1
|
Sierevelt IN, van Kampen PM, Terwee CB, Nolte PA, Kerkhoffs GMMJ, Haverkamp D. The minimal important change is not a universal fixed value across diagnoses when using the FAOS and FAAM in patients undergoing elective foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38860725 DOI: 10.1002/ksa.12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE This study aimed to calculate region and diagnosis-specific minimal important changes (MICs) of the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM) in patients requiring foot and ankle surgery and to assess their variability across different foot and ankle diagnoses. METHODS The study used routinely collected data from patients undergoing elective foot and ankle surgery. Patients had been invited to complete the FAOS and FAAM preoperatively and at 3-6 months after surgery, along with two anchor questions encompassing change in pain and daily function. Patients were categorised according to region of pathology and subsequent diagnoses. MICs were calculated using predictive modelling (MICPRED) and receiver operating characteristic curve (MICROC) method and evaluated according to strict credibility criteria. RESULTS Substantial variability of the MICs between forefoot and ankle/hindfoot region was observed, as well as among specific foot and ankle diagnoses, with MICPRED and MICROC values ranging from 7.8 to 25.5 points and 9.4 to 27.8, respectively. Despite differences between MICROC and MICPRED estimates, both calculation methods exhibited largely consistent patterns of variation across subgroups, with forefoot conditions systematically showing smaller MICs than ankle/hindfoot conditions. Most MICs demonstrated high credibility; however, the majority of the MICs for the FAOS symptoms subscale and forefoot conditions exhibited insufficient or low credibility. CONCLUSION The MICs of the FAOS and FAAM vary across foot and ankle diagnoses in patients undergoing elective foot and ankle surgery and should not be used as a universal fixed value, but recognised as contextual parameters. This can help clinicians and researchers in more accurate interpretation of the FAOS and FAAM change scores. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Inger N Sierevelt
- Department of Orthopedic Surgery, Xpert Clinics, Amsterdam, The Netherlands
- Department of Orthopedic Surgery, Spaarnegasthuis Academy, Hoofddorp, The Netherlands
| | - Paulien M van Kampen
- Department of Research and Innovation, Bergman Clinics, Naarden, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam, The Netherlands
| | - Peter A Nolte
- Department of Orthopedic Surgery, Spaarnegasthuis Academy, Hoofddorp, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Daniel Haverkamp
- Department of Orthopedic Surgery, Xpert Clinics, Amsterdam, The Netherlands
| |
Collapse
|
2
|
Migliorini F, Maffulli N, Cocconi F, Schäfer L, Bell A, Katusic D, Vaishya R. Better outcomes using suture button compared to screw fixation in talofibular syndesmotic injuries of the ankle: a level I evidence-based meta-analysis. Arch Orthop Trauma Surg 2024; 144:2641-2653. [PMID: 38740648 DOI: 10.1007/s00402-024-05354-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/28/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION The present meta-analysis evaluated current level I clinical trials which compared the use of a suture button (SB) versus syndesmotic screw (SS) fixation techniques for syndesmosis injuries of the ankle. The outcomes of interest were to compare patient-reported outcome measures (PROMs) and complications. It was hypothesised that SB might achieve better PROMs along with a lower rate of complications. METHODS This study was conducted according to the 2020 PRISMA statement. In August 2023, PubMed, Web of Science, Google Scholar, and Embase were accessed. All the randomised controlled trials (RCTs) which compared SB versus SS fixation for syndesmosis injuries of the ankle were accessed. Data concerning the American Orthopaedic Foot & Ankle Society (AOFAS), and Olerud-Molander score (OMS) were collected at baseline and at last follow-up. Data on implant failure, implant removal, and joint malreduction were also retrieved. RESULTS Data from seven RCTs (490 patients) were collected. 33% (161 of 490) were women. The mean length of the follow-up was 30.8 ± 27.4 months. The mean age of the patients was 41.1 ± 4.1 years. Between the two groups (SB and SS), comparability was found in the mean age, and men:women ratio. The SS group evidenced lower OMS (P = 0.0006) and lower AOFAS (P = 0.03). The SS group evidenced a greater rate of implant failure (P = 0.0003), implant removal (P = 0.0005), and malreduction (P = 0.04). CONCLUSION Suture button fixation might perform better than the syndesmotic screw fixation in syndesmotic injuries of the ankle.
Collapse
Affiliation(s)
- Filippo Migliorini
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy.
| | - Nicola Maffulli
- Department of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Stoke On Trent, ST4 7QB, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK
| | - Federico Cocconi
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy
| | - Luise Schäfer
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, Simmerath, Germany
| | - Andreas Bell
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, Simmerath, Germany
| | - Dragana Katusic
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospitals, New Delhi, India
| |
Collapse
|
3
|
Olszewski M, Zając B, Golec J. Cross cultural adaptation, reliability and validity of the Polish version of the Cumberland Ankle Instability Tool. Disabil Rehabil 2024; 46:2926-2932. [PMID: 37463065 DOI: 10.1080/09638288.2023.2232719] [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: 01/03/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023]
Abstract
Purpose: The aim of this study was to develop a Polish version of the Cumberland Ankle Instability Tool (CAIT-PL) questionnaire and perform CAIT-PL cultural adaptation with assessment of its psychometric properties.Methods: The original CAIT was translated into the Polish language using standard guidelines. The CAIT-PL was completed on 2 occasions by 105 participants both with and without a history of ankle sprains. Psychometric evaluation of CAIT-PL included an assessment of internal consistency, test-retest reliability, standard error of measurement, convergent and construct validity.Results: The CAIT-PL was successfully translated and adapted into Polish culture with satisfactory internal consistency (Cronbach's α = 0.83) and adequate test-retest reliability resulting in ICC2,1 = 0.89 (95% CI: 0.84-0.92). Measurement error was low (SEM = 0.76 and MDC = 2.10). Convergent validity of the CAIT-PL ranged from weak to strong using Spearman's correlation coefficient between CAIT-PL and FAOS subscales (r = 0.39-0.67; p < 0.05). Construct validity was confirmed.Conclusion: The Polish version of the Cumberland Ankle Instability Tool is a valid and reliable questionnaire for assessment of functional ankle instability among the Polish population.
Collapse
Affiliation(s)
- Maciej Olszewski
- Doctoral School, University of Physical Education in Kraków, Poland
| | - Bartosz Zając
- Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education in Kraków, Poland
| | - Joanna Golec
- Institute of Rehabilitation in Traumatology, University of Physical Education in Kraków, Poland
| |
Collapse
|
4
|
Alshahrani MS, Reddy RS, Alshahrani A, Gautam AP, Alsubaie SF. Exploring the interplay between ankle muscle strength, postural control, and pain intensity in chronic ankle instability: A comprehensive analysis. Heliyon 2024; 10:e27374. [PMID: 38486775 PMCID: PMC10937675 DOI: 10.1016/j.heliyon.2024.e27374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
Background Chronic Ankle Instability (CAI) is a common musculoskeletal condition characterized by recurring ankle sprains and impaired postural control (PC). Understanding the relationship between ankle muscle strength, PC, and the role of pain is essential for effective management. Objectives This prospective cross sectional study aimed to 1. Compare ankle isometric muscle strength (IMS) and PC between CAI and asymptomatic sides. 2. Assess the correlations between ankle IMS and PC and explore the potential mediating effect of pain in individuals with CAI. Methods A total of 44 individuals with CAI, were enrolled in the study. Ankle IMS (dorsiflexors, plantar flexors, invertors, and evertors) was measured using a dynamometer, while PC was evaluated using sway parameters (anterior-posterior and medial-lateral sway, ellipse area). Pain levels were reported using a Visual Analog Scale. Results The CAI ankles exhibited significantly lower ankle IMS in all muscle groups compared to the asymptomatic ankles (p < 0.001). Additionally, the CAI side showed increased postural sway and a larger ellipse area (p < 0.001), indicating reduced PC. Negative correlations were observed between ankle IMS and PC parameters on the CAI side, with dorsiflexor strength showing correlations ranging from -0.423 to -0.387, plantar flexor strength ranging from -0.423 to -0.371, invertor strength ranging from -0.412 to -0.238, and evertor strength ranging from -0.451 to -0.365 (p < 0.001). Mediation analysis revealed that pain played a significant mediating role in connecting ankle IMS and PC parameters among individuals with CAI, with statistical significance (p < 0.05). Conclusions Individuals with CAI exhibit weaker ankle IMS and diminished PC in comparison to their healthy side. Moreover, pain was identified as a mediator in the relationship between ankle IMS and PC in CAI. These findings underscore the importance of addressing both ankle IMS and pain in the rehabilitation and management of CAI.
Collapse
Affiliation(s)
- Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Adel Alshahrani
- Department of Medical Rehabilitation Sciences-Physiotherapy Program, College of Applied Medical Sciences, Najran University, Najran, 55461, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Saud F. Alsubaie
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| |
Collapse
|
5
|
Owoeye OBA, Paz J, Emery CA. Injury severity at the time of sport-related ankle sprain is associated with symptoms and quality of life in young adults after 3-15 years. Ann Med 2023; 55:2292777. [PMID: 38092008 PMCID: PMC10880560 DOI: 10.1080/07853890.2023.2292777] [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: 09/21/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Ankle sprains are the most common sports-related injuries. Individuals with time-loss ankle sprains often experience residual symptoms and chronic ankle instability years after injury. Up to 90% of post-traumatic ankle osteoarthritis cases are associated with severe ankle sprain. This study aimed to examine whether ankle injury severity sustained during youth sports participation is associated with ankle symptoms and function. MATERIALS AND METHODS Cohort study included 50 young adults (mean age, 23 years) with a 3-to 15-year history of a youth-sport related 'significant ankle sprain' (SAS). The primary independent variable was injury severity, which was captured in the index SAS injury details through interviews. SAS was defined as ligament and other intra/extra-articular structure injuries that disrupted youth sport participation, at least 3 days of time loss, and required medical consultation. Severe SAS was defined as SAS involving >28 days of time loss, and non-severe SAS only involved ankle ligaments and/or with ≤28 days of time loss. The Foot and Ankle Outcome Score questionnaire was used to assess ankle symptoms and function. Descriptive statistics and multivariable linear regression models were used to examine the association between SAS severity and outcomes, with sex and time since injury as covariates. RESULTS Compared to participants with non-severe SAS, participants with a history of severe SAS demonstrated significantly poorer outcomes in symptoms [-18.4 (99% CI: -32.2 to -4.6)], pain [-10.1 (99% CI: -19.2 to -1.1)] and QoL [-17.1 (99% CI: -33.1 to -1.1)] in multivariable linear regression models. CONCLUSIONS Severe ankle sprain with a loss of > 4 weeks from sports participation at the time of injury is independently associated with poorer ankle symptoms, pain, and ankle-related quality of life after 3-15 years. Secondary prevention measures are needed in individuals with a history of severe ankle sprains to mitigate the potential health consequences.
Collapse
Affiliation(s)
- Oluwatoyosi B. A. Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St Louis, MO, USA
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Center of Excellence in Maternal and Child Health Education, Science and Practice, College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA
| | - Juan Paz
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St Louis, MO, USA
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
6
|
Candeniz Ş, Kocaman H, Erol Çelik S, Bek N. Cross-cultural adaptation, reliability, and validity of the Turkish version of the Cumberland Ankle Instability Tool. Musculoskelet Sci Pract 2023; 68:102873. [PMID: 37897935 DOI: 10.1016/j.msksp.2023.102873] [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: 06/19/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES The objective of the study was to cross-culturally adapt and assess the validity and reliability of the Turkish version of the CAIT (CAIT-TR). METHODS The CAIT was translated and adapted into Turkish according to accepted cross-cultural adaptation guidelines of self-reported measures. A total of 130 individuals, including healthy participants (n = 40) and with chronic ankle instability (CAI) (n = 90), were recruited in this study. The internal consistency and test-retest reliability of the CAIT-TR were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. To assess convergent validity, hypotheses were tested regarding expected correlations between CAIT-TR, Foot and Ankle Outcome Score (FAOS) subscales, and the Visual Analogue Scale (VAS). Discriminative validity was evaluated with the hypothesis that the CAIT-TR can distinguish between subjects with and without CAI and also calculated a cut-off score for CAI. The dimensional structure of the CAIT-TR was investigated with confirmatory factor analysis. Additionally, minimal detectable change (MDC), floor/ceiling effects, and measurement error values were determined. RESULTS The CAIT-TR demonstrated high Internal consistency (Cronbach's alpha = 0.854) and test-retest reliability (ICC = 0.919). Regarding convergent validity, the CAIT-TR exhibited a moderate-strong correlation with both the FAOS and VAS. The confirmatory factor analysis supported the unidimensional structure of the questionnaire. The identified cut-off value for the CAIT-TR was 25, and the MDC for individual-level CAIT-TR scores was determined to be 1.87. No floor or ceiling effects were observed. CONCLUSION The CAIT-TR is a valid and reliable questionnaire for the assessment of ankle instability within the Turkish population.
Collapse
Affiliation(s)
- Şeyda Candeniz
- Department of Therapy and Rehabilitation, Kızılcahamam Vocational School of Health Services, Ankara University, Ankara, Turkey.
| | - Hikmet Kocaman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey.
| | - Seher Erol Çelik
- Department of Therapy and Rehabilitation, Kızılcahamam Vocational School of Health Services, Ankara University, Ankara, Turkey.
| | - Nilgün Bek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey.
| |
Collapse
|
7
|
Barnavon T, Hardy A, Duguay T, Bouche PA, Lopes R. Description of the Simple Ankle Value: A Simplified Patient-Reported Outcome Measure for the Assessment of Ankle and Hindfoot Function. Orthop J Sports Med 2023; 11:23259671231200498. [PMID: 37868219 PMCID: PMC10585994 DOI: 10.1177/23259671231200498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/03/2023] [Indexed: 10/24/2023] Open
Abstract
Background The Simple Ankle Value (SAV) is a patient-reported outcome measure (PROM) in which patients grade their ankle function as a percentage of that of their contralateral uninjured ankle. Purpose/Hypothesis The primary aims of this study were to validate the SAV and evaluate its correlation with other PROMs. It was hypothesized that the SAV would be seen as a valid score that provides results comparable with those of the Foot and Ankle Ability Measure (FAAM) and the European Foot & Ankle Society (EFAS) score. Study Design Cohort study (Diagnosis); Level of evidence, 2. Methods Patients seen for an ankle or hindfoot tissue were divided into those treated operatively and nonoperatively. A control group of patients treated for issues outside of the foot and ankle was also created. All patients completed the SAV followed by the FAAM and the EFAS scores. Patients treated operatively completed the questionnaires before surgery and 3 months after surgery. Patients treated nonoperatively completed the questionnaires twice 15 days apart. The correlation between the SAV score, the FAAM score, and the EFAS score was estimated with the Spearman correlation coefficient. Results A total of 209 patients (79 in the operative group, 103 in the nonoperative group, and 27 in the control group) were asked to complete the questionnaire, and all were included. The test-retest reliability of the SAV was excellent (intraclass correlation coefficient, 0.92; 95% CI, 0.88-0.94). No ceiling or floor effect was reported. Strong correlation was found between the SAV and the FAAM and EFAS scores. The SAV was able to discriminate patients from controls (54.18 ± 21.22 and 93.52 ± 9.589; P < .0001); however, SAV was not able to detect change from preoperative to 3 months postoperative (from 54.18 ± 21.22 to 62.53 ± 20.83; P = .44). Conclusion Our study suggests that the SAV is correlated with existing accepted ankle PROMs. Further work with this PROM is needed to validate the questionnaire.
Collapse
Affiliation(s)
- Thomas Barnavon
- Santé Atlantique, Pied Cheville Nantes Atlantique, Saint Herblain, France
| | | | - Tristan Duguay
- Service de Chirurgie Orthopédique, Hôpital Cochin, Saint-Jacques, Paris, France
| | | | - Ronny Lopes
- Santé Atlantique, Pied Cheville Nantes Atlantique, Saint Herblain, France
| |
Collapse
|
8
|
Cervera-Garvi P, Marchena-Rodriguez A, Lopezosa-Reca E, Diaz-Miguel S, Ortega-Avila AB. Systematic review of the methodological quality of patient-reported outcome measure for patients with chronic ankle instability. Clin Rehabil 2023; 37:1332-1346. [PMID: 36987581 DOI: 10.1177/02692155231166217] [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: 03/30/2023]
Abstract
OBJETIVE Chronic ankle instability is generally associated with ankle sprain. Its consequences can be measured by means of patient-reported outcome measures (PROMs). The aim of this review is to identify the PROMs specifically available for chronic ankle instability and to evaluate their methodological quality and that of the cross-cultural adaptations made. DATA SOURCES Papers were retrieved from PubMed, Embase, Scopus and Google Scholar databases, with no time limit applied, based on the following inclusion criteria: (1) type of participants: patients with chronic ankle instability, over 18 years of age; (2)type of study: those specifically focused on this pathology, using PROMs specific to chronic ankle instability and published in English; (3) type of outcome: measurement properties based on COSMIN criteria in patient-reported outcomes associated with chronic ankle instability. METHODS This systematic review, following the COSMIN checklist, was conducted to determine the methodological quality of PROMs specific to foot and ankle pathologies, for patients presenting chronic ankle instability. RESULTS Of the 576 studies identified in the initial search, 34 were included in the final analysis of measurement properties. Four - the Ankle Instability Instrument, the Chronic Ankle Instability Scale, the Cumberland Ankle Instability Tool and the Identification of Functional Ankle Instability - were original questionnaires, and the remaining 30 were cross-cultural adaptations. CONCLUSION The Cumberland Ankle Instability Tool and the Identification of Functional Ankle Instability questionnaires can be useful instruments for evaluating chronic ankle instability, both in patients with this condition and also in non-pathological patients.
Collapse
Affiliation(s)
- Pablo Cervera-Garvi
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Ana Marchena-Rodriguez
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Eva Lopezosa-Reca
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Salvador Diaz-Miguel
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
| | - Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, Faculty Health Sciences, University of Malaga, Malaga, Spain
- Instituto de investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| |
Collapse
|
9
|
Wen Z, Lyu R, Wang W, Hua X, Yu Y, Zeng K, Kong L, Wang J. The effect of Tuina based on the concept of hip-knee-ankle conjugation in patients with chronic ankle instability: study protocol for a randomized controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1165548. [PMID: 37691913 PMCID: PMC10491012 DOI: 10.3389/fresc.2023.1165548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023]
Abstract
Background Chronic ankle instability (CAI) is a common sports injury disease and characterized by limited mobility, perceived instability and muscle weakness, combined treatment of hip-knee-ankle is a common rehabilitation method. Tuina, as a traditional Chinese manual therapy, is usually used for CAI, but many of them only focus on the local ankle joint rather than the combination of hip and knee joint. Therefore, we have designed a randomized controlled trial (RCT) to investigate the effects of Tuina base on the concept of hip-knee-ankle conjugation on the stability and balance of lower limbs and ankle function in patients with CAI. Methods We have designed a randomized controlled trial. A total of 72 participants with CAI will be randomly divided into functional training groups and hip-knee-ankle Tuina combined with functional training group in a 1:1 ratio. Participants in control group will receive 8 sessions of functional training (30 min per session, twice a week for 4 weeks). Participants in intervention group will receive 8 sessions of Tuina combined with functional training (twice a week for 4 weeks). The primary outcomes include the Y-Balance Test (YBT) and Cumberland Ankle Instability Tool (CAIT). The Secondary outcomes include the Foot and Ankle Ability Measure (FAAM) and ankle range of motion (ROM). The outcome assessments will be conducted before the first intervention and after the last intervention. Discussion The aim of this study is to explore a safe and effective manipulation program and serve as reference for clinical treatment of CAI and expect to provide the necessary theoretical and practical support to our future research. Clinical Trial Registration Chinese Clinical Trail Registry ChiCTR2300068274.
Collapse
Affiliation(s)
- Zonglin Wen
- Department of Tuina, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ruoyun Lyu
- Department of Traditional Chinese Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China
| | - Wei Wang
- Department of Tuina, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xia Hua
- Department of Tuina, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yifeng Yu
- Department of Tuina, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ke Zeng
- Department of Tuina, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingjun Kong
- Department of Tuina, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - JianWei Wang
- Department of Tuina, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
10
|
Ge L, Holmes JR, Talusan PG, Walton DM. Lateral Talar Subluxation Measurements in Nonoperatively Managed Weber B Ankle Fractures. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231187887. [PMID: 37492127 PMCID: PMC10363887 DOI: 10.1177/24730114231187887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
Background Lateral talar subluxation (LTS) was introduced as a measurement tool for evaluating isolated Weber B ankle fractures, with LTS >4 mm on gravity stress (GS) radiographs possibly indicating need for surgery. This study reviews LTS measurements in nonoperatively managed isolated Weber B fibula fractures to further investigate the validity of this previously stated cutoff. Methods The senior authors previously reported outcomes of a novel algorithm for nonoperative management of isolated Weber B ankle fractures. Outcome scores reported include American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot, Olerud-Molander (OMA), Foot and Ankle Ability Measure for activities of daily living (FAAM/ADL), and visual analog scale (VAS) scores. All patients achieved union of their fracture. LTS was measured on GS radiographs of both injured and contralateral uninjured extremities. Results Forty-two patients were included with minimum 1-year follow-up. Average age was 49 years (range 19-72). Mean measurements on injury GS radiographs were as follows: medial clear space (MCS) 4.45 mm (SD = 0.93), superior clear space (SCS) 3.46 mm (SD = 0.70), and LTS 2.33 mm (SD = 1.57, range 0-4.7 mm), with 35 (83.3%) patients having injury LTS ≤4 mm. Mean measurements on contralateral (uninjured) GS radiographs were as follows: MCS 3.39 mm (SD = 0.63), SCS 3.15 mm (SD = 0.50), and LTS 1.30 mm (SD = 1.28, range 0-4.8 mm). There was no statistically significant difference in all outcome measures based on amount of LTS (<2 mm, 2-4 mm, >4 mm). Conclusion Most patients had injury LTS ≤4 mm, although those with LTS >4 mm had excellent outcome scores. LTS measurements on normal ankles reveal a large range. LTS may be a useful adjunct in evaluating isolated Weber B ankle fractures but the 4-mm cutoff may not be entirely reliable. Further studies are required to validate LTS as a decision-making tool. Level of Evidence Level IV, case series.
Collapse
Affiliation(s)
- Laurence Ge
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - James R. Holmes
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Paul G. Talusan
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - David M. Walton
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
11
|
Impairment-based assessments for patients with lateral ankle sprain: A systematic review of measurement properties. PLoS One 2023; 18:e0280388. [PMID: 36812288 PMCID: PMC9946235 DOI: 10.1371/journal.pone.0280388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/28/2022] [Indexed: 02/24/2023] Open
Abstract
STUDY DESIGN Systematic review. BACKGROUND AND OBJECTIVE The International Ankle Consortium developed a core outcome set for the assessment of impairments in patients with lateral ankle sprain (LAS) without consideration of measurement properties (MP). Therefore, the aim of this study is to investigate MPs of assessments for the evaluation of individuals with a history of LAS. METHODS This systematic review of measurement properties follows PRISMA and COSMIN guidelines. Databases Pubmed, CINAHL, Embase, Web of Science, Cochrane Library and SPORTDiscus were searched for eligible studies (last search: July 2022). Studies on MP of specific tests and patient-reported outcome measurements (PROMs) in patients with acute and history of LAS (>4 weeks post injury) were deemed eligible. RESULTS Ten studies of acute LAS and 39 studies of history of LAS patients with a total of 3313 participants met the inclusion criteria. Anterior Drawer Test (ADT) in supine position five days post injury and Reverse Anterolateral Drawer Test are recommended in acute settings in single studies. In the history of LAS patients, Cumberland Ankle Instability Tool (CAIT) (4 studies) as a PROM, Multiple Hop (3 studies) and Star Excursion Balance Tests (SEBT) (3 studies) for dynamic postural balance testing showed good MPs. No studies investigated pain, physical activity level and gait. Only single studies reported on swelling, range of motion, strength, arthrokinematics, and static postural balance. Limited data existed on responsiveness of the tests in both subgroups. CONCLUSION There was good evidence to support the use of CAIT as PROM, Multiple Hop, and SEBT for dynamic postural balance testing. Insufficient evidence exists in relation to test responsiveness, especially in the acute situation. Future research should assess MPs of assessments of other impairments associated with LAS.
Collapse
|
12
|
One double-loaded suture anchor is sufficient for all-inside arthroscopic anterior talofibular ligament repair. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07348-5. [PMID: 36810947 DOI: 10.1007/s00167-023-07348-5] [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] [Received: 12/25/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE All-inside anterior talofibular ligament (ATFL) repair using anchors is frequently used to manage chronic lateral ankle instability (CLAI) with satisfactory functional outcomes. It remains unclear whether there are differences in the functional results between the use of one or two double-loaded anchors. METHODS This retrospective cohort study included 59 CLAI patients who underwent an all-inside arthroscopic ATFL repair procedure from 2017 to 2019. Patients were divided into two groups according to the number of anchors used. In the one-anchor group (n = 32), the ATFL was repaired with one double-loaded suture anchor. In the two-anchors group (n = 27), the ATFL was repaired with two double-loaded suture anchors. At the last follow-up time point, the Visual Analogue Scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, Karlsson Ankle Function Score (KAFS), Anterior Talar Translation (ATT), Active Joint Position Sense (AJPS), and the rate of return to sports in both groups were compared. RESULTS All the patients were followed up for at least 24 months. Improvement in the functional results (VAS, AOFAS, KAFS, ATT, and AJPS) were recorded at the final follow-up time point. No significant differences were observed regarding VAS, AOFAS, KAFS, ATT, and AJPS between the two groups. CONCLUSION In patients with CLAI undergoing all-inside arthroscopic ATFL repair, the use of either one or two double-loaded suture anchors produces comparable and predictably good functional outcomes. LEVEL OF EVIDENCE Level III.
Collapse
|
13
|
Fu S, Yang K, Li X, Chen C, Mei G, Su Y, Xue J, Zou J, Zhang J, Shi Z. Radiographic and Clinical Outcomes After Arthroscopic Microfracture for Osteochondral Lesions of the Talus: 5-Year Results in 355 Consecutive Ankles. Orthop J Sports Med 2022; 10:23259671221128772. [PMID: 36263313 PMCID: PMC9575450 DOI: 10.1177/23259671221128772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Arthroscopic microfracture for osteochondral lesion of the talus (OLT) has
shown good functional outcomes in the short and long term. Purpose: To investigate 5-year radiographic and clinical outcomes after arthroscopic
microfracture in treatment of OLT and the effectiveness of adjunct therapies
including platelet-rich plasma (PRP) and hyaluronic acid (HA). Study Design: Cohort study; Level of evidence, 2. Methods: We prospectively enrolled 432 patients who underwent arthroscopic
microfracture for OLT from May 1, 2011, to May 31, 2015. Magnetic resonance
imaging (MRI) and weightbearing radiographs were performed annually after
the initial surgery. The MOCART (magnetic resonance observation of cartilage
repair tissue) score was used to evaluate the structure of the repaired
cartilage on MRI, and patient-reported outcomes (American Orthopaedic Foot
and Ankle Society ankle-hindfoot scale [AOFAS] and the Foot and Ankle
Outcome Score) were collected annually. The primary outcome measure was
5-year AOFAS score. We recorded baseline characteristics including age, body
mass index (BMI), and lesion size, and other potentially related factors
including number of PRP/HA injection and change in BMI from baseline. Results: Included were 355 patients, all with minimum 5-year follow-up data. The
overall reoperation rate was 9.0% (32 of 355). According to multivariable
analysis, 5-year AOFAS scores were associated with number of PRP injections
(correlation coefficient, 3.12 [95% CI, 2.36 to 3.89]; P
< .001), BMI at baseline (correlation coefficient, -0.222 [95% CI, -0.363
to -0.082]; P = .002), and mean BMI change from baseline
(correlation coefficient, -1.15 [95% CI, -1.32 to -0.98]; P
< .001). When comparing number of PRP injections (0, 1-2, or ≥3), we
found that patients who had serial PRP injection (≥3 with at least a 3-month
interval between injections) had diminished functional and radiographic
deterioration over time. Conclusion: Arthroscopic microfracture improved patient-reported and structural outcomes
for patients with OLT at 5 years after surgery. Serial PRP injections and
reduction in BMI from baseline were able to slow radiographic and functional
deterioration. Future trials regarding the combination of microfracture and
PRP in treatment of OLT should focus on the efficacy of longer term,
intra-articular, serial injections of PRP instead of single injections.
Collapse
Affiliation(s)
- Shaoling Fu
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China
| | - Kai Yang
- Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai,
China
| | - Xueqian Li
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China
| | - Cheng Chen
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China
| | - Guohua Mei
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China
| | - Yan Su
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China
| | - Jianfeng Xue
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China
| | - Jian Zou
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China
| | - Jieyuan Zhang
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China.,Zhongmin Shi, MD, or Jieyuan Zhang, MD, Department of Orthopedic
Surgery, Shanghai Sixth People’s Hospital, 600 Yishan Road, Shanghai 200233,
China ( or
)
| | - Zhongmin Shi
- Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital,
Shanghai, China.,Zhongmin Shi, MD, or Jieyuan Zhang, MD, Department of Orthopedic
Surgery, Shanghai Sixth People’s Hospital, 600 Yishan Road, Shanghai 200233,
China ( or
)
| |
Collapse
|
14
|
Jiang Q, Kim Y, Choi M. Kinetic Effects of 6 Weeks' Pilates or Balance Training in College Soccer Players with Chronic Ankle Instability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12903. [PMID: 36232203 PMCID: PMC9566560 DOI: 10.3390/ijerph191912903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Lateral ankle sprain (LAS) is a common sports injury that frequently occurs in active individuals. LAS is characterized by a high recurrence rate, with a large proportion of patients progressing to chronic ankle instability (CAI). Pilates exercises have provided positive results in health care and in rehabilitation. This study compared Pilates training (PT) with traditional balance training (BT) in patients with CAI. Fifty-one college football players with CAI, divided into PT (n = 26) and BT (n = 25) groups, were included in the study. The groups performed PT or BT training as assigned, three times per week for 6 weeks. Isokinetic ankle strength, one-leg hop tests, Y-balance test (YBT), and foot and ankle outcome score (FAOS) were evaluated before and after training. There were considerable improvements in both the PT and BT groups after training. Group and time comparisons revealed that the PT group achieved better triple hop test results than the BT group, whereas the BT group exhibited a greater improvement in YBT posteromedial and posterolateral reach distances. In athletes with CAI, both PT and BT effectively improved symptoms and function. These findings suggest that ankle strength, balance, and core stability should be comprehensively evaluated and targeted in CAI rehabilitation programs.
Collapse
Affiliation(s)
- Quan Jiang
- Department of Public Sports, Luoyang Normal University, Luoyang 471934, China
| | - Yonghwan Kim
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Moonyoung Choi
- Department of Sports Science Convergence, Dongguk University, Seoul 04620, Korea
| |
Collapse
|
15
|
Dias S, Lewis TL, Alkhalfan Y, Ahluwalia R, Ray R. Current concepts in the surgical management of chronic ankle lateral ligament instability. J Orthop 2022; 33:87-94. [PMID: 35874042 PMCID: PMC9305620 DOI: 10.1016/j.jor.2022.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022] Open
Abstract
Background/aims Ankle sprains are common injuries which can lead to chronic lateral ankle ligament instability (CAI). Methods The aim of this review is to provide a comprehensive overview of the epidemiology, pathophysiology, investigation, surgical management and rehabilitation of CAI. Results Investigation of CAI is based on history, clinical examination, and imaging. Surgical management of CAI can be defined as anatomic reconstruction, anatomic and non anatomic repair of ATFL and/or CFL. Anatomic repair has been shown to have better functional outcomes and less secondary osteoarthritis when compared to non anatomic repair. Non-anatomic methods do not replicate the normal anatomical course of ATFL/CFL and may lead to stiffness. The most common surgical treatment for CAI is the open modified Broström repair augmented with the Gould modification. There are arthroscopic techniques being developed which have reported promising clinical results. However, there are considerable areas of further research which should be carried out to improve understanding and effectiveness of current treatment options. Standardised validated patient reported outcome measures and evidence-based protocols in the rehabilitation periods are crucial for positive and reproducible outcomes. Conclusion Surgical repair has proven to show excellent outcomes for patients suffering from CAI, however larger prospective studies should be carried out to evaluate the use of newer surgical techniques.
Collapse
Affiliation(s)
- Shiluka Dias
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Thomas L. Lewis
- Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Foot and Ankle Unit, King's College Hospital NHS Foundation Trust, London, UK
| | | | - Raju Ahluwalia
- King's College Hospital MTC, London; King's College Hospital Diabetic Foot Unit & King's Foot and Ankle Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Robbie Ray
- King's Foot and Ankle Unit, King's College Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
16
|
Khan S, Faulkner S, Algarni FS, Almalki A, Almansour A, Altowaijri AM. Foot Function Index for Arabic-speaking patients (FFI-Ar): translation, cross-cultural adaptation and validation study. J Orthop Surg Res 2022; 17:212. [PMID: 35392981 PMCID: PMC8991848 DOI: 10.1186/s13018-022-03092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foot Function Index (FFI) is a valid and reliable outcome measure, which is widely used to measure the foot and ankle functional level and disorders. Until now, no validated Arabic version of the FFI is available. This study was conducted at a tertiary care hospital in Riyadh, Saudi Arabia. The purpose of this project was to translate and adapt the FFI into Arabic and to evaluate its psychometric properties of validity and reliability. METHODS The study consisted of two phases. The first phase was the translation and cultural adaptation of the FFI to Arabic. The next phase involved, testing the psychometric properties of the Arabic version of the FFI on a sample of 50 consecutive participants which included internal consistency, test-retest reliability, floor and ceiling effects and construct validity. RESULTS The mean age of the study participants was 38 ± 12.94 years. Both the genders were evenly enrolled with 50% of the participants as male and 50% as female. Majority of them complained of plantar fasciopathy (32%) followed by pes planus (22%) and ankle sprain (18%). The scores of FFI-Ar were normally distributed, confirmed by a significant Shapiro-Wilk test. The mean value of FFI-Ar total score was 47.73 ± 19.85. There were no floor or ceiling effects seen in any of the subscales and total score. The internal consistency was good with the Cronbach's alpha value of 0.882, 0.936 and 0.850 for the pain, disability and activity limitation subscales, respectively. The reproducibility of the FFI-Ar was analysed by intra-class correlation coefficient which revealed good to excellent test-retest reliability. A significant correlation was found between FFI-Ar and SF-36 and numeric rating scale (NRS) confirming its construct validity. CONCLUSION The FFI-Arabic version showed good validity and reliability in patients with foot and ankle problems. This tool can be used in usual practice and research for analysing foot and ankle disorders in Arabic-speaking people.
Collapse
Affiliation(s)
- Shershah Khan
- Medical Rehabilitation Department, King Saud University Medical City, King Saud University, Riyadh, 11461, Saudi Arabia.
| | - Suzanne Faulkner
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, Wolfson Building, University of Strathclyde, Glasgow, UK
| | - Fahad S Algarni
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Abdulaziz Almalki
- Medical Rehabilitation Department, King Saud University Medical City, King Saud University, Riyadh, 11461, Saudi Arabia
| | - Ahmed Almansour
- Department of Physical Therapy, College of Applied Medical Science, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Abdulrahman M Altowaijri
- Medical Rehabilitation Department, King Saud University Medical City, King Saud University, Riyadh, 11461, Saudi Arabia
| |
Collapse
|
17
|
Lu J, Wu Z, Adams R, Han J, Cai B. Sex differences in the relationship of hip strength and functional performance to chronic ankle instability scores. J Orthop Surg Res 2022; 17:173. [PMID: 35313904 PMCID: PMC8935730 DOI: 10.1186/s13018-022-03061-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/09/2022] [Indexed: 12/26/2022] Open
Abstract
Background While decreased hip abductor strength, functional performance, and self-reported instability scores have all been shown in association with CAI, any sex difference in the relationship between these indicators is unclear. This study was to determine whether sex differences are present in the relationship between these indicators in individuals with CAI. Methods Thirty-two women and twenty-nine men with unilateral CAI took part. Hip abductor strength and functional performance were respectively assessed using a hand-held dynamometer and the figure-8-hop test. All 61 participants scored the Cumberland Ankle Instability Tool (CAIT) for self-reported ankle instability. Independent sample t-tests and correlation analysis were conducted. Results Normalized hip abductor strength and functional performance measures for females were lower than for males. The self-reported ankle instability CAIT score, where higher values represent less instability, was significantly and positively correlated with both normalized hip abductor strength (p = 0.003) and functional performance (p = 0.001) on the affected side in females, but not in males (p = 0.361 and p = 0.192 respectively). Conclusions Sex differences were observed in that there were significant relationships between normalized hip abductor strength, functional performance, and CAIT scores in female CAI participants, but not males, suggesting that CAI evaluation and rehabilitation strategies should be sex-specific. Highlights In females with CAI, hip abductor strength and functional performance showed significant relationships with self-reported instability scores. Correspondingly, in clinical practice with individuals with CAI, evaluation criteria may be formulated according to these observed sex differences. Sex differences should be factored into the evaluation and treatment of CAI individuals. Hip strength assessment should be employed with CAI individuals. Hip strengthening and functional hopping may be recommended for the rehabilitation of CAI, especially in female patients.
Collapse
Affiliation(s)
- Junlan Lu
- Children's Rehabilitation Center, Division of Pediatric Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhigang Wu
- Department of Rehabilitation Medicine, Hainan Western Central Hospital, Danzhou, Hainan, China
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Bruce, ACT, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, 279 Zhouzhu Highway,Pudong New Area, Shanghai, 201318, China. .,Research Institute for Sport and Exercise, University of Canberra, Bruce, ACT, Australia.
| | - Bin Cai
- Department of Rehabilitation Medicine, Hainan Western Central Hospital, Danzhou, Hainan, China. .,Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.
| |
Collapse
|