating mechanical joint restrictions that interfere with active movement in children may result in decreased pain and improved motor skills, balance, self-regulation, sleep hygiene, and social interactions. Clinicians should consider manual therapy as an intervention strategy for pediatric patients with mechanical joint restrictions.
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Dong S, Liu Y, Liu Z, Shen P, Sun H, Zhang P, Fong DTP, Song Q. Can Arthrogenic Muscle Inhibition Exist in Peroneal Muscles Among People with Chronic Ankle Instability? A Cross-sectional Study. SPORTS MEDICINE - OPEN 2024; 10:35. [PMID: 38598018 PMCID: PMC11006644 DOI: 10.1186/s40798-024-00710-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Ankle sprains lead to an unexplained reduction of ankle eversion strength, and arthrogenic muscle inhibition (AMI) in peroneal muscles is considered one of the underlying causes. This study aimed to observe the presence of AMI in peroneal muscles among people with chronic ankle instability (CAI). METHODS Sixty-three people with CAI and another sixty-three without CAI conducted maximal voluntary isometric contraction (MVIC) and superimposed burst (SIB) tests during ankle eversion, then fifteen people with CAI and fifteen without CAI were randomly invited to repeat the same tests to calculate the test-retest reliability. Electrical stimulation was applied to the peroneal muscles while the participants were performing MVIC, and the central activation ratio (CAR) was obtained by dividing MVIC torque by the sum of MVIC and SIB torques, representing the degree of AMI. RESULTS The intra-class correlation coefficients were 0.77 (0.45-0.92) and 0.92 (0.79-0.97) for the affected and unaffected limbs among people with CAI, and 0.97 (0.91-0.99) and 0.93 (0.82-0.97) for the controlled affected and unaffected limbs among people without CAI; Significant group × limb interaction was detected in the peroneal CAR (p = 0.008). The CARs were lower among people with CAI in the affected and unaffected limbs, compared with those without CAI (affected limb = 82.54 ± 9.46%, controlled affected limb = 94.64 ± 6.37%, p < 0.001; unaffected limb = 89.21 ± 8.04%, controlled unaffected limb = 94.93 ± 6.01%, p = 0.016). The CARs in the affected limbs were lower than those in the unaffected limbs among people with CAI (p = 0.023). No differences between limbs were found for CAR in the people without CAI (p = 0.10). CONCLUSIONS Bilateral AMI of peroneal muscles is observed among people with CAI. Their affected limbs have higher levels of AMI than the unaffected limbs.
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Affiliation(s)
- Shiyu Dong
- College of Sports and Health, Shandong Sport University, Jinan, 250102, Shandong, China
| | - Yanhao Liu
- College of Sports and Health, Shandong Sport University, Jinan, 250102, Shandong, China
| | - Ziyin Liu
- College of Sports and Health, Shandong Sport University, Jinan, 250102, Shandong, China
| | - Peixin Shen
- College of Sports and Health, Shandong Sport University, Jinan, 250102, Shandong, China
| | - Hao Sun
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Ping Zhang
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, 250102, Shandong, China.
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Labanca L, Tedeschi R, Mosca M, Benedetti MG. Individuals With Chronic Ankle Instability Show Abnormalities in Maximal and Submaximal Isometric Strength of the Knee Extensor and Flexor Muscles. Am J Sports Med 2024; 52:1328-1335. [PMID: 38459686 PMCID: PMC10986150 DOI: 10.1177/03635465241232090] [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: 07/18/2023] [Accepted: 12/15/2023] [Indexed: 03/10/2024]
Abstract
BACKGROUND It has been shown that chronic ankle instability (CAI) leads to abnormalities in neuromuscular control of more proximal joints than the ankle. Although strength of the hip and the ankle muscles has been largely investigated providing concordant results, limited evidence with contrasting results has been reported regarding knee extensor and flexor muscles. PURPOSE To investigate maximal and submaximal isometric muscle strength in individuals with CAI. STUDY DESIGN Controlled laboratory study. METHODS Fifteen participants with unilateral CAI and 15 healthy matched controls were recruited. To quantify maximal strength, peak forces were recorded during a maximal isometric voluntary contraction of knee extensor and flexor muscles at 30° and 90° of knee flexion and normalized by the body weight of each participant. At both angles, submaximal isometric contractions at 20%, 50%, and 80% of the maximal voluntary isometric contraction were performed to analyze strength steadiness, in terms of coefficient of variation, and strength accuracy, in terms of absolute error. During all the assessments, knee extensor and flexor muscle activation was recorded by means of surface electromyography. RESULTS Knee flexor maximal isometric strength was significantly lower in the injured limb of individuals with CAI in comparison with healthy controls at both 30° (0.15 ± 0.05 vs 0.20 ± 0.05; P < .05) and 90° (0.14 ± 0.04 vs 0.18 ± 0.05; P < .05). Knee extensor and flexor steadiness was significantly lower (higher coefficient of variation) in both the injured and the noninjured limbs of individuals with CAI in comparison with healthy individuals at 90° and at 30° for knee flexor steadiness of the injured limb. Knee extensor and flexor accuracy was lower (higher absolute error) in both the injured and noninjured limbs of individuals with CAI in comparison with healthy individuals, mainly at 30°, while at 90° it was lower only in the injured limb. No differences between the 2 groups were found for maximal isometric strength of knee extensor muscles, as well as for muscle activations. CONCLUSION Individuals with CAI show abnormalities in maximal and submaximal isometric strength of knee flexor muscles, and submaximal strength of the knee extensor muscles. Further studies should deeply investigate mechanisms leading to these abnormalities. CLINICAL RELEVANCE Rehabilitation interventions should consider abnormalities of neuromuscular control affecting joints more proximal than the ankle in individuals with CAI. REGISTRATION NCT05273177 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Luciana Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Roberto Tedeschi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Massimiliano Mosca
- II Clinic of Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Kim H, Kipp K. Chronic ankle instability affects the association between knee joint angle and loading: musculoskeletal simulation study. Comput Methods Biomech Biomed Engin 2024:1-10. [PMID: 38469862 DOI: 10.1080/10255842.2024.2327632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/01/2024] [Indexed: 03/13/2024]
Abstract
The purpose of this study was to calculate and compare (1) knee loads, (2) muscle-specific contributions to knee loads, and (3) effects of knee flexion angle on knee loads and muscle-specific load contributions during a forward jump-landing task in people with and without chronic ankle instability (CAI). Eight CAI patients and seven healthy controls performed a forward jump-landing task. We collected 3D kinematics, ground reaction force, and muscle activation and used musculoskeletal modeling. The results showed that only healthy controls exhibited an association between knee flexion angle and knee compressive impulse (r = 0.854, p = .014). The lack of association in CAI group may lead to knee instability and increase knee injury risk in people with CAI.
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Affiliation(s)
- Hoon Kim
- Department of Sports Medicine, Soonchunhyang University, Asan, South Korea
- Department of Software Convergence, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Kristof Kipp
- Department of Physical Therapy - Program in Exercise Science, Marquette University, Milwaukee, USA
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Gottlieb U, Hayek R, Hoffman JR, Springer S. Exercise combined with electrical stimulation for the treatment of chronic ankle instability - A randomized controlled trial. J Electromyogr Kinesiol 2024; 74:102856. [PMID: 38198892 DOI: 10.1016/j.jelekin.2023.102856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 12/03/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To compare the short, medium, and long-term effects of balance exercises combined with either peroneal neuromuscular electrical stimulation (NMES) or peroneal transcutaneous electrical nerve stimulation (TENS) on dynamic postural control and patient reported outcome measures (PROMs) in patients with chronic ankle instability (CAI). METHODS Thirty-four participants with CAI were randomly assigned to a 12-session home based exercise program combined with NMES (Ex-NMES) or TENS (Ex- TENS). Baseline postural control was tested with the modified Star Excursion Balance Test (mSEBT) and time to stabilization (TTS) after a single-leg drop-jump. The self-reported function was measured using the Cumberland Ankle Instability Tool (CAIT), the Identification of Functional Ankle Instability (IdFAI), and the Sports subscale of the Foot and Ankle Ability Measure (FAAMSport). RESULTS Both groups showed significant improvements in all self-reported outcome measures at the 12-month follow-up. Subjects in the Ex-NMES group had significantly better IdFAI (-4.2 [95% CI -8.1, -0.2]) and FAAMSport (13.7 [95% CI 2.2, 25.2]) scores at 6- and 12-month follow-up, respectively, compared to the Ex-TENS group. Medium to large between-group effect sizes were observed in self-reported functional outcomes and the mSEBT. CONCLUSION The consistent trend of improvement in self-reported functional outcomes when training is combined with NMES compared with training with TENS may indicate a potential benefit that should be further investigated as a treatment for patients with CAI.
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Affiliation(s)
- Uri Gottlieb
- Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Israel.
| | - Roee Hayek
- Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Israel
| | - Jay R Hoffman
- Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Israel
| | - Shmuel Springer
- Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Israel.
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Shadegani R, Khanmohammadi R, Olyaei G. Comparison of effects of Mulligan taping and Kinesio taping on ankle neuromuscular control in response to a sudden inversion perturbation in individuals with chronic ankle instability. Phys Ther Sport 2023; 63:58-66. [PMID: 37506655 DOI: 10.1016/j.ptsp.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES This study was aimed to compare the effects of Mulligan taping (MT) with Kinesio taping (KT) and the un-taped ankle on neuromuscular control during a sudden inversion perturbation in individuals with chronic ankle instability (CAI). DESIGN Randomized, single blind cross-over. SETTING Biomechanics lab. PARTICIPANTS 16 individuals with chronic ankle instability. MAIN OUTCOME MEASURES The outcome measures were the onset time and magnitude of short (SLR) and medium latency response (MLR) for peroneus brevis (PB), peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) muscles and the TA/P and SOL/TA antagonist co-activation. RESULTS In the groups of KT and MT, the onset time was significantly decreased at post-taping compared to pre-taping, such that for the onset time of PB MLR, the groups of KT and MT had an earlier onset time than the un-taped group. For the magnitude of TA SLR and PB MLR, groups exhibited different behaviors. In the KT group, the magnitude was significantly increased post-taping, however, in the MT group, it was decreased. Regarding the TA/P and SOL/TA co-activation, the groups of KT and MT showed significant changes post-taping. CONCLUSION This study suggests that KT and MT significantly affect neuromuscular control in response to a sudden perturbation in individuals with CAI, although the behavior of KT and MT appears to be somewhat different from each other.
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Affiliation(s)
- Roghaye Shadegani
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran.
| | - Gholamreza Olyaei
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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Mineta S, Fukano M, Hirose N. Less impact absorption at the ankle joint is related to the single-leg landing stability deficit in patients with chronic ankle instability. J Biomech 2023; 149:111509. [PMID: 36841207 DOI: 10.1016/j.jbiomech.2023.111509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/21/2023]
Abstract
Single-leg landing (SLL) stability deficits are common dysfunctions after lateral ankle sprain (LAS), and are associated with reinjury and needs to be addressed. SLL stability deficits could be associated with impact absorption ability. Thus, we evaluated these relationships. We recruited 46 patients with chronic ankle instability (CAI) and 64 control patients and measured their kinematics, SLL stability, and impact absorption ability. The SLL stability was evaluated by calculating the anterior-posterior stability index (APSI) and medial-lateral stability index (MLSI). The impact absorption ability was evaluated by calculating the energy absorption (EA). The large negative value of the EA indicated the absorption of a large amount of energy. The Japanese version of identification of functional ankle instability (IdFAI-J) score (P < 0.001), MLSI value (P = 0.004), and sagittal plane ankle EA value (less EA at ankle joint) (P < 0.001) were significantly high in CAI, and sagittal plane knee EA value (more EA at knee joint) (P < 0.041) was significantly low in CAI than in the control group. Multiple regression analysis showed that the APSI was associated with sagittal plane ankle EA (β = 0.275, P = 0.004). The MLSI was associated with sagittal plane ankle EA (β = 0.204, P = 0.034) and the idFAI score (β = 0.234, P = 0.015). The SLL stability impairment after LAS was related to decreased impact absorption ability at the ankle joint.
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Affiliation(s)
- Shinshiro Mineta
- Graduate School of Sport Sciences, Waseda University, Tokyo, Japan.
| | - Mako Fukano
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan; College of Engineering, Shibaura Institute of Technology, Saitama, Japan.
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Kim H, Palmieri-Smith R, Kipp K. Muscle Synergies in People With Chronic Ankle Instability During Anticipated and Unanticipated Landing-Cutting Tasks. J Athl Train 2023; 58:143-152. [PMID: 34793595 PMCID: PMC10072091 DOI: 10.4085/1062-6050-74-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Although neuromuscular deficits in people with chronic ankle instability (CAI) have been identified, previous researchers have mostly investigated the activation of multiple muscles in isolation. Investigating muscle synergies in people with CAI would provide information about the coordination and control of neuromuscular activation strategies and could supply important information for understanding and rehabilitating neuromuscular deficits in this population. OBJECTIVE To assess and compare muscle synergies using nonnegative matrix factorization in people with CAI and healthy control individuals as they performed different landing-cutting tasks. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 11 people with CAI (5 men, 6 women; age = 22 ± 3 years, height = 1.68 ± 0.11 m, mass = 69.0 ± 19.1 kg) and 11 people without CAI serving as a healthy control group (5 men, 6 women; age = 23 ± 4 years, height = 1.74 ± 0.11 m, mass = 66.8 ± 15.5 kg) participated. MAIN OUTCOME MEASURE(S) Muscle synergies were extracted from electromyography of the lateral gastrocnemius, medial gastrocnemius, fibularis longus, soleus, and tibialis anterior (TA) muscles during anticipated and unanticipated landing-cutting tasks. The number of synergies, activation coefficients, and muscle-specific weighting coefficients were compared between groups and across tasks. RESULTS The number of muscle synergies was the same for each group and task. The CAI group exhibited greater TA weighting coefficients in synergy 1 than the control group (P = .02). In addition, both groups demonstrated greater fibularis longus (P = .03) weighting coefficients in synergy 2 during the unanticipated landing-cutting task than the anticipated landing-cutting task. CONCLUSIONS These results suggest that, although both groups used neuromuscular control strategies of similar complexity or dimensionality to perform the landing-cutting tasks, the CAI group displayed different muscle-specific weightings characterized by greater emphasis on TA function in synergy 1, which may reflect an effort to increase joint stability to compensate for ankle instability.
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Affiliation(s)
- Hoon Kim
- Department of Sports Medicine, Soonchunhyang University, Asan, South Korea
| | - Riann Palmieri-Smith
- School of Kinesiology and Orthopaedic and Rehabilitation Biomechanics Laboratory, University of Michigan, Ann Arbor
| | - Kristof Kipp
- Department of Physical Therapy—Program in Exercise & Rehabilitation Science, Marquette University, Milwaukee, WI
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Foster KS, Greenlee TA, Fraser JJ, Young JL, Rhon DI. The Influence of Therapeutic Exercise after Ankle Sprain on the Incidence of Subsequent Knee, Hip, and Lumbar Spine Injury. Med Sci Sports Exerc 2023; 55:177-185. [PMID: 36084225 DOI: 10.1249/mss.0000000000003035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE This study aimed to investigate the burden of knee, hip, and lumbar spine disorders occurring in the year after an ankle sprain and the influence therapeutic exercise (TE) has on this burden. METHODS A total of 33,361 individuals diagnosed with ankle sprain in the Military Health System between 2010 and 2011 were followed for 1 yr. The prevalence of knee, hip, and lumbar care-seeking injuries sustained after sprain was identified. Relationships between demographic groups, ankle sprain type, and use of TE with rate of proximal injuries were evaluated using Cox proportional hazard models to determine hazard rate effect modification by attribute. The observed effect of TE for ankle sprain on rate of injury to proximal joints was evaluated using Kaplan-Meier survival analyses. RESULTS Of the total cohort, 20.5% ( n = 6848) of patients sustained a proximal injury. Specifically, 10.1% of the cohort sustained a knee ( n = 3356), 2.9% a hip ( n = 973), and 10.3% a lumbar injury ( n = 3452). Less than half of the cohort received TE after initial sprain. Patients that did were less likely to have subsequent knee (HR = 0.87, 95% confidence interval [CI] = 0.80-0.94), hip (HR = 0.68, 95% CI = 0.58-0.79), or lumbar (HR = 0.82, 95% CI = 0.76-0.89) injuries. CONCLUSIONS One in five individuals that sought care for an ankle sprain experienced a proximal joint injury in the following year. TE for the management of the initial ankle sprain reduced the likelihood of proximal injury diagnosis and should be considered in treatment plans for return to work and sport protocols after ankle sprains.
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Affiliation(s)
- Kaitlyn S Foster
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX
| | - Tina A Greenlee
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX
| | - John J Fraser
- Directorate for Operational Readiness and Health, Naval Health Research Center, San Diego, CA
| | - Jodi L Young
- Doctor of Science Program in Physical Therapy, Bellin College, Green Bay, WI
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Spinal Reflex Excitability of Lower Leg Muscles Following Acute Lateral Ankle Sprain: Bilateral Inhibition of Soleus Spinal Reflex Excitability. Healthcare (Basel) 2022; 10:healthcare10071171. [PMID: 35885698 PMCID: PMC9315602 DOI: 10.3390/healthcare10071171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 12/22/2022] Open
Abstract
Neural changes in the ankle stabilizing muscles following ankle sprains are thought to be one contributing factor to persistent ankle dysfunction. However, empirical evidence is limited. Therefore, we aimed to examine spinal reflex excitability of lower leg muscles following acute ankle sprains (AAS). We performed a case-control study with 2 groups consisting of 30 young adults with AAS and 30 aged-matched uninjured controls. Hoffmann reflex (H-reflex) testing was performed to estimate spinal reflex excitability of lower leg muscles: soleus, fibularis longus (FL), tibialis anterior (TA). Maximal H-reflex (Hmax) and motor responses (Mmax) were determined by delivering a series of electrical stimuli at the sciatic nerve. Hmax/Mmax ratios were calculated to represent normalized spinal reflex excitability. Separate group-by-limb analyses of variance (ANOVA) with repeated measures found there were no significant interactions for any of the muscles (SL: F1,56 = 0.95, p = 0.33, FL: F1,51 = 0.65, p = 0.42, TA: F1,51 = 1.87, p = 0.18), but there was a significant main effect of group in the soleus (F1,56 = 6.56, p = 0.013), indicating the Hmax/Mmax ratio of soleus in the AAS group was significantly lower bilaterally (AAS = 0.56 ± 0.19, control = 0.68 ± 0.17, p = 0.013), with no significant group differences in the other muscles (FL: F1,51 = 0.26, p = 0.61, TA: F1,51 = 0.93, p = 0.34). The bilateral inhibition of the soleus spinal reflex excitability following AAS may be significant in that it may explain bilateral sensorimotor deficits (postural control deficits) following unilateral injury, and provide insights into additional therapies aimed at the neural change.
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Understanding Athletic Trainers' Knowledge, Intervention, and Barriers Toward Arthrogenic Muscle Inhibition. J Sport Rehabil 2021; 31:667-675. [PMID: 34853183 DOI: 10.1123/jsr.2021-0162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/12/2021] [Accepted: 09/13/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Arthrogenic muscle inhibition (AMI) is a common neurophysiological response to joint injury. While athletic trainers (ATs) are constantly treating patients with AMI, it is unclear how clinicians are using the available evidence to treat the condition. OBJECTIVE To investigate ATs' general knowledge, clinical practice, and barriers for treating AMI. METHODS A cross-sectional web-based survey was utilized. The survey was distributed to a random sample of 3000 ATs from the National Athletic Trainers' Association and through social media. 143 board certified ATs (age: 34.6 [10.3] y; experience: 11.7 [9.8] y) from various clinical settings and educational backgrounds were included in the analysis. RESULTS One hundred one respondents were able to correctly identify the definition of AMI. The majority of these respondents correctly reported that joint effusion (n = 95, 94.1%) and abnormal activity from joint receptors (n = 91, 90.1%) resulted in AMI. Of the 101 respondents, only 58 (57.4%) reported using disinhibitory interventions to treat AMI. The most frequently used evidence supported interventions were transcutaneous electrical nerve stimulation (n = 38, 65.5%), neuromuscular electrical stimulation (n = 33, 56.9%), and focal joint cooling (n = 25, 43.1%). The interventions used correctly most often based on current evidence were neuromuscular electrical stimulation (n = 29/33, 87.9%) and transcutaneous electrical nerve stimulation (n = 26/38, 68.4%). Overall, difficulty quantifying AMI (n = 62, 61.24%) and lack of education (n = 71, 76.2%) were most frequently perceived as barriers. Respondents that did not use disinhibitory interventions perceived lack of experience treating AMI, understanding the terminology, and access to therapeutic modalities more often than the respondents that reported using disinhibitory interventions. CONCLUSION Further education about concepts and treatment about AMI is warranted for ATs. Continued understanding of ATs' clinical practice in regard to AMI may help identify gaps in athletic training clinical education.
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Eraktas İ, Ayhan C, Hayran M, Soylu AR. Alterations in forearm muscle activation patterns after scapholunate interosseous ligament injury: A dynamic electromyography study. J Hand Ther 2021; 34:384-395. [PMID: 32620427 DOI: 10.1016/j.jht.2020.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/26/2020] [Accepted: 03/16/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Case control. PURPOSE OF THE STUDY This study aimed to investigate the alterations seen in the activation patterns of the forearm muscles and to demonstrate the associated functional outcomes, in patients with scapholunate interosseous ligament (SLIL) injury. METHODS The study involved 15 patients with SLIL injury (instability group) and 11 healthy participants (control group). Both groups were evaluated with regard to their pain, grip strength, and upper extremity functional level (disabilities of the arm, shoulder and hand and patient-rated wrist evaluation questionnaires), and they also underwent a dynamic electromyography analysis of their forearm muscle activity. The activation patterns of the extensor carpi ulnaris (ECU), extensor carpi radialis (ECR), flexor carpi ulnaris, and flexor carpi radialis muscles during wrist extension and flexion were recorded by means of surface electromyography. RESULTS In the instability group, the pain severity was higher and the functional level was worse than in the control group (P < .05). Furthermore, during wrist extension, the ECR activity was lower and the ECU activity was higher in the instability group than in the control group (P < .05). CONCLUSION Dynamic stabilization of the wrist, flexor carpi ulnaris, and flexor carpi radialis muscles have been shown to play an active role with ECU and ECR. Increased ECU and decreased ECR activation may pose a potential risk in terms of enhancing the scapholunate gap. We, therefore, propose that appropriate preventive neuromuscular exercise strategies implemented as part of a physiotherapy program for patients with SLIL lesions might increase the contribution of the dynamic stability effect of the relevant muscles.
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Affiliation(s)
- İrem Eraktas
- Bolu Physical Therapy and Rehabilitation Hospital, Bolu, Turkey
| | - Cigdem Ayhan
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Mutlu Hayran
- School of Medicine, Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
| | - Abdullah Ruhi Soylu
- School of Medicine, Department of Biophysics, Hacettepe University, Ankara, Turkey
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Gluteal Activity During Gait in Patients With Chronic Ankle Instability Following Rehabilitation: A Randomized Controlled Trial. J Sport Rehabil 2021; 31:158-164. [PMID: 34615741 DOI: 10.1123/jsr.2021-0148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Ankle positioning gait biofeedback (GBF) has improved ankle inversion for patients with chronic ankle instability. However, the effects on proximal deficits remain unknown. The purpose of this study was to determine the effects of impairment-based rehabilitation with GBF and without biofeedback on gluteal activity during walking in patients with chronic ankle instability. DESIGN Randomized controlled trial. METHODS Eighteen patients with chronic ankle instability (14 women and 4 men; age 22 [4] y; height 171 [10] cm; mass 71.6 [13.8] kg) were recruited from a university setting, following International Ankle Consortium guidelines. Patients were randomly allocated to GBF or without biofeedback groups (N = 9 per group). Both groups performed 4 weeks of exercises and treadmill walking. The GBF group alone received feedback on frontal ankle positioning at initial contact during walking. Ultrasound videos of the gluteus maximus and medius were recorded during walking at baseline and follow-up by a blinded clinician. Gluteal activity ratios were obtained at each 10% of the gait cycle. Statistical parametric mapping repeated-measures analysis of variance were used to compare groups and time points. RESULTS Both groups demonstrated significantly increased gluteus medius activity across the gait cycle compared with baseline (P < .01, mean differences: 0.13-0.21, Hedge g: 0.97-1.89); however, there were no significant between-group differences. There were no statistically significant changes noted for the gluteus maximus. No adverse events were observed. CONCLUSIONS Impairment-based rehabilitation led to increased gluteus medius activity, but GBF did not provide any additional improvement to this parameter. Clinicians may consider implementing impairment-based strengthening interventions to improve gluteus medius function during gait for patients with CAI.
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Plangtaisong P, Shen W, Wheeler PC, Fong DT. Effect of exercise interventions and prophylactic devices on reducing peroneal muscle reaction time by sudden ankle perturbation: A systematic review and meta-analysis. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Kim H, Palmieri-Smith R, Kipp K. Muscle force contributions to ankle joint contact forces during an unanticipated cutting task in people with chronic ankle instability. J Biomech 2021; 124:110566. [PMID: 34171680 DOI: 10.1016/j.jbiomech.2021.110566] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/26/2021] [Accepted: 06/07/2021] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to compare muscle force contributions to ankle joint compression and anteroposterior shear forces between people with chronic ankle instability (CAI) and healthy controls (CON) during an unanticipated cutting task. Eleven people with CAI and 11 CON performed an unanticipated cutting task as three-dimensional motion capture, ground reaction force (GRF), and muscle activation data were collected. A musculoskeletal modeling was used to calculate talocrural joint compression and anteroposterior shear forces and parse out the contributions to these forces from ankle-spanning muscles and from GRF. Independent t-tests were used for statistical analysis. People with CAI exhibited greater anterior shear force peaks during early (p = 0.048, d = 0.98) and late (p = 0.017,d = 1.21) stance compared to CON. The difference in early stance shear force appeared to arise from greater GRF contribution (p = 0.026, d = 1.12) in CAI group, whereas the difference in late stance shear force appeared to arise from greater contribution of lateral gastrocnemius (p = 0.026, d = 1.12), medial gastrocnemius (p = 0.048, d = 0.98), tibialis posterior (p = 0.017, d = 1.22), fibularis brevis (p = 0.035, d = 1.05), and fibularis longus (p = 0.023, d = 1.15). People with CAI exhibit greater anterior shear, but not compressive forces in talocrural joint during an unanticipated cutting task. The differences in anterior shear force were the result of passive and active contributions from GRF during early stance and lower leg muscles during late stance, respectively.
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Affiliation(s)
- Hoon Kim
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
| | - Riann Palmieri-Smith
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Orthopaedic and Rehabilitation Biomechanics Laboratory, University of Michigan, Ann Arbor, MI, USA
| | - Kristof Kipp
- Department of Physical Therapy - Program in Exercise Science, Marquette University, Milwaukee, WI, USA
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Kim H, Palmieri-Smith R, Kipp K. Peak Forces and Force Generating Capacities of Lower Extremity Muscles During Dynamic Tasks in People With and Without Chronic Ankle Instability. Sports Biomech 2021; 21:487-500. [PMID: 33541234 DOI: 10.1080/14763141.2020.1869295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
People with chronic ankle instability (CAI) exhibit neuromuscular deficits. However, no study has investigated deficits in forces or force-generating capacities of individual muscles in people with CAI during dynamic tasks. Therefore, the purpose of this study was to estimate and compare peak forces and force-generating capacities of individual muscles during dynamic tasks in people with CAI and healthy controls (CON). Eleven people with CAI and eleven CON performed landing, anticipated cutting, and unanticipated cutting as motion capture, force plate, and electromyography data were recorded. A musculoskeletal model was used to estimate the force and force-generating capacity of lower extremity muscles. People with CAI exhibited greater gluteus maximus force and force-generating capacity than CON during all tasks. In addition, people with CAI exhibited greater force-generating capacity of the vastii muscles than CON during the unanticipated cutting task. These findings suggest that, during dynamic tasks, people with CAI exhibit a neuromuscular control strategy that is characterised by differences in peak forces and force-generating capacities of proximal muscles, which may allow them to compensate for previously described deficits in distal muscles.
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Affiliation(s)
- Hoon Kim
- Department of Physical Therapy, Program in Exercise Science, Marquette University, Milwaukee, WI, USA
| | - Riann Palmieri-Smith
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.,Orthopaedic and Rehabilitation Biomechanics Laboratory, University of Michigan, Ann Arbor, MI, USA
| | - Kristof Kipp
- Department of Physical Therapy, Program in Exercise Science, Marquette University, Milwaukee, WI, USA
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Kosik KB, Terada M, McCann RS, Drinkard CP, Gribble PA. Association between corticospinal inhibition and active dorsiflexion range of motion in patients with chronic ankle instability. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kyle B. Kosik
- Department of Athletic Training & Clinical Nutrition University of Kentucky Lexington KY USA
| | - Masafumi Terada
- Department of Sport and Health Science Ritsumeikan University Kyoto Japan
| | - Ryan S. McCann
- School of Physical Therapy & Athletic Training Old Dominion University Norfolk VA USA
| | | | - Phillip A. Gribble
- Department of Athletic Training & Clinical Nutrition University of Kentucky Lexington KY USA
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Wattananon P, Sungnak P, Songjaroen S, Kantha P, Hsu WL, Wang HK. Using neuromuscular electrical stimulation in conjunction with ultrasound imaging technique to investigate lumbar multifidus muscle activation deficit. Musculoskelet Sci Pract 2020; 50:102215. [PMID: 33220931 DOI: 10.1016/j.msksp.2020.102215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/29/2020] [Accepted: 06/25/2020] [Indexed: 02/08/2023]
Abstract
Lumbar multifidus muscle (LM) activation deficit has been proposed as a potential underlying mechanism responsible for recurrence episode of low back pain (LBP). The quantification of voluntary LM activation can provide a better understanding of the role of muscle activation deficit in LBP. The objective of this technical report is to propose a new approach using neuromuscular electrical stimulation (NMES) in combination with the ultrasound imaging technique (USI) to investigate the ability of individual to voluntarily activate the LM. We recruited ten participants with a recurrent LBP (rLBP) and twelve participants with no history of LBP (NoLBP). Theoretically, the superimposition of NMES on the LM during maximum voluntary isometric contraction (MVIC) should activate all motor units available in the LM. The percentage of LM activation (%LM) can be calculated by the changes of LM thickness during MVIC, divided by the changes of LM thickness during the combination of MVIC and NMES. This %LM was used to compare between groups. The individuals with rLBP had significantly lower %LM (p < 0.05) compared with the NoLBP counterpart (%LM = 72.4 and 92.9, respectively). Results demonstrate that this new approach can potentially differentiate %LM among individuals with rLBP and NoLBP. This new approach can be potentially used to 1) determine the extent of LM activation deficit, 2) identify the existence of muscle activation deficit in the LM, and 3) objectively measure the effect of the intervention designed to address the LM activation deficit.
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Affiliation(s)
- Peemongkon Wattananon
- Motor Control and Neural Plasticity Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
| | - Panakorn Sungnak
- Motor Control and Neural Plasticity Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
| | - Sranya Songjaroen
- Motor Control and Neural Plasticity Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
| | - Phunsuk Kantha
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, No.17, Xuzhou Rd., Zhongzheng District, Taipei City, 100, Taiwan.
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, No.17, Xuzhou Rd., Zhongzheng District, Taipei City, 100, Taiwan.
| | - Hsing-Kuo Wang
- Sports Physiotherapy Lab, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, No.17, Xuzhou Rd., Zhongzheng District, Taipei City, 100, Taiwan.
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20
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Jagodinsky AE, Angles R, Wilburn C, Weimar WH. Lower-Extremity Motor Synergies in Individuals With and Without Chronic Ankle Instability. J Appl Biomech 2020; 36:416-422. [PMID: 32932229 DOI: 10.1123/jab.2019-0398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/21/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022]
Abstract
Current theoretical models suggest that ankle sprain copers exhibit movement adaptations contributing to the avoidance of chronic ankle instability. However, few studies have examined adaptations at the level of biomechanical motor synergies. The purpose was to examine characteristics of the support moment synergy between individuals with chronic ankle instability, copers, and healthy individuals. A total of 48 individuals participated in the study. Lower-extremity kinetics and variability in the moment of force patterns were assessed during the stance phase of walking trials. The copers exhibited reductions in the support moment during the load response and preswing phase compared with the chronic ankle instability group, as well as during the terminal stance and preswing phase compared the healthy group. The copers also exhibited reductions in the hip extensor moment and ankle plantarflexion moment compared with healthy and chronic ankle instability groups during intervals of stance phase. Variability of the support moment and knee moment was greater in the copers compared with the chronic ankle instability group. Dampening of the support moment and select joint moments exhibited by the copers may indicate an adaptive mechanism to mitigate loading perturbations on the previously injured ankle. Heightened motor variability in copers may be indicative of a more adaptable motor synergy compared with individuals with chronic ankle instability.
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Kim H, Palmieri-Smith R, Kipp K. Time-frequency analysis of muscle activation patterns in people with chronic ankle instability during Landing and cutting tasks. Gait Posture 2020; 82:203-208. [PMID: 32949904 DOI: 10.1016/j.gaitpost.2020.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/03/2020] [Accepted: 09/03/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND People with chronic ankle instability (CAI) exhibit neuromuscular deficits. Previous studies, however, only investigated magnitudes of muscle activation and not the time-frequency domain. RESEARCH QUESTION Do people with CAI exhibit differences in muscle activation patterns in the time-frequency domain during landing, anticipated cutting, and unanticipated cutting compared to matched controls? METHODS Eleven people with CAI and eleven healthy matched controls (CON) performed landing, anticipated cutting, and unanticipated cutting as surface EMG of the lateral gastrocnemius, medial gastrocnemius, fibularis longus, soleus, and tibialis anterior were recorded. The time-frequency domain of surface EMG data was analyzed with wavelet transformations and principal component analysis (PCA), PC scores were compared across group, task, and muscle with three-way ANOVAs. RESULTS The PCA extracted two PCs that captured the overall magnitude (PC1) of wavelet intensities across the time-frequency domain and a shift among the range of frequencies (PC2) where wavelet intensities were most prominent. A main effect for group indicated that people with CAI demonstrated smaller (p = 0.009) PC1 scores than people in the CON group across all muscles and tasks. An interaction between group and task indicated that people in the CAI group exhibited smaller (p = 0.041) PC2 scores than people in the CON group during only anticipated cutting. SIGNIFICANCE People with CAI exhibited neuromuscular deficits in the time-frequency domain of EMG during dynamic tasks. These deficits appear to reflect a neuromuscular strategy characterized by the recruitment of fewer motor units in ankle muscles regardless of task, and an inability to scale the recruitment of motor units in the frequency domain in response to different task demands. Rehabilitation for people with CAI should consider that this population exhibits differences in neuromuscular control that exist not only in the overall magnitudes, but also in the time-frequency domain, of muscle activation patterns.
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Affiliation(s)
- Hoon Kim
- Department of Physical Therapy - Program in Exercise & Rehabilitation Science, Marquette University, Cramer Hall 004B, 604 N. 16th St. 004B, Milwaukee, WI, 53233, USA.
| | - Riann Palmieri-Smith
- School of Kinesiology, University of Michigan, CCRB 4745G, 401 Washtenaw Ave., Ann Arbor, MI, 48109-2214, USA; Orthopaedic and Rehabilitation Biomechanics Laboratory, University of Michigan, CCRB 4745G, 401 Washtenaw Ave., Ann Arbor, MI, 48109-2214, USA.
| | - Kristof Kipp
- Department of Physical Therapy - Program in Exercise & Rehabilitation Science, Marquette University, Cramer Hall 215D, 604 N. 16th St. 215D, Milwaukee, WI, 53233, USA.
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Suttmiller AM, McCann RS. Neural excitability of lower extremity musculature in individuals with and without chronic ankle instability: A systematic review and meta-analysis. J Electromyogr Kinesiol 2020; 53:102436. [DOI: 10.1016/j.jelekin.2020.102436] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 03/23/2020] [Accepted: 05/27/2020] [Indexed: 11/24/2022] Open
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Lawrence MA, Raymond JT, Look AE, Woodard NM, Schicker CM, Swanson BT. Effects of Tibiofibular and Ankle Joint Manipulation on Hip Strength and Muscle Activation. J Manipulative Physiol Ther 2020; 43:406-417. [PMID: 32703611 DOI: 10.1016/j.jmpt.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 08/07/2019] [Accepted: 10/10/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The purpose of this study was to determine whether high-velocity, low-amplitude ankle region manipulations could increase force output and muscle activation of hip musculature in individuals with a history of ankle sprain and unilateral tensor fascia latae (TFL) weakness during muscle testing. METHODS This investigation used a single-arm repeated measures design. Twenty-five participants' force outputs were tested at three time points (before manipulation, immediately after manipulation, and 48 hours after manipulation), and muscle activation of the rectus femoris, gluteus medius, and TFL was measured before and immediately after manipulation. Manipulations were applied to the talocrural, subtalar, proximal, and distal tibiofibular joints of the weaker limb. No contralateral manipulations were applied. Two-way repeated measures analysis of variance was used to compare maximal and average force production for each limb. In addition, paired t tests were used to compare muscle activation before and after manipulations. RESULTS There was a significant limb × time interaction. The involved limb average force increased from before manipulation (65.7 N) to 48 hours after manipulation (77.8 N; P = .014), maximal force increased (76.9 N) 48 hours after manipulation (87.8 N; P = .030), and gluteus medius activation increased (9.8% maximum, 12.2% average) immediately after manipulation. No significant differences were found in the uninvolved limb. CONCLUSION The results of this study suggest that high-velocity, low-amplitude ankle region manipulations might improve hip abductor strength in individuals with a history of ankle sprain and unilateral weakness during a TFL muscle test.
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Affiliation(s)
- Michael A Lawrence
- Department of Physical Therapy, University of New England, Portland, ME, USA.
| | - Jamie T Raymond
- Raymond Chiropractic and Sports Injury Center, Portland, Maine
| | - Amy E Look
- Department of Physical Therapy, University of New England, Portland, ME, USA
| | - Nicholas M Woodard
- Department of Physical Therapy, University of New England, Portland, ME, USA
| | | | - Brian T Swanson
- Department of Rehabilitation Sciences, University of Hartford, West Hartford, Connecticut
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Balasukumaran T, Gottlieb U, Springer S. Muscle activation patterns during backward walking in people with chronic ankle instability. BMC Musculoskelet Disord 2020; 21:489. [PMID: 32711488 PMCID: PMC7382804 DOI: 10.1186/s12891-020-03512-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/15/2020] [Indexed: 11/23/2022] Open
Abstract
Background Altered walking patterns are often described in individuals with chronic ankle instability (CAI). Contemporary treatment paradigms recommend backward walking (BW) to improve locomotion in people with musculoskeletal disorders. The purpose of this study was to determine whether muscle activity and activation variability during BW differs between subjects with and without CAI. Methods Sixteen participants with CAI and 16 healthy controls walked on a treadmill at their self-selected speed under BW and forward walking (FW) conditions. Surface electromyography (EMG) data for the peroneus longus, tibialis anterior, medial gastrocnemius and gluteus medius muscles were collected. EMG amplitude normalized to maximum voluntary isometric contraction (%MVIC) and the standard deviation (SD) of the %MVIC EMG amplitude was calculated throughout the gait cycle. In addition, the area under the curve (AUC) of the %MVIC EMG amplitude was calculated before and after initial contact (pre-IC: 90–100% of stride; post-IC: 0–10% of stride). Results No differences between groups were noted in the %MVIC amplitude or activation variability (SD of %MVIC EMG) under BW or FW. In both groups, decreased tibialis anterior (p < 0.001) and gluteus medius (p = 0.01), and increased medial gastrocnemius (p < 0.001) activation were observed during pre- and post-IC under BW condition. Conclusion Participants with CAI and healthy controls have similar muscle activity patterns during BW. Yet, the results should be interpreted with caution due to the heterogeneity of the CAI population.
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Affiliation(s)
- Tharani Balasukumaran
- Faculty of Health Sciences, Department of Physical Therapy, Ariel University, Ariel, Israel
| | - Uri Gottlieb
- Faculty of Health Sciences, Department of Physical Therapy, Ariel University, Ariel, Israel
| | - Shmuel Springer
- Faculty of Health Sciences, Department of Physical Therapy, Ariel University, Ariel, Israel.
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Cheng WL, Jaafar Z. Effects of lateral ankle sprain on range of motion, strength and postural balance in competitive basketball players: a cross-sectional study. J Sports Med Phys Fitness 2020; 60:895-902. [PMID: 32487984 DOI: 10.23736/s0022-4707.20.10619-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Lateral ankle sprain is the most common injury in basketball, and many of these sprains resulted in residual functional deficits. This study aimed to compare ankle strength and range of motion, and postural balance between competitive basketball players with and without lateral ankle sprain. METHODS This was a cross-sectional study involving 42 male competitive basketball players. Subjects were divided into the injured and uninjured groups based on self-reported questionnaires. Ankle range of motion (ROM) was measured using a goniometer, ankle isokinetic strength testing performed using Biodex System 4 PRO, and single-leg stability tests performed using Biodex Balance System SD. RESULTS Between the injured and uninjured ankles, there was a decrease in plantarflexion ROM (44.89±6.85 vs. 50.75±9.31, P<0.05) and an increase in eversion ROM (14.50±5.63 vs. 11.74±4.53, P<0.05). There was a reduction in inversion and plantarflexion strength at 30°/s peak torque and 120 °/s peak torque (P<0.05). However, no significant difference observed in the postural stability indexes between the two groups. CONCLUSIONS This study proves that there are residual ROM and strength deficits after an ankle sprain, however, these deficits do not affect their balance ability.
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Affiliation(s)
- Wern L Cheng
- Department of Sports Medicine, University of Malaya Medical Center, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Zulkarnain Jaafar
- Department of Sports Medicine, University of Malaya Medical Center, Lembah Pantai, Kuala Lumpur, Malaysia -
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Kosik KB, Johnson NF, Terada M, Thomas AC, Mattacola CG, Gribble PA. Decreased ankle and hip isometric peak torque in young and middle-aged adults with chronic ankle instability. Phys Ther Sport 2020; 43:127-133. [DOI: 10.1016/j.ptsp.2020.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 12/26/2022]
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Jb F, Lesley T, I H, Dj C, Jt H. Whole-body vibration and stretching enhances dorsiflexion range of motion in individuals with chronic ankle instability. Phys Ther Sport 2020; 44:1-7. [PMID: 32325415 DOI: 10.1016/j.ptsp.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this study was to determine if WBV performed concurrently with static stretching was more effective than static stretching alone to increase dorsiflexion ROM (DFROM) in individuals with chronic ankle instability (CAI). DESIGN Controlled laboratory study. PARTICIPANTS Thirty-nine participants with CAI (history of ankle sprain, a feeling of "giving way" during activity, and a qualifying Foot and Ankle Ability Measure Ankle score) were divided into 3 groups (normative (N), static stretch (SS), and static stretch with vibration (SV)). Participants stretched the triceps surae 4 days/wk for 3 wks. Vibration was imposed at 34 Hz and 1.8 mm. MAIN OUTCOME MEASURES DFROM was assessed in a straight and bent-leg position. RESULTS No differences were detected at any time in the N or SS group, however SS did exhibit large effect sizes with 95% confidence intervals (CI) that did not cross zero from baseline to 3 weeks for both measures. The SV group demonstrated increased DFROM from baseline for both time points and a large effect size with 95% CI that did not cross zero from post tx-1 to post tx-2. CONCLUSIONS Static stretching with WBV increases DFROM in participants with CAI more effectively than static stretching alone.
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Affiliation(s)
- Feland Jb
- College of Life Sciences, Department of Exercise Sciences, SFH-106, Brigham Young University, Provo, UT, 84602, USA.
| | - Thalman Lesley
- College of Life Sciences, Department of Exercise Sciences, SFH-106, Brigham Young University, Provo, UT, 84602, USA.
| | - Hunter I
- College of Life Sciences, Department of Exercise Sciences, SFH-106, Brigham Young University, Provo, UT, 84602, USA.
| | - Cochrane Dj
- School of Sport, Exercise & Nutrition, Massey University, New Zealand.
| | - Hopkins Jt
- College of Life Sciences, Department of Exercise Sciences, SFH-106, Brigham Young University, Provo, UT, 84602, USA.
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DEJONG ALEXANDRAF, KOLDENHOVEN RACHELM, HERTEL JAY. Proximal Adaptations in Chronic Ankle Instability: Systematic Review and Meta-analysis. Med Sci Sports Exerc 2020; 52:1563-1575. [DOI: 10.1249/mss.0000000000002282] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Motoneuron Function Does not Change Following Whole-Body Vibration in Individuals With Chronic Ankle Instability. J Sport Rehabil 2019; 28:614-622. [PMID: 30222478 DOI: 10.1123/jsr.2017-0364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 07/20/2018] [Accepted: 07/22/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Following a lateral ankle sprain, ∼40% of individuals develop chronic ankle instability (CAI), characterized by recurrent injury and sensations of giving way. Deafferentation due to mechanoreceptor damage postinjury is suggested to contribute to arthrogenic muscle inhibition (AMI). Whole-body vibration (WBV) has the potential to address the neurophysiologic deficits accompanied by CAI and, therefore, possibly prevent reinjury. OBJECTIVE To determine if an acute bout of WBV can improve AMI and proprioception in individuals with CAI. DESIGN AND PARTICIPANTS The authors examined if an acute bout of WBV can improve AMI and proprioception in individuals with CAI with a repeated-measures design. A total of 10 young adults with CAI and 10 age-matched healthy controls underwent a control, sham, and WBV condition in randomized order. SETTING Biomechanics laboratory. INTERVENTION WBV. MAIN OUTCOME MEASURES Motoneuron pool recruitment was assessed via Hoffmann reflex (H-reflex) in the soleus. Proprioception was evaluated using ankle joint position sense at 15° and 20° of inversion. Both were assessed prior to, immediately following, and 30 minutes after the intervention (pretest, posttest, and 30mPost, respectively). RESULTS Soleus maximum H-reflex:M-response (H:M) ratios were 25% lower in the CAI group compared with the control group (P = .03). Joint position sense mean constant error did not differ between groups (P = .45). Error at 15° in the CAI (pretest 0.8 [1.6], posttest 2.0 [2.8], 30mPost 2.0 [1.9]) and control group (pretest 0.8 [2.0], posttest 0.6 [2.9], 30mPost 0.5 [2.1]) did not improve post-WBV. Error at 20° did not change post-WBV in the CAI (pretest 1.3 [1.7], posttest 1.0 [2.4], 30mPost 1.5 [2.2]) or control group (pretest -0.3 [3.0], posttest 0.8 [2.1], 30mPost 0.6 [1.8]). CONCLUSION AMI is present in the involved limb of individuals with CAI. The acute response following a single bout of WBV did not ameliorate the presence of AMI nor improve proprioception in those with CAI.
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Song K, Wikstrom EA. Plausible mechanisms of and techniques to assess ankle joint degeneration following lateral ankle sprains: a narrative review. PHYSICIAN SPORTSMED 2019; 47:275-283. [PMID: 30739572 DOI: 10.1080/00913847.2019.1581511] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Lateral ankle sprain (LAS) is the most common lower extremity musculoskeletal injury sustained during daily life and sport. The cascade of events that starts with ligamentous trauma leads to clinical manifestations such as recurrent sprains and giving way episodes, hallmark characteristics of chronic ankle instability (CAI). The sequelae of lateral ankle sprains and CAI appear to contribute to aberrant biomechanics. Combined, joint trauma and aberrant biomechanics appear to directly and/or indirectly play a role in talar cartilage degeneration. Up to 80% of all cases of ankle osteoarthritis (OA) are post-traumatic in nature and common etiologies for ankle post-traumatic osteoarthritis (PTOA) are histories of a single and recurrent ankle sprains. Despite known links between LAS, CAI, and PTOA and evidence demonstrating the burden of LAS and its sequelae, early pathoetiological changes of ankle PTOA and how they can be assessed are poorly understood. Therefore, the purpose of this paper is to review the plausible mechanistic links among LAS and its sequelae of CAI and PTOA as well as review non-surgical techniques that can quantify talar cartilage health. Understanding the pathway from ligamentous ankle injury to ankle PTOA is vital to developing theoretically sound therapeutic interventions aimed at slowing ankle PTOA progression. Further, directly assessing talar cartilage health non-surgically provides opportunities to quantify if current and novel intervention strategies are able to slow the progression of ankle PTOA.
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Affiliation(s)
- Kyeongtak Song
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Erik A Wikstrom
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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Changes in Spinal and Corticospinal Excitability in Patients with Chronic Ankle Instability: A Systematic Review with Meta-Analysis. J Clin Med 2019; 8:jcm8071037. [PMID: 31315231 PMCID: PMC6678466 DOI: 10.3390/jcm8071037] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 12/26/2022] Open
Abstract
The objective of this systematic review with meta-analysis was to determine alterations in spinal and corticospinal excitability of ankle muscles in patients with chronic ankle instability (CAI) compared to uninjured controls. Independent researchers performed comprehensive literature searches of electronic databases and included studies that compared groups with and without CAI and investigated neural excitability with Hoffmann reflex (H-reflex) and/or transcranial magnetic stimulation (TMS). A fixed-effect meta-analysis was conducted to determine group differences for (1) soleus and fibularis maximal H-reflex (Hmax)/maximal M-wave (Mmax)-ratios, and (2) soleus and fibularis longus cortical motor thresholds (CMTs). Seventeen studies were included in the current meta-analysis. They showed that the Hmax/Mmax-ratios of the soleus and the fibularis longus in the CAI group were significantly lower than those in the uninjured control group (soleus: d = −0.41, p < 0.001; fibularis longus: d = −0.27, p = 0.04). There was no evidence for changes in the CMT. This systematic review is the first to demonstrate evidence that patients with CAI present decreased spinal reflex excitability in the soleus and fibularis longus. However, there is no evidence of changes in supraspinal excitability when considering only the CMT. The latter result needs to be interpreted with caution as all except one study demonstrate some changes at the supraspinal level with CAI.
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Moran U, Gottlieb U, Gam A, Springer S. Functional electrical stimulation following anterior cruciate ligament reconstruction: a randomized controlled pilot study. J Neuroeng Rehabil 2019; 16:89. [PMID: 31299999 PMCID: PMC6626389 DOI: 10.1186/s12984-019-0566-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/06/2019] [Indexed: 11/29/2022] Open
Abstract
Background Inadequate quadriceps strength following anterior cruciate ligament reconstruction (ACLR) often results in alterations in gait pattern that are usually reported during loading response. Neuro-muscular electrical stimulation (NMES) is frequently used to overcome this quadriceps weakness. Despite the beneficial effects of NMES, persistent deficits in strength and gait are reported. The aim of this study was to investigate the feasibility of applying quadriceps functional electrical stimulation (FES) during walking in addition to standard rehabilitation, in the initial stage of ACLR rehabilitation. Methods Subjects were randomized to quadriceps FES synchronized with walking group (n = 10) or quadriceps NMES (duty cycle of 10 s on/10 s off) group (n = 13). Both interventions were performed for 10 min three days a week, in addition to a standard rehabilitation program. Assessments were performed up to 2 weeks before the ACLR (pre-ACLR), and 4 weeks postoperatively. Outcomes measured were gait speed, single limb stance gait symmetry, quadriceps isometric peak strength ratio (peak strength at 4 weeks/peak strength pre-ACLR) and peak strength inter-limb symmetry. Gait outcomes were also assessed 1-week post-surgery. Results Subjects in both groups regained pre-ACLR gait speed and symmetry after 4 weeks of rehabilitation, with no difference between groups. However, although pre-ACLR quadriceps peak strength was similar between groups (FES - 205 Nm, NMES − 225 Nm, p = 0.605), subjects in the FES group regained 82% of their pre-quadriceps strength compared to 47% in the NMES group (p = 0.02). In addition, after 4 weeks, the FES group had significantly better inter-limb strength symmetry 0.63 ± 0.15 vs. 0.39 ± 0.18 in the NMES group (p = 0.01). Conclusions Quadriceps FES combined with traditional rehabilitation is a feasible, early intervention treatment option, post-ACLR. Furthermore, at 4 weeks post-surgery, FES was more effective in recovering quadriceps muscle strength than was NMES. While spatiotemporal gait parameters did not differ between groups, kinetic and kinematic studies may be useful to further understand the effects of quadriceps FES post-ACLR. The promising results of this preliminary investigation suggest that such studies are warranted. Trial registration ISRCTN 02817399. First posted June 29, 2016.
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Affiliation(s)
- Uria Moran
- Israel Defense Forces Medical Corps, Ariel, Israel.,Department of Physical Therapy, Faculty of Health Sciences, Ariel University, 40700, Ariel, Israel
| | - Uri Gottlieb
- Israel Defense Forces Medical Corps, Ariel, Israel.,Department of Physical Therapy, Faculty of Health Sciences, Ariel University, 40700, Ariel, Israel
| | - Arnon Gam
- Israel Defense Forces Medical Corps, Ariel, Israel
| | - Shmuel Springer
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, 40700, Ariel, Israel.
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Abstract
Lateral ankle sprains (LASs) are among the most common injuries incurred during participation in sport and physical activity, and it is estimated that up to 40% of individuals who experience a first-time LAS will develop chronic ankle instability (CAI). Chronic ankle instability is characterized by a patient's being more than 12 months removed from the initial LAS and exhibiting a propensity for recurrent ankle sprains, frequent episodes or perceptions of the ankle giving way, and persistent symptoms such as pain, swelling, limited motion, weakness, and diminished self-reported function. We present an updated model of CAI that aims to synthesize the current understanding of its causes and serves as a framework for the clinical assessment and rehabilitation of patients with LASs or CAI. Our goal was to describe how primary injury to the lateral ankle ligaments from an acute LAS may lead to a collection of interrelated pathomechanical, sensory-perceptual, and motor-behavioral impairments that influence a patient's clinical outcome. With an underpinning of the biopsychosocial model, the concepts of self-organization and perception-action cycles derived from dynamic systems theory and a patient-specific neurosignature, stemming from the Melzack neuromatrix of pain theory, are used to describe these interrelationships.
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Affiliation(s)
- Jay Hertel
- Department of * Kinesiology, University of Virginia, Charlottesville.,Department of Orthopaedic Surgery, University of Virginia, Charlottesville
| | - Revay O Corbett
- Department of * Kinesiology, University of Virginia, Charlottesville
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DeJong AF, Mangum LC, Hertel J. Gluteus medius activity during gait is altered in individuals with chronic ankle instability: An ultrasound imaging study. Gait Posture 2019; 71:7-13. [PMID: 30999270 DOI: 10.1016/j.gaitpost.2019.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/18/2019] [Accepted: 04/09/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Altered gait mechanics are frequently reported in individuals with chronic ankle instability (CAI), and increasing information suggests proximal muscle adaptations occur in this population. Ultrasound imaging (USI) offers a visual means to evaluate muscle activity during movement, and overcomes limitations of electromyography (EMG) to detect hip muscle activity. RESEARCH QUESTION A descriptive laboratory study was conducted to determine if gluteus maximus (GMAX) and medius (GMED) muscle activity differed throughout gait in patients with CAI compared to healthy counterparts. METHODS Twenty young adults with CAI (21.6 ± 2.4 years, 10 males) and 20 healthy participants (21.2 ± 2.8 years, 10 males) walked on a treadmill at 1.35 m/s while researchers obtained 10-second clips of bilateral USI of the GMAX and GMED. USI clips were reduced to 55 frames consisting of 11 points over five full gait cycles. Muscle thickness values during walking were normalized to quiet bipedal standing USI images to obtain functional activity ratios (FARs). FARs with 90% confidence intervals (CI) were plotted as 10% interludes from 0 to 100% of the gait cycle to compare groups and limbs. Mean differences and Cohen's d effect sizes were used to assess the extent of differences. The CAI group had decreased GMED activity bilaterally from 0 to 40% of walking gait compared to healthy counterparts with large effect sizes (d≥0.60). CAI group FARs were below quiet stance levels (FARs<1.0) throughout the entire gait cycle. There were no differences noted between groups or limbs for GMAX measures. SIGNIFICANCE Proximal stabilizing musculature was altered bilaterally in CAI individuals compared to healthy counterparts, which may contribute to movement dysfunction. Previous studies using EMG have not detected this extent of bilateral gluteal muscle alterations in CAI groups during gait, however our findings suggest USI was able to detect significant proximal alterations during walking in this population.
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Affiliation(s)
- Alexandra F DeJong
- University of Virginia Exercise and Sports Injury Lab, 210 Emmet Street South, Charlottesville, VA, 22904-4407, United States.
| | - L Colby Mangum
- University of Central Florida College of Health Professions and Sciences, 12805 Pegasus Drive, Orlando, FL, 32816, United States.
| | - Jay Hertel
- University of Virginia Exercise and Sports Injury Lab, 210 Emmet Street South, Charlottesville, VA, 22904-4407, United States.
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Madsen LP, Kitano K, Koceja DM, Zehr EP, Docherty CL. Effects of chronic ankle instability on cutaneous reflex modulation during walking. Exp Brain Res 2019; 237:1959-1971. [DOI: 10.1007/s00221-019-05565-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/21/2019] [Indexed: 12/26/2022]
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Huang TH, Chou LW, Huang CY, Wei SW, Tsai YJ, Chen YJ. H-reflex in abductor hallucis and postural performance between flexible flatfoot and normal foot. Phys Ther Sport 2019; 37:27-33. [PMID: 30818085 DOI: 10.1016/j.ptsp.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 02/14/2019] [Accepted: 02/14/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Morphological changes of the abductor hallucis muscle (AbH) in flexible flatfoot (FF) individuals influence regulations of the medial longitudinal arch (MLA). Prolonged and repeated stretching of AbH in flexible flatfoot may cause changes in muscle reflex properties and further influence postural performance. However, AbH muscle reflex under different postural conditions have never been examined. The purpose of this study was to investigate differences in AbH H-reflex and postural performance between individuals with normal foot (NF) alignment and FF under prone, double-leg stance (DLS), and single-leg stance (SLS) conditions. DESIGN Cross-sectional study. SETTING University laboratory. PARTICIPANTS Individuals with FF (n = 12) and NF (n = 12). MAIN OUTCOME MEASURES AbH H-reflex, AbH EMG and center of pressure (CoP) displacement. RESULTS Under all postural conditions, AbH H-reflex was significantly lower in the FF group (P < .05). Under the SLS condition, AbH EMG was significantly higher in the FF group (P < .05), and CoP displacement for the medial-lateral and anterior-posterior directions were significantly higher in the FF group (P < .05). CONCLUSIONS With increased postural demand, FF individuals maintained their postural stability by recruiting greater AbH activities than through automatic stretch reflex, but FF individuals still showed inferior posture stability.
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Affiliation(s)
- Tzu-Hui Huang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3, No.17, Xuzhou Rd., Zhongzheng District, Taipei City, 100, Taiwan, ROC.
| | - Li-Wei Chou
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, ROC.
| | - Cheng-Ya Huang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3, No.17, Xuzhou Rd., Zhongzheng District, Taipei City, 100, Taiwan, ROC.
| | - Shun-Wa Wei
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, ROC.
| | - Yi-Ju Tsai
- Department of Physical Therapy, National Cheng-Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.
| | - Yu-Jen Chen
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3, No.17, Xuzhou Rd., Zhongzheng District, Taipei City, 100, Taiwan, ROC; Department of Physical Education, Fu Jen Catholic University, No.510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205, Taiwan, ROC.
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Sakai S, Urabe Y, Morikawa M, Fujishita H, Komiya M, Sasadai J, Fujishita H, Maeda N. Quantity and quality of the peroneus longus assessed using ultrasonography in leg with chronic ankle instability. J Phys Ther Sci 2018; 30:1396-1400. [PMID: 30568323 PMCID: PMC6279707 DOI: 10.1589/jpts.30.1396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/12/2018] [Indexed: 12/25/2022] Open
Abstract
[Purpose] Muscle quantity (e.g., cross-sectional area) and quality (e.g., muscle adipose
tissue), which are muscle strength determinants, can be assessed using ultrasonography.
The study aimed to investigate the changes in the quantity and quality of the peroneus
longus and evaluate evertor strength in legs with chronic ankle instability (CAI).
Furthermore, the associations among cross-sectional area, echogenicity, evertor strength,
and frequency of ankle sprain were examined. [Participants and Methods] Nine males with
CAI in unilateral legs were the voluntary participants in this study. The cross-sectional
area of the peroneus longus, echogenicity, and evertor strength were measured for all the
participants on the sides with CAI and that without. [Results] No significant difference
in cross-sectional area was observed between the sides. Significant differences in
echogenicity (higher on the CAI side) and evertor strength (lower on the CAI side) were
observed between the sides. In addition, a moderate correlation was observed between
echogenicity and increased sprain frequency on both sides. [Conclusion] Muscle adipose
tissue increased, evertor strength decreased, and the cross-sectional area remained
unchanged on the CAI side. The study results suggested that muscle adipose tissue
increases with increasing frequency of ankle sprain.
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Affiliation(s)
- Shogo Sakai
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
| | - Yukio Urabe
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
| | - Masanori Morikawa
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
| | - Hironori Fujishita
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
| | - Junpei Sasadai
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
| | - Hironori Fujishita
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University: 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8553, Japan
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Physical Impairments in Adults With Ankle Osteoarthritis: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2018; 48:449-459. [PMID: 29629614 DOI: 10.2519/jospt.2018.7569] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Systematic review with meta-analysis. Background Lower-limb osteoarthritis (OA) is associated with pain and reduced function. Most research focuses on hip and knee OA- related impairments; consequently, impairments that characterize ankle OA are not well understood. Objective To systematically review available evidence of physical impairments in individuals with ankle OA. Methods A comprehensive search of electronic databases was conducted from their inception to July 2017. Studies were screened using predefined inclusion/exclusion criteria. Studies that compared physical measures (excluding gait) between individuals with ankle OA and healthy controls or the unaffected ankle were included. Two reviewers rated studies for quality. Meta-analyses with random effects were conducted when appropriate. Results Of 4565 identified studies (563 participants), 8 satisfied the inclusion criteria and 3 studies were included in meta-analyses. All studies evaluated a range of impairments at end-stage OA, and exhibited poor reporting of missing data, assessor blinding, and measurement validity. Meta-analyses revealed large impairments of ankle sagittal plane motion and strength. Evidence from single studies indicated large deficits of ankle frontal plane motion and strength, talar translation and rotation on arthrometry, balance, and electromyography of ankle joint muscles. There were also abnormal bony alignments and greater fatty infiltrate in all calf muscle compartments. Conclusion The results of this literature review suggest significant ankle motion, strength, and functional impairments in individuals with ankle OA. The strength of the conclusions is limited, due to the small number and methodological limitations of published studies. Level of Evidence Symptom prevalence, level 1a. J Orthop Sports Phys Ther 2018;48(6):449-459. Epub 7 Apr 2018. doi:10.2519/jospt.2018.7569.
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Assessing Outcomes in People With Chronic Ankle Instability: The Ability of Functional Performance Tests to Measure Deficits in Physical Function and Perceived Instability. J Orthop Sports Phys Ther 2018; 48:372-380. [PMID: 29602302 DOI: 10.2519/jospt.2018.7514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Laboratory-based, cross-sectional study. Background Functional performance tests (FPTs) assess short bouts of unilateral hops for either distance or speed. More research is needed to identify specific FPTs that may be useful for measuring asymmetry outcomes related to functional performance and perceived instability deficits in individuals with chronic ankle instability (CAI). Objectives To identify FPTs that are sensitive to subjective and objective deficits associated with CAI. Methods Twenty-four subjects with unilateral CAI (10 male, 14 female; mean ± SD age, 20.7 ± 3.0 years) and 24 healthy, matched controls (10 male, 14 female; age, 20.1 ± 2.6 years) completed 5 unilateral FPTs in random order. Mean FPT scores and functional symmetry percentages were calculated and compared between groups using 2 separate 1-way multivariate analyses of variance (MANOVAs). Perceived instability symmetry percentages were compared between groups using a Mann-Whitney U analysis. Results There were no differences in the mean FPT scores (P>.05) or functional symmetry percentages (P>.05) between groups for any of the 5 FPTs. However, participants with CAI perceived greater instability when using their involved limb during the side hop (P = .02), 6-meter crossover hop (P = .003), lateral hop (P = .007), and figure-of-eight hop (P = .008). Conclusion There were no differences in mean functional scores between groups for all 5 FPTs, and each group performed symmetrically. Regardless, administering a visual analog scale following the completion of the side hop, 6-meter crossover hop, lateral hop, and figure-of-eight hop tests captures subjective reports of perceived instability in the involved limb that can be compared bilaterally throughout treatment. J Orthop Sports Phys Ther 2018;48(5):372-380. Epub 30 Mar 2018. doi:10.2519/jospt.2018.7514.
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Park KN, Kwon OY, Kim SJ, Kim SH. Asymmetry of neck motion and activation of the cervical paraspinal muscles during prone neck extension in subjects with unilateral posterior neck pain. J Back Musculoskelet Rehabil 2018; 30:751-758. [PMID: 28372307 DOI: 10.3233/bmr-150378] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although unilateral posterior neck pain (UPNP) is more prevalent than central neck pain, little is known about how UPNP affects neck motion and the muscle activation pattern during prone neck extension. OBJECTIVE To investigate whether deviation in neck motion and asymmetry of activation of the bilateral cervical paraspinal muscles occur during prone neck extension in subjects with UPNP compared to subjects without UPNP. METHODS This study recruited 20 subjects with UPNP and 20 age- and sex-matched control subjects without such pain. Neck motion and muscle onset time during prone neck extension were measured using a three-dimensional motion-analysis system and surface electromyography. RESULTS The deviation during prone neck extension was greater in the UPNP group than in the controls (p < 0.05). Compared with the controls, cervical extensor muscle activation in the UPNP group was significantly delayed on the painful side during prone neck extension (p < 0.05). CONCLUSIONS Subjects with UPNP showed greater asymmetry of neck motion and muscle activation during prone neck extension compared with the controls. This suggests that UPNP has specific effects on neck motion asymmetry and the functions of the cervical extensors, triggering a need for specific evaluation and exercises in the management of patients with UPNP.
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Affiliation(s)
- Kyue-Nam Park
- Department of Physical Therapy, College of Medical Science, Jeonju University, Korea
| | - Oh-Yun Kwon
- Laboratory of Kinetic Ergocise Based on Movement Analysis, Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Korea
| | | | - Si-Hyun Kim
- Department of Physical Therapy, Yonsei University, Wonju, Korea
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McCann RS, Terada M, Kosik KB, Gribble PA. Energy dissipation differs between females with and without chronic ankle instability. Scand J Med Sci Sports 2017; 28:1227-1234. [PMID: 29110366 DOI: 10.1111/sms.13004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2017] [Indexed: 12/26/2022]
Abstract
Chronic ankle instability (CAI) is associated with altered energy dissipation patterns, but comparisons to lateral ankle sprain (LAS) copers have not been explored. The purpose of this study was to examine differences in relative sagittal plane energy dissipation during a single-leg landing between female CAI and LAS coper participants. We separated 33 females (23.6 ± 4.6 years, 164.3 ± 6.2 cm, 69.4 ± 13.7 kg) into CAI (n = 17) and LAS coper (n = 16) groups. Participants completed 5 single-leg landings followed by a 5-second stabilization. We collected sagittal plane kinematics and joint moments at the ankle, knee, hip, and proximal joints (knee and hip) combined then calculated each joint's energy dissipation at 50, 100, 150, and 200 ms post-landing. We compared the percentage of total energy dissipated by the ankle, knee, hip, and proximal joints during each interval utilizing independent t tests and Cohen's d effect sizes. Statistical significance was set a priori at P < .05. The CAI group had lower relative energy dissipation from the ankle at 50 (24.7 ± 11.5% vs 39.2 ± 11.8%, P < .01, d = 1.25 [0.47, 1.95]), 100 (66.9 ± 19.4% vs 77.7 ± 6.5%, P = .04, d = 0.74 [0.01, 1.42]), and 150 ms (70.7 ± 17.8% vs 81.0 ± 5.7%, P = .03, d = 0.77 [0.04, 1.46]) compared to LAS copers. The CAI group had a greater hip contribution through 150 ms (17.9 ± 10.7% vs 11.7 ± 4.4%, P = .04, d =-0.75 [-1.44, -0.03]) and the proximal joints at 50 (75.3 ± 11.5% vs 60.8 ± 11.8%, P < .01, d = -1.25 [-1.96, -0.47]), 100 (33.1 ± 19.4% vs 22.3 ± 6.5%, P = .04, d = -0.74 [-1.42, -0.01]), and 150 ms (29.3 ± 17.8 vs 19.0 ± 5.7%, P = .03, d =-0.77 [-1.46, -0.04]) compared to LAS copers. Females with CAI may benefit from therapeutic exercises designed to correct a single-leg energy dissipation strategy that relies less on the ankle joint.
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Affiliation(s)
- R S McCann
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA, USA
| | - M Terada
- College of Sport and Health Sciences, Ritsumeikan University, Kyoto, Japan
| | - K B Kosik
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, USA
| | - P A Gribble
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, USA
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Needle AR, Baumeister J, Farquhar WB, Greaney JL, Higginson JS, Kaminski TW, Swanik CB. The relationship between the sensory responses to ankle-joint loading and corticomotor excitability. Int J Neurosci 2017; 128:435-441. [DOI: 10.1080/00207454.2017.1396219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Alan R. Needle
- Department of Health & Exercise Science, Appalachian State University, Boone, NC, USA
| | - Jochen Baumeister
- Exercise & Neuroscience Unit, Institute of Health, Nutrition, and Sports Sciences, Europa-Universität Flensburg, Flensburg, Germany
| | - William B. Farquhar
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE, USA
| | - Jody L. Greaney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Jill S. Higginson
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Thomas W. Kaminski
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE, USA
| | - C. Buz Swanik
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE, USA
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Kosik KB, Terada M, Drinkard CP, McCann RS, Gribble PA. Potential Corticomotor Plasticity in Those with and without Chronic Ankle Instability. Med Sci Sports Exerc 2017; 49:141-149. [PMID: 27501358 DOI: 10.1249/mss.0000000000001066] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Quantifying corticomotor alterations is important to understand the neurophysiological mechanisms that likely contribute to the neuromuscular control deficits observed in patients with chronic ankle instability (CAI). Corticomotor output mapping provides further insight into the changes within the motor cortex and identifies potential changes in the area of the motor cortex associated with selected muscles. Therefore, this investigation compared the corticomotor map output for the fibularis longus (FL) muscle in patients with and without CAI. METHODS Eighteen CAI patients and 16 healthy controls (HC) volunteered. Transcranial magnetic stimulation was used to map the motor cortex's representation of the FL. The normalized average of three motor evoked potentials at 100% of active motor threshold intensity was recorded for each scalp site on a 6 × 6 cm grid. Corticomotor output map was compared between groups through 1) the size of the corticomotor map area, 2) the volume of the corticomotor map, and 3) the location of cortical representation. Independent t-tests were used to assess group differences in each mapping outcome variable. Cohen's d effect sizes along with 95% confidence intervals were calculated using the pooled SD values. RESULTS CAI patients exhibited less map volume (P = 0.018, CAI = 8.2 ± 3.2 cm mV vs HC = 11.3 ± 3.9 cm mV) and map area (P = 0.046, CAI = 12.8 ± 6.0 cm vs HC: 17.4 ± 6.9 cm) compared with HC. CONCLUSIONS The smaller map area and volume suggest a more concentrated area of neurons communicating with the FL muscle in patients with CAI. Consequently, motor cortical cells on the border of the FL excitation area are less committed to the proper function of the FL muscle and may be recruited by other surrounding areas. This may explain altered movement strategies that lead to ankle reinjury.
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Affiliation(s)
- Kyle B Kosik
- 1Department of Rehabilitation Sciences, Division of Athletic Training, University of Kentucky, Lexington, KY; and 2College of Sport and Health Sciences Ritsumeikan University, Kusatsu, Shiga-ken, JAPAN
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Kosik KB, McCann RS, Terada M, Gribble PA. Therapeutic interventions for improving self-reported function in patients with chronic ankle instability: a systematic review. Br J Sports Med 2016; 51:105-112. [PMID: 27806951 DOI: 10.1136/bjsports-2016-096534] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To identify which therapeutic intervention may be most effective for improving self-reported function in patients with chronic ankle instability (CAI). DESIGN Systematic literature review. Articles were appraised using the Downs and Black Checklist by 3 reviewers. DATA SOURCES PubMed along with CINAHL, MEDLINE and SPORTDiscus within EBSCOhost for pertinent articles from their inception through August 2016. ELIGIBILITY CRITERIA FOR SELECTED STUDIES Articles included were required to (1) be written in English, (2) report adequate data to calculate effect sizes, (3) identify patients with CAI, (4) use some form of therapeutic intervention and (5) use a self-reported questionnaire as a main outcome measurement. RESULTS A broad spectrum of therapeutic interventions were identified related to balance training, multimodal rehabilitation, joint mobilisation, resistive training, soft-tissue mobilisation, passive calf stretching and orthotics. All of the articles included in the balance training category had moderate-to-strong Hedges g with none of the 95% CIs crossing 0. Hedges g effect sizes ranged from -0.67 to -2.31 and -0.51 to -1.43 for activities of daily living and physical activity, respectively. The multimodal rehabilitation category also produced moderate-to-strong Hedges g effect sizes but with large CIs crossing 0. Hedges g effect sizes ranged from -0.47 to -9.29 and -0.62 to -24.29 for activities of daily living and physical activity, respectively. CONCLUSIONS The main findings from this systematic review were balance training provided the most consistent improvements in self-reported function for patients with CAI.
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Affiliation(s)
- Kyle B Kosik
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Ryan S McCann
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Masafumi Terada
- College of Sport and Health Sciences, Ritsumeikan University, Kyoto, Japan
| | - Phillip A Gribble
- Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA
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Lubetzky AV, Price R, McCoy SW. Effects of Achilles tendon vibration, surface and visual conditions on lower leg electromyography in young adults with and without recurrent ankle sprains. J Bodyw Mov Ther 2016; 20:639-49. [PMID: 27634090 DOI: 10.1016/j.jbmt.2016.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/04/2016] [Accepted: 01/10/2016] [Indexed: 10/22/2022]
Abstract
Functional ankle instability is associated with decreased ankle muscle function. Compliant surfaces and eyes-closed training are commonly used for rehabilitation and prevention of ankle sprains. Brief Achilles tendon vibration is commonly used in the study of postural control. To test the level of activation of tibialis anterior (TIB) and fibularis longus (FIB), bilateral Achilles tendon vibration was applied for the middle 20 s in a series of 60-s trials, when 10 healthy young adults and 10 adults with history of repeated ankle sprains were standing bipedal: on floor, on memory foam, or on a Both Sides Up (BOSU) ball, with eyes open, and on floor and foam with eyes closed. Differences in Integrated surface electromyography (IEMG) of TIB and FIB were significant for both groups pre, during, and post vibration (Friedman Tests, p < 0.001 for all). In both groups, the highest IEMG for TIB was obtained during vibration when standing on foam with eyes closed, whereas the highest IEMG for FIB was obtained during vibration when standing on the BOSU. Bipedal stance on BOSU and brief Achilles tendon vibration may be a useful intervention when a session's goal is to facilitate lower leg muscles activation. Future research should explore training effects as well as the effect of FIB tendon vibration.
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Affiliation(s)
| | - Robert Price
- University of Washington, Seattle, WA, United States
| | - Sarah W McCoy
- University of Washington, Seattle, WA, United States
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Kim KM, Davis B, Hertel J, Hart J. Effects of Kinesio taping in patients with quadriceps inhibition: A randomized, single-blinded study. Phys Ther Sport 2016; 24:67-73. [PMID: 28126423 DOI: 10.1016/j.ptsp.2016.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 05/11/2016] [Accepted: 08/20/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine effects of Kinesio taping (KT) on quadriceps activation and maximal voluntary isometric contraction (MVIC) in patients with quadriceps inhibition. DESIGN Randomized, single-blinded. SETTING Laboratory. PATIENTS Sixteen participants (9 males, 7 females) with quadriceps inhibition, as determined by 90% or lower in central activation ratio (CAR), participated. MAIN OUTCOME MEASURES Hoffmann reflex (H-reflex) of the vastus medialis and quadriceps CAR and MVIC were measured before taping, and participants were randomly allocated to either KT (KT application with tension) or sham (non-elastic tape application without tension) group. H-reflexes were assessed immediately and 20 min after tape was applied over the rectus femoris. All outcomes were measured again after tape was removed when participants returned the laboratory 24-48 h after taping. RESULTS Two-way repeated ANOVA found no group-by-time interaction for: H-reflex (F3,42 = 1.94, P = 0.14), CAR (F1,14 = 0.03, P = 0.86), or MVIC (F1,14 = 0.007, P = 0.93). None of the outcome measures differed between groups or over time (P > 0.05). CONCLUSIONS KT applied to the rectus femoris did not change H-reflex of the vastus medialis and quadriceps CAR and MVIC in patients with quadriceps inhibition.
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Affiliation(s)
- Kyung-Min Kim
- University of Miami, 1507 Levante Avenue, Miami, FL 33146, USA.
| | - Brandon Davis
- Hampden-Sydney College, 80 College Road Hampden Sydney, VA 23943, USA.
| | - Jay Hertel
- University of Virginia, 210 Emmet St. South, PO Box 400407, Charlottesville, VA 22904, USA.
| | - Joseph Hart
- University of Virginia, 210 Emmet St. South, PO Box 400407, Charlottesville, VA 22904, USA.
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Kim KM, Hart JM, Saliba SA, Hertel J. Modulation of the Fibularis Longus Hoffmann Reflex and Postural Instability Associated With Chronic Ankle Instability. J Athl Train 2016; 51:637-643. [PMID: 27583692 DOI: 10.4085/1062-6050-51.10.05] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Individuals with chronic ankle instability (CAI) present with decreased modulation of the Hoffmann reflex (H-reflex) from a simple to a more challenging task. The neural alteration is associated with impaired postural control, but the relationship has not been investigated in individuals with CAI. OBJECTIVE To determine differences in H-reflex modulation and postural control between individuals with or without CAI and to identify if they are correlated in individuals with CAI. DESIGN Descriptive laboratory study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 15 volunteers with CAI (9 males, 6 females; age = 22.6 ± 5.8 years, height = 174.7 ± 8.1 cm, mass = 74.9 ± 12.8 kg) and 15 healthy sex-matched volunteers serving as controls (9 males, 6 females; age = 23.8 ± 5.8 years, height = 171.9 ± 9.9 cm, mass = 68.9 ± 15.5 kg) participated. INTERVENTION(S) Maximum H-reflex (Hmax) and motor wave (Mmax) from the soleus and fibularis longus were recorded while participants lay prone and then stood in unipedal stance. We assessed postural tasks of unipedal stance with participants' eyes closed for 10 seconds using a forceplate. MAIN OUTCOME MEASURE(S) We normalized Hmax to Mmax to obtain Hmax : Mmax ratios for the 2 positions. For each muscle, H-reflex modulation was quantified using the percentage change scores in Hmax : Mmax ratios calculated from prone position to unipedal stance. Center-of-pressure data were used to compute 4 time-to-boundary variables. Separate independent-samples t tests were performed to determine group differences. Pearson product moment correlation coefficients were calculated between the modulation and balance measures in the CAI group. RESULTS The CAI group presented less H-reflex modulation in the soleus (t26 = -3.77, P = .001) and fibularis longus (t25 = -2.59, P = .02). The mean of the time-to-boundary minima in the anteroposterior direction was lower in the CAI group (t28 = -2.06, P = .048). We observed a correlation (r = 0.578, P = .049) between the fibular longus modulation and mean of time-to-boundary minima in the anteroposterior direction. CONCLUSIONS The strong relationship indicated that, as H-reflex amplitude in unipedal stance was less down modulated, unipedal postural control was more impaired. Given the deficits in H-reflex modulation and postural control in the CAI group, the relationship may provide insights into the neurophysiologic mechanism of postural instability.
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Affiliation(s)
- Kyung-Min Kim
- Department of Kinesiology and Sport Sciences, University of Miami, FL
| | - Joseph M Hart
- Department of Kinesiology, University of Virginia, Charlottesville
| | - Susan A Saliba
- Department of Kinesiology, University of Virginia, Charlottesville
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville
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Burcal CJ, Hoch MC, Wikstrom EA. Effects of a stocking on plantar sensation in individuals with and without ankle instability. Muscle Nerve 2016; 55:513-519. [PMID: 27490972 DOI: 10.1002/mus.25362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/27/2016] [Accepted: 08/02/2016] [Indexed: 11/05/2022]
Abstract
INTRODUCTION It is unknown whether footwear has a beneficial or deleterious effect on cutaneous sensitivity. We aimed to test a preliminary model of footwear and its effect on tactile perception among groups of controls, copers, and chronic ankle instability participants. METHODS Light-touch thresholds were obtained for 45 participants (age: 20.2 ± 2.8 years; height: 167.6 ± 9.8 cm; mass: 66.3 ± 14.7 kg) using Semmes-Weinstein monofilaments at the head of the first metatarsal (1MT), base of the fifth metatarsal (5MT), and calcaneus (CAL). Baseline measurements were compared with those taken after wearing a nylon stocking for 5 min. RESULTS Thresholds were increased at all 3 sites when the stocking was worn (P < 0.05). Controls had an increase at 1MT, copers had an increase at 5MT and CAL, and chronic ankle instability had an increase at CAL. CONCLUSIONS Cutaneous thresholds increase when subjects wear a nylon stocking, a model for the sensory effects of footwear. A history of ankle injury appears to influence which sites have altered sensibility. Muscle Nerve, 2016. Muscle Nerve 55: 513-519, 2017.
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Affiliation(s)
- Christopher J Burcal
- Department of Kinesiology, University of North Carolina at Charlotte, 209 Belk Gym, 9201 University City Blvd., Charlotte, North Carolina, USA
| | - Matthew C Hoch
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, Virginia, USA
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Kirby JL, Houston MN, Gabriner ML, Hoch MC. Relationships between mechanical joint stability and somatosensory function in individuals with chronic ankle instability. Foot (Edinb) 2016; 28:1-6. [PMID: 27322958 DOI: 10.1016/j.foot.2016.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 12/01/2015] [Accepted: 04/15/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Individuals with chronic ankle instability (CAI) have demonstrated alterations in ankle mechanics and deficits in sensory function. However, relationships between mechanical stability and somatosensory function have not been examined, nor have those between somatosensory function and injury history characteristics. Therefore, the objective of this study was to examine relationships between (1) somatosensory function and mechanical stability and (2) somatosensory function and injury history characteristics. METHODS Forty adults with CAI volunteered to participate. In a single testing session, participants completed mechanical and sensory assessments in a counterbalanced order. Dependent variables included anterior/posterior displacement (mm), inversion/eversion rotation (°), SWM index values, JPS absolute error (°), number of previous ankle sprains, and number of "giving way" episodes in the previous 3 months. Spearman's Rho correlations examined the relationships between somatosensory function and (1) mechanical stability and (2) injury history characteristics (p<0.05). RESULTS No significant correlations were identified between any variables (p>0.11), and all r-values were considered weak. CONCLUSIONS These results revealed somatosensory function was not significantly correlated to mechanical stability or injury history characteristics. This indicates peripheral sensory impairments associated with CAI are likely caused by factors other than mechanical stability and injury history characteristics.
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Affiliation(s)
- Jessica L Kirby
- Human Movement Sciences, Old Dominion University, Norfolk, VA, United States.
| | - Megan N Houston
- Human Movement Sciences, Old Dominion University, Norfolk, VA, United States.
| | - Michael L Gabriner
- Human Movement Sciences, Old Dominion University, Norfolk, VA, United States.
| | - Matthew C Hoch
- School of Physical Therapy & Athletic Training, Old Dominion University, Norfolk, VA, United States.
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Song K, Kang TK, Wikstrom EA, Jun HP, Lee SY. Effects of reduced plantar cutaneous sensation on static postural control in individuals with and without chronic ankle instability. J Sci Med Sport 2016; 20:910-914. [PMID: 28571626 DOI: 10.1016/j.jsams.2016.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/21/2016] [Accepted: 04/30/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to determine how reduced plantar cutaneous sensation influences static postural control in individuals with and without CAI. DESIGN A case-control study design. METHODS Twenty-six individuals with self-reported CAI and 26 matched healthy controls participated in this study. The plantar aspect of the participants' foot was then submersed in ice water (0°C) for 10min to reduce plantar sensation. Before and after the cooling procedure, plantar cutaneous sensation thresholds and single leg balance with eyes open and closed were assessed. RESULTS Significantly, higher scores were observed in both groups after ice water submersion (p<0.001) indicating a significant reduction in the plantar cutaneous sensitivity after the cooling procedure. In single limb balance with eyes open, there were significant intervention main effects for the TTB ML mean (p<0.001), TTB AP mean (p=0.035) and TTB ML SD (p=0.021); indicating postural control improvement in both groups post-cooling. In single limb balance with eyes closed, Group×Intervention interactions were observed for the TTB AP mean (p=0.003) and TTB AP SD (p=0.017); indicating postural control deficits in CAI group post-cooling, but no changes in the control group. CONCLUSIONS The main finding of this study was that reduced plantar cutaneous sensation induced by an ice submersion procedure caused eyes closed postural control impairments in those with CAI but not healthy controls. The present investigation demonstrated that the ability to dynamically reweight among sensory inputs to maintain postural stability appears to be diminished in CAI patients compared to healthy controls.
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Affiliation(s)
- Kyeongtak Song
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, USA; Human Movement Science Curriculum, University of North Carolina at Chapel Hill, USA
| | - Tae Kyu Kang
- Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Republic of Korea
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, USA
| | - Hyung-Pil Jun
- Department of Movement Sciences, University of Idaho, USA
| | - Sae Yong Lee
- Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Republic of Korea.
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