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Kikumoto T, Kobayashi M, Omori G, Kubo M. Single-legged landing behavior of high school basketball players with chronic ankle instability. J Bodyw Mov Ther 2024; 39:454-462. [PMID: 38876668 DOI: 10.1016/j.jbmt.2024.03.054] [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: 12/21/2022] [Revised: 02/20/2024] [Accepted: 03/19/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES Anterior cruciate ligament injury is one of the most serious ligamentous injuries. The purpose is to compare the impact of the ankle joint on the knee during landing between athletes with chronic instability and a control group (coper group) and to verify the effects of the kinetic chain from other joints. DESIGN Prospective study. SETTING High school basketball. PARTICIPANTS Participants were 62 female high school basketball players who had participated in team sports for >6 months. MAIN OUTCOME MEASURES Player joint angles, movements, and moments. RESULTS The knee valgus moment was significantly higher in the chronic ankle instability group than in the coper group (20%-60% [p < 0.01]; 80%-100% [p < 0.05]) during landing motion. The knee valgus moment was also significantly higher during the change from the maximum knee joint flexion position to the maximum extension (p < 0.05). In addition, the landing motions of the chronic instability group may have utilized suboptimal compensatory motor strategy on the sagittal plane, depending heavily on the knee joint's abduction moment. CONCLUSIONS Our findings indicate that the chronic ankle instability group uses a different landing strategy pattern than the coper group by changing the joint moment and joint angle during landing, which may increase the risk of anterior cruciate ligament injury.
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Affiliation(s)
- Takanori Kikumoto
- Institute for Human Movement and Medical Sciences, Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan.
| | - Marina Kobayashi
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Masayoshi Kubo
- Institute for Human Movement and Medical Sciences, Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
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Sung PS, Lee D. Postural control and trunk stability on sway parameters in adults with and without chronic low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:1455-1464. [PMID: 38374241 DOI: 10.1007/s00586-024-08147-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/16/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Postural sway changes often reflect functional impairments in adults with chronic low back pain (LBP). However, there is a gap in understanding how these individuals adapt their postural strategies to maintain stability. PURPOSE This study investigated postural sway distance and velocity, utilizing the center of pressure (COP) and center of gravity (COG), between adults with and without LBP during repeated unilateral standing trials. METHODS Twenty-six subjects with LBP and 39 control subjects participated in the study. Postural sway ranges, COP/COG sways, and sway velocities (computed by dividing path length by time in anteroposterior (AP) and mediolateral (ML) directions over 10 s) were analyzed across three unilateral standing trials. RESULTS A significant group interaction in sway range difference was observed following repeated trials (F = 5.90, p = 0.02). For COG sway range, significant group interactions were demonstrated in both directions (F = 4.28, p = 0.04) and repeated trials (F = 5.79, p = 0.02). The LBP group demonstrated reduced ML sway velocities in the first (5.21 ± 2.43 for the control group, 4.16 ± 2.33 for the LBP group; t = 1.72, p = 0.04) and second (4.87 ± 2.62 for the control group, 3.79 ± 2.22 for the LBP group; t = 1.73, p = 0.04) trials. CONCLUSION The LBP group demonstrated decreased ML sway velocities to enhance trunk stability in the initial two trials. The COG results emphasized the potential use of trunk strategies in augmenting postural stability and optimizing neuromuscular control during unilateral standing.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy, Indiana Wesleyan University, 4201 South Washington Street, Marion, IN, 46953, USA.
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Yetiş M, Kocaman H, Canli M, Alkan H, Yildirim H, Yildiz NT, Kuzu Ş. Validity and reliability of the Modified Four Square Step Test in individuals with ankle sprain. J Orthop Surg Res 2024; 19:182. [PMID: 38491530 PMCID: PMC10941393 DOI: 10.1186/s13018-024-04664-5] [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: 12/21/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Postural instability and gait abnormalities are frequently observed after an ankle sprain. A modified Four Square Step Test (mFSST) was developed to assess dynamic balance during gait. The aim of this study was to evaluate the reliability and validity of the mFSST in individuals with ankle sprains. METHODS The study included 39 individuals with grade 1 and 2 ankle sprains with a mean age of 30.36 ± 6.21 years. The dynamic balance of the participants was assessed with the mFSST and Timed Up & Go test (TUG). To determine the test-retest reliability of the mFSST, the test was repeated approximately 1 h apart. RESULTS The test-retest reliability of the mFSST was excellent (ICC = 0.85). Furthermore, when the concurrent validity of the mFSST was examined, a high correlation was found between with the TUG (r = 0.78, p < 0.001). CONCLUSION The mFSST is a valid and reliable clinical assessment method for evaluating dynamic balance during walking in individuals with ankle sprains. We think that the mFSST is preferable in clinical evaluations because its platform is easy to prepare and requires very little equipment.
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Affiliation(s)
- Mehmet Yetiş
- Department of Orthopedics and Traumatology, Faculty of Medicine, Kirşehir Ahi Evran University, Kirşehir, Turkey
| | - Hikmet Kocaman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karamanoglu Mehmetbey University, Karaman, Turkey
| | - Mehmet Canli
- School of Physical Therapy and Rehabilitation, Kirşehir Ahi Evran University, Kirşehir, Turkey.
| | - Halil Alkan
- Deparment of Physiotherapy and Rehabilitation, Faculty of Health Science, Muş Alparslan University, Muş, Turkey
| | - Hasan Yildirim
- Department of Mathematics, Faculty of Kamil Özdağ Science, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Nazim Tolgahan Yildiz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karamanoglu Mehmetbey University, Karaman, Turkey
| | - Şafak Kuzu
- School of Physical Therapy and Rehabilitation, Kirşehir Ahi Evran University, Kirşehir, Turkey
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Lee D, Sung PS. Normalized stability time analysis within the boundaries between adults with and without fear of falling. Aging Clin Exp Res 2024; 36:13. [PMID: 38281190 PMCID: PMC10822799 DOI: 10.1007/s40520-023-02651-0] [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] [Received: 08/20/2023] [Accepted: 10/29/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND The unilateral stance test, measured by the center of pressure (COP), has been widely used to identify balance deficits. However, there is a critical gap in understanding the specific COP thresholds on postural stability in adults with a fear of falling (FOF). AIMS To investigate the normalized stability time, which was defined as the ratio of time spent within stability boundaries to the total test duration, under different visual conditions and specific thresholds between adults with and without FOF. METHODS Twenty-one older adults with FOF and 22 control subjects completed the unilateral limb standing test in eyes-open and eyes-closed conditions. Normalized stability times were computed based on five pre-determined COP sway range thresholds: 10 mm, 15 mm, 20 mm, 25 mm, and 30 mm. RESULTS Receiver operating characteristic analysis determined the diagnostic accuracy of FOF. There were significant differences in the effects of both visual conditions (F = 46.88, p = 0.001) and threshold settings (F = 119.38, p = 0.001) on stability time between groups. The FOF group significantly reduced normalized stability time at the 10 mm COP threshold under eyes-closed conditions (t = - 1.95, p = 0.03). DISCUSSION The findings highlight the heightened sensitivity of the 10 mm COP threshold in identifying group variances in postural stability when eyes are closed. Moreover, the FOF group displayed a marked reduction in stability duration based on visual scenarios and normalized thresholds. CONCLUSION The study highlights the need to account for both COP boundaries and visual conditions in adults with FOF. When assessing postural control during unilateral stances, clinicians must also give attention to non-visual cues.
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Affiliation(s)
- Dongchul Lee
- Nevro Inc., 1800 Bridge Parkway, Redwood City, CA, USA
| | - Paul S Sung
- Doctor of Physical Therapy Program, Indiana Wesleyan University, 4201 South Washington Street, Marion, IN, 46953, USA.
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Bertrand-Charette M, Perron MP, da Silva RA, Beaulieu LD. Vibration-induced postural reactions: a scoping review on parameters and populations studied. Front Hum Neurosci 2024; 17:1307639. [PMID: 38234593 PMCID: PMC10791994 DOI: 10.3389/fnhum.2023.1307639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024] Open
Abstract
Objective Mechanical vibration is an effective way for externally activating Ia primary endings of the muscle spindles and skin mechanoreceptors. Despite its popularity in proprioception and postural control studies, there is still no review covering the wide variety of vibration parameters or locations used in studies. The main purpose of this scoping review was thus to give an overview of general vibration parameters and to identify, if available, the rationale for justifying methodological choices concerning vibration parameters. Methods Three databases (Pubmed, CINHAL, and SPORTDiscus) were searched from inception to July 2022. Included articles were to focus on the study of muscle spindles and skin mechanoreceptors vibration in humans and assess postural control. Following inclusion, data regarding demographic information, populations, vibration parameters and rationale were extracted and summarized. Results One hundred forty-seven articles were included, mostly targeting lower extremities (n = 137) and adults (n = 126). The parameters used varied widely but were most often around 80 Hz, at an amplitude of 1 mm for 10-20 s. Regarding rationales, nearly 50% of the studies did not include any, whereas those including one mainly cited the same two studies, without elaborating specifically on the parameter's choice. Conclusion This scoping review provided a comprehensive description of the population recruited and parameters used for vibration protocols in current studies with humans. Despite many studies, there remain important gaps of knowledge that needs to be filled, especially for vibration amplitude and duration parameters in various populations.
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Affiliation(s)
- Michaël Bertrand-Charette
- BioNR Research Lab, Université du Québec à Chicoutimi, Saguenay, QC, Canada
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada
| | - Marie-Pier Perron
- BioNR Research Lab, Université du Québec à Chicoutimi, Saguenay, QC, Canada
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada
| | - Rubens A. da Silva
- BioNR Research Lab, Université du Québec à Chicoutimi, Saguenay, QC, Canada
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada
- Centre Intégré de Santé et Services Sociaux du Saguenay—Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services–La Baie Hospital, Saguenay, QC, Canada
| | - Louis-David Beaulieu
- BioNR Research Lab, Université du Québec à Chicoutimi, Saguenay, QC, Canada
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada
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Xue X, Wang Y, Xu X, Li H, Li Q, Na Y, Tao W, Yu L, Jin Z, Li H, Wang R, Hua Y. Postural Control Deficits During Static Single-leg Stance in Chronic Ankle Instability: A Systematic Review and Meta-Analysis. Sports Health 2024; 16:29-37. [PMID: 36872589 PMCID: PMC10732110 DOI: 10.1177/19417381231152490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
CONTEXT Postural control deficits arising from injured ankles are central to chronic ankle instability (CAI) and its persistent symptoms. This is usually measured by recording the center of pressure (CoP) trajectory during static single-leg stance using a stable force plate. However, existing studies have produced conflicting results on whether this mode of measurement adequately reveals the postural deficits in CAI. OBJECTIVE To determine whether postural control during static single-leg stance is impaired in CAI patients when compared with uninjured healthy controls. DATA SOURCES Literature databases, PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, and SPORTDiscus, were searched from inception to April 1, 2022, using ankle-, injury-, and posture-related terms. STUDY SELECTION Two authors independently performed the step-by-step screening of article titles, abstracts, and full texts to select peer-reviewed studies investigating CoP trajectory during static single-leg stance using a stable force plate in CAI patients and healthy controls. A total of 13,637 studies were reviewed, and 38 studies (0.003%) met the selection criteria. STUDY DESIGN Meta-analyses of descriptive epidemiological study. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION CoP parameters, sway directions, visual condition, and numerical data (means and standard deviations) were extracted. RESULTS The injured ankles of CAI patients had higher standard deviations of sway amplitude in both anterior-posterior and medial-lateral directions (standardized mean difference [SMD] = 0.36 and 0.31, respectively) under conditions of open eyes than controls. Higher mean sway velocity in anterior-posterior, medial-lateral, and total directions (SMD = 0.41, 0.37, and 0.45, respectively) with closed eyes was also found. CONCLUSION CAI patients had deficits of postural control during static single-leg stance, and these deficits were identified by the CoP trajectory. Further methodological explorations of CoP parameters and corresponding test conditions are required to enhance the sensitivity and reliability of postural deficit assessments in CAI using force plates.
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Affiliation(s)
- Xiao’ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiran Wang
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoyun Xu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Hong Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyan Na
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Weichu Tao
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Le Yu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Zhengbiao Jin
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongyun Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ru Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China; Yiwu Research Institute, Fudan University, Yiwu, China
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Kim KM, Needle AR, Kim JS, An YW, Cruz-Díaz D, Taube W. What interventions can treat arthrogenic muscle inhibition in patients with chronic ankle instability? A systematic review with meta-analysis. Disabil Rehabil 2024; 46:241-256. [PMID: 36650898 DOI: 10.1080/09638288.2022.2161643] [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: 04/04/2022] [Accepted: 12/18/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify, critically appraise, and synthesize the existing evidence regarding the effects of therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability (CAI). MATERIALS AND METHODS Two reviewers independently performed exhaustive database searches in Web of Science, PubMed, Medline, CINAHL, and SPORTDiscus. RESULTS Nine studies were finally included. Five types of disinhibitory interventions were identified: focal ankle joint cooling (FAJC), manual therapy, fibular reposition taping (FRT), whole-body vibration (WBV), and transcranial direct current stimulation (tDCS). There were moderate effects of FAJC on spinal excitability in ankle muscles (g = 0.55, 95% CI = 0.03-1.08, p = 0.040 for the soleus and g = 0.54, 95% CI = 0.01-1.07, p = 0.046 for the fibularis longus). In contrast, manual therapy, FRT, WBV were not effective. Finally, 4 weeks of tDCS combined with eccentric exercise showed large effects on corticospinal excitability in 2 weeks after the intervention (g = 0.99, 95% CI = 0.14-1.85 for the fibularis longus and g = 1.02, 95% CI = 0.16-1.87 for the tibialis anterior). CONCLUSIONS FAJC and tDCS may be effective in counteracting AMI. However, the current evidence of mainly short-term studies to support the use of disinhibitory interventions is too limited to draw definitive conclusions.
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Affiliation(s)
- Kyung-Min Kim
- Department of Sport Science, Sungkyunkwan University, Suwon-si, Korea
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - Alan R Needle
- Department of Public Health & Exercise Science, Appalachian State University, Boone, NC, USA
- Department of Rehabilitation Sciences, Appalachian State University, Boone, NC, USA
| | - Joo-Sung Kim
- Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA
| | - Yong Woo An
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, USA
| | - David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
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Wang L, Yu G, Zhang X, Wang YZ, Chen YP. Relationship between ankle pain, range of motion, strength and balance in individuals with functional ankle instability: a cross-sectional study. BMC Musculoskelet Disord 2023; 24:955. [PMID: 38066472 PMCID: PMC10704625 DOI: 10.1186/s12891-023-07079-1] [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: 08/20/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND About 15-60% of individuals with ankle sprains may develop functional ankle instability (FAI), which is characterised by ankle pain, decreased muscle strength, limited range of motion, and impaired balance, causing a decline in social activity and quality of life. However, the relationship between those characters is still unclear. This study aimed to investigate whether a relationship existed between ankle pain, active range of motion (AROM), strength and balance and if ankle pain, AROM and strength can predict balance in individuals with FAI. METHODS Seventy-seven subjects (46 males; 31 females) with unilateral FAI participated in this study. Ankle pain was measured by the visual analogue scale (VAS), ankle AROM was measured using a universal goniometer, ankle strength was measured using a handheld dynamometer, the static balance was measured by the Time in Balance Test (TBT) and the dynamic balance was measured by the modified Star Excursion Balance Test (mSEBT). Pearson product-moment correlations were used to determine the correlations between ankle pain, AROM, strength and balance. Multiple linear regressions were used to investigate if ankle pain, AROM and strength can predict balance in individuals with FAI. RESULTS VAS and AROM-plantarflexion predicted 25.6% of the TBT (f2 = 0.344, P < 0.001). AROM-dorsiflexion predicted 24.6% of the mSEBT-anterior reach (f2 = 0.326, P < 0.001). VAS, AROM-plantarflexion and strength-plantarflexion predicted 33.5% of the mSEBT-posteromedial reach (f2 = 0.504, P < 0.001). AROM-plantarflexion and strength-plantarflexion predicted 28.2% of the mSEBT-posterolateral reach (f2 = 0.393, P < 0.001). CONCLUSION This study shows that ankle plantarflexion strength, AROM of dorsiflexion and plantarflexion and pain are predictors of balance in individuals with FAI. These factors could be considered in the rehabilitation of FAI. TRIAL REGISTRATION Trial registration number: ChiCTR2200063532.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Ge Yu
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Xi Zhang
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China
| | - Yu-Zhang Wang
- Department of Rehabilitation Medicine, Beijing Jishuitan Hospital of Capital Medical University, 31 Xinjiekou East Street, Beijing, 100035, China
| | - Ya-Ping Chen
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730, China.
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Lee D, Sung PS. Postural adaptations within normalized stability between older adults with and without chronic low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:4420-4427. [PMID: 37718340 DOI: 10.1007/s00586-023-07939-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Adaptations of dynamic balance performance are related to sway excursions in older adults with chronic low back pain (LBP). However, there is a lack of understanding on postural control within different thresholds of radius from the center of pressure (COP). PURPOSE This study was conducted to compare the normalized stability based on the time-in-boundary (TIB) during repeated unilateral limb standing trials between subjects with and without chronic LBP. METHODS There were 26 older adults with LBP and 39 control subjects who completed three trials of repeated unilateral limb standing on a force plat. RESULTS The TIB based on the seven thresholds was analyzed, and the groups demonstrated a significant interaction on thresholds for TIB (F = 8.76, p = 0.01). The TIB was significantly different in the 10 mm (F = 4.01, p = 0.04), 15 mm (F = 5.21, p = 0.03), and 20 mm (F = 4.48, p = 0.04) radius of thresholds only in the second trial. However, there was no group difference on TIB at the first and third trials due to potential compensatory and/or adaptive reactions to avoid fall risks. CONCLUSION The LBP group lacked postural stability within the thresholds less than a 20 mm radius at the second trial of unilateral standing. The significant group interaction with the thresholds indicates an adaptation strategy on sway thresholds. This postural reaction from repeated trials should be considered with sway excursion adjustments and fall prevention in older adults with LB.
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Affiliation(s)
| | - Paul S Sung
- Doctor of Physical Therapy Program, Indiana Wesleyan University, 4201 South Washington Street, Marion, IN, 46953, USA.
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Mohammadi N, Hadian MR, Olyaei GR. Compare the Effect of Traditional and Virtual Reality Training on Subjective-sense of Instability and Balance in Basketball-players with Functional Ankle Instability: Matched Randomized Clinical Trial. J Biomed Phys Eng 2023; 13:269-280. [PMID: 37312892 PMCID: PMC10258205 DOI: 10.31661/jbpe.v0i0.2007-1146] [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: 07/24/2020] [Accepted: 08/20/2020] [Indexed: 06/15/2023]
Abstract
Background Functional ankle instability (FAI) is a common injury. Traditional training improved the reported balance impairment and subjective sense of instability in athletes with FAI. Objective This study aims to compare the effects of traditional and virtual reality training on a subjective sense of instability and balance in athlete with FAI. Material and Methods In this single-blinded matched randomized clinical trial design, Fifty-four basketball players were randomly assigned in the virtual reality (n=27) or control (n=27) groups. All athletes performed 12 sessions Wii exercises or traditional training in the virtual reality and the control group, respectively, for three days a week. To assess the subjective-sense of instability and balance, we used Cumberland Ankle Instability Tool (CAIT) and Star Excursion Balance Test (SEBT), respectively. Measures were taken at pre- and post-test and one month after training as a follow-up. The between-group comparisons were done by the analysis of Covariance. Results At the pre-test, the CAIT score was 22.37, 22.04 in the control and virtual reality groups, respectively and at the post-test, these scores increased to 26.63, 27.26. The involved limb showed significant differences in posteromedial and posterior directions of the SEBT and CAIT score in the post-test and in the posterior direction and CAIT score in the follow-up. The virtual reality group had better performance than the control group but the effect size is small (cohen's d<0.2). Conclusion Based on our results, both training protocols were effective in reducing the subjective-sense of instability and improved balance in athletes with FAI. Moreover, virtual reality training was very attractive for the participants.
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Affiliation(s)
- Niloofar Mohammadi
- Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Hadian
- Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam-Reza Olyaei
- Department of Physical Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Yoshida K, Kuramochi R, Shinohara J. Effect of a Balance Adjustment System on Postural Control in Patients with Chronic Ankle Instability. Int J Sports Phys Ther 2023; V18:636-644. [PMID: 37425119 PMCID: PMC10324292 DOI: 10.26603/001c.74722] [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: 11/15/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background/Purpose This study aimed to evaluate how a two-week program using the in-phase mode of a balance adjustment system (the BASYS) affected postural control in participants with chronic ankle instability (CAI). It was hypothesized that the in-phase mode on the BASYS would lead to improved postural control compared with training on a balance disc. Study Design Randomized control trial. Methods Twenty participants with CAI were recruited. The participants were divided into two intervention groups: the BASYS (n = 10) and Balance Disc (BD; cushion type, n = 10). All participants underwent six supervised training sessions over a two-week period. Static postural control during single leg standing with closed eyes was assessed for the CAI limb. We collected COP data while participants balanced on the BASYS. The test was performed for 30 sec, and the total trajectory length and 95% ellipse area were calculated. In the assessment of dynamic postural stability, Y-Balance tests-anterior, posteromedial, and posterolateral directions were measured on the CAI limb for all participants and normalized to the individual's leg length. Participants were recorded at three instances: pretraining (Pre), post-training 1 (Post1: after the first training), and post-training 2 (Post2: after the last training). Results There was an effect on time in the COP total trajectory length of the BASYS group, which was significantly decreased for Post 1 and Post 2 than for the Pre (p = 0.001, 0.0001). Group differences and time-by-group interactions were not observed for either of the Y-balance test reach distances. Conclusions The study's primary finding was that two weeks of intervention in the in-phase mode on the BASYS improved static postural control in participants with CAI. Level of Evidence Level Ⅰ, randomized control trial.
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Affiliation(s)
- Kazushi Yoshida
- Graduate School of Health and Sports Sciences Chukyo University
| | - Rieko Kuramochi
- Graduate School of Health and Sports Sciences Chukyo University
- School of Health and Sports Sciences Chukyo University
| | - Junji Shinohara
- Graduate School of Health and Sports Sciences Chukyo University
- School of Health and Sports Sciences Chukyo University
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12
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Kawabata S, Murata K, Iijima H, Nakao K, Kawabata R, Terada H, Kojima T, Takasu C, Kano T, Kanemura N. Ankle instability as a prognostic factor associated with the recurrence of ankle sprain: A systematic review. Foot (Edinb) 2023; 54:101963. [PMID: 36709590 DOI: 10.1016/j.foot.2023.101963] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
DESIGN Systematic review using PRISMA guidelines. PURPOSE To explore Relationship between ankle instability and ankle sprain recurrence in preventing recurrence of ankle sprains and to provide appropriate treatment. METHODS MEDLINE (the Cochrane Library) and the Physiotherapy Evidence Database (PEDro) were explored using key words related to ankle instability and ankle sprains in for April 2022. According to the inclusion criteria, studies that 1) targeted patients with ankle sprains, 2) assessed ankle instability, and 3) investigated ankle sprain recurrence rates, were extracted. The author names, publication year, patient characteristics, comparison groups, intervention methods, and outcome data (ankle instability and recurrence) were extracted. A correlation analysis between recurrence rate and ankle instability was conducted. In addition, A meta-analysis was performed on the correlation coefficients within each article. RESULTS Eight studies were extracted from 149 studies. A correlation analysis was conducted on five studies and meta-analysis was on three studies with the same post-intervention follow-up period and the same assessment methods for ankle instability and recurrence rate. Strong positive correlations were found for the same follow-up periods (r = 0.95: 95%CI [0.62-0.99]; 3-month, r = 0.97: 95%CI [0.75-0.10]; 1 year, p < .05). The correlation became stronger as the follow-up period increased. Furthermore, the meta-analysis showed that ankle instability as well as the main symptoms of sprain, such as pain and swelling, tended to be positively correlated with the recurrent rate of ankle sprains. These results suggest that ankle instability is strongly related to recurrence, and the longer the time since onset, the stronger the relationship. CONCLUSIONS Ankle instability was a prognostic factor associated with recurrence of ankle sprains in patients with ankle sprains. Therefore, ankle instability is one of important factor in preventing recurrence of ankle sprains.
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Affiliation(s)
- Sora Kawabata
- Department of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Kenji Murata
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan.
| | - Hirotaka Iijima
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan; Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kouki Nakao
- Department of Rehabilitation, Amakusa Rehabilitation Hospital, Saitama, Japan
| | - Riku Kawabata
- Department of Rehabilitation, Minami-Koshigaya Hospital, Saitama, Japan
| | - Hidenobu Terada
- Department of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Takuma Kojima
- Department of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Chiharu Takasu
- Department of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Takuma Kano
- Department of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naohiko Kanemura
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan
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13
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Ho MT, Tan JC. The association between foot posture, single leg balance and running biomechanics of the foot. Foot (Edinb) 2022; 53:101946. [PMID: 36463612 DOI: 10.1016/j.foot.2022.101946] [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: 09/20/2020] [Revised: 10/05/2022] [Accepted: 10/28/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES A mal-aligned foot posture (high-arched and flat feet) and poor single leg balance ability have been separately associated with foot injuries during running. Therefore, clinicians assess these routinely. However, the extent to which foot posture and single-leg balance ability affect actual foot biomechanics during running is not known. This study aims to investigate the association of foot posture, single-leg balance ability, and foot biomechanics during running. METHOD This is a cross sectional study of sixty-nine participants who had their foot postures and single-leg balance ability assessed. The Foot Posture Index and Balance Error Scoring System were used. Their foot kinetics was measured as they ran on an instrumented treadmill and foot kinematics was processed using a 3D motion capture system. Multiple-regression was used to analyse the variance of foot biomechanics explained by foot posture and single-leg balance ability. RESULTS Foot posture and single-leg balance ability were found to account significantly for the variance in rearfoot eversion (24%) and forefoot dorsiflexion (7%). Two regression equations were derived, where rearfoot eversion and forefoot dorsiflexion during running may be predicted. CONCLUSION Foot posture and single-leg balance ability can predict rearfoot eversion and forefoot dorsiflexion only during running. Based on the regression equations, individuals with the same foot posture but different single-leg balance ability may exhibit different foot kinematics. However, the angular differences are small. The equations may be useful for clinicians working in places where running gait analysis equipment are not readily accessible. Further studies with larger sample sizes are required to validate these equations. In addition, further studies are necessary to investigate the effect of these two variables under different running conditions e.g. with footwear and with orthoses.
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Affiliation(s)
- Malia T Ho
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - John C Tan
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore.
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14
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Ota M, Tateuchi H, Hashiguchi T, Fujiwara K, Sasaki A, Okumura K, Ichihashi N. Validity of the frame subtraction method in dynamic postural stability. BMC Sports Sci Med Rehabil 2022; 14:174. [PMID: 36163189 PMCID: PMC9511721 DOI: 10.1186/s13102-022-00570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022]
Abstract
Background The movement of targeted subjects can be calculated using the frame subtraction method. However, the validity of this evaluation method of dynamic postural stability has not been clarified yet. This study aimed to verify the validity of the evaluation method for jump landing using the frame subtraction score based on the ground reaction force (GRF). Methods Twenty subjects performed single-leg jump landing, and their dynamic postural stability index (DPSI), medial‒lateral stability index (MLSI), anterior‒posterior stability index, and vertical stability index (VSI) were calculated from the GRF. Simultaneously, motion images were captured using digital video cameras in the sagittal and frontal planes. After the motion images were analyzed using the frame subtraction method, the frame subtraction scores in the frontal, sagittal, and combined planes were calculated. To confirm its validity, the relationship between the frame subtraction scores and GRF parameters was investigated using Pearson's correlation analysis. Results The frame subtraction scores in the frontal and combined planes were significantly correlated with the DPSI, MLSI, and VSI (r = 0.46–0.75, P < 0.05). Conclusions Therefore, the frame subtraction method could be applied to the evaluation of dynamic postural stability. Markerless systems are deemed useful in clinical practice.
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Affiliation(s)
- Megumi Ota
- Department of Preventive Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Hiroshige Tateuchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takaya Hashiguchi
- Mixi Incorporated, Shibuya Scramble Square 36F, 2-24-12 Shibuya, Shibuya-ku, Tokyo, 150-6136, Japan
| | - Karen Fujiwara
- Kansai Medical University Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Ayano Sasaki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kiseki Okumura
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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15
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de Ruvo R, Russo G, Lena F, Giovannico G, Neville C, Turolla A, Torre M, Pellicciari L. The Effect of Manual Therapy Plus Exercise in Patients with Lateral Ankle Sprains: A Critically Appraised Topic with a Meta-Analysis. J Clin Med 2022; 11:jcm11164925. [PMID: 36013167 PMCID: PMC9409935 DOI: 10.3390/jcm11164925] [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: 06/17/2022] [Revised: 08/08/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
A high percentage of patients with lateral ankle sprains report poor outcomes and persistent neuromuscular impairment leading to chronic ankle instability and re-injury. Several interventions have been proposed and investigated, but the evidence on manual therapy combined with therapeutic exercise for pain reduction and functional improvement is still uncertain. The purpose was to study the effectiveness of adding manual therapy to therapeutic exercise in patients with lateral ankle sprains through a critically appraised topic. The literature search was performed in PubMed, PEDro, EMBASE and CINAHL databases, and only randomized clinical trials were included according to following criteria: (1) subjects with acute episodes of lateral ankle sprains, (2) administered manual therapy plus therapeutic exercise, (3) comparisons with therapeutic exercise alone and (4) reported outcomes for pain and function. Three randomized clinical trials (for a total of 180 patients) were included in the research. Meta-analyses revealed that manual therapy plus exercise was more effective than only exercises in improving dorsal (MD = 8.79, 95% CI: 6.81, 10.77) and plantar flexion (MD = 8.85, 95% CI 7.07, 10.63), lower limb function (MD = 1.20, 95% CI 0.63, 1.77) and pain (MD = -1.23; 95% IC -1.73, -0.72). Manual therapy can be used with therapeutic exercise to improve clinical outcome in patients with lateral ankle sprains.
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Affiliation(s)
- Rocco de Ruvo
- Fondazione Centri di Riabilitazione “Padre Pio Onlus”, 71013 San Giovanni Rotondo, Italy
| | - Giuseppe Russo
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Francesco Lena
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
- IRCCS INM Neuromed, 86077 Isernia, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
- Correspondence:
| | - Christoper Neville
- Department of PT Education, Upstate Medical University, Syracuse, NY 13210, USA
| | - Andrea Turolla
- Dipartimento di Scienze Biomediche e Neuromotorie—DIBINEM, Università degli Studi di Bologna, 40126 Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria, 40138 Bologna, Italy
| | - Monica Torre
- Sanstefar Abruzzo Riabilitazione, 65100 Pescara, Italy
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16
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Differences in postural control between healthy and subjects with chronic ankle instability. Phys Ther Sport 2022; 56:8-14. [DOI: 10.1016/j.ptsp.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022]
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17
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Picot B, Hardy A, Terrier R, Tassignon B, Lopes R, Fourchet F. Which Functional Tests and Self-Reported Questionnaires Can Help Clinicians Make Valid Return to Sport Decisions in Patients With Chronic Ankle Instability? A Narrative Review and Expert Opinion. Front Sports Act Living 2022; 4:902886. [PMID: 35721875 PMCID: PMC9204606 DOI: 10.3389/fspor.2022.902886] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/04/2022] [Indexed: 12/26/2022] Open
Abstract
Lateral ankle sprain is the most common injury in sports, with up to 40% of patients developing chronic ankle instability (CAI). One possible cause underlying this high rate of recurrence or feeling of giving way may be a premature return to sport (RTS). Indeed, except for time-based parameters, there are no specific criteria to guide clinicians in their RTS decisions in patients with CAI. A recent international consensus highlighted the relevance and importance of including patient-reported ankle function questionnaires combined with functional tests targeting ankle impairments in this population. Thus, the aim of this narrative review and expert opinion was to identify the most relevant functional performance tests and self-reported questionnaires to help clinicians in their RTS decision-making process following recurrent ankle sprains or surgical ankle stabilization. The PubMed (MEDLINE), PEDro, Cochrane Library and ScienceDirect databases were searched to identify published articles. Results showed that the single leg stance test on firm surfaces, the modified version of the star excursion balance test, the side hop test and the figure-of-8 test appeared to be the most relevant functional performance tests to target ankle impairments in patients with CAI. A combination of the Foot and Ankle Ability Measure (FAAM) and the Ankle Ligament Reconstruction-Return to Sport after Injury (ALR-RSI) questionnaires were the most relevant self-reported questionnaires to assess patient function in the context of CAI. Although these functional tests and questionnaires provide a solid foundation for clinicians to validate their RTS decisions in patient with CAI, objective scientific criteria with cut-off scores are still lacking. In addition to the proposed test cluster, an analysis of the context, in particular characteristics related to sports (e.g., fatigue, cognitive constraints), to obtain more information about the patient's risk of recurrent injury could be of added value when making a RTS decision in patients with CAI. In order to evaluate the strength of evertors under ecological conditions, it would also be interesting to assess the ability to control weight-bearing ankle inversion in a unipodal stance. Further studies are needed to assess the relevance of this proposed test cluster in RTS decision-making following lateral ankle sprain injury and CAI.
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Affiliation(s)
- Brice Picot
- French Handball Federation, Creteil, France
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
- Inter-University Laboratory of Human Movement Biology (LIBM), Savoie Mont-Blanc University, Chambéry, France
- *Correspondence: Brice Picot
| | | | - Romain Terrier
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
- Inter-University Laboratory of Human Movement Biology (LIBM), Savoie Mont-Blanc University, Chambéry, France
- SARL Whergo, Savoie Technolac (BP 80218), La Motte-Servolex, France
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronny Lopes
- Santé Atlantique, Pied Cheville Nantes Atlantique, Nantes, France
| | - François Fourchet
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
- Motion Analysis Lab, Physiotherapy Department, La Tour Hospital, Swiss Olympic Medical Center, Meyrin, Switzerland
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18
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Effects of Instrument Assisted Soft-Tissue Mobilization on Dynamic Balance in Those with Chronic Ankle Instability. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Our objective was to examine the effectiveness of IASTM application to the FL on dynamic balance in individuals with CAI. Fifteen individuals (seven females, eight males, age = 26.07 ± 9.18 years, mass = 87.33 ± 24.07 kg, height = 178.83 ± 12.83 cm) with CAI, as determined by the Ankle Instability Instrument (AII) volunteered to participate. Participants completed two counterbalanced sessions (experimental and control), and we recorded measurements at two time points (pre- and post-). The application of IASTM to the FL muscle was carried out using Técnica Gavilán® instruments for 90 s during the intervention, and participants sat for 2 min during the control session. Dynamic balance was assessed using the Y-balance test (YBT). The interaction between session and time for anterior reach was significant (F1,14 = 5.26, p = 0.04, η2 = 0.27). Post-hoc tests revealed farther reach distances at post-test (71.02 ± 9.45 cm) compared to pre-test (66.57 ± 10.87 cm) when IASTM was applied (p = 0.02, Mean Difference = 4.45 cm, CI95 = 0.71–8.19 cm, Cohen’s d = 0.44). The interaction between session and time was not significant for posteromedial (F1,14 = 0.25, p = 0.62, η2 = 0.02, 1 − β = 0.08) or posterolateral reaches (F1,14 = 1.17, p = 0.30, η2 = 0.08, 1 − β = 0.17). The application of IASTM to the FL improved anterior reach of the YBT, but not posterolateral or posteromedial reaches in individuals with CAI. However, the 4.45 cm increase in anterior reach could have clinical implications for improved function.
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19
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Influence of Landing in Neuromuscular Control and Ground Reaction Force with Ankle Instability: A Narrative Review. Bioengineering (Basel) 2022; 9:bioengineering9020068. [PMID: 35200421 PMCID: PMC8869733 DOI: 10.3390/bioengineering9020068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 12/26/2022] Open
Abstract
Ankle sprains are generally the most common injuries that are frequently experienced by competitive athletes. Ankle sprains, which are the main cause of ankle instability, can impair long-term sports performance and cause chronic ankle instability (CAI). Thus, a comprehensive understanding of the key factors involved in repeated ankle strains is necessary. During jumping and landing, adaptation to the landing force and control of neuromuscular activation is crucial in maintaining ankle stability. Ankle mobility provides a buffer during landing, and peroneus longus activation inhibits ankle inversion; together, they can effectively minimize the risk of ankle inversion injuries. Accordingly, this study recommends that ankle mobility should be enhanced through active and passive stretching and muscle recruitment training of the peroneus longus muscles for landing strategies should be performed to improve proprioception, which would in turn prevent ankle sprain and injury to neighboring joints.
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20
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DiSanti JS, Marshall AN, Valier ARS, McLeod TCV. High School Athletes’ Health-Related Quality of Life Across Recovery After Sport-Related Concussion or Acute Ankle Injury: A Report From the Athletic Training Practice-Based Research Network. Orthop J Sports Med 2022; 10:23259671211068034. [PMID: 35155704 PMCID: PMC8832601 DOI: 10.1177/23259671211068034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Evaluating adolescent athletes’ perceived health status after a sport-related injury can provide important direction for health promotion strategies and preparation for a successful return to play. Furthermore, comparing specific injury types regarding their impact on athletes' perspectives of their global and domain-specific health perceptions allows for a more detailed understanding of an athlete's experience while also providing avenues for targeted treatment strategies. Purpose: To compare health-related quality of life (HRQOL) between high school athletes who had sustained either a concussion or an acute ankle injury and compare how these injury types related to their global and domain-specific HRQOL across recovery. Study Design: Cohort study; Level of evidence, 3. Methods: Electronic medical records created by athletic trainers working in 32 high school facilities were examined, and records from 1749 patients who sustained either a sport-related concussion (n = 862) or ankle sprain (n = 887) were screened for inclusion. HRQOL was assessed by self-reported scores on the Pediatric Quality of Life Inventory (PedsQL) at 2 time points after injury (T1 = 0-2 days; T2 = 11-29 days). A 2-way group by time analysis of variance was conducted to examine differences in trajectories and disrupted areas of HRQOL. Results: Overall, 85 patient cases (46 concussion, 39 ankle sprain) fit the inclusion criteria. Each injury group exhibited improved global and domain-specific PedsQL scores between their 2 measured time points (P < .05), indicating recovery. However, domain-specific comparisons revealed that at T2, patients who had sustained an ankle sprain reported significantly lower PedsQL physical functioning scores (78.3 ± 19.3 vs 86.2 ± 15.7 for concussion; P = .005), whereas patients who had sustained a concussion reported lower scores related to their school functioning (80.0 ± 20.0 vs 90.8 ± 12.7 for ankle sprain; P = .006). Conclusion: The study results indicated that in high school athletes, the trajectories and disrupted areas of HRQOL stemming from a sport-related injury may be influenced differentially when comparing concussions with ankle sprains.
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Affiliation(s)
- Justin S. DiSanti
- Department of Interdisciplinary Health Sciences, Athletic Training Program, Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Ashley N. Marshall
- Department of Health and Exercise Science, Athletic Training Program, Appalachian State University, Boone, North Carolina, USA
| | - Alison R. Snyder Valier
- Department of Interdisciplinary Health Sciences, Athletic Training Program, Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Tamara C. Valovich McLeod
- Department of Interdisciplinary Health Sciences, Athletic Training Program, Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
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21
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Watabe T, Takabayashi T, Tokunaga Y, Kubo M. Copers adopt an altered dynamic postural control compared to individuals with chronic ankle instability and controls in unanticipated single-leg landing. Gait Posture 2022; 92:378-382. [PMID: 34923258 DOI: 10.1016/j.gaitpost.2021.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 11/02/2021] [Accepted: 12/12/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Several prior studies involving "expected" single-leg landings have not succeeded in establishing a difference between copers and a control group. RESEARCH QUESTION Does expected and unanticipated single-leg landing affect dynamic postural stability in lateral ankle sprain individuals with chronic ankle instability (CAI), copers, and controls? METHODS In this prospective cross-sectional study, physically active adults with CAI (n = 12), copers (n = 12), and controls (n = 12) were included. Participants performed expected single-leg landing by stepping off a 30-cm box. They also performed unanticipated landings including side-step cutting, side-step cutting at 60°, single-leg landing, and forward stepping. The expected and unanticipated conditions of each groups were compared in terms of time to stabilization (TTS) and center of pressure (COP) for the anterior-posterior (AP) and medial-lateral (ML) conditions. To analyze the data, a mixed-model one-way analysis of variance and a Tukey-Kramer post hoc test were performed. RESULTS A significant condition × group interaction was observed in only TTS ML, with the CAI group demonstrating a significantly longer TTS ML than the coper (p < 0.001) and control (p < 0.001) groups during unanticipated trials. In addition, group interaction effects were observed for COP AP and TTS AP. The coper group demonstrated significantly longer COP AP and TTS AP than the control group (p < 0.001). SIGNIFICANCE The CAI group demonstrated a significantly longer TTS ML than the coper and control groups during the unanticipated condition, and the coper group demonstrated significantly longer TTS AP and COP AP than the control group. Thus, longer COP AP and TTS AP sway time in the coper group may be a protection mechanism, allowing greater freedom in the AP plane while quickly controlling ML sway and preventing lateral ankle sprains. These findings can help in the prevention of lateral ankle sprains and assessment of dynamic postural control.
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Affiliation(s)
- Takaya Watabe
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| | - Tomoya Takabayashi
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| | - Yuta Tokunaga
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| | - Masayoshi Kubo
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
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22
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Lee JK. Comparison of maximum strength, proprioceptive, dynamic balance, maximum joint angle between two groups classified through the ankle instability instrument. J Phys Ther Sci 2022; 34:720-724. [PMID: 36337214 PMCID: PMC9622348 DOI: 10.1589/jpts.34.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/05/2022] [Indexed: 11/06/2022] Open
Abstract
[Purpose] The purpose of this study is to figure out the information obtainable from
ankle instability instrument (AII) survey among various factors related to the ankle
instability. [Participants and Methods] This study targeted on 34 participants, divided
the participants into stability group and instability group based on AII survey results,
and measured the maximum isometric contraction, proprioception, dynamic balance, and
maximum joint angles. The independent t-test was used. [Results] The maximum isometric
contraction showed significance in the plantar flexion while the proprioceptive sense
showed significance in both dorsiflexion and plantar flexion. The dynamic balanced showed
significance in the anterior direction while the maximum joint angles showed significance
in the dorsiflexion. [Conclusion] According to the results, the participants who were
classified as ankle instability patients based on AII survey results involved problems in
the maximum isometric contraction, proprioception, dynamic balance, and maximum joint
angles.
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Affiliation(s)
- Jae-Kwang Lee
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu: 13-13 Hayang-ro, Hayang-eup, Gyeongsan-si, Gyeongbuk 712-702, Republic of Korea
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23
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Song K, Jang J, Nolte T, Wikstrom EA. Dynamic reach deficits in those with chronic ankle instability: A systematic review and meta-analysis. Phys Ther Sport 2021; 53:40-50. [PMID: 34808538 DOI: 10.1016/j.ptsp.2021.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this review with meta-analyses was to determine the dynamic reach differences 1) between chronic ankle instability (CAI) and uninjured individuals, 2) between the limbs of an individual with CAI, and 3) between the uninvolved CAI limb and the healthy control limb across all possible reach directions of the Star Excursion Balance Test (SEBT). METHODS PubMed, CINAHL, SPORTDiscus, and Scopus databases were searched up to October 2021. Data were extracted from the retained studies and underwent methodological quality assessment and meta-analysis using random-effect models. RESULTS After screening, 33 articles were included for the analyses. In all possible SEBT reach directions, the CAI group demonstrated significantly decreased normalized dynamic reach distances relative to the uninjured control group (SMDs: -0.66 to -0.48, p ≤ 0.05). Similarly, the involved CAI limb demonstrated significantly decreased normalized dynamic reach distances relative to the uninvolved CAI limb (SMDs: -0.61 to -0.33, p ≤ 0.05). However, no differences were noted between the uninvolved CAI limb and the healthy control limb (SMDs: -0.22 to 0.09, p ≥ 0.13). CONCLUSIONS Our findings were that the involved limb of those with CAI has dynamic postural deficits relative to (i) an uninjured control group and (ii) relative to their uninvolved limb. However, the uninvolved limb of the CAI group does not differ from an uninjured control group in any reach direction.
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Affiliation(s)
- Kyeongtak Song
- Sports Medicine Research Institute, Department of Athletic Training & Clinical Nutrition, University of Kentucky, United States.
| | - Jaeho Jang
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, United States
| | - Tiffanie Nolte
- Department of Health, Athletic Training, Recreation & Kinesiology, Longwood University, United States
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, United States
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Hwang JH, Kim CM, Lee JK, Lee JK, Park JW. Comparison of maximum strength, proprioceptive, dynamic balance, maximum joint angle of stability and instability ankle by Cumberland Ankle Instability Tool. J Phys Ther Sci 2021; 33:728-732. [PMID: 34658514 PMCID: PMC8516603 DOI: 10.1589/jpts.33.728] [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: 06/01/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the factors of ankle instability by using Cumberland ankle instability tool (CAIT), which have been frequently used as ankle instability tools. The participants were divided into the normal ankle group and the instability ankle group. Maximum strength, proprioception, dynamic balance and maximum rage of joint motion were compared in order to find out factors of instability in the questionnaires. [Participants and Methods] A total of 44 participants were classified into the control (CON) group and the chronic ankle instability (CAI) group according to questionnaire types. Muscle strength, proprioception, dynamic balance and maximum joint angle were measured. The independent t-test was used. [Results] In the case of maximum ankle strength, it showed significance in CON group and CAI group ankle dorsiflexion and plantarflexion. In proprioception, it showed significance in CON group and CAI group. In dynamic balance, it showed significance in anterior (ANT) direction of the CON group and CAI group. Maximum joint angle produced significance in dorsiflexion of CON group and CAI group. [Conclusion] Information on maximum strength, proprioception, dynamic balance of anterior direction, and maximum joint angle of dorsiflexion is available through questionnaire CAIT.
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Affiliation(s)
- Jong-Ha Hwang
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu: 13-13 Hayang-ro, Hayang-eup, Gyeongsan-si, Gyeongbuk 712-702, Republic of Korea
| | - Chan-Myeong Kim
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu: 13-13 Hayang-ro, Hayang-eup, Gyeongsan-si, Gyeongbuk 712-702, Republic of Korea
| | - Jong-Kyung Lee
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu: 13-13 Hayang-ro, Hayang-eup, Gyeongsan-si, Gyeongbuk 712-702, Republic of Korea
| | - Jae-Kwang Lee
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu: 13-13 Hayang-ro, Hayang-eup, Gyeongsan-si, Gyeongbuk 712-702, Republic of Korea
| | - Ji-Won Park
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu: 13-13 Hayang-ro, Hayang-eup, Gyeongsan-si, Gyeongbuk 712-702, Republic of Korea
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Lee JH, Jung HW, Jung TS, Jang WY. Reliability and usefulness of the single leg heel raise balance test in patients with chronic ankle instability. Sci Rep 2021; 11:20369. [PMID: 34645864 PMCID: PMC8514424 DOI: 10.1038/s41598-021-99466-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/17/2021] [Indexed: 12/26/2022] Open
Abstract
We aimed to analyze the differences in static (including conventional and modified [single-leg heel-raise balance]) and dynamic postural stability and muscle endurance between patients with chronic ankle instability (CAI) and healthy controls, and to determine the reliability and usefulness of the single-leg heel-raise balance test in patients with CAI. In total, 26 patients with CAI and 26 healthy controls were enrolled. Postural stability was assessed using a postural stabilometry system. Muscle endurance was measured in dorsiflexion and plantarflexion using an isokinetic device. Modified static postural stability (P < 0.001) and dynamic postural stability (P < 0.001) were significantly poorer in the affected ankles of patients with CAI than in the controls. Plantarflexion endurance was significantly lower in the affected ankles of the patients with CAI than in the controls (P = 0.023). Modified static postural stability significantly correlated with plantarflexion endurance in both groups (CAI group: r = - 0.470, P = 0.015; healthy controls group: r = - 0.413, P = 0.036). Plantarflexion endurance was a significant risk factor for modified static postural stability in both the CAI group (R2 = 0.221, P = 0.015) and healthy controls (R2 = 0.170, P = 0.036). Given the reliability of the modified static postural stability test, clinicians and therapists should consider using it to assess improvements in postural stability and muscle endurance in patients with CAI before and after rehabilitation.
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Affiliation(s)
- Jin Hyuck Lee
- Department of Sports Medical Center, Korea University College of Medicine Anam Hospital, Seoul, Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul, South Korea
| | | | - Woo Young Jang
- Department of Sports Medical Center, Korea University College of Medicine Anam Hospital, Seoul, Korea. .,Department of Orthopedic Surgery, College of Medicine, Korea University, 73, Inchon‑ro, Seongbuk‑gu, Seoul, 02841, Republic of Korea.
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Nagamoto H, Yaguchi H, Takahashi H. History of ankle sprain affect the star excursion balance test among youth football players. Foot Ankle Surg 2021; 27:784-788. [PMID: 33160832 DOI: 10.1016/j.fas.2020.10.004] [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: 03/17/2020] [Revised: 09/18/2020] [Accepted: 10/10/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The relationship between the results of the Star Excursion Balance Test (SEBT) and lateral ankle sprain (LAS) among youth football players was investigated. METHODS The dominant leg and history of LASs were asked from 33 male youth football players. The SEBT in the anterior, posterolateral, and posteromedial directions were measured for both limbs. The relationship between the history of LAS and reach difference over 4 cm between the dominant and nondominant legs in each direction was statistically analyzed. RESULTS The number of players with the history of LAS, whose dominant/nondominant reach difference was over 4 cm in the anterior direction, was significantly higher to that in players without a history of LAS in both the dominant (94% vs. 63%, p = 0.02) and nondominant (100% vs. 25%, p = 0.02) legs. CONCLUSION Youth football players with a history of LAS showed reach deficit in the anterior direction in the SEBT.
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Affiliation(s)
- Hideaki Nagamoto
- Department of Orthopaedic Surgery, Kurihara Central Hospital, Japan.
| | - Haruki Yaguchi
- Department of Physical Medicine and Rehabilitation, Tohoku University School of Medicine, Japan
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Wang J, Zhang D, Zhao T, Ma J, Jin S. Effectiveness of balance training in patients with chronic ankle instability: protocol for a systematic review and meta-analysis. BMJ Open 2021; 11:e053755. [PMID: 34548370 PMCID: PMC8458363 DOI: 10.1136/bmjopen-2021-053755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Lateral ankle sprains are one of the most common musculoskeletal injuries. Up to 70% of individuals who sustain lateral ankle sprains develop chronic ankle instability (CAI). Balance training has been used in patients with CAI, but the evidence for its efficacy is inconsistent. This systematic review and meta-analysis aims to determine the short-term (end of the treatment period) and long-term (6 months after treatment) effectiveness of balance training for patients with CAI. METHODS AND ANALYSIS We will search PubMed, EMBASE, the Cochrane Library, Ovid, EBSCO-host, Pedro, ClinicalKey, ScienceDirect, Springer, China National Knowledge Infrastructure, Technology Periodical Database (VIP), WanFang Data and China Biology Medicine for reports of randomised trials of balance training in patients with CAI, from inception to 1 October 2021. The language will be restricted to English and Chinese, and articles will be screened and collected by two reviewers independently. Dynamic balance and functional ankle instability are the primary outcomes of this study. Secondary outcomes include pain, ankle range of motion, ankle strength and health-related quality of life. Review Manager V.5.3 software will be used for meta-analysis, and stratification analysis will be conducted for study quality according to the Jadad score. Subgroup and sensitivity analyses will be conducted. Grading of Recommendations, Assessment, Development and Evaluation will be used to assess confidence in the cumulative evidence. The protocol follows the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines. ETHICS AND DISSEMINATION Ethical approval is not required for literature-based studies. The results will be disseminated through peer-reviewed publications.
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Affiliation(s)
- Ju Wang
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Di Zhang
- Rehabilitation Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Tianyu Zhao
- Rehabilitation Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jiang Ma
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Song Jin
- Rehabilitation Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Udompanich N, Thanasootr KO, Chanavirut R, Chatchawan U, Hunsawong T. The Cut-Off Score of Four Clinical Tests to Quantify Balance Impairment in Individuals with Chronic Ankle Instability. Malays J Med Sci 2021; 28:87-96. [PMID: 34512133 PMCID: PMC8407791 DOI: 10.21315/mjms2021.28.4.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/05/2021] [Indexed: 02/08/2023] Open
Abstract
Background Balance impairment is a common consequence of chronic ankle instability (CAI). This study aimed to assess the discriminative validity of four clinical tests for quantifying balance impairment in individuals with CAI. Methods Participants were screened for their balance using the single-leg balance test (SLBT) and were assigned to either the positive or the negative SLBT groups. Fifty-four individuals with CAI (N = 27 per group) were recruited and completed four clinical tests including the foot-lift test (FLT), the time-in-balance test (TIBT), the modified star excursion balance test in the posteromedial (mSEBT-PM) direction and the side-hop test (SHT). The receiver operating characteristics (ROC) curve coupled with Youden index were calculated to determine the optimal cut-off scores of each test. Results We found significant differences in balance between groups for all tests, with good to excellent values for the area under the ROC curve (AUC). All four tests reached good to excellent sensitivity and specificity values and had significant cut-off scores to discriminate balance performance among CAI participants. Conclusion All four clinical tests can be conducted with their respective cut-off scores to quantify balance impairment in individuals with CAI.
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Affiliation(s)
- Nontawit Udompanich
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Kanok-On Thanasootr
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Raoyrin Chanavirut
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Uraiwan Chatchawan
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
| | - Torkamol Hunsawong
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
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Zhang R, Zhang X, Chen Y, Song W. Current perception threshold testing in chronic ankle instability. BMC Musculoskelet Disord 2021; 22:453. [PMID: 34006258 PMCID: PMC8132381 DOI: 10.1186/s12891-021-04345-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Damage to sensory input is an underlying pathology of chronic ankle instability (CAI). Therefore, it is necessary to evaluate the sensory function of patients with CAI. The present study quantitatively evaluated sensory nerve function in patients with CAI and healthy controls using current perception threshold (CPT) measurements, as well as the influence of sex, age, and body mass index (BMI) on CPT values and the relations between CPT frequencies. METHODS Fifty-nine subjects with CAI and 30 healthy controls participated in this study. CPT values at the anterior talofibular ligament region were recorded on the injured and uninjured sides in CAI patients and on both sides in the healthy control group. Between group differences were compared. The influence of sex, age and BMI on CPT values was evaluated. Correlations between different frequencies were also studied. RESULTS There were no significant differences in age, sex, height, weight or BMI between the CAI and healthy control groups. The CPT values did not show a significant difference by sex. The CPT values did not significantly correlate with age or BMI. Compared to the control group, the CAI group had significantly higher CPT values on the injured and uninjured sides under 250-Hz and 5-Hz electrical stimuli; the difference between the groups was significant (p < 0.01), and the effect size were large. No significant difference was observed under 2000-Hz stimuli. There were correlations between CPT values at different frequencies (p < 0.01), especially 250 Hz and 5 Hz. CONCLUSION The present study revealed increased sensory thresholds in 250-Hz- and 5-Hz-related sensory nerve fibres in the injured and uninjured ankles of patients with CAI. This increase may indicate dysfunction of A-delta and C fibres. Sex, age and BMI did not significantly impact CPT values. There were correlations between CPT values at different frequencies, especially 250 Hz and 5 Hz. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Ran Zhang
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, 45 Changchunjie, Beijing, 100054 China
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Xi Zhang
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Yaping Chen
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Weiqun Song
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, 45 Changchunjie, Beijing, 100054 China
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Svorai Band S, Pantanowitz M, Funk S, Waddington G, Steinberg N. Factors associated with musculoskeletal injuries in an infantry commanders course. PHYSICIAN SPORTSMED 2021; 49:81-91. [PMID: 32511050 DOI: 10.1080/00913847.2020.1780098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate the prevalence of injuries among young combat soldiers as assessed and reported by the military physicians, and to investigate whether parameters such as anthropometric measures, postural balance, proprioceptive ability, and chronic ankle instability are related to injuries during and following an infantry commanders course. METHODS In this cross-sectional study, 165 soldiers were tested for anthropometric measurements, proprioceptive ability, and dynamic postural balance (DPB), as well as for their responses to an ankle stability questionnaire (CAIT), on three occasions: pre-course, middle-course, and end-course testing. All musculoskeletal injuries were assessed and recorded in the digital medical file of each participant by specialist military physicians before and during/following the course. RESULTS Ninety-eight soldiers (59.4%) were injured before the course. Forty soldiers (24.2%) incurred an injury during/following the course (with 33 out of the 40 [82.5%] soldiers that were injured during/following the course having also been injured before the course). Sixty soldiers had no injury before/during/following the course. A survival curve showed that half of the soldiers who were injured during/following the course (20 soldiers) were recorded as injured in the first half of the course (during the first 46 days of the 92-day course). Logistic regression showed that the pre-course parameters that were significant among injured soldiers compared with the non-injured soldiers were: low CAIT results (OR = 2.736, 95% CI = 1.178-6.354), high BMI (OR = 1.234, 95% CI = 1.082-1.406) and reduced proprioceptive ability (OR =.858, 95% CI =.797-.924). CONCLUSION With a high prevalence of soldiers injured during and following a commanders course, a somatosensory intervention program should be generalized into the practical daily preparation and training routines of the soldiers for improving somatosensory abilities, optimizing military physical readiness, and for preventing future musculoskeletal injuries.
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Affiliation(s)
| | - Michal Pantanowitz
- Wingate College of Physical Education and Sports Sciences, Wingate Institute , Netanya, Israel
| | - Shany Funk
- Combat Fitness Department, Doctrine and Research Branch, Israel Defense Forces , Israel
| | | | - Nili Steinberg
- Wingate College of Physical Education and Sports Sciences, Wingate Institute , Netanya, Israel
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Proprioceptive Training on Dynamic Neuromuscular Control in Fencers: A Clinical Trial. J Sport Rehabil 2021; 30:220-225. [DOI: 10.1123/jsr.2019-0469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/10/2019] [Accepted: 02/23/2020] [Indexed: 12/26/2022]
Abstract
Context: Fencing is a sport of agility, with a higher incidence of lower-limb injuries, of which the ankle sprain is the most prevalent. Injury prevention is very important to improve performance and decrease the withdrawal time of athletes. Proprioceptive training programs can be added to the training of athletes, since, in addition to easy application and low cost, proprioception has the function of stabilizing the ankle joint to prevent injuries. Objective: To verify the influence of a 12-week proprioceptive training program on dynamic neuromuscular control in fencing athletes. Design: The study was a clinical trial, and the athletes were allocated, for convenience, in the intervention group or in the control group. Setting: The study was developed in 4 stages (preintervention, intervention, postintervention, and follow-up of 3). The neuromuscular control during the star excursion balance test was evaluated. Participants: The participants were 19 fencing athletes (intervention group: 10, and control group: 9), aged 14–35 years, from a multisport club. Interventions: The athletes performed the proprioceptive training during 12 weeks, 3 times a week, with a duration of 30 minutes. Main Outcome Measures: Dynamic neuromuscular control. Results: The data and SE were considered for statistical analysis, submitted to the generalized estimates equations test with Bonferroni post hoc. The level of significance was .05. The distance reached in the star excursion balance test increased significantly in all 8 directions evaluated in the 2 legs of the intervention group. Conclusions: The proprioceptive training program was able to improve dynamic neuromuscular control in fencing athletes.
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Gabriela V, Rafael G, Felipe M, Cláudia L. Effects of proprioceptive training on ankle muscle strength in fencers: A clinical trial. J Bodyw Mov Ther 2021; 27:141-147. [PMID: 34391225 DOI: 10.1016/j.jbmt.2021.01.011] [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: 07/13/2020] [Revised: 01/07/2021] [Accepted: 01/23/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fencing is a combat sport, which depends of lower limbs muscular strength and neuromuscular function. Because of that, approximately half of all injuries occur in lower limbs, especially in ankle. Thus, the objective of this study was to verify the influence of a twelve-week proprioceptive training program on ankle muscular strength and muscular balance in fencers. METHODS The study was a clinical trial, with 19 fencing athletes from 14 to 35-year-old. The main outcome was ankle invertors, evertors, plantiflexors and dorsiflexors muscular strength and ankle muscle balance. The study was performed in six stages: familiarization of muscular strength test in isokinetic dynamometer; pre-intervention; intervention; post-intervention; three- and six-months follow-up. At pre-intervention stage, the muscular strength was evaluated. At intervention stage, the athletes performed 12-week proprioceptive training program, three times a week. At post-intervention, three- and the six-months follow-ups, same pre-intervention test was performed. RESULTS The proprioceptive training improved front leg ankle dorsiflexor strength at three- and six-months follow-ups compared to pre-intervention. Furthermore, training increased the front leg dorsiflexors/plantiflexors conventional ratio at three- and six-months follow-ups compared to pre-intervention; and evertors/invertors conventional ratio at three-months follow-up compared to pre-intervention; and evertors/invertors functional ratio at post-intervention and three- and six-months follow-ups compared to pre-intervention. CONCLUSIONS The improvement and/or maintenance of ankle muscle strength occurred in intervention group seems to be due to stimulus provided by proprioceptive training, with ankle dorsiflexors being the most stimulated group.
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Affiliation(s)
- Vasconcelos Gabriela
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil.
| | - Grazioli Rafael
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil
| | - Minozzo Felipe
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil
| | - Lima Cláudia
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil
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Murata K, Kumai T, Hirose N. Lateral Ankle Sprains and Their Association with Physical Function in Young Soccer Players. Open Access J Sports Med 2021; 12:1-10. [PMID: 33469390 PMCID: PMC7811480 DOI: 10.2147/oajsm.s283421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/03/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose Lateral ankle sprain (LAS) in childhood can result in lateral malleolus avulsion fractures; additionally, bone nonunion may occur. Physical maturity relates to the development of bone morphology and physical functionality. It is unknown how changes in physical functionality attributable to physical maturity affect young soccer players with abnormal lateral malleolus (ALM) morphology. Hence, the present study aimed to investigate the bone morphology of the lateral malleolus in young soccer players and to examine its relationship with physical functionality at different maturity levels. Subjects and Methods Two hundred and ninety young soccer players aged 6–15 years were included. The presence of ALM was assessed using ultrasonography. The subjects were allocated to three groups based on physical maturity (Pre-, Mid-, and Post-peak height velocity age [PHVA]). The prevalence of ALM and the relationship between ALM and physical maturity were examined for body composition, foot pressure distribution, foot alignment, ankle mobility, and single-leg balance. Results The prevalence of ALM was 17.6%. For physical maturity, the post-PHVA group showed a decrease in ankle dorsiflexion and eversion and an increase in one-leg hop distance compared to the Pre-PHVA group (P < 0.05). In the ALM group, the center of pressure during heel raising was distributed laterally in the Post-PHVA (P < 0.01), and the weight-bearing dorsiflexion angle was decreased in the Mid- and Post-PHVA (P < 0.05). Conclusion In the Post-PHVA young soccer players, decreased ankle dorsiflexion and eversion and increased one-leg hop distance were observed. The ALM group exhibited lateral loading during heel raising in the Post-PHVA group and decreased weight-bearing ankle dorsiflexion angle in the Mid- and Post-PHVA groups. The findings indicate the importance of secondary prevention of LAS and ultrasonography. Prospective studies of LAS in young athletes are required in the future.
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Affiliation(s)
- Kenichiro Murata
- Graduate School of Sport Sciences, Waseda University, Nishi-tokyo, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Nozu S, Takemura M, Sole G. Assessments of Sensorimotor Deficits Used in Randomized Clinical Trials With Individuals With Ankle Sprains and Chronic Ankle Instability: A Scoping Review. PM R 2020; 13:901-914. [PMID: 32902164 DOI: 10.1002/pmrj.12487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 08/18/2020] [Accepted: 08/31/2020] [Indexed: 11/11/2022]
Abstract
The main purpose of this scoping review was to summarize the most common tasks and outcome measures in randomized control trials (RCTs) used to assess sensorimotor function following ankle sprain and chronic ankle instability (CAI). We also aimed to summarize the description of inclusion criteria used in articles. We searched for RCTs published between 2008 and 2018 using the following databases: MEDLINE, PubMed, SPORTDiscus, and Web of Science. Eligible studies included participants of either sex who had had at least one ankle sprain with/without subsequent CAI. All articles assessed sensorimotor function. The tasks, outcome measures, and inclusion criteria were categorized, and frequencies of use in each category were calculated. Of 272 publications, 31 met the eligibility criteria. The most common task was single-limb stance (58% of 31). The most common outcome measure was the posterior-medial reach distance of the Star Excursion Balance Test (SEBT) (13 of 16 articles, 81%). Different inclusion criteria for a history of ankle sprains or CAI were used. A wide range of sensorimotor assessments and inclusion criteria was used among studies involving individuals with a history of ankle sprain with or without CAI, which could make it difficult to compare and generalize study results. This scoping review provides a baseline for planning future studies exploring outcome measures to assess sensorimotor function of individuals with a history of ankle sprain with or without CAI.
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Affiliation(s)
- Shojiro Nozu
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Masahiro Takemura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Han G, Ko MM, Kim SY, Lee YS. Treatment of ankle sprain or instability in Korean medicine clinics: A protocol for a prospective multicenter observational study. Integr Med Res 2020; 9:100423. [PMID: 32642422 PMCID: PMC7334374 DOI: 10.1016/j.imr.2020.100423] [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: 03/24/2020] [Revised: 05/09/2020] [Accepted: 05/10/2020] [Indexed: 10/31/2022] Open
Abstract
Background Korean medicine (KM), including acupuncture, has been used to treat many patients with ankle sprains in Korea. The purpose of this prospective observational study is to determine how ankle sprains are treated using KM practice and to assess the outcomes of these treatments. Methods We will perform a prospective observational study to include around 200 participants from KM clinics with a chief complaint of ankle sprain or ankle instability. All participants will receive individualized KM treatments which may include acupuncture, pharmacopuncture, moxibustion, cupping therapy, and herbal medicine. The participants will be assessed on the information related to both ankle discomfort using a visual analogue scale and on the participant's overall condition including quality of life. Discussion Through this study, we would be able to collect specific and detailed data for various treatments from actual practice, such as the characteristics of the KM treatment system for treating ankle sprains or the method of acupuncture point selection. We also expect that the results of this study based on daily clinical practice will allow other researchers to create research questions that are beneficial from a clinical, societal, and patient's perspective. Clinical research registration This study has been registered at the Clinical Research Information Service (CRiS) of Korea: KCT0004016.
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Affiliation(s)
- Gajin Han
- JINRESEARCH, Namyangju, Republic of Korea.,Department of Gastroenterology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Mi Mi Ko
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Song-Yi Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Ye-Seul Lee
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
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Hadadi M, Haghighat F, Mohammadpour N, Sobhani S. Effects of Kinesiotape vs Soft and Semirigid Ankle Orthoses on Balance in Patients With Chronic Ankle Instability: A Randomized Controlled Trial. Foot Ankle Int 2020; 41:793-802. [PMID: 32383634 DOI: 10.1177/1071100720917181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic ankle instability (CAI) is a frequent complication of ankle sprain that may be associated with long-term consequences. Although taping and bracing are common interventions that are widely used by clinicians and athletic trainers for patients with CAI, no studies have compared the effects of kinesiotaping and bracing on balance performance in these patients. The present study aimed to compare the effects of ankle kinesiotaping, a soft ankle orthosis, and a semirigid ankle orthosis on balance performance in patients with CAI. METHODS Sixty patients with CAI were randomly assigned to 4 groups that received kinesiotaping, a soft orthosis, a semirigid orthosis, or no treatment (control group). Dynamic and static balance were measured with the modified Star Excursion Balance Test, single leg hop test, and single leg stance test before and after a 4-week intervention period. RESULTS Significant between-group differences were seen in all evaluated outcomes (P ≤ .003). The lowest reach distances in all directions in the modified Star Excursion Balance Test were found in the control group, and these patients also had a significantly shorter measured distance in the single leg hop test, and more errors in the single leg stance test compared with the 3 intervention groups. No significant differences were found among the 3 intervention groups. CONCLUSION Use of kinesiotaping and a soft or a semirigid ankle brace for 4 weeks were all beneficial in improving static and dynamic balance in individuals with CAI. None of the interventions was superior to the other 2. LEVEL OF EVIDENCE Level I, randomized controlled trial.
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Affiliation(s)
- Mohammad Hadadi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Haghighat
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Navid Mohammadpour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sobhan Sobhani
- Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Halabchi F, Abbasian L, Mirshahi M, Mazaheri R, Pourgharib Shahi MH, Mansournia MA. Comparison of Static and Dynamic Balance in Male Football and Basketball Players. Foot Ankle Spec 2020; 13:228-235. [PMID: 31122066 DOI: 10.1177/1938640019850618] [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] [Indexed: 11/16/2022]
Abstract
Introduction. The aim of the present study was to compare static and dynamic balance among professional athletes in football and basketball. Methods. In this cross-sectional study, 47 professional, male football and basketball players from Pro League in Iran participated. They were divided into 3 groups. Group 1 included 16 participants with history of grade 1 or 2 single ankle sprain within the past 6 months. Group 2 included 17 participants with recurrent ankle sprain. Group 3 included 14 participants without history of ankle sprain. Static and dynamic balance were measured by the Balance Error Scoring System (BESS) and modified Star Excursion Balance Test (SEBT), respectively. Results. For the single-leg stance on a firm surface, group 2 scored errors with a high mean value of 3.94 compared with the other 2 groups, and the difference was statistically significant (P = .03). Significant differences in BESS scores are observed on both surfaces across the tandem limb between groups 2 and 3. Conclusion. The measures from the SEBTs may not reflect the balance performance especially in well-trained athletes who have a better balance when performing sport-related skills. However, BESS includes static postures, and it may reflect postural deficits better than dynamic tests in the more experienced athlete. Level of Evidence: Diagnostic, Level IV.
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Affiliation(s)
- Farzin Halabchi
- Sports Medicine Research Center, Neuroscience Institute (FH, LA, MHPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine (FH, RM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Sina Hospital (MM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics (MAM), Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Abbasian
- Sports Medicine Research Center, Neuroscience Institute (FH, LA, MHPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine (FH, RM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Sina Hospital (MM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics (MAM), Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mirshahi
- Sports Medicine Research Center, Neuroscience Institute (FH, LA, MHPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine (FH, RM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Sina Hospital (MM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics (MAM), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mazaheri
- Sports Medicine Research Center, Neuroscience Institute (FH, LA, MHPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine (FH, RM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Sina Hospital (MM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics (MAM), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Pourgharib Shahi
- Sports Medicine Research Center, Neuroscience Institute (FH, LA, MHPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine (FH, RM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Sina Hospital (MM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics (MAM), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Sports Medicine Research Center, Neuroscience Institute (FH, LA, MHPS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine (FH, RM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, Sina Hospital (MM), Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics (MAM), Tehran University of Medical Sciences, Tehran, Iran
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Wang W, Sheng J, Tang Y, Xie Q, Wei M, Li Z, Zheng W. Adaptation and psychometric evaluation of the simplified Chinese version of the identification of functional ankle instability questionnaire in Chinese-speaking patients with chronic ankle instability disorders. BMC Musculoskelet Disord 2020; 21:325. [PMID: 32450830 PMCID: PMC7249687 DOI: 10.1186/s12891-020-03314-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 04/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aims of this study were to adapt the Identification of Functional Ankle Instability (IdFAI) questionnaire into a simplified Chinese version and to assess its reliability, validity, and responsiveness in Chinese-speaking patients with chronic ankle instability (CAI) disorders. METHODS The simplified Chinese version of the IdFAI (SC-IdFAI) questionnaire was developed with a five-step procedure involving cross-cultural translation and adaptation. Three questionnaires, including the SC-IdFAI, Medical Outcomes Study Short-Form 36 (SF-36), and Foot and Ankle Ability Measure (FAAM), were administered to the recruited patients. Then, the Cronbach's alpha value, intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), Spearman's correlation coefficient (rs), effect size (ES), and standardized response mean (SRM) were calculated to evaluate the reliability, validity, and responsiveness of the SC-IdFAI questionnaire. RESULTS A total of 131, 119, and 86 patients with CAI successfully completed the first, second, and third rounds of the questionnaires, respectively. Good or excellent internal consistency and test-retest reliability were found for the overall scale and subscales of the SC-IdFAI questionnaire. The values for the SEM (1.346) and MDC (3.73) were low, indicating that small clinical changes can be detected by the SC-IdFAI questionnaire. The correlations of the SC-IdFAI with FAAM and SF-36 were generally in agreement with the a priori hypotheses (85%, 34/40), suggesting the SC-IdFAI questionnaire has good construct validity. Moreover, the results suggest that the SC-IdFAI (ES = 1.123 and SRM = 1.554) has an acceptable level of responsiveness. CONCLUSION The SC-IdFAI scale may be an effective tool, and it is responsive, reliable and valid for the assessment of Chinese patients suffering from CAI.
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Affiliation(s)
- Wei Wang
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China
| | - Jun Sheng
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China
| | - Yinchao Tang
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China
| | - Qingyun Xie
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China
| | - Meng Wei
- Department of Rheumatism and Immunology, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China
| | - Zhiqiang Li
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China.
| | - Wei Zheng
- Department of Orthopedics, The General Hospital of Western Theater Command, Tianhui Road 270, Chengdu, 610000, People's Republic of China.
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Zhang L, Lu J, Cai B, Fan S, Jiang X. Quantitative assessments of static and dynamic balance performance in patients with chronic ankle instability. Medicine (Baltimore) 2020; 99:e19775. [PMID: 32332619 PMCID: PMC7220543 DOI: 10.1097/md.0000000000019775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/17/2020] [Accepted: 03/05/2020] [Indexed: 12/26/2022] Open
Abstract
Patients with chronic ankle instability (CAI) have postural-control deficits during center-of-pressure excursions than do healthy individuals. While an external analysis of center-of-pressure excursions in CAI has been performed, a quantitative analysis of center-of-gravity movements, to detect the balance deficits associated with CAI, has yet to be performed. Therefore, the aim of the study is to quantify the balance deficits in patients with unilateral CAI.Forty-four patients with unilateral CAI (24 men; age, 31.7 ± 5.5 years) and 26 uninjured volunteers (12 men; age, 28.6 ± 5.9 years) underwent Neurocom Balance Manager assessments of dynamic and static balance responses in limits of stability, unilateral stance, and forward lunge tests.In the limits of stability test, there were no significant group differences in the forward direction; however, reaction times were longer in the CAI group than in the control group in the backward (P = .037, effect size [ES] = 0.49) and rightward directions (P = .032, ES = 0.47). Furthermore, the CAI group showed more excursions in the rightward (P = .046, ES = 0.50) and leftward directions (P = .002, ES = 0.80), and less directional control in the leftward direction (P = .036, ES = 0.59). In the unilateral stance test, the center of gravity sway velocity was faster in the CAI group than in the control group, whether eyes were opened or closed (P < .05). There were no significant group differences in forward lunge-test outcomes.Patients with CAI have poor static and dynamic balance performance compared to that in healthy counterparts. Thus, balance retraining should be an essential component of rehabilitation programs for patients with CAI.
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Yin L, Wang L. Acute Effect of Kinesiology Taping on Postural Stability in Individuals With Unilateral Chronic Ankle Instability. Front Physiol 2020; 11:192. [PMID: 32265726 PMCID: PMC7105687 DOI: 10.3389/fphys.2020.00192] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/19/2020] [Indexed: 12/21/2022] Open
Abstract
Background Chronic ankle instability (CAI), which is characterized by deficient postural control, could be improved through kinesiology taping (KT). However, the effect of KT on postural control in CAI individuals is controversial. Therefore, this study aimed to investigate the acute effect of KT on postural control through computerized dynamic posturography (CDP) and self-perceived sensation in CAI individuals. Methods Participants with CAI received four different ankle treatments randomly, including KT, athletic taping (AT), sham taping (ST), and no taping (NT). A series of postural stability measurements was performed using CDP subsequently. The measurements included sensory organization test (SOT), unilateral stance (US), limit of stability (LOS), motor control test (MCT), and adaption test (ADT). In addition, self-perceived sensation was measured through visual analog scaling. Repeated measures analysis of variance was conducted to determine whether the difference among KT, AT, ST, and NT was significant; Bonferroni test was used for post hoc analysis. Results No significant difference was observed for parameters in SOT, US, and LOS in four different taping treatments. In MCT, the amplitude scaling scores of KT were 35.87% significantly lower than that of NT [p < 0.001, 95% confidence interval (CI) = 0.548–1.795] in forward-small slip and 21.58% significantly lower than that of ST (p = 0.035, 95% CI = 0.089–3.683) in backward-large slip. In ADT, sway energy scores were 7.59% significantly greater in ST than in AT (p = 0.028, 95% CI = −8.343 to −0.320). For perceived stability, KT was significantly greater than ST (p < 0.001, 95% CI = 0.552–1.899) and NT (p < 0.001, 95% CI = 0.797–2.534), and AT was significantly greater than ST (p = 0.001, 95% CI = 0.423–2.246) and NT (p < 0.001, 95% CI = 0.696–2.852). For perceived comfort, KT was significantly greater than AT (p = 0.001, 95% CI = 0.666–3.196) and NT (p = 0.031, 95% CI = 0.074–2.332), and ST was significantly greater than AT (p = 0.007, 95% CI = 0.349–2.931). Conclusion KT and AT have limited effect to facilitate postural control for CAI individuals during SOT, US, and LOS. However, KT and AT could provide effective support to cope with sudden perturbation in MCT and ADT. Moreover, KT provided excellent perceived stability and comfort, whereas AT provided excellent perceived stability but least comfort.
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Affiliation(s)
- Lulu Yin
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Tsikopoulos K, Sidiropoulos K, Kitridis D, Cain Atc SM, Metaxiotis D, Ali A. Do External Supports Improve Dynamic Balance in Patients with Chronic Ankle Instability? A Network Meta-analysis. Clin Orthop Relat Res 2020; 478:359-377. [PMID: 31625960 PMCID: PMC7438122 DOI: 10.1097/corr.0000000000000946] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 08/08/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND To improve ankle stability in patients who have experienced an ankle sprain with residual symptoms of instability and/or objective joint laxity, external supports (such as taping, bracing, and orthotic insoles) are used sometimes. However, available randomized trials have disagreed on whether restraints improve balance in those individuals. In this situation, a network meta-analysis can help because it allows for comparing multiple treatments simultaneously, taking advantage not only of direct but also indirect evidence synthesis. QUESTIONS/PURPOSES The aim of this network meta-analysis was to assess (1) the impact of taping and orthotic devices on dynamic postural control in individuals with ankle instability and (2) the presence of a placebo effect in participants treated with sham taping and complications resulting from the administered treatments. METHODS We searched the PubMed, Scopus, and CENTRAL databases up to February 13, 2019 for completed studies. Randomized trials assessing the results of real and/or sham taping, wait-and-see protocols, ankle bracing, and foot orthotics for ankle instability as determined by one or more ankle sprains followed by ongoing subjective symptoms and/or mechanical laxity were included. We evaluated dynamic postural control in terms of the Star Excursion Balance Test in the posteromedial direction (SEBT-PM), which is considered the most representative of balance deficits in patients with ankle instability. Standardized mean differences were re-expressed to percentage differences in SEBT-PM, with higher scores representing possible improvement. Subsequently, those data were checked against the established minimal detectable change of 14% for this scale to make judgements on clinical importance. We also assessed the presence of a placebo effect by comparing the results of sham taping with no treatment and complications resulting from the administered treatments. Additionally, we judged the quality of trials using the Cochrane risk of bias tool and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. A total of 22 trials met our inclusion criteria, 18 of which were deemed to be at a low risk of bias. A network of treatments consisting of 13 studies was created, and the level of evidence was judged to be high. As far as participants' allocation to treatment arms, 85 patients followed a wait-and-see protocol, 29 received placebo taping, 99 were treated with taping, 16 were treated with bracing, 27 were administered insoles, and six individuals were offered a combination of insoles with bracing. Of note, with statistical power set at 80%, a minimum of 16 patients per treatment group was required to provide sufficient statistical power and detect a SEBT-PM percentage difference of 14%. RESULTS A network meta-analysis did not demonstrate a benefit of taping or bracing over no treatment (percentage difference in SEBT-PM between taping and bracing versus control: -2.4 [95% CI -6 to 1.1]; p = 0.18, and -7.5 [95% CI -15.9 to 1]; p = 0.08, respectively). This was also the case for sham taping because the measurement increase failed to exceed the minimal detectable change (percentage difference in SEBT-PM between sham taping and untreated control: -1.1 [95% CI -6.9 to 4.7]; p = 0.72). Importantly, there were no reported adverse events after treatment application. CONCLUSIONS Evidence of moderate strength indicated that external supports of any type were no more effective than controls in improving dynamic postural control in patients with at least one ankle sprain and residual functional or mechanical deficits. Therefore, implementing those tools as a standalone treatment does not appear to be a viable strategy for the primary management of ankle instability. It is conceivable that combinations of rehabilitation and external supports could be more effective than external supports alone, and future trials should evaluate the potential of such combinations in enhancing not only clinician-reported but also patient-oriented outcomes using long-term follow-up measurements. LEVEL OF EVIDENCE Level I, therapeutic study.
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Affiliation(s)
- Konstantinos Tsikopoulos
- K. Tsikopoulos, D. Kitridis, 424 Army General Training Hospital, Thessaloniki, Greece
- K. Tsikopoulos, Orthopedic Department, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | | | - Dimitrios Kitridis
- K. Tsikopoulos, D. Kitridis, 424 Army General Training Hospital, Thessaloniki, Greece
- D. Kitridis, First Orthopedic Department of Aristotle University, G. Papanikolaou General Hospital, Exohi, Thessaloniki, Greece
| | - Spencer M Cain Atc
- S. M. Cain, Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dimitrios Metaxiotis
- D. Metaxiotis, Second Orthopedic Department, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ashique Ali
- A. Ali, Orthopedic Department, University Hospitals of North Midlands, Stoke-on-Trent, UK
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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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Huynh B, Tacker R, Hung YJ. Active ankle position sense and single-leg balance in runners versus non-runners. Physiother Theory Pract 2019; 37:1429-1437. [PMID: 31793354 DOI: 10.1080/09593985.2019.1698084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Ankle sprain is one of the most common injuries in collegiate athletes, including runners. The purpose of the study was to examine whether runners exhibited compromised ankle stability, ankle position sense, and single-leg balance.Methods: Thirty-seven individuals (21 non-runners and 16 runners) participated in the study. To be included in the runner group, subjects were required to run greater than 150 minutes per week for the past three months. We used the Cumberland Ankle Instability Tool (CAIT) to categorize ankle stability, and we used a dual-axis electronic goniometer to examine active ankle position sense. We examined single-leg balance with the Athletic Single Leg Stability Test of the Biodex Balance System using three different protocols: 1) default setting, 2) no extrinsic visual feedback, and 3) no extrinsic feedback with a cognitive demand.Results: Runners and non-runners had similar ankle stability (CAIT = 26.88 and 26.45 respectively; p = .666). Although runners had significantly larger ankle position errors than non-runners overall (2.56° vs. 1.68°; p = .004), they had better single-leg balance than non-runners without extrinsic visual feedback (Stability Index 1.67 vs. 4.39; p < .001), even with an added cognitive loading (Stability Index 2.18 vs. 4.32; p < .001).Conclusions: For runners, having worse ankle position sense did not compromise ankle stability, nor contribute to single-leg balance deficits. Runners may have established better motor control to maintain their single-leg balance and ankle stability.
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Affiliation(s)
- Brian Huynh
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - Ryan Tacker
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - You-Jou Hung
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
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Rosen AB, Needle AR, Ko J. Ability of Functional Performance Tests to Identify Individuals With Chronic Ankle Instability: A Systematic Review With Meta-Analysis. Clin J Sport Med 2019; 29:509-522. [PMID: 31688183 DOI: 10.1097/jsm.0000000000000535] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this systematic review with meta-analysis was to determine the effectiveness of functional performance tests (FPTs) in differentiating between individuals with chronic ankle instability (CAI) and healthy controls. DATA SOURCES The National Library of Medicine Catalog (PubMed), the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and the SPORTDiscus, from inception to June 2017 were searched. Search terms consisted of: "Functional Performance Test*" OR "Dynamic Balance Test*" OR "Postural Stability Test*" OR "Star Excursion Balance Test*" OR "Hop Test*" AND "Ankle Instability" OR "Ankle Sprain." Included articles assessed differences in FPTs in patients with CAI compared with a control group. MAIN RESULTS Included studies were assessed for methodological quality and level of evidence. Individual and mean effect sizes were also calculated for FPTs from the included articles. Twenty-nine studies met the criteria and were analyzed. The most common FPTs were timed-hop tests, side-hop, multiple-hop test, single-hop for distance, foot-lift test, and the Star Excursion Balance Tests (SEBTs). The side-hop (g = -1.056, P = 0.009, n = 7), timed-hop tests (g = -0.958, P = 0.002, n = 9), multiple-hop test (g = 1.399, P < 0.001, n = 3), and foot-lift tests (g = -0.761, P = 0.020, n = 3) demonstrated the best utility with large mean effect sizes, whereas the SEBT anteromedial (g = 0.326, P = 0.022, n = 7), medial (g = 0.369, P = 0.006, n = 7), and posteromedial (g = 0.374, P < 0.001, n = 13) directions had moderate effects. CONCLUSIONS The side-hop, timed-hopping, multiple-hop, and foot-lift seem the best FPTs to evaluate individuals with CAI. There was a large degree of heterogeneity and inconsistent reporting, potentially limiting the clinical implementation of these FPTs. These tests are cheap, effective, alternatives compared with instrumented measures.
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Affiliation(s)
- Adam B Rosen
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska
| | - Alan R Needle
- Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina
| | - Jupil Ko
- Department of Physical Therapy & Athletic Training, Northern Arizona University, Flagstaff, Arizona
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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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Preliminary Study of the Effect of Training With a Gaming Balance Board on Balance Control in Children With Cerebral Palsy: A Randomized Controlled Trial. Am J Phys Med Rehabil 2019; 99:142-148. [PMID: 31464757 DOI: 10.1097/phm.0000000000001300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A new protocol based on the use of a gaming balance board for children with cerebral palsy was tested. DESIGN A total of 56 children with cerebral palsy were enrolled and randomly divided into two groups: experimental and control. The children in experimental group underwent 12 wks of rehabilitation using their foot to play personal computer games with the proposed balance board, whereas those in the control group played personal computer games with a computer mouse in the standing position. Balance control was assessed before and after the intervention using the Zebris FDM System for measuring the center of pressure. The Pediatric Balance Scale and 2-min walk test were used for evaluating functional balance. RESULTS In the analysis of covariance, the proposed new balance board used for the personal computer games decreased the postural sway (sway path, F = 6.95, P = 0.011; sway area, F = 11.79, P = 0.001) and improved the performance of the functional balance tests. CONCLUSIONS This study demonstrated the possibility that this new gaming balance board can be used for balance control in children with cerebral palsy.
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de la Motte SJ, Lisman P, Gribbin TC, Murphy K, Deuster PA. Systematic Review of the Association Between Physical Fitness and Musculoskeletal Injury Risk: Part 3-Flexibility, Power, Speed, Balance, and Agility. J Strength Cond Res 2019; 33:1723-1735. [PMID: 29239989 DOI: 10.1519/jsc.0000000000002382] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
de la Motte, SJ, Lisman, P, Gribbin, TC, Murphy, K, and Deuster, PA. Systematic review of the association between physical fitness and musculoskeletal injury risk: part 3-flexibility, power, speed, balance, and agility. J Strength Cond Res 33(6): 1723-1735, 2019-We performed a systematic review and evaluation of the existing scientific literature on the association between flexibility, power, speed, balance, and agility, and musculoskeletal injury (MSK-I) risk in military and civilian populations. MEDLINE, EBSCO, EMBASE, and the Defense Technical Information Center were searched for original studies published from 1970 to 2015 that examined associations between these physical fitness measures (flexibility, power, speed, balance, and agility) and MSK-I. Methodological quality and strength of the evidence were determined after criteria adapted from previously published systematic reviews. Twenty-seven of 4,229 citations met our inclusion criteria. Primary findings indicate that there is (a) moderate evidence that hamstring flexibility, as measured by performance on a sit-and-reach test or active straight leg raise test assessed with goniometry, and ankle flexibility, assessed with goniometry, are associated with MSK-I risk; (b) moderate evidence that lower body power, as measured by performance on a standing broad jump or vertical jump with no countermovement, is associated with MSK-I risk; (c) moderate evidence that slow sprint speed is associated with MSK-I risk; (d) moderate evidence that poor performance on a single-leg balance test is associated with increased risk for ankle sprain; and (e) insufficient evidence that agility is associated with MSK-I risk. Several measures of flexibility, power, speed, and balance are risk factors for training-related MSK-I in military and civilian athletic populations. Importantly, these findings can be useful for military, first responder, and athletic communities who are seeking evidence-based metrics for assessing or stratifying populations for risk of MSK-I.
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Affiliation(s)
- Sarah J de la Motte
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Peter Lisman
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Department of Kinesiology, Towson University, Towson, Maryland
| | - Timothy C Gribbin
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Kaitlin Murphy
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Medina McKeon JM, Hoch MC. The Ankle-Joint Complex: A Kinesiologic Approach to Lateral Ankle Sprains. J Athl Train 2019; 54:589-602. [PMID: 31184957 DOI: 10.4085/1062-6050-472-17] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Copious research exists regarding ankle instability, yet lateral ankle sprains (LASs) persist in being among the most common recurrent musculoskeletal injuries. Key anatomical structures of the ankle include a triform articulating structure that includes the inferior tibiofibular, talocrural, and subtalar joints. Functionally, force absorption and propulsion through the ankle complex are necessary for any task that occurs in weight bearing. For optimal ankle performance and avoidance of injury, an intricate balance between stability and mobility is necessary to ensure that appropriate force transfer occurs during sports and activities of daily living. Consideration for the many structures that may be directly or indirectly involved in LASs will likely translate into advancements in clinical care. In this clinical review, we present the structure, function, and relevant pathologic states of the ankle complex to stimulate a better understanding of the prevention, evaluation, and treatment of LASs.
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Affiliation(s)
| | - Matthew C Hoch
- Sports Medicine Research Institute, University of Kentucky, Lexington
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Abstract
Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the need to expand the evaluation of ankle instability beyond the acute time point. Physical assessments of the injured ankle should be similar, regardless of whether this is the initial lateral ankle sprain or the patient has experienced multiple sprains. To this point, a thorough injury history of the affected ankle provides important information during the clinical examination. The physical examination should assess the talocrural and subtalar joints, and clinicians should be aware of efficacious diagnostic tools that provide information about the status of injured structures. As patients progress into the subacute and return-to-activity phases after injury, comprehensive assessments of lateral ankle-complex instability will identify any disease and patient-oriented outcome deficits that resemble chronic ankle instability, which should be addressed with appropriate interventions to minimize the risk of developing long-term, recurrent ankle instability.
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Affiliation(s)
- Phillip A Gribble
- Department of Athletic Training and Clinical Nutrition, College of Health Sciences, University of Kentucky, Lexington
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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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