1
|
Kazemi K, Javanshir K, Saadi F, Goharpey S, Shaterzadeh Yazdi MJ, Calvo-Lobo C, López-López D, Nassadj G. The Effect of Additional Neuromuscular Training on Peri-Ankle Muscle Morphology and Function in Chronic Ankle Instability Subjects: A Randomized Controlled Trial. Sports Health 2024:19417381241258467. [PMID: 38898814 DOI: 10.1177/19417381241258467] [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: 06/21/2024] Open
Abstract
BACKGROUND Lateral ankle sprain is one of the most common musculoskeletal issues during sports and activities of daily living. This study investigated the effect of combined neuromuscular training and conventional training (including strengthening, range of motion, and balance exercises) on muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with chronic ankle instability (CAI). HYPOTHESIS The combination of neuromuscular and conventional training programs might result in additional benefits on the morphology of muscle, dynamic balance, and functional capacity in subjects with CAI. STUDY DESIGN A single-blind parallel-arm randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS A total of 34 participants with CAI were divided randomly into experimental (EG) and control groups (CG). The EG received conventional and neuromuscular training, while the CG underwent conventional training. Cross-sectional areas of the peroneus longus and tibialis anterior muscles were measured using ultrasonography. Measurements included reaching direction distance, ankle instability, and the foot and ankle outcome score, all evaluated before and immediately after 12 intervention sessions and 4 weeks later in the follow-up phase. RESULTS Repeated-measures analysis of variance (ANOVA) revealed significant improvement in the EG, particularly in the cross-sectional area of the tibialis anterior muscle on the injured side and the posteromedial reaching direction displacement of the Y balance test. Moreover, the EG's foot and ankle outcome scores increased significantly compared with the CG (P < 0.05). However, the group effect size ranged from minor to moderate (Hedges g, 0.40-0.73). CONCLUSION Combining neuromuscular and conventional training programs yields greater benefits than conventional training alone regarding tibialis anterior muscle morphology, posteromedial dynamic balance, and functional capacity in persons with CAI. CLINICAL RELEVANCE The combination of neuromuscular and conventional training programs could enhance muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with CAI.
Collapse
Affiliation(s)
- Khadijeh Kazemi
- Department of Rehabilitation, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Khodabakhsh Javanshir
- Department of Physiotherapy, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Feryal Saadi
- Department of Radiology, Medicine School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahin Goharpey
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Jafar Shaterzadeh Yazdi
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - César Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniel López-López
- Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
| | - Gholamhossein Nassadj
- Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
2
|
Liu S, Tang J, Hu G, Xiong Y, Ji W, Xu D. Blood flow restriction training improves the efficacy of routine intervention in patients with chronic ankle instability. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:159-166. [PMID: 38708328 PMCID: PMC11067764 DOI: 10.1016/j.smhs.2023.11.001] [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: 05/13/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 05/07/2024] Open
Abstract
As a new means of rehabilitation, blood flow restriction training (BFRT) is widely used in the field of musculoskeletal rehabilitation. To observe whether BFRT can improve the efficacy of routine rehabilitation intervention in patients with chronic ankle instability (CAI). Twenty-three patients with CAI were randomly divided into a routine rehabilitation group (RR Group) and a routine rehabilitation + blood flow restriction training group (RR + BFRT Group) according to the Cumberland Ankle Instability Tool (CAIT) score. The RR Group was treated with routine rehabilitation means for intervention, and the RR + BFRT Group was treated with a tourniquet to restrict lower limb blood flow for rehabilitation training based on routine training. Before and after the intervention, the CAIT score on the affected side, standing time on one leg with eyes closed, comprehensive scores of the Y-balance test, and surface electromyography data of tibialis anterior (TA) and peroneus longus (PL) were collected to evaluate the recovery of the subjects. Patients were followed up 1 year after the intervention. After 4 weeks of intervention, the RR + BFRT Group CAIT score was significantly higher than the RR Group (19.33 VS 16.73, p < 0.05), the time of standing on one leg with eyes closed and the comprehensive score of Y-balance were improved, but there was no statistical difference between groups (p > 0.05). RR + BFRT Group increased the muscle activation of the TA with maximum exertion of the ankle dorsal extensor (p < 0.05) and had no significant change in the muscle activation of the PL with maximum exertion of the ankle valgus (p > 0.05). There was no significant difference in the incidence of resprains within 1 year between the groups (36.36% VS 16.67%, p > 0.05). The incidence of ankle pain in the RR + BFRT Group was lower than that in the RR Group (63.64% VS 9.09%, p < 0.01). Therefore, four-weeks BFRT improves the effect of the routine intervention, and BFRT-related interventions are recommended for CAI patients with severe ankle muscle mass impairment or severe pain.
Collapse
Affiliation(s)
- Shen Liu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jiafu Tang
- Sports Health College, Tianjin University of Sport, Tianjin, China
| | - Guangjun Hu
- Sports Health College, Tianjin University of Sport, Tianjin, China
| | - Yinghong Xiong
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Weixiu Ji
- Sports Health College, Tianjin University of Sport, Tianjin, China
| | - Daqi Xu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
3
|
Koltermann JJ, Floessel P, Hammerschmidt F, Disch AC. A Statistical and AI Analysis of the Frequency Spectrum in the Measurement of the Center of Pressure Track in the Seated Position in Healthy Subjects and Subjects with Low Back Pain. SENSORS (BASEL, SWITZERLAND) 2024; 24:3011. [PMID: 38793865 PMCID: PMC11125709 DOI: 10.3390/s24103011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/04/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
Measuring postural control in an upright standing position is the standard method. However, this diagnostic method has floor or ceiling effects and its implementation is only possible to a limited extent. Assessing postural control directly on the trunk in a sitting position and consideration of the results in the spectrum in conjunction with an AI-supported evaluation could represent an alternative diagnostic method quantifying neuromuscular control. In a prospective cross-sectional study, 188 subjects aged between 18 and 60 years were recruited and divided into two groups: "LowBackPain" vs. "Healthy". Subsequently, measurements of postural control in a seated position were carried out for 60 s using a modified balance board. A spectrum per trail was calculated using the measured CoP tracks in the range from 0.01 to 10 Hz. Various algorithms for data classification and prediction of these classes were tested for the parameter combination with the highest proven static influence on the parameter pain. The best results were found in a frequency spectrum of 0.001 Hz and greater than 1 Hz. After transforming the track from the time domain to the image domain for representation as power density, the influence of pain was highly significant (effect size 0.9). The link between pain and gender (p = 0.015) and pain and height (p = 0.012) also demonstrated significant results. The assessment of postural control in a seated position allows differentiation between "LowBackPain" and "Healthy" subjects. Using the AI algorithm of neural networks, the data set can be correctly differentiated into "LowBackPain" and "Healthy" with a probability of 81%.
Collapse
Affiliation(s)
- Jan Jens Koltermann
- Sport Medicine and Rehabilitation, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany (F.H.)
| | - Philipp Floessel
- Sport Medicine and Rehabilitation, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany (F.H.)
| | - Franziska Hammerschmidt
- Sport Medicine and Rehabilitation, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany (F.H.)
| | - Alexander C. Disch
- University Center for Orthopedics, Trauma & Plastic Surgery—University Comprehensive Spine Center (UCSC), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany;
| |
Collapse
|
4
|
Su Y, Li W, Pan C, Shi Y. Effects of combination of strength and balance training on postural control and functionality in people with chronic ankle instability: a systematic review and meta analysis. BMC Sports Sci Med Rehabil 2024; 16:79. [PMID: 38594775 PMCID: PMC11005148 DOI: 10.1186/s13102-024-00845-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 02/09/2024] [Indexed: 04/11/2024]
Abstract
AIM To identify the effects of strength and balance training on dynamic balance and patient reported outcomes in people with chronic ankle instability(CAI). METHOD Five databases(CNKI, WanFang, Web of Science, EBSCO-SPORTD and PubMed were searched in September 2022. The search was conducted on randomized controlled trials(RCTs) that the effects of strength training, balance training and combination of strength and balance training in people with chronic ankle instability compared to a control group. Using Review Manager 5.3 and Stata-SE 15 to conduct Meta-analysis on the included literature. methodological quality and risk of bias were assessed by using the PEDro scale. RESULTS A total of 33 Chinese and English RCTs document were screened and 1154 patients with CAI were included in the study. Compared with control group, strength training, balance training and combination of strength and balance training demonstrated to be more effective in terms of improving patient reported outcomes(strength training: SMD = 0.80, 95%CI = 0.39-1.22; balance training: SMD = 0.79, 95%CI = 0.41-1.17; combination of strength and balance training: SMD = 1.28, 95%CI = 0.57, 1.99). Subgroup analysis: Intervention for 6 weeks, more than 3 times a week and more than 30 min each time were the best rehabilitation programs to improve CAI patientreported outcomes. Compared with control group, balance training demonstrated to be more effective in terms of improving Star Excursion Balance Test (SEBT)((anterior: SMD = 0.71, 95%CI = 0.03-1.40; posterolateral: SMD = 0.84, 95%CI = 0.22-1.46; posteromedial: SMD = 0.88, 95%CI = 0.45-1.32). However, strength training and combination of strength and balance training had no improvement effects on SEBT. CONCLUSIONS Available evidence showed that, results of the comparison between balance training versus strength training suggest that the combination of strength and balance training achieves greater benefits for patient reported outcomes and balance training could bring greater benefits to dynamic balance. Strength training should be used cautiously in clinic to improve the dynamic balance in individuals with CAI. TRIAL REGISTRATION ( http://www.crd.york.ac.uk/PROSPERO , Registration No. CRD42022371396).
Collapse
Affiliation(s)
- Yuying Su
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
- Physical Education College, Bohai University, Jinzhou, Liaoning, China
| | - Wei Li
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China.
| | - Changbo Pan
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Yu Shi
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| |
Collapse
|
5
|
Sánchez-Morales S, Gutiérrez-Martín B, Ibáñez-Vera AJ, Rodríguez-Almagro D, Pecos-Martín D, Achalandabaso-Ochoa A. Effectiveness of a specific strength program of the gluteus maximus muscle to improve dynamic postural control in female basketball players. A randomized controlled trial. Gait Posture 2024; 108:90-96. [PMID: 38016398 DOI: 10.1016/j.gaitpost.2023.11.010] [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: 04/03/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Basketball is a team sport in which players perform multidirectional movements, jumps and landings, experiencing abrupt accelerations and decelerations and numerous changes of rhythm. In this sport, speed and intensity are two key factors that are associated with an increased risk of injury. The aim of this randomized controlled trial was to determine the effectiveness of a specific gluteus maximus strength programme as preventive work for young female basketball players, to improve dynamic postural stability and to observe its impact in the rate of lower limb injuries, vertical jump, dynamic knee valgus and pain. RESEARCH QUESTION Is effective a strength programme to improve dynamic postural stability, vertical jump and dynamic valgus in female basketball players? METHODS A hundred and thirteen female basketball players that play in professional clubs were recruited, reaching the final stage 92 (46 per group). One group (CG) received conventional injury prevention training while the experimental group (EG) added to the conventional team prevention program, a gluteus maximus strength programme of 5 months composed of 4 exercises/2 days per week/2 sets of 10 repetitions per leg. RESULTS The total injury incidence decreased from 0.33 to 0.16 cases (control group pre=0.43 to post=0.14 cases, EG pre=022 to post=0.19). The EG improved overall (p = 0.000), posterior (p = 0.001), posteromedial (p = 0.001) and posterolateral (p = 0.000) dynamic stability of the right leg; anterior (p = 0.024), medial (p = 0.07) and posteromedial (p = 0.01) of the left leg. Both groups improved vertical jump (GC: p = 0.045 and GE: p = 0.000). There was no significant improvement in pain or valgus. SIGNIFICANCE This strength programme is effective in improving dynamic stability especially of the dominant leg and jump height.
Collapse
Affiliation(s)
- Sandra Sánchez-Morales
- Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Madrid, Spain
| | - Belén Gutiérrez-Martín
- Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Madrid, Spain
| | | | | | - Daniel Pecos-Martín
- Physiotherapy and Pain Group, Department of Physical Therapy, University of Alcala, Madrid, Spain
| | | |
Collapse
|
6
|
Kim S, Qu F, Wang Y, Lam WK. Examining the joint coordination during dynamic balance learning using vector coding and statistical parametric mapping analyses. Sci Rep 2024; 14:1724. [PMID: 38242922 PMCID: PMC10799072 DOI: 10.1038/s41598-023-44216-1] [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: 06/01/2023] [Accepted: 10/05/2023] [Indexed: 01/21/2024] Open
Abstract
We aimed to examine the changes in balance performance, kinematic variables, and joint coordination of the lower extremities during the Y-balance learning task. Twenty female university students completed five consecutive blocks of Y-balance learning from days 3 to 7 (135 trials). Pre-tests and tests were performed on days 1 and 9. Maximum reach distance, peak joint angle, and joint coordination in the anterior (AL), posterolateral (PL), and posteromedial (PM) directions were measured to determine the efficacy of Y-balance performance. A repeated measures ANOVA was performed for the maximum reach distance across learning blocks to confirm whether learning had occurred. Our results indicated that the maximum reach distance on day 5 was longer than that on other learning days. The maximum reach distance significantly increased in the PL and PM directions after learning. The hip flexion (PL/PM), abduction (PM), internal rotation (PM), and external rotation (PL) angles increased after learning. The knee joint flexion angle increased in both AL and PL directions. Only the ankle dorsiflexion angle increased in the AL direction. Joint coordination indicated that the knee and hip joints performed simultaneously during internal rotation. Ankle-knee joint coordination was performed using dorsiflexion and flexion strategies. Statistical parametric mapping analysis indicated significant differences in the ankle sagittal plane in the AL direction, hip horizontal and hip/knee sagittal planes in the PL direction, and hip/knee sagittal and hip frontal/horizontal planes in the PM direction. These data suggest that the dynamic balance ability of the novice participants improved in relation to changes in coordination patterns after learning. The results of this study can be applied to other populations to improve their dynamic balance and prevent fall injuries.
Collapse
Affiliation(s)
- Sungmin Kim
- Institute of School Physical Education, Korea National University of Education, Cheongju, Chungbuk, Republic of Korea
| | - Feng Qu
- Biomechanics Laboratory, Beijing Sports University, Beijing, China.
| | - Yi Wang
- Department of Physical Education, Renmin University of China, Beijing, China.
- Sports and Social Development Research Center, Renmin University of China, Beijing, China.
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institutes, Sha Tin, Hong Kong, China
| |
Collapse
|
7
|
Yang QH, Zhang YH, Du SH, Wang YC, Xu HR, Chen JW, Mao Y, Wang XQ. Reliability and Validity of the Star Excursion Balance Test for Evaluating Dynamic Balance of Upper Extremities. Sports Health 2024:19417381231221716. [PMID: 38229219 DOI: 10.1177/19417381231221716] [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: 01/18/2024] Open
Abstract
BACKGROUND Upper extremity (UE) dynamic balance is a significant physical fitness ability, which includes high-level neuromuscular proprioception, joint mobility, force, and coordination. The evaluation methods of UE dynamic balance are insufficient and lack experimental support. The Star Excursion Balance Test (SEBT) is a reliable assessment of dynamic balance and injury risk of the lower extremity. HYPOTHESIS The UE-SEBT is a reliable and reproducible approach for evaluating dynamic balance of UEs. STUDY DESIGN Observational study. LEVEL OF EVIDENCE Level 4. METHODS This cross-sectional study recruited 65 healthy adults. All participants were required to complete UE-SEBT, UE Y-balance test (UE-YBT), maximal voluntary isometric contraction (MVIC) of UE, closed kinetic chain UE stability test (CKCUEST), trunk flexor endurance test (TFET), trunk extensor endurance test (TEET), and lateral trunk endurance test (LTET). Intra- and inter-rater reliability and the correlation of UE-SEBT with other outcomes were measured. RESULTS Among the participants, the intra- and interoperator reliability of UE-SEBT in all directions and composite score achieved a moderate-to-excellent (intraclass correlation coefficients [ICC], 0.729-0.946) reliability. For validity, the UE-SEBT had a moderate to very strong correlation with UE-YBT (r = 0.315-0.755, P < 0.01) and a strong correlation with CKCUEST (r = 0.4-0.67, P < 0.01). Furthermore, the UE-SEBT performance showed weak-to-strong correlations with MVIC (r = 0.26-0.43, P < 0.05). UE-SEBT was also correlated with LTET, TEET, and TFET to varying degrees. CONCLUSION UE-SEBT has good reliability and validity to assess UE dynamic balance compared with other tests. CLINICAL RELEVANCE UE-SEBT can be used as a clinical assessment method to evaluate UE dynamic balance and injury prevention.
Collapse
Affiliation(s)
- Qi-Hao Yang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Yong-Hui Zhang
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shu-Hao Du
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu-Chen Wang
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao-Ran Xu
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ji-Wei Chen
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Yuan Mao
- Graduate School, Xi'an Physical Education University, Xi'an, China
| | - Xue-Qiang Wang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Chuadthong J, Lekskulchai R, Hiller C, Ajjimaporn A. A Home-Based Exercise Program With Active Video Games for Balance, Motor Proficiency, Foot and Ankle Ability, and Intrinsic Motivation in Children With Chronic Ankle Instability: Feasibility Randomized Controlled Trial. JMIR Serious Games 2023; 11:e51073. [PMID: 38235982 PMCID: PMC10811453 DOI: 10.2196/51073] [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: 07/20/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 01/19/2024] Open
Abstract
Background Children with chronic ankle instability (CAI) frequently experience ankle unsteadiness, causing trips, falls, and ankle sprain injuries resulting in poor quality of life. A specific exercise program focused on physical and psychological purposes in children with CAI is needed. Objective The purpose of this study was to investigate the feasibility of a 4-week home-based exercise training program using active video games (AVGs) for balance, motor proficiency, foot and ankle ability, and intrinsic motivation in children with CAI. Methods Sixty children with CAI (mean age 10, SD 2 years) were randomly assigned to an experimental group (AVG group; n=30) or a control group (CG; n=30). The AVG group played 2 selected video games, Catching Fish and Russian Block, while the CG received the traditional exercise program for CAI. Both programs were scheduled for 30 minutes per day, 3 times per week, for 4 weeks at home. The single-leg stance test was used to assess static balance. The walking forward on a line and standing long jump tests were used to assess motor proficiency. The Foot and Ankle Ability Measure (FAAM) and the Intrinsic Motivation Inventory questionnaire were used to assess foot and ankle ability and intrinsic motivation, respectively. Assessments were conducted at baseline and after 4 weeks. Results In the AVG group, the single-leg stand test (eyes open; on floor and on foam conditions), the FAAM (activities of daily living subscale), and intrinsic motivation (interest/enjoyment, pressure/tension, and value/usefulness dimensions) were improved compared with the CG (all P<.05). Motor proficiency did not differ between the 2 groups at the end of the 4-week program (P=.31 for the walking forward on a line, P=.34 for the standing long jump test). Conclusions A 4-week home-based exercise training program using AVGs can be beneficial and may be an effective approach for improving balance, foot and ankle ability, and enhancing positive motivation by increasing the interest/enjoyment and value/usefulness dimensions and lowering the pressure/tension dimension in children with CAI that require long-term rehabilitation sessions.
Collapse
Affiliation(s)
- Janya Chuadthong
- Faculty of Physical Therapy, Mahidol University, Nakon Pathom, Thailand
| | | | - Claire Hiller
- Faculty of Medicine and Health, The University of Sydney, SydneyNew South Wales, Australia
| | - Amornpan Ajjimaporn
- College of Sports Science and Technology, Mahidol University, Salaya, Nakon Pathom, Thailand
| |
Collapse
|
10
|
Fakontis C, Iakovidis P, Kasimis K, Lytras D, Koutras G, Fetlis A, Algiounidis I. Efficacy of resistance training with elastic bands compared to proprioceptive training on balance and self-report measures in patients with chronic ankle instability: A systematic review and meta-analysis. Phys Ther Sport 2023; 64:74-84. [PMID: 37801793 DOI: 10.1016/j.ptsp.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Proprioceptive training and resistance training are physiotherapy treatment methods for Chronic Ankle Instability (CAI). OBJECTIVE To compare the efficacy of proprioceptive training to resistance training with elastic bands for treating CAI as measured by the Star Excursion Balance Test (SEBT), the Foot and Ankle Ability Measure (FAAM), and the Cumberland Ankle Instability Tool (CAIT). METHOD Our systematic study and meta-analysis was based on the PICOS and PRISMA protocols. The PubMed, PEDro, and ScienceDirect databases were searched for randomized clinical trials on proprioceptive and resistance training. Risk of bias was assessed according to Cochrane guidelines and quality of evidence was reported using the Grading of Recommendations Assessment, Development, and Evaluation approach (GRADE). RESULTS Five studies involving 259 patients were included in the review. According to the findings of the meta-analysis, proprioceptive training was similarly effective with resistance training in SEBT and FAAM measures. Compared with resistance exercise, proprioceptive training demonstrated some benefits in CAIT scores (weighted mean difference [WMD] = -2.21, 95% CI = -4.05-0.36), but these intervention results were not clinically significant (MDC, MCID score >3 points). CONCLUSION Low-quality evidence from studies showed that neither of the interventions was superior on the SEBT or the FAAM scores in individuals with CAI because no clinically significant differences were found. More high-quality studies comparing the two interventions are needed to draw firm conclusions.
Collapse
Affiliation(s)
- Christos Fakontis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Paris Iakovidis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Konstantinos Kasimis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Dimitrios Lytras
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece.
| | - Georgios Koutras
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | - Antonis Fetlis
- Laboratory of Biomechanics & Ergonomics, Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus P.O. Box 141, 57 400, Sindos, Thessaloniki, Greece
| | | |
Collapse
|
11
|
Cerbezer N, Çil ET, Subaşı F. The effect of neuromuscular and vestibular-ocular reflex training program on balance, isokinetic muscle strength and proprioception in people with chronic ankle instability. Foot (Edinb) 2023; 56:101992. [PMID: 36913763 DOI: 10.1016/j.foot.2023.101992] [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: 02/01/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/15/2023]
Abstract
OBJECTIVE This study aimed to compare and investigate the effectiveness of neuromuscular exercise combined with vestibular-ocular reflex training and only neuromuscular exercise training on balance, isokinetic muscle strength, and proprioception in chronic ankle instability (CAI). METHOD The study included 20 patients with unilateral CAI. The functional status was evaluated with the Foot and Ankle Ability Measure (FAAM). The star-excursion balance test was used for dynamic balance, and the joint position sense test assessed proprioception. Ankle concentric muscle strength was measured by an isokinetic dynamometer. The subjects were randomly divided into neuromuscular and vestibular-ocular reflex training (VOG, n = 10) and neuromuscular training group (NG, n = 10). Both rehabilitation protocols were applied for four weeks. RESULTS Although VOG had higher means of all parameters, no superiority was found between the two groups in post-treatment results. However, the VOG significantly improved FAAM scores at the sixth-month follow-up than NG (P < .05). In the linear regression analysis, the post-treatment proprioception inversion-eversion for unstable side and FAAM- S were found to be independent factors of FAAM-S scores at the six months follow -up in VOG. Post-treatment isokinetic strength for inversion of unstable side (120 º /s) and FAAM- S were determined as predictor factors of FAAM- S scores at the six months follow -up (p < .05) in NG. CONCLUSION The Neuromuscular combined with vestibular-ocular reflex training protocol effectively managed unilateral CAI. Furthermore, it may be considered an effective strategy for clinical outcomes for a long-term period in terms of functional status.
Collapse
Affiliation(s)
- Nilüfer Cerbezer
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Elif Tuğçe Çil
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Feryal Subaşı
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| |
Collapse
|
12
|
Bartolomeu RF, Sampaio T, Oliveira JP, Barbosa TM, Morais JE. Association between the Upper Quarter Dynamic Balance, Anthropometrics, Kinematics, and Swimming Speed. J Funct Morphol Kinesiol 2023; 8:96. [PMID: 37489309 PMCID: PMC10366733 DOI: 10.3390/jfmk8030096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/22/2023] [Accepted: 07/05/2023] [Indexed: 07/26/2023] Open
Abstract
Besides recurrently assessed water-based parameters, there are also some individual characteristics that affect swimming performance that are not water related. In the past few years, dynamic balance has been associated with land sports performance. Conversely, evidence on this topic in swimming is scarce. The purpose of this study was to assess the association between on-land dynamic balance and swimming performance. Sixteen young adults and recreational swimmers were recruited for the present study (8 males 20.8 ± 2.0 years, and 8 females 20.1 ± 1.9 years). A set of anthropometric features were measured. The upper quarter Y-balance test was selected as a dynamic balance outcome, and swimming speed as the swimming performance indicator. The results showed a moderate and positive correlation between dynamic balance and swimming performance (p < 0.05). Speed fluctuation was highly and negatively related to swimming speed (p < 0.001), i.e., swimmers who had higher scores in the dynamic balance were more likely to deliver better performances. This suggests that in recreational swimmers, the stability and mobility of the upper extremity had a greater influence on swimming performance. Therefore, swimming instructors are advised to include dynamic balance exercises in their land-based training sessions to improve their swimmers' performance.
Collapse
Affiliation(s)
- Raul F Bartolomeu
- Department of Sports Sciences, Polytechnic of Guarda, 6300-559 Guarda, Portugal
- Department of Sport Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-252 Bragança, Portugal
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5000-801 Vila Real, Portugal
| | - Tatiana Sampaio
- Department of Sport Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-252 Bragança, Portugal
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5000-801 Vila Real, Portugal
| | - João P Oliveira
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5000-801 Vila Real, Portugal
- Department of Sports Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal
| | - Tiago M Barbosa
- Department of Sport Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-252 Bragança, Portugal
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5000-801 Vila Real, Portugal
| | - Jorge E Morais
- Department of Sport Sciences and Physical Education, Instituto Politécnico de Bragança, 5300-252 Bragança, Portugal
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5000-801 Vila Real, Portugal
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Segal AD, Vargas BL, Richards FG, Shelley CJ, Silverman AK. Healthy aging reduces dynamic balance control as measured by the simplified Star Excursion Balance Test. Gait Posture 2023; 103:190-195. [PMID: 37244214 DOI: 10.1016/j.gaitpost.2023.05.020] [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: 11/06/2022] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Detecting and classifying factors that contribute to age-related balance decline are essential for targeted interventions. Dynamic postural tests that challenge neuromuscular balance control are important to detect subtle deficits that affect functional balance in healthy aging. RESEARCH QUESTION How does healthy aging affect specific components of dynamic postural control as measured by the simplified Star Excursion Balance Test (SEBT)? METHODS Twenty healthy younger (18-39 years) and twenty healthy older (58-74 years) adults performed the standardized simplified SEBT, which involved standing on one leg and reaching the contralateral leg as far as possible in the anterior, posteromedial, and posterolateral directions. Optical motion capture was used to quantify the maximum reach distance normalized by body height (%H) for three repeated trials in each direction per leg. Linear mixed effects models and pairwise comparisons of estimated marginal means were used to assess differences (p < 0.05) in normalized maximum reach distance by age group, reach direction, and leg dominance. Intersubject and intrasubject variability were also assessed by age group using coefficients of variation (CV). RESULTS Healthy older adults had less dynamic postural control compared to younger adults, with shorter reach distances in the anterior (7.9 %), posteromedial (15.8 %), and posterolateral (30.0 %) directions (p < 0.05). Leg dominance and sex did not significantly affect SEBT score for either age group (p > 0.05). Low intrasubject variability (CV<0.25 %) was found for repeated trials in both the older and younger participants. Therefore, the comparatively higher intersubject variability (Range CV=8-25 %) was mostly attributed to differences in SEBT performance across participants. SIGNIFICANCE Quantifying dynamic postural control in healthy older adults in a clinical setting is important for early detection of balance decline and guiding targeted and effective treatment. These results support that the simplified SEBT is more challenging for healthy older adults, who may benefit from dynamic postural training to mitigate age-related decline.
Collapse
Affiliation(s)
- Ava D Segal
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA.
| | - Brooklyn L Vargas
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Fiona G Richards
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Cameron J Shelley
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA; Quantitative Biosciences and Engineering, Colorado School of Mines, Golden, CO, USA
| |
Collapse
|
15
|
Hoch MC, Hertel J, Gribble PA, Heebner NR, Hoch JM, Kosik KB, Long D, Sessoms PH, Silder A, Torp DM, Thompson KL, Fraser JJ. Effects of foot intensive rehabilitation (FIRE) on clinical outcomes for patients with chronic ankle instability: a randomized controlled trial protocol. BMC Sports Sci Med Rehabil 2023; 15:54. [PMID: 37032355 PMCID: PMC10084629 DOI: 10.1186/s13102-023-00667-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Lateral ankle sprains account for a large proportion of musculoskeletal injuries among civilians and military service members, with up to 40% of patients developing chronic ankle instability (CAI). Although foot function is compromised in patients with CAI, these impairments are not routinely addressed by current standard of care (SOC) rehabilitation protocols, potentially limiting their effectiveness. The purpose of this randomized controlled trial is to determine if a Foot Intensive REhabilitation (FIRE) protocol is more effective compared to SOC rehabilitation for patients with CAI. METHODS This study will use a three-site, single-blind, randomized controlled trial design with data collected over four data collection points (baseline and post-intervention with 6-, 12-, and 24-month follow-ups) to assess variables related to recurrent injury, sensorimotor function, and self-reported function. A total of 150 CAI patients (50 per site) will be randomly assigned to one of two rehabilitation groups (FIRE or SOC). Rehabilitation will consist of a 6-week intervention composed of supervised and home exercises. Patients assigned to SOC will complete exercises focused on ankle strengthening, balance training, and range of motion, while patients assigned to FIRE will complete a modified SOC program along with additional exercises focused on intrinsic foot muscle activation, dynamic foot stability, and plantar cutaneous stimulation. DISCUSSION The overall goal of this trial is to compare the effectiveness of a FIRE program versus a SOC program on near- and long-term functional outcomes in patients with CAI. We hypothesize the FIRE program will reduce the occurrence of future ankle sprains and ankle giving way episodes while creating clinically relevant improvements in sensorimotor function and self-reported disability beyond the SOC program alone. This study will also provide longitudinal outcome findings for both FIRE and SOC for up to two years. Enhancing the current SOC for CAI will improve the ability of rehabilitation to reduce subsequent ankle injuries, diminish CAI-related impairments, and improve patient-oriented measures of health, which are critical for the immediate and long-term health of civilians and service members with this condition. Trial Registration Clinicaltrials.gov Registry: NCT #NCT04493645 (7/29/20).
Collapse
Grants
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
Collapse
Affiliation(s)
- Matthew C Hoch
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA.
| | - Jay Hertel
- Sports Medicine and Chair, Department of Kinesiology, University of Virginia, 550 Brandon Avenue, Charlottesville, VA, 22904-4407, USA
| | - Phillip A Gribble
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Nicholas R Heebner
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Johanna M Hoch
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Kyle B Kosik
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Doug Long
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, 900 South Limestone, Lexington, KY, 40536-0200, USA
| | - Pinata H Sessoms
- Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Amy Silder
- Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Danielle M Torp
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Katherine L Thompson
- Dr. Bing Zhang Department of Statistics, University of Kentucky, 725 Rose Street, Lexington, KY, 40536, USA
| | - John J Fraser
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| |
Collapse
|
16
|
Tennler J, Raeder C, Praetorius A, Ohmann T, Schoepp C. Effectiveness of the SMART training intervention on ankle joint function in patients with first-time acute lateral ankle sprain: study protocol for a randomized controlled trial. Trials 2023; 24:162. [PMID: 36869403 PMCID: PMC9985260 DOI: 10.1186/s13063-023-07195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The lateral ankle sprain (LAS) is the most common injury in the field of everyday and sports-related activities. There is a high rate of patients with LAS who will develop chronic ankle instability (CAI). A possible explanation for this high rate is an insufficient rehabilitation and/or a premature return to intense exercise and workloads. Currently, there are general rehabilitation guidelines for LAS but there is a lack of standardized evidenced-based rehabilitation concepts for LAS, which effectively reduce the high CAI rate. The primary aim of the study is to investigate the effectiveness of a 6-week sensorimotor training intervention (SMART-Treatment, SMART) in contrast to standard therapy (Normal Treatment, NORMT) after an acute LAS on perceived ankle joint function. METHODS This study will be a prospective, single-center, interventional randomized controlled trial with an active control group. Patients (14-41 years) with an acute LAS and a MRI confirmed lesion or rupture of at least one ankle ligament will be included. Exclusion criteria are acute concomitant injuries of the ankle, pre-injuries of the ankle, serious lower-extremity injuries of the last 6 months, lower-extremity surgery, and neurological diseases. The primary outcome measure will be the Cumberland Ankle Instability Tool (CAIT). Secondary outcomes include the Foot and Ankle Ability Measurement (FAAM), isokinetic and isometric strength diagnostics, joint repositioning sense, range of motion, measurements of postural control, gait and run analysis, and jump analysis. This protocol will follow the SPIRIT guidance. DISCUSSION Current management of LAS rehabilitation lacks since there is a high rate of patients developing a CAI. It has been shown that exercise therapy improves ankle function in acute LAS as well as in patients with CAI. It is further recommended to address specific impairment domains in ankle rehabilitation. However, empirical data for such a holistic treatment algorithm is missing. Therefore, this study has the potential to improve the healthcare for LAS patients and might be used for a future standardized evidence-based rehabilitation concept. TRIAL REGISTRATION "Prospectively registered" ISRCTN - ISRCTN13640422 17/11/2021; DRKS (German Clinical Trials Register) - DRKS00026049.
Collapse
Affiliation(s)
- Janina Tennler
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.
| | - Christian Raeder
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Arthur Praetorius
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Tobias Ohmann
- Research Department, BG Klinikum Duisburg, Duisburg, Germany
| | - Christian Schoepp
- Department for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.,Department of Trauma and Reconstructive Surgery, University Hospital, Essen, Germany
| |
Collapse
|
17
|
Hou ZC, Ao YF, Hu YL, Jiao C, Guo QW, Li N, Jiang YF, Jiang D. Balance training benefits chronic ankle instability with generalized joint hypermobility: a prospective cohort study. BMC Musculoskelet Disord 2023; 24:71. [PMID: 36707814 PMCID: PMC9881354 DOI: 10.1186/s12891-023-06179-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/19/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Balance training is the first choice of treatment for chronic ankle instability (CAI). However, there is a lack of research on the effects of balance training in CAI with generalized joint hypermobility (GJH). This study is to compare the outcomes of balance training in CAI patients with and without GJH. METHODS Forty CAI patients were assigned into the GJH group (Beighton ≥ 4, 20) and non-GJH group (Beighton < 4, 20) and they received same 3-month supervised balance training. Repeated measure ANOVA and independent t test were used to analyze self-reported questionnaires (Foot and ankle ability measure, FAAM), the number of patients experiencing ankle sprain, isokinetic muscle strength and postural control tests (Star excursion balance test, SEBT and Balance errors system, BES) before training, post-training immediately, and post-training 3 months, respectively. RESULTS At baseline, no differences were found between groups with except for GJH group having poorer SEBT in the posteromedial direction (83.6 ± 10.1 vs 92.8 ± 12.3, %) and in the posterolateral direction (84.7 ± 11.7 vs 95.7 ± 8.7, %). Following the balance training, GJH group demonstrated lower re-sprain ratio (immediately after training, 11.1% vs 23.5%, 3 month after training, 16.7% vs 29.4%) than non-GJH group, as well as greater FAAM-S score, plantarflexion strength and dorsiflexion strength at post-training immediately and 3 months, and both groups improved similarly in the FAAM-A score, muscle strength and balance control (SEBT in the posterior-lateral and posterior-medial directions, and BES scores) compared with baseline. CONCLUSIONS CAI patients with GJH gained equally even better postural stability and muscle strength after the balance training than the non-GJH patients. Balance training could still be an effective treatment for CAI patients with GJH before considering surgery. TRIAL REGISTRATION ChiCTR1900023999, June 21st, 2019.
Collapse
Affiliation(s)
- Zong-chen Hou
- grid.419897.a0000 0004 0369 313XDepartment of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, No.49 North Garden Road, 100191 Beijing, China
| | - Ying-fang Ao
- grid.419897.a0000 0004 0369 313XDepartment of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, No.49 North Garden Road, 100191 Beijing, China
| | - Yue-lin Hu
- grid.419897.a0000 0004 0369 313XDepartment of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, No.49 North Garden Road, 100191 Beijing, China
| | - Chen Jiao
- grid.419897.a0000 0004 0369 313XDepartment of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, No.49 North Garden Road, 100191 Beijing, China
| | - Qin-wei Guo
- grid.419897.a0000 0004 0369 313XDepartment of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, No.49 North Garden Road, 100191 Beijing, China
| | - Nan Li
- grid.411642.40000 0004 0605 3760Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 North Garden Road, Beijing, 100191 Haidian China
| | - Yan-fang Jiang
- grid.419897.a0000 0004 0369 313XDepartment of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, No.49 North Garden Road, 100191 Beijing, China
| | - Dong Jiang
- grid.419897.a0000 0004 0369 313XDepartment of Sports Medicine of Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, No.49 North Garden Road, 100191 Beijing, China
| |
Collapse
|
18
|
Juneja H, Frandsen C, Nielsen NO, Larsen K, Praestegaard J. Reliability of the Wii Balance Board for measurement of steady state balance in children aged 6-9 years. J Pediatr Rehabil Med 2022:PRM210106. [PMID: 36314228 DOI: 10.3233/prm-210106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE The Wii Balance Board (WBB) can be used for assessment of steady state balance (SSB), but its reliability has not been studied in children aged 6-9 years. This study aimed to determine the test-retest reliability of the WBB for measuring SSB in this population. A secondary aim was to determine the minimum detectable change (MDC) and standard error of measurement (SEM) of the WBB in children aged 6-9 years. METHODS 52 children between 6-9 years of age participated. "One leg stand balance" was used to assess center of pressure velocity (COPV) and center of pressure area (COPA) on three occasions by the same tester. Two tests were conducted on the same day (Day 1) and the third test was performed on another day (Day 2), with a period of 5-13 days between the two test days. Intraclass correlation coefficient (ICC 3,1), SEMs, and MDC were calculated. RESULTS Intra-day test-retest reliability of COPA was found to be good (ICC3,1 =0.86; 95% confidence interval [CI]: 0.75, 0.92) and that of COPV was also found to be good (ICC3,1 =0.87; 95% CI: 0.77, 0.92). Inter-day test-retest reliability was found to be good for COPA (ICC3,1 = 0.87; 95% CI: 0.75, 0.93) and COPV (ICC3,1 = 0.89; 95% CI: 0.81, 0.94). SEM for COPA in intra-day testing was 18.90 mm2 (15.78%), and in inter-day testing it was 16.44 mm2 (13.61%). SEM for COPV in intra-day testing was 1.12 mm/s (7.6%), and in inter-day testing it was 1.01 mm/s (6.9%). MDC for COPA in intra-day testing was 52.41mm2 (42.75%), and in inter-day testing was 45.58 mm2 (35.75%). MDC for COPV in intra-day testing was 3.11 mm/s (21.2%), and in inter-day testing it was 2.80 mm/s (18.9%). CONCLUSION The WBB has good test-retest reliability for assessing SSB of children between 6-9 years. COPA measurements appear to be less sensitive to clinical changes in SSB when compared to COPV. Assessment of validity of the WBB in this age group is recommended before it can be considered as a potential balance assessment tool in children.
Collapse
Affiliation(s)
- Hemant Juneja
- University College Absalon, Center of Nutritionand Rehabilitation Roskilde, Denmark
| | - Christian Frandsen
- University College Copenhagen, Department of Physiotherapy, Hilleroed, Denmark
| | - Nina Odgaard Nielsen
- University College Absalon, Center of Nutritionand Rehabilitation Roskilde, Denmark
| | - Kim Larsen
- University College Absalon, Center of Nutritionand Rehabilitation Roskilde, Denmark
| | | |
Collapse
|
19
|
Predicting the success of multimodal rehabilitation in chronic ankle instability based on patient-reported outcomes. BMC Musculoskelet Disord 2022; 23:706. [PMID: 35879757 PMCID: PMC9310506 DOI: 10.1186/s12891-022-05676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to identify potential indicators to predict the success of multimodal rehabilitation in chronic ankle instability (CAI) patients based on patient-reported outcomes. Methods Sixty patients with self-reported CAI participated. Their demographic information, injury history, and symptoms were recorded. Physical examinations and dynamic posture control tests were performed. The participants underwent sixteen 30-min treatment sessions of multimodal rehabilitation over 8 weeks. Fifty-one patients (85.0%) were available for follow-up after 8 weeks of the intervention. Treatment success was defined based on the participants’ perceived recovery using the global rating of change (GRC). Potential predictor variables were entered into a stepwise logistic regression model to identify variables for the prediction of treatment success. Results Forty of 51 participants (78.4%) were considered to have a successful outcome. Of the variables assessed, time since last sprain ≤ 8 months was a predictor of treatment success (p < 0.05). If a patient met the criteria, there was an 88.03% probability of successful multimodal rehabilitation. Conclusion A time since the last sprain ≤ 8 months may predict successful patient-reported outcomes after multimodal rehabilitation in CAI patients. Level of evidence Prospective study, Level 2. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05676-0.
Collapse
|
20
|
Halvorson RT, Castillo FT, Ahamed F, Khattab K, Scheffler A, Matthew RP, Lotz J, Vail TP, Feeley BT, Bailey JF. Point-of-care motion capture and biomechanical assessment improve clinical utility of dynamic balance testing for lower extremity osteoarthritis. PLOS DIGITAL HEALTH 2022; 1:e0000068. [PMID: 36812556 PMCID: PMC9931224 DOI: 10.1371/journal.pdig.0000068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/20/2022] [Indexed: 11/19/2022]
Abstract
Musculoskeletal conditions impede patient biomechanical function. However, clinicians rely on subjective functional assessments with poor test characteristics for biomechanical outcomes because more advanced assessments are impractical in the ambulatory care setting. Using markerless motion capture (MMC) in clinic to record time-series joint position data, we implemented a spatiotemporal assessment of patient kinematics during lower extremity functional testing to evaluate whether kinematic models could identify disease states beyond conventional clinical scoring. 213 trials of the star excursion balance test (SEBT) were recorded by 36 subjects during routine ambulatory clinic visits using both MMC technology and conventional clinician scoring. Conventional clinical scoring failed to distinguish patients with symptomatic lower extremity osteoarthritis (OA) from healthy controls in each component of the assessment. However, principal component analysis of shape models generated from MMC recordings revealed significant differences in subject posture between the OA and control cohorts for six of the eight components. Additionally, time-series models of subject posture change over time revealed distinct movement patterns and reduced overall postural change in the OA cohort compared to the controls. Finally, a novel metric quantifying postural control was derived from subject specific kinematic models and was shown to distinguish OA (1.69), asymptomatic postoperative (1.27), and control (1.23) cohorts (p = 0.0025) and to correlate with patient-reported OA symptom severity (R = -0.72, p = 0.018). Time series motion data have superior discriminative validity and clinical utility than conventional functional assessments in the case of the SEBT. Novel spatiotemporal assessment approaches can enable routine in-clinic collection of objective patient-specific biomechanical data for clinical decision-making and monitoring recovery.
Collapse
Affiliation(s)
- Ryan T. Halvorson
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Francine T. Castillo
- School of Medicine, University of California San Francisco, United States of America
| | - Fayyaz Ahamed
- School of Medicine, University of California San Francisco, United States of America
| | - Karim Khattab
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Aaron Scheffler
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Robert P. Matthew
- Department of Physical Therapy and Rehabilitation, University of California San Francisco, United States of America
| | - Jeffrey Lotz
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Thomas P. Vail
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Brian T. Feeley
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
| | - Jeannie F. Bailey
- Department of Orthopaedic Surgery, University of California San Francisco, United States of America
- * E-mail:
| |
Collapse
|
21
|
Han S, Lee H, Hopkins JT. Acute effects of external visual feedback using cross-line laser on landing neuromechanics and postural control in chronic ankle instability. Sports Biomech 2022:1-16. [PMID: 35678240 DOI: 10.1080/14763141.2022.2085620] [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: 02/05/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
Although neuromuscular training (NMT) programmes positively enhance clinical deficits in chronic ankle instability (CAI) patients, the effectiveness of NMTs in restoring movement patterns during jump landing is still questionable. Before developing new prolonged motor-learning interventions, it is important to determine the immediate effects of intervention on movement patterns during jump-landing in patients with CAI. Therefore, the purpose of this study was to determine whether real-time external feedback using a crossline laser device changes the movement patterns during jump-landing and balance tasks in patients with CAI. Eighteen patients with CAI completed three successful single-leg jump-landing tasks and single-leg balance tasks under the conditions of with and without external feedback. Lower-extremity joint angles, moments, and EMG activation of six muscles were collected during the single leg jump-landing task and centre of pressure data were collected during the single-leg balance test. Real-time external feedback allowed to change neuromechanical characteristics in the entire lower-extremity (i.e., ankle, knee, and hip joints) during jump-landing. However, there were no differences in static postural control between the two conditions. Clinicians should carefully consider incorporating a cost-effective laser device into an augmented NMT programme of longer duration to improve movement patterns during functional tasks in patients with CAI.
Collapse
Affiliation(s)
- Seunguk Han
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - Jon Tyson Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| |
Collapse
|
22
|
Shousha T, Alowais F, Arumugam A. Cross-cultural adaptation and validation of the Arabic version of the simple shoulder test in the United Arab Emirates. PLoS One 2022; 17:e0267885. [PMID: 35507561 PMCID: PMC9067704 DOI: 10.1371/journal.pone.0267885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 04/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Simple Shoulder Test (SST) is a simple and short patient-reported outcome measuring functional limitations of the affected shoulder in patients with shoulder dysfunction. Although it is widely used in different clinical cultures, literature review to date revealed that the SST has not been yet translated nor validated in the Arabic language. Research objectives To translate, culturally adapt, and validate the Arabic version of the Simple Shoulder Test (SST). Methodology A forward-backward translation method was adopted. One hundred and forty-one patients with shoulder pain were recruited for psychometric analysis based on the inclusion criteria. The test–retest reliability of the Arabic SST (ASST), pain, disability and total scores were assessed using intraclass correlation coefficients (ICC). The construct validity of the ASST was tested by Spearman rank coefficients through comparing the Arabic SST scores to the severity of shoulder pain measured using the visual analogue scale (VAS) and the Arabic version of the Shoulder Pain and Disability Index (SPADI). Internal consistency was assessed by the Cronbach’s alpha. Findings One hundred and forty participants (60 males and 80 females) with a mean (Standard Deviation) age of 39.3 (4.9) years participated in the study. The ICCs for score of ASST were reported high; pain 0.84 (0.78–0.93), disability 0.96 (0.93–0.97) and total score 0.95 (0.91–0.97). Similarly, the Cronbach α values for the ASST scores were also of high values with regards to pain (0.89), disability (0.94), and total score (0.97) respectively. Comparing the scores between the first and the second use of the ASST revealed no statistically significant mean differences of -1.9 (95% CI—3.61 to 0.17). Conclusion The Arabic-translated version of the SST showed high reliability, internal consistency, and construct validity based on substantial correlations of the ASST with Arabic SPADI and VAS. We recommend the Arabic version of the SST for the evaluation of Arabic-speaking patients with shoulder dysfunction.
Collapse
Affiliation(s)
- Tamer Shousha
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
- Neuromusculoskeletal Rehabilitation Research Group, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- Department of Physical Therapy for Musculoskeletal Disordered and its Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- * E-mail:
| | - Fatima Alowais
- Department of Physiotherapy, Qassimi Hospital, Sharjah, UAE
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health sciences, University of Sharjah, Sharjah, UAE
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, UAE
| |
Collapse
|
23
|
In Patients with Grade I and II Ankle Sprains, Dynamic Taping Seems to Be Helpful during Certain Tasks, Exercises and Tests in Selected Phases of the Rehabilitation Process: A Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095291. [PMID: 35564686 PMCID: PMC9100756 DOI: 10.3390/ijerph19095291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/26/2022]
Abstract
We aimed to investigate changes in postural stability on a stable surface after the application of dynamic tape for patients with inversion ankle sprains. This study enrolled 30 patients (age 25.5 ± 8.0 years) with grade I and II ankle sprains, which occurred 7−21 days before enrolment. Postural stability (balance, coordination, feedback) was assessed before and after the application of dynamic tape using a stabilographic platform. Three 32-s exercises were performed on the stabilographic platform, one with eyes open, one with eyes closed and one with visual feedback. After the application of dynamic tape, an improvement was observed in terms of the mean radius of sway (4.2 ± 1.3 mm vs. 3.4 ± 0.9 mm; p = 0.012) and coordination (48.8 ± 19.2% vs. 59.3 ± 5.8%; p = 0.021). Selected balance parameters did not improve significantly in the tests with open and closed eyes. Asymmetric load improved for all tests, but significant differences were only observed with eyes closed (34.9 ± 24.4 vs. 41.7 ± 30.5; p < 0.01). We concluded that the use of dynamic tape after an ankle sprain significantly improved balance and coordination on a stable surface. The benefits were shown in terms of a significant improvement in the asymmetric load of the injured limb in comparison to the healthy limb during the test with closed eyes and a considerable improvement in the asymmetric load that was evaluated with visual feedback on a stable surface.
Collapse
|
24
|
Werasirirat P, Yimlamai T. Effect of supervised rehabilitation combined with blood flow restriction training in athletes with chronic ankle instability: a randomized placebo-controlled trial. J Exerc Rehabil 2022; 18:123-132. [PMID: 35582686 PMCID: PMC9081407 DOI: 10.12965/jer.2244018.009] [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: 01/12/2022] [Accepted: 02/05/2022] [Indexed: 11/24/2022] Open
Abstract
Blood flow restriction (BFR) resistance exercise has been advocated as an alternative approach for improving muscle strength in patients undergoing musculoskeletal rehabilitation. The present study aimed to evaluate the effectiveness of a 4-week supervised rehabilitation (R) with and without BFR on muscle strength, cross-sectional area (CSA), dynamic balance, and functional performance in athletes with chronic ankle instability (CAI). A total of 16 collegiate athletes with CAI participated in this study. They were randomly assigned to the BFR+R group (n=8) or the R group (n=8). Both groups underwent supervised rehabilitation 3 times weekly for 4 consecutive weeks. Additionally, the BFR+R group was applied with a cuff around the proximal thigh at 80% arterial occlusion pressure in addition to the traditional rehabilitation program, whereas the R group received the sham BFR only. Before and after 4 weeks of intervention, isokinetic muscle strength, CSA, Y-balance test, and side hop test (SHT) were measured. Following a 4-week intervention, the BFR+R group exhibited significant improvements in muscle strength of ankle plantarflexor and evertor, CSA of fibularis longus, and SHT timed performance compared with prior training and the R group (all, P<0.05). However, no significant difference was observed on dynamic balance among the groups. The present finding indicated that a 4-week supervised rehabilitation combined with BFR is more effective in improving muscle strength and size and functional performance compared with the traditional rehabilitation alone. This information could have implications for physical therapists and clinician in developing and designing a rehabilitation program for athletes with CAI.
Collapse
Affiliation(s)
| | - Tossaporn Yimlamai
- Corresponding author: Tossaporn Yimlamai, Department of Sports Science, Faculty of Sports Science, Chulalongkorn University, Rama I Road, Pathumwan District, Bangkok 10330, Thailand,
| |
Collapse
|
25
|
Young KL, Morris B, Herda TJ. The Role of Strength and Conditioning in the Prevention and Treatment of Chronic Lateral Ankle Instability. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
26
|
Hou ZC, Huang HS, Ao YF, Hu YL, Jiao C, Guo QW, Miao X, Li N, Jiang YF, Jiang D. The effectiveness and sustainability of supervised balance training in chronic ankle instability with grade III ligament injury: a one-year prospective study. J Foot Ankle Res 2022; 15:9. [PMID: 35105372 PMCID: PMC8805278 DOI: 10.1186/s13047-022-00514-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 01/20/2022] [Indexed: 12/26/2022] Open
Abstract
Background To determine the effectiveness and sustainability of supervised balance training in people with chronic ankle instability (CAI) with grade III ligament injury. Methods Twenty young adults (12 males and 8 females) diagnosed with CAI with grade III ligament injury underwent 3 months of supervised balance training. The self-reported functional questionnaire, plantar pressure (walking and single leg standing), and isokinetic ankle strength were consecutively evaluated at pre-training, 3 months, 6 months and one year. Paired T tests were used to explore changes in muscle strength and plantar pressures following the supervised balance training. According to whether the patient had sprain recurrence, the patients were divided into sprain recurrence group and control group. The risk factors of sprain recurrence were explored with univariate analysis and multivariable logistic regression. Results The self-reported functional scores, the plantar pressure distribution and the muscle strength showed significant immediate improvements after 3 months of supervised balance training. At 6 months post-training, peak force under 2nd metatarsal, time to peak force under the medial hindfoot, time to boundary measurements and dorsiflexion, and eversion strength were partly declined to the pre-training level. 16 patients (80%) resumed the daily life and sports without sprain recurrence during the follow-up. Four patients (20%) reported ankle sprain during the follow-up, and the sprain recurrence group showed significantly higher Beighton scores (p = 0.012) and weaker initial inversion strength (p = 0.022) than the control group. Conclusions Three months’ of supervised balance training could effectively improve postural control and muscle strength of CAI cases with grade III ligament injury, although these improvements would partially deceased over time. Additional strength exercises for dorsiflexion and eversion should be supplemented from 6 months. Higher Beighton score and initial inversion muscle strength weakness might increase the risk of sprain recurrence. Trial registration ChiCTR, ChiCTR1900023999, Registered 21 June 2019, https://www.chictr.org.cn/edit.aspx?pid=39984&htm=4 Supplementary Information The online version contains supplementary material available at 10.1186/s13047-022-00514-x.
Collapse
Affiliation(s)
- Zong-Chen Hou
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Hong-Shi Huang
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Ying-Fang Ao
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Yue-Lin Hu
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Chen Jiao
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Qin-Wei Guo
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Xin Miao
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Yan-Fang Jiang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 North Garden Road, Haidian, Beijing, 100191, China
| | - Dong Jiang
- Department of sports medicine of Peking university third hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, No.49 North Garden Road, Haidian, Beijing, 100191, China.
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
Seyedi M, Nobari H, Abbasi H, Khezri D, Oliveira R, Pérez-Gómez J, Badicu G, Afonso J. Effect of Four Weeks of Home-Based Balance Training on the Performance in Individuals with Functional Ankle Instability: A Remote Online Study. Healthcare (Basel) 2021; 9:healthcare9111428. [PMID: 34828475 PMCID: PMC8622790 DOI: 10.3390/healthcare9111428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 12/26/2022] Open
Abstract
The purpose of the current study is to evaluate the effect of 4 weeks of home-based balance training (HBBT) on the performance of individuals with functional ankle instability (FAI) in daily activities and sports. Thirty college students diagnosed with FAI and with a mean weight of 79.8 ± 3.4 kg, height of 182.5 ± 5.1 cm, age of 23.5 ± 1.2 years, and instability score of 20 ± 2.3 were selected to participate in this study and were randomly divided by computer-generated methods into two groups: the HBBT group and the control group (CG), each consisting of 15 subjects. The HBBT group performed the program at home for 4 weeks, while the CG was non-exercise. Before and after the 4 weeks of exercise program, a form containing the foot and ankle ability measure for daily activities and sports was completed by the individuals. For data analysis, intra- and inter-group comparisons were performed using paired and independent sample t-tests, respectively, at a significance level of p ≤ 0.05. The results showed that 4 weeks of progressive HBBT were sufficient to significantly improve the measurement of the ability of ankle and foot function in individuals with FAI, even with a total volume of only 60 min per week. Accordingly, it is suggested that individuals with FAI can benefit from short-term HBBT programs, which are simple yet powerful enough to promote improvements in daily activities.
Collapse
Affiliation(s)
- Mohammadreza Seyedi
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran 1587958711, Iran;
| | - Hadi Nobari
- Department of Physical Education and Sports, University of Granada, 18010 Granada, Spain
- HEME Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
- Correspondence: (H.N.); (H.A.)
| | - Hamed Abbasi
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran 1587958711, Iran;
- Correspondence: (H.N.); (H.A.)
| | - Davood Khezri
- Department of Sport Biomechanics and Technology, Sport Sciences Research Institute, Tehran 1587958711, Iran;
| | - Rafael Oliveira
- ESDRM-IPS—Sports Science School of Rio Maior–Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal;
- Research Centre in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, Complexo Andaluz, Apartado 279, 2001-904 Santarém, Portugal
| | - Jorge Pérez-Gómez
- HEME Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, 500036 Brasov, Romania;
| | - José Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, 4099-002 Porto, Portugal;
| |
Collapse
|
29
|
Martinez B, Sauers A, da Conceição Souza V, de Oliveira J, Yi LC. Responsiveness of the Brazilian IdFAI questionnaire in patients with chronic ankle instability. Physiother Theory Pract 2021; 38:3045-3054. [PMID: 34637678 DOI: 10.1080/09593985.2021.1975336] [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: 12/06/2022]
Abstract
PURPOSE This study aimed to determine the responsiveness of the Brazilian version of the Identification of Functional Ankle Instability (IdFAI) questionnaire in students who received an eight-week treatment for chronic ankle instability (CAI). METHODS Twenty-five college students (aged 23.12 ± 2.80 years) with CAI, as identified by the IdFAI questionnaire, were recruited. We used distribution and anchor-based methods to assess the responsiveness of the questionnaire, and its ability to determine clinical changes in participants. Eleven anchors were used: Visual Analog Scale for instability (VAS-i); Cumberland Ankle Instability Tool (CAIT); Isometric dorsiflexion, plantar flexion, inversion, and eversion muscle strength measured using a manual dynamometer; Dynamic balance as assessed through the Star Excursion Balance Test (SEBT-Y); Active ankle dorsiflexion range of motion as measured using the weight-bearing lunge test; and Functional performance assessment using three hop tests: single hop, triple crossover hop, and side hop. The distribution-based method used effect size (ES) and standardized response mean (SRM), whereas the anchor-based method used paired t-tests. Both methods allowed the calculation of the minimal important difference (MID). RESULTS The Brazilian IdFAI showed high responsiveness, with a large magnitude of change (ES = 1.34) and a high responsiveness index (SRM = 1.28) when assessed after a treatment for CAI. The IdFAI total score (p < .001) and all the 11 anchors [VAS-i (p < .001); CAIT (p < .001); Isometric dorsiflexion (p < .001), plantar flexion (p < .001), inversion (p < .001), and eversion (p < .001) muscle strength; SEBT-Y (p < .001); Lunge test (p = .002); Single hop (p < .001); triple crossover hop (p < .001); and side hop tests (p < .001)] showed significant differences. The anchor and distribution-based methods demonstrated MID values of 3.72 and 1.49-2.27, respectively. CONCLUSION The Brazilian IdFAI questionnaire is a patient-reported outcome measure sensitive to clinical changes in individuals with CAI. It can be used as an identification of patients with CAI, and as a parameter to verify clinical changes of clinical trials or therapeutic interventions in the population with CAI.
Collapse
Affiliation(s)
- Bruna Martinez
- Department of Human Movement Science, Federal University of Sao Paulo, Santos, Brazil
| | - Andrea Sauers
- Department of Human Movement Science, Federal University of Sao Paulo, Santos, Brazil
| | | | - Juliana de Oliveira
- Department of Human Movement Science, Federal University of Sao Paulo, Santos, Brazil
| | - Liu Chiao Yi
- Department of Human Movement Science, Federal University of Sao Paulo, Santos, Brazil
| |
Collapse
|
30
|
Disrupted somatosensory input alters postural control strategies during the Star Excursion Balance Test (SEBT) in healthy people. Gait Posture 2021; 90:141-147. [PMID: 34481264 PMCID: PMC9278490 DOI: 10.1016/j.gaitpost.2021.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 07/20/2021] [Accepted: 08/27/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chronic adaptations, including persistent sensorimotor deficits, remain in individuals with a history of ankle instability, resulting in altered postural control strategies during functional tasks such as gait, running, or landing. However, we do not know the contribution of the altered somatosensory input on postural control strategies during a dynamic balance task such as the Star Excursion Balance Test (SEBT). RESEARCH QUESTION The purpose of this study was to characterize postural control strategies with and without disrupted somatosensory input during a dynamic balance task in people without chronic ankle sprain. METHODS This study was a crossover study design. Twenty healthy young adults (10 men, 10 women; age = 23.9 ± 3.0 years, height = 174.2 ± 7.4 cm, mass = 71.2 ± 16.7 kg) performed the posteromedial reach test during the SEBT while standing on the ground and on foam. We measured the maximum reach distance (MRD); joint angles of the ankle, knee, hip, and trunk in the sagittal, frontal, and transverse planes; and position and displacement of the center of mass (COM) and center of pressure (COP) during the posteromedial reach task. RESULTS The MRD was shorter when standing on the foam than on the ground (p < 0.001). There was a condition by phase interaction for ankle dorsiflexion; tibia internal rotation; and trunk flexion (p < 0.001; p = 0.03; p = 0.01, respectively). The COM and COP were positioned more laterally on the foam (p < 0.001). The COM and COP anterior-posterior displacements were more anterior during the foam condition (p = 0.017). SIGNIFICANCE By using a foam pad to disrupt somatosensory information, participants demonstrated altered strategies to control the joint kinematics, COM, and COP, as a function of posteromedial distance. Ankle and trunk movement strategies may influence the posteromedial reach distance. This model may simulate changes that occur with chronic ankle instability.
Collapse
|
31
|
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.
Collapse
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
| | | |
Collapse
|
32
|
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.
Collapse
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
| |
Collapse
|
33
|
Antico M, Balletti N, Laudato G, Lazich A, Notarantonio M, Oliveto R, Ricciardi S, Scalabrino S, Simeone J. Postural control assessment via Microsoft Azure Kinect DK: An evaluation study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 209:106324. [PMID: 34375852 DOI: 10.1016/j.cmpb.2021.106324] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/25/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Equipments generally used for entertainment, such as Microsoft Kinect, have been widely used for postural control as well. Such systems-compared to professional motion tracking systems-allow to obtain non-invasive and low-cost tracking. This makes them particularly suitable for the implementation of home rehabilitation systems. Microsoft has recently released a new version of Kinect, namely Azure Kinect DK, that is meant for developers, not consumers, and it has been specifically designed to implement professional applications. The hardware of this new version of the Kinect has been substantially improved as compared with previous versions. However, the accuracy of the Azure Kinect DK has not been evaluated yet in the context of the assessment of postural control as done for its predecessors. METHODS We present a study to compare the motion traces of the Azure Kinect DK with those of a Vicon 3D system, typically considered the gold standard for high-accuracy motion tracking. The study involved 26 subjects performing specific functional reach and functional balance exercises. RESULTS The results clearly indicates that the Azure Kinect DK provides a very accurate tracking of the main joints of the body for all the recording taken during the lateral reach movement. The Root Mean Square Error (RMSE) between the two tracking systems obtained is approximately 0.2 for the lateral and forward exercises while for the balance exercise it is around 0.47 considering the average of the results among all the joints. The angular Mean Absolute Error is approximately in the range 5-15 degrees for all the upper joints and independently on the exercise. The lower body joints show a higher angular error between the two systems. Not surprisingly, it was found that results are much better in correspondence of slow movements. CONCLUSIONS The results achieved that the Azure Kinect DK has an incredibly high potential to be used in applications of home rehabilitation, where the assessment of postural control is a fundamental and crucial activity.
Collapse
Affiliation(s)
| | - Nicoletta Balletti
- Defense Veterans Center, Ministry of Defense, Rome, Italy; STAKE Lab, University of Molise, Pesche, IS, Italy
| | | | - Aldo Lazich
- Defense Veterans Center, Ministry of Defense, Rome, Italy; DIAG, University of Rome "Sapienza", Rome, Italy
| | | | - Rocco Oliveto
- STAKE Lab, University of Molise, Pesche, IS, Italy; Datasound srl, Pesche, IS, Italy.
| | | | - Simone Scalabrino
- STAKE Lab, University of Molise, Pesche, IS, Italy; Datasound srl, Pesche, IS, Italy
| | | |
Collapse
|
34
|
Ahern L, Nicholson O, O'Sullivan D, McVeigh JG. Effect of Functional Rehabilitation on Performance of the Star Excursion Balance Test Among Recreational Athletes With Chronic Ankle Instability: A Systematic Review. Arch Rehabil Res Clin Transl 2021; 3:100133. [PMID: 34589684 PMCID: PMC8463475 DOI: 10.1016/j.arrct.2021.100133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE To determine (1) the effectiveness of rehabilitation for chronic ankle instability as measured by the Star Excursion Balance Test (SEBT) and (2) the relative efficacy and the long-term effects of these rehabilitation interventions. DATA SOURCES Ten electronic databases were searched (2009-2019). STUDY SELECTION Included articles were randomized controlled trials in English investigating recreational athletes aged ≥18 years with chronic ankle instability. At least 1 functional rehabilitation intervention had to be included and the SEBT test (or the modified version) used as an outcome measure. DATA EXTRACTION Two researchers (L.A., O.N.) extracted data regarding participant demographics; intervention characteristics; trial size; and results at baseline, postintervention, and at follow-up, where appropriate. DATA SYNTHESIS A systematic review and narrative synthesis was conducted. Methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool and the van Tulder scale. The review was registered with PROSPERO (ID: 164468). Ten studies (n=368), 2 high-quality, 1 moderate-quality, and 7 low-quality, were included in the review. Interventions included balance training, strength training, vibration training, and mixed training. Results suggest that rehabilitation of chronic ankle instability that includes wobble board exercises (average percentage change: 14.3%) and hip strengthening exercises (average percentage change: 12.8%) are most effective. Few studies compared different types of rehabilitation for chronic ankle instability. However, improvements on the SEBT suggest that a rehabilitation program focusing on wobble board training and hip strengthening performed 3 times weekly for 4-6 weeks is the optimal rehabilitation program to improve dynamic postural control in recreational athletes with chronic ankle instability. CONCLUSIONS Few studies directly compared different rehabilitation interventions, and there was limited long-term follow-up; therefore, the relative efficacy of different rehabilitation programs remains unclear. However, it seems that rehabilitation of chronic ankle instability should include proprioceptive and strengthening exercises of relatively short duration.
Collapse
Affiliation(s)
- Leanne Ahern
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Orla Nicholson
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Declan O'Sullivan
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Joseph G McVeigh
- Discipline of Physiotherapy, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| |
Collapse
|
35
|
Binaei F, Hedayati R, Mirmohammadkhani M, Taghizadeh Delkhoush C, Bagheri R. Examining the Use of Kinesiology Tape During Weight Bearing Exercises on Proprioception in Participants With Functional Ankle Instability. Percept Mot Skills 2021; 128:2654-2668. [PMID: 34396803 DOI: 10.1177/00315125211036425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The aim of this study was to examine the effect of tape worn during weight bearing exercises on proprioception (i.e., ankle angle repositioning error) in participants with functional ankle instability. We employed a randomized, controlled clinical study in a laboratory setting, with 56 participants with functional ankle instability. Participants were randomly assigned to three groups: (a) weight bearing exercises without tape (n = 18), (b) weight bearing exercises with tape (n = 19) and controls not engaged in weight bearing exercises (n = 19). Weight bearing exercises included six weeks of bilateral squats in partial form with up to 45 degrees of knee flexion, and unilateral partial squats with full heel raise, and with full toe raise. In the taped condition, participants wore tape for six weeks with up to three tape replacements per week. Proprioception was measured as ankle repositioning error. Results showed that the mean angle repositioning error among participants in the active weight bearing groups was decreased by the taping intervention, relative to the control group's performance (p = 0.042). There were no significant differences between weight bearing exercise groups and control groups. The addition of kinesiology tape in weight bearing exercises can improve proprioception in active conditions.
Collapse
Affiliation(s)
- Fatemeh Binaei
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Rozita Hedayati
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| |
Collapse
|
36
|
Portable 3D Gait Analysis Assessment in MTT Treat Chronic Ankle Instability: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6098978. [PMID: 34195271 PMCID: PMC8203342 DOI: 10.1155/2021/6098978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/20/2021] [Accepted: 05/29/2021] [Indexed: 11/17/2022]
Abstract
Purpose Retrospective analysis of the effect of portable 3D gait analysis as an innovative evaluation method in the treatment with MTT on chronic ankle instability patient. Methods From January 1, 2019, to December 31, 2019, 56 cases of chronic ankle instability (CAI) were extracted from the medical record system of Shenzhen Longhua District Central Hospital. All the patients of 56 cases accepted the medical training therapy (MTT). As outcome parameters, the alterations of the Cumberland ankle instability tool (CAIT), foot and ankle ability measure (FAAM), were used before the treatment and after treatment; meanwhile, the portable apparatus 3D gait analysis was used to measure the gait parameters. Conclusion The results showed only ankle angle parameters Y-axis, maximum dorsiflexion during support period (°) had a significant difference, and the p value is 0.039. Meanwhile, the CAIT, FAAM, and most 3D gait analysis data had no significant difference. This particular statistical difference shows that CAI can be measured scientifically and objectively, although most measurement parameters have no change. These results make further reveal that the CAI patients are suffering with dynamic abnormality of ankle motion angle; this also provides us with a measurable and systematic evaluation reference plan for CAI treatment in the future.
Collapse
|
37
|
Mollà-Casanova S, Inglés M, Serra-Añó P. Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: Systematic review and meta-analysis. Clin Rehabil 2021; 35:1694-1709. [PMID: 34058832 DOI: 10.1177/02692155211022009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To identify the effects of balance and strength training on function, ankle instability and dynamic balance in people with chronic ankle instability. METHOD The search was conducted on randomized controlled trials that investigated the effects of balance training or strength training in people with chronic ankle instability compared to a control group. Therefore, a systematic electronic search was performed until April 2021 in Pubmed/MEDLINE, Cochrane, and Embase databases. Moreover, an additional search was further performed checking the reference lists of the selected articles. The main outcomes were ankle instability, functionality, and dynamic balance. Finally, a qualitative and quantitative synthesis was performed. RESULTS Fifteen randomized controlled trials with 457 volunteers were included. Compared to regular exercise, balance training demonstrated to be more effective in terms of improving functionality (0.81 (0.48, 1.14)), ankle instability (0.77 (0.27, 1.26)), and dynamic balance (0.83 (0.57, 1.10)) outcomes. However, when compared to strength training, the effectiveness of balance training was only greater in terms of the functionality outcome (0.49 (0.06, 0.92)), since no differences were found for instability (0.43 (0.00, 0.85)) and dynamic balance (0.21 (-0.15, 0.58)). CONCLUSIONS Based on fair-to-high quality evidence, balance training significantly improves functionality, instability, and dynamic balance outcomes in people with chronic ankle instability Moreover, results of the comparison between balance training versus strength training suggest that the former achieves greater benefits for functionality, but not for instability and dynamic balance. SYSTEMATIC REVIEW REGISTRATION NUMBER CRD42021224179.
Collapse
Affiliation(s)
| | - Marta Inglés
- UBIC, Departament de Fisioteràpia, Universitat de València, València, Spain
| | - Pilar Serra-Añó
- UBIC, Departament de Fisioteràpia, Universitat de València, València, Spain
| |
Collapse
|
38
|
Wang H, Yu H, Kim YH, Kan W. Comparison of the Effect of Resistance and Balance Training on Isokinetic Eversion Strength, Dynamic Balance, Hop Test, and Ankle Score in Ankle Sprain. Life (Basel) 2021; 11:life11040307. [PMID: 33916136 PMCID: PMC8065734 DOI: 10.3390/life11040307] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 12/26/2022] Open
Abstract
Ankle sprain is a commonly recurring sports injury. This study aimed to compare the rehabilitation effects of resistance and balance training programs in patients with recurrent ankle sprain. Patients with recurrent lateral ankle sprain completed a home-based rehabilitation program comprising resistance training (RT; n = 27) or balance training (BT; n = 27). RT consisted of exercises using elastic tube bands, and BT consisted mainly of exercises performed using a variety of balance tools. Exercises were performed for 6 weeks, twice a day for 20 min, 5 days per week. Isokinetic eversion strength, Y-Balance test and hop tests, and foot and ankle outcome score (FAOS) were evaluated. Both RT and BT significantly improved strength and dynamic balance (p < 0.05). Compared to RT, BT also significantly improved the outcome of the crossover hop test (p = 0.008). The changes reflected group and time in pain (p = 0.022), sports (p = 0.027), and quality of life (p = 0.033) of FAOS were significantly greater in BT than RT.
Collapse
Affiliation(s)
- Haifang Wang
- School of Physical Education, Luoyang Normal College, Yibin District, Luoyang City 471934, China;
| | - Hailong Yu
- Department of Athletic Sports, Beijing Sport University, Beijing 100084, China;
| | - Yong Hwan Kim
- Department of Physical Education, Gangneung–Wonju National University, Gangwon 25457, Korea
- Correspondence: (Y.H.K.); (W.K.); Tel.: +82-33-640-2557 (Y.H.K.); +86-13-9301-00387 (W.K.); Fax: +82-33-641-3659 (Y.H.K.); +86-931-891-2129 (W.K.)
| | - Wencong Kan
- Sports Teaching and Research Department, Lanzhou University, Lanzhou 730000, China
- Correspondence: (Y.H.K.); (W.K.); Tel.: +82-33-640-2557 (Y.H.K.); +86-13-9301-00387 (W.K.); Fax: +82-33-641-3659 (Y.H.K.); +86-931-891-2129 (W.K.)
| |
Collapse
|
39
|
Kalaycioglu T, Apostolopoulos NC, Yurt Y, Tunay VB. The effectiveness of different ankle strengthening training programs on performance. J Sports Med Phys Fitness 2021; 62:435-447. [PMID: 33768775 DOI: 10.23736/s0022-4707.21.12130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the effectiveness of different ankle strengthening training programs: eccentric, concentric, and resistance bands, on performance of university level sedentary males. METHODS Sixty-three males between the ages of 18 and 26 years were randomized to either eccentric isokinetic (n=21), concentric isokinetic (n=21), and resistance bands ankle strengthening groups (n=21). Training was performed three days a week, for eight weeks for both sides of ankle. Each program was made progressively harder by increasing the number of repetitions or sets. Measurements evaluating strength, balance and jumping performance were repeated pre, post and at one month (follow-up) after training. RESULTS Statistical significance was observed for concentric evertor strength for both sides of the ankle for all groups after training (p<0.05). In addition, statistically significant increases were seen in jumping performance for all groups and dynamic balance for eccentric and concentric groups (p<0.05), with the concentric being statistically higher compared to the resistance bands group for all parameters (p<0.05). CONCLUSIONS Ankle isokinetic strength (eccentric, concentric) training is more effective than resistance bands regarding improvement on strength, explosive strength, and dynamic balance. Ankle isokinetic strength training, which includes evertor and invertor muscles, improves performance, especially when applied concentrically. Therefore, the proper strengthening of ankle muscles will prevent the re-injury of ankles with individuals returning to activities.
Collapse
Affiliation(s)
- Tugce Kalaycioglu
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Cyprus Health and Social Sciences University, Morphou, North Cyprus via Mersin, Turkey -
| | - Nikos C Apostolopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Yasin Yurt
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus via Mersin, Turkey
| | - Volga B Tunay
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| |
Collapse
|
40
|
Sadakuni D, Takeuchi K, Tsukuda F, Komatsu T. Change in dynamic postural control after a training program in collegiate soccer players with unilateral chronic ankle instability. J Sports Med Phys Fitness 2021; 62:238-243. [PMID: 33619951 DOI: 10.23736/s0022-4707.21.11920-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Improving dynamic postural stability after lateral ankle sprain due to chronic ankle instability helps prevent recurrence, and changes in dynamic postural stability can be assessed with the Star Excursion Balance Test. To date, no studies have examined the change in Star Excursion Balance Test score after the end of a balance training program or whether chronic ankle instability affects the rate of change. To examine the effect of chronic ankle instability on changes in Star Excursion Balance Test. score over time after a balance training program. METHODS Fifteen collegiate soccer players with chronic ankle instability selected with the Cumberland Ankle Instability Tool and ultrasonography. Participants completed a 6-week balance training program. We assessed the Star Excursion Balance Test 5 times (before and immediately after the program and 2, 4, and 6 weeks later) and examined differences in the duration of training effects by a 2-way analysis of variance, with Bonferroni correction for post hoc comparisons to explain any significant interactions. The significance level for all analyses was set at P < .05. We performed statistical analyses with SPSS version 25. RESULTS Analysis of the posterolateral and posteromedial scores in Star Excursion Balance Test showed a significant effect of time. Post hoc analysis of the posterolateral score showed that for each leg, participants reached significantly farther after the program than before (P = .012). The posterolateral scores at 2, 4, and 6 weeks after the training program did not differ from before the program, but the posteromedial score was significantly improved immediately after the program (P = .008) and also 2 (P = .004) and 4 weeks later (P = .006). CONCLUSIONS A 6-week balance training program to improve dynamic postural control can improve posterolateral and posteromedial scores in people with chronic ankle instability, and the improvements in posteromedial are still present 4 weeks after program completion.
Collapse
Affiliation(s)
- Daichi Sadakuni
- Department of Sport, Biwako Seikei Sport College, Faculty of Sport Study, Kyoto, Japan -
| | - Kosuke Takeuchi
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Hyogo, Japan
| | - Fumiko Tsukuda
- Department of Sport, Biwako Seikei Sport College, Faculty of Sport Study, Kyoto, Japan
| | - Takeshi Komatsu
- Department of Sport, Biwako Seikei Sport College, Faculty of Sport Study, Kyoto, Japan
| |
Collapse
|
41
|
Geist KT, Frierson EM, Goudiss HL, Kitchen H, Wilkins M, Pruszynski D, Carter VM. Short-term effects of dry needling at a spinal and peripheral site on functional outcome measures, strength, and proprioception among individuals with a lateral ankle sprain. J Bodyw Mov Ther 2021; 26:158-166. [PMID: 33992238 DOI: 10.1016/j.jbmt.2020.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The purpose of the study was to compare the effects of spinal and peripheral dry needling with peripheral dry needling alone, in addition to a strength and proprioception home exercise program, on pain, balance, strength, proprioception, and functional limitations among individuals with a history of a lateral ankle sprain. METHODS The study design is a single-blinded, repeated measures randomized clinical trial. Thirty-four participants, aged 18-50, with a history of a lateral ankle sprain within the last twelve months were randomly assigned into a peripheral dry needling (PDN) group or a spinal and peripheral dry needling (SPDN) group. Outcome measures included a pain assessment, strength testing, Modified Clinical Test of Sensory Integration and Balance, physical performance on hop tests, Cumberland Ankle Instability Tool and the Foot and Ankle Disability Index assessed at baseline, one week, and at four to six weeks. RESULTS The mixed model ANOVAs showed significant side by time interaction (p < 0.05) for inverter/dorsiflexion strength and significant improvements in side, time, and side by time (p < 0.05) for the CAIT. CONCLUSION Trigger point dry needling demonstrated short-term improvements in strength of the inverters/dorsiflexors and the CAIT scores on the involved side at one week and at four to six weeks irrespective of a PDN or SPDN approach. DISCUSSION These results suggest that improvements in strength and function can be achieved with PDN without additional needling at the corresponding spinal level.
Collapse
Affiliation(s)
- Kathleen T Geist
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA.
| | | | - Harrison L Goudiss
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Hope Kitchen
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Maggie Wilkins
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - David Pruszynski
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| | - Vincent M Carter
- Department of Rehabilitation Medicine, Emory University, Atlanta, 30322, USA
| |
Collapse
|
42
|
The Effects of Therapeutic Exercise With and Without Mobilization in Participants With Chronic Ankle Instability: A Randomized Controlled Trial. J Sport Rehabil 2021; 30:206-213. [PMID: 37159607 DOI: 10.1123/jsr.2019-0373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Context: Manual therapy (MT) is reported to increase range of motion (ROM), improve balance, and decrease pain in individuals with chronic ankle instability (CAI). Additional literature is needed to examine the effectiveness of the addition of MT to a therapeutic exercise regimen in individuals with CAI. Objective: To examine the combined effects of thrust joint manipulation (TJM) and exercise on function in participants reporting CAI. Design: Randomized controlled trial. Setting: Research laboratory. Participants: A convenience sample of 30 participants (mean age 23.7 [3.65] y; mean height 169.50 [9.50] cm; mean mass 66.48 [10.64] kg). Intervention: Participants were randomly allocated to the exercise (n = 15) or exercise + TJM group (n = 20) and completed an exercise program. The exercise + TJM group also received MT at the talocrural, proximal, and distal tibiofibular joints in the first 3 sessions. Main Outcome Measures: Self-reported outcomes were recorded at baseline and follow-up using the Foot and Ankle Ability Measure (FAAM), the FAAM-Sport (FAAM-S) subscale, and the Ankle Joint Functional Assessment Tool (AJFAT). The side-hop test, figure-of-8 hop test, 3 directions of the Star Excursion Balance Test, and dorsiflexion ROM were also assessed at baseline and follow-up. Results: Only the exercise + TJM group demonstrated an improvement in weight-bearing dorsiflexion with the knee flexed following treatment (P = .02). For all outcome measures, except ROM, subjects improved significantly at follow-up regardless of group assignment (P ≤ .01). Conclusions: Our data suggest that rehabilitation of patients with CAI is related to improved ROM, function, and self-reported outcomes. This provides evidence that the addition of MT to exercise may enhance improvements in ROM as compared with exercise alone. Additional research is needed to identify optimal parameters to maximize therapeutic benefit.
Collapse
|
43
|
Attia S, Diefenbach J, Schmermund D, Böttger S, Pons-Kühnemann J, Scheibelhut C, Heiss C, Howaldt HP. Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life. Cancers (Basel) 2020; 12:cancers12082217. [PMID: 32784461 PMCID: PMC7465780 DOI: 10.3390/cancers12082217] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 12/21/2022] Open
Abstract
The free fibula flap has been one of the most important microvascular grafts for orofacial reconstruction for more than 30 years. The complication rates at the donor-site reported in literature are considered to be low, but the published data vary greatly in some cases. In particular, restrictions in the stability and balance of the involved leg and their effects on the quality of life have been described very inconsistently to date. Therefore, this study mainly focuses on the stability and balance of the affected leg in a split-leg design. Between December 2014 and January 2018, out of 119 subjects who underwent mainly jaw ablative tumor surgery and reconstruction using a fibula flap, 68 subjects were examined for donor site morbidity. Besides reporting general types of complications, two specific test procedures were used. The Star Excursion Balance Test (SEBT) as a practical test for ankle function and the Foot and Ankle Disability Index (FADI) as a questionnaire in order to assess quality of life, depending on the lower leg function. SEBT revealed an average of 55.3 cm with the operated leg as the supporting leg, which corresponds to 95.5% of 57.9 cm achieved with the healthy leg as the supporting leg. An average FADI score of 89.4% was recorded. SEBT and FADI seem to be suitable methods of examination for subjects post fibular transplantation and pointed out minimal limitations of the involved legs in comparison to the unaffected legs. These limitations were clinically not relevant and they had minor influence on the subjects’ quality of life and their daily activities.
Collapse
Affiliation(s)
- Sameh Attia
- Department of Cranio Maxillofacial Surgery, Justus-Liebig University Giessen, Klinik Str. 33, 35392 Giessen, Germany; (J.D.); (D.S.); (S.B.); (H.-P.H.)
- Correspondence: ; Tel.: +49-641-994-6110; Fax: +49-641-994-6109
| | - Jonas Diefenbach
- Department of Cranio Maxillofacial Surgery, Justus-Liebig University Giessen, Klinik Str. 33, 35392 Giessen, Germany; (J.D.); (D.S.); (S.B.); (H.-P.H.)
| | - Daniel Schmermund
- Department of Cranio Maxillofacial Surgery, Justus-Liebig University Giessen, Klinik Str. 33, 35392 Giessen, Germany; (J.D.); (D.S.); (S.B.); (H.-P.H.)
| | - Sebastian Böttger
- Department of Cranio Maxillofacial Surgery, Justus-Liebig University Giessen, Klinik Str. 33, 35392 Giessen, Germany; (J.D.); (D.S.); (S.B.); (H.-P.H.)
| | - Jörn Pons-Kühnemann
- Institute for Medical Informatics, Medical Statistics, Faculty of Medicine, Justus-Liebig University Giessen, Rudolf-Buchheim Str. 6, 35392 Giessen, Germany; (J.P.-K.); (C.S.)
| | - Christine Scheibelhut
- Institute for Medical Informatics, Medical Statistics, Faculty of Medicine, Justus-Liebig University Giessen, Rudolf-Buchheim Str. 6, 35392 Giessen, Germany; (J.P.-K.); (C.S.)
| | - Christian Heiss
- Department of Trauma, Hand and Reconstructive Surgery, Justus-Liebig University Giessen, Rudolf-Buchheim- Str. 7, 35392 Giessen, Germany;
| | - Hans-Peter Howaldt
- Department of Cranio Maxillofacial Surgery, Justus-Liebig University Giessen, Klinik Str. 33, 35392 Giessen, Germany; (J.D.); (D.S.); (S.B.); (H.-P.H.)
| |
Collapse
|
44
|
Feger MA, Donovan L, Herb CC, Hart JM, Saliba SA, Abel MF, Hertel J. Effects of 4-week impairment-based rehabilitation on jump-landing biomechanics in chronic ankle instability patients. Phys Ther Sport 2020; 48:201-208. [PMID: 33515967 DOI: 10.1016/j.ptsp.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine effects of 4-weeks of impairment-based rehabilitation on lower extremity neuromechanics during jump-landing. DESIGN Descriptive laboratory study. PARTICIPANTS Twenty-six CAI subjects (age = 21.4 ± 3.1 sex=(M = 7,F = 19), height = 169.0 ± 8.8 cm, weight = 71.0 ± 13.8 kg) completed 15 jump-landing trials prior to and following 12 supervised rehabilitation sessions. MAIN OUTCOME MEASURES Frontal and sagittal lower extremity kinematics and kinetics and sEMG amplitudes (anterior tibialis, peroneus brevis, peroneus longus, and medial gastrocnemius). Means and 90% confidence intervals (CIs) were calculated for 100 ms prior to and 200 ms following ground contact. Areas where pre- and post-rehabilitation CIs did not overlap were considered significantly different. Kinematic and kinetic peaks and kinematic excursion were compared with paired t-test (P ≤ 0.05). RESULTS Following rehabilitation, CAI subjects exhibited less ankle (2.1° (0.8, 3.4), P < 0.01) and hip (2.0° (0.5, 3.7), P = 0.01) frontal plane excursion and lower peak hip abduction (2.5° (0.0, 5.0), P = 0.05). There was less ankle (5.0° (1.7, 8.3), P < 0.01) and knee (3.4° (0.8, 6.0), P = 0.01) sagittal plane excursion following rehabilitation. There was decreased peroneus longus activity from 9 ms to 135 ms post ground contact and decreased peak plantar flexion moment (0.08 N∗m/kg (0.01, 0.13), P = 0.02) following rehabilitation. CONCLUSION Progressive impairment-based rehabilitation resulted in reductions in kinematic excursion and peroneus longus muscle activity, suggesting a more efficient landing strategy.
Collapse
Affiliation(s)
- Mark A Feger
- University of Virginia, Department of Kinesiology, USA.
| | - Luke Donovan
- University of North Carolina at Charlotte, Department of Kinesiology, USA
| | - C Collin Herb
- Northern Kentucky University, School of Kinesiology, Counseling & Rehabilitative Sciences, USA
| | - Joseph M Hart
- University of Virginia, Department of Kinesiology, USA; University of Virginia, Department of Orthopedic Surgery, USA
| | | | - Mark F Abel
- University of Virginia, Department of Orthopedic Surgery, USA
| | - Jay Hertel
- University of Virginia, Department of Kinesiology, USA
| |
Collapse
|
45
|
Manipulative Therapy Plus Ankle Therapeutic Exercises for Adolescent Baseball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144997. [PMID: 32664535 PMCID: PMC7399978 DOI: 10.3390/ijerph17144997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 12/26/2022]
Abstract
Manipulative therapies and exercises are commonly used for the management of chronic ankle instability (CAI), but there is no evidence regarding the efficacy of high-velocity low-amplitude manipulation (HVLA) in addition to ankle therapeutic exercise to improve CAI in adolescent baseball players (ABP). To compare the effects of HVLA plus ankle therapeutic exercise and ankle therapeutic exercise alone on ankle status, pain intensity, pain pressure threshold (PPT), range of motion (ROM) of the ankle joint, and balance ability in ABP with CAI, a single-blinded randomized controlled trial was conducted. A total of 31 ABP with CAI were randomly allocated to the intervention (n = 16) or control (n = 15) groups. The intervention group received HVLA plus resistance exercise twice a week for 4 weeks, while the control group received resistance exercise alone. Ankle status, pain intensity, PPT, ROM, and balance ability were assessed before and after the intervention. The American Orthopedic Foot and Ankle Society scores showed significant group and time interactions (total, p = 0.002; pain, p < 0.001; alignment, p = 0.001). There were significant group and time interactions in pain intensity (resting pain, p = 0.008; movement pain, p < 0.001). For ROM, there were significant group and time interactions on dorsiflexion (p = 0.006) and eversion (p = 0.026). The unipedal stance of the balance ability showed significant group and time interactions in path length (p = 0.006) and velocity (p = 0.006). Adding HVLA to resistance exercises may be synergistically effective in improving the ankle status, pain intensity, ROM, and balance ability in ABP with CAI.
Collapse
|
46
|
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.
Collapse
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
| |
Collapse
|
47
|
Rodríguez-Torres J, López-López L, Cabrera-Martos I, Prados-Román E, Granados-Santiago M, Valenza MC. Effects of an Individualized Comprehensive Rehabilitation Program on Impaired Postural Control in Women With Chronic Pelvic Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil 2020; 101:1304-1312. [PMID: 32325162 DOI: 10.1016/j.apmr.2020.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/23/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effectiveness of an individualized comprehensive rehabilitation program (ICPR) on impaired postural control, pain, self-perceived health status, and functionality in women with chronic pelvic pain. DESIGN Randomized controlled trial. SETTING Women with chronic pelvic pain were recruited from the Gynecology Department of the University Hospital San Cecilio in Granada, Spain. PARTICIPANTS Participants (N=38) who were randomly divided into 2 groups. INTERVENTIONS The intervention group received an 8-week ICRP, and the control group received a leaflet with ergonomic information. MAIN OUTCOME MEASURES The main outcomes included were postural control (Mini Balance Evaluation Systems [Mini BESTest] and timed Up and Go [TUG]), pain (Brief Pain Inventory), self-perceived health status (EuroQol 5 dimensions [EQ-5D]), and functionality (Oswestry Disability Index [ODI]). RESULTS Significant differences were found between groups in the Mini BESTest and TUG scores with large effect sizes. The Brief Pain Inventory, EQ-5D, and ODI also presented significant differences in the between-groups analysis, with better scores in the intervention group after treatment. In the follow-up analysis, significant differences were found between groups in the Mini BESTest (P<.001), the cognitive TUG subscale (P=.032), interference of pain (P<.001), anxiety and depression (P=.001), and visual analog scale EQ-5D (P=.026) subscales, as well as the ODI (P<.001). CONCLUSIONS Our results show significant improvements on postural control, pain, self-perceived health status, and functionality in women with chronic pelvic pain who received an 8-week ICRP.
Collapse
Affiliation(s)
- Janet Rodríguez-Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Esther Prados-Román
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - María Granados-Santiago
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie C Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.
| |
Collapse
|
48
|
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.
Collapse
|
49
|
Functional Outcomes and Psychological Benefits of Active Video Games in the Rehabilitation of Lateral Ankle Sprains: A Case Report. J Sport Rehabil 2020; 29:213-224. [PMID: 30676209 DOI: 10.1123/jsr.2017-0135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 11/06/2018] [Accepted: 12/03/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT The use of active video games (AVG) as a treatment modality in the rehabilitation context is increasing. However, little is known about the functional outcomes and psychological benefits of such rehabilitation in college athletes with lateral ankle sprains (LASs). OBJECTIVE To examine functional outcomes and psychological benefits of AVG-aided rehabilitation program for LAS. DESIGN A mixed-methods, single-subject case series design. SETTING College athletic training clinic. PATIENTS Two female college soccer players who sustained LAS (grades I and II) during sport participation. INTERVENTION A 4-week balance training program. One patient completed balance exercises using AVG, whereas the other patient completed traditional balance exercises. MAIN OUTCOME MEASURES Several validated instruments were used to evaluate different functional outcomes and psychological factors: balance (Balance Error Scoring System, Star Excursion Balance Test), rehabilitation adherence (Rehabilitation Adherence Measure for Athletic Training), foot and ankle function (Foot and Ankle Ability Measure), perceptions of pain (Visual Analog Scale for pain), perceived readiness to return to sport (Injury-Psychological Readiness to Return to Sport Scale), and mood (Brunel Mood Scale). RESULTS It appears that the balance training protocols (AVG and traditional balance exercises) were equally effective in restoring patient's balance to functional levels. Despite very individualistic processes of rehabilitation, the participants' perceived pain, perceived readiness to return to sport, and mood states were closely linked with objective and subjective functional measures of progress. CONCLUSIONS Based on the results, AVG has the potential to provide more versatility into the static and dynamic postural control exercises typically used following acute LAS. Moreover, the current results support the existing psychological and biopsychosocial theoretical conceptualizations of athletes' responses to injuries and rehabilitation process.
Collapse
|
50
|
Karagiannakis DN, Iatridou KI, Mandalidis DG. Ankle muscles activation and postural stability with Star Excursion Balance Test in healthy individuals. Hum Mov Sci 2019; 69:102563. [PMID: 31989955 DOI: 10.1016/j.humov.2019.102563] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 12/03/2019] [Accepted: 12/08/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The ankle joint, a part of the kinetic chain of the lower limb, plays a significant role in the maintenance of postural stability during bipedal and unipedal balancing activities. This study aimed to evaluate the neuromuscular control of the ankle joint and the postural stability while executing the Star Excursion Balance Test (SEBT), by recording the EMG activity of the extrinsic ankle musculature and the displacement of the center of pressure (CoP). METHODS The EMG activity of the tibialis anterior (TA), the peroneus brevis (PB) and the medial and lateral gastrocnemius (GM, GL), along with the anteroposterior and mediolateral displacements (APd and MLd) of CoP as well as the plantar pressure distribution of the supportive lower limb were recorded during reaching to the eight directions of SEBT in 29 healthy, physically active college students (15 males and 14 females; mean ± SD of age 25.6 ± 4.5 yrs.; height: 172.5 ± 8.2 cm; body weight: 67.7 ± 13.6 kg; and BMI: 22.6 ± 2.9 kg/m2). RESULTS The tibialis anterior muscle demonstrated the greatest EMG activity during SEBT, followed by the PB, GL and GM muscles. The increased EMG activity of TA and PB during the execution of all posterior-oriented and lateral directions coincided with a decreased APd of CoP and increased reaching distances. The opposite occurred during the execution of all the anterior-oriented and medial directions. The differences among the directions of SEBT regarding the EMG activity of GL, GM and the mediolateral displacement of CoP were, in general, not significant. CONCLUSIONS The neuromuscular control of the ankle joint and the associated postural stability during SEBT was highly depended upon the activation level of TA and PB, which should be considered by clinicians and sports specialists when using this test for screening and/or rehabilitation purposes.
Collapse
Affiliation(s)
- Dimitris N Karagiannakis
- Sports Physical Therapy Laboratory, Department of Physical Education and Sports Science, School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Greece.
| | - Katerina I Iatridou
- Sports Physical Therapy Laboratory, Department of Physical Education and Sports Science, School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Greece.
| | - Dimitris G Mandalidis
- Sports Physical Therapy Laboratory, Department of Physical Education and Sports Science, School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Greece.
| |
Collapse
|