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Basciani S, Zampogna B, Gregori P, Shanmugasundaram S, Guelfi M, Marinozzi A. Current concepts in ankle microinstability and ankle functional instability. J Clin Orthop Trauma 2024; 51:102380. [PMID: 38577562 PMCID: PMC10988036 DOI: 10.1016/j.jcot.2024.102380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/25/2024] [Accepted: 02/21/2024] [Indexed: 04/06/2024] Open
Affiliation(s)
- Susanna Basciani
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - Biagio Zampogna
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
- BIOMORF Department Biomedical, Dental and Morphological and Functional Images, University of Messina. A.O.U Policlinico "G. Martino" Via Consolare Valeria, 1, 98124, Messina, Italy
| | - Pietro Gregori
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | | | - Matteo Guelfi
- Foot and Ankle Unit, Clinica Montallegro, Genoa, Italy
| | - Andrea Marinozzi
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo 21, 00128, Rome, Italy
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Zhuang Y, Hong Z, Wu L, Zou C, Zheng Y, Chen L, Yin L, Qin J. Influence of age on static postural control in adults with type 2 diabetes mellitus: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1242700. [PMID: 37795373 PMCID: PMC10546331 DOI: 10.3389/fendo.2023.1242700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/28/2023] [Indexed: 10/06/2023] Open
Abstract
Aim It was the aim of this study to assess static postural control characteristics in people with type 2 diabetes mellitus (T2D) of different ages using a force platform. A relationship was also established between static postural control parameters and age in this study. Methods A total of 706 participants with T2D were included in this study. The participants were stratified into three age groups: Group 1 (<60 years old), Group 2 (60-70 years old), and Group 3 (>70 years old). Static postural control assessment during two-leg stance was performed on a force platform by all participants. The center of pressure (CoP)-related parameters were measured under two stance conditions (eyes open and closed). Kruskal-Wallis tests were applied to explore the difference among the different age groups. Multivariate regression analysis was performed to determine the relation between age and static postural control parameters. Results Group 1 (<60 years old) had significantly less CoP total tracking length (TTL), sway area (SA), and CoP velocity along the Y direction (V-Y) under both eyes-open and eyes-closed conditions compared with Group 2 (60-70 years old) and Group 3 (>70 years old). Group 1 (<60 years old) had significantly less CoP maximum sway length along the X direction (MSL_X) and longer tracking length each area unit (TTL/SA) under the eyes-open condition compared with Group 2 (60-70 years old) and Group 3 (>70 years old). There was a significantly positive correlation between age and the most static postural parameters such as CoP TTL, SA, MSL-X, MSL-Y, and V-Y. There was a significantly negative correlation between age and TTL/SA. Conclusion This study suggested that older T2D participants had worse static postural control ability than younger ones. Most static postural parameters presented a significant correlation with age; the higher the age, the worse the static postural control.
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Affiliation(s)
- Yujun Zhuang
- Department of Outpatient, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Zhenzhen Hong
- Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Lijuan Wu
- Health Management Center, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Chunyan Zou
- Health Management Center, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yan Zheng
- Health Management Center, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Liming Chen
- Health Management Center, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lianhua Yin
- Health Management Center, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiawei Qin
- Department of Rehabilitation Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
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Ikuta Y, Nakasa T, Fujishita H, Obayashi H, Fukuhara K, Sakamitsu T, Ushio K, Adachi N. An association between excessive valgus hindfoot alignment and postural stability during single-leg standing in adolescent athletes. BMC Sports Sci Med Rehabil 2022; 14:64. [PMID: 35410244 PMCID: PMC9004062 DOI: 10.1186/s13102-022-00457-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Diminished balance is associated with the incidence of ankle and lower extremity injuries in adolescents. Although flexible flatfoot is a common foot condition in pediatric and adolescent populations, the association between balance control and foot morphology remain unclear in adolescent athletes. METHODS Rearfoot angle in the double-limb standing position, body mass index (BMI), and isometric muscle strength related to the knee joint were retrospectively reviewed in 101 adolescent athletes (75 boys and 26 girls) with a mean age of 14.0 years (range 12-17). Postural stability during single-leg standing on static and dynamic platforms was investigated using Balance System SD in 119 feet without functional ankle instability. The participants were divided according to their rearfoot angle into control (less than 7°) and valgus (greater than or equal to 7°) groups. The measured parameters were compared between the control and valgus groups using Welch's t-test, and P values < 0.05 were considered statistically significant. Multiple regression analysis was conducted to identify the factors that significantly influenced postural control. RESULTS The average rearfoot angle was 4.6° in all participants. An excessive valgus rearfoot angle was detected in 53 feet (26.2%). No significant difference was found between the groups in terms of BMI and isometric knee muscle strength. Although no statistical differences were observed in postural stability on the static platform between the control and valgus groups, the valgus group demonstrated poorer postural stability for single-leg standing on the dynamic platform. Multiple regression analysis revealed that BMI and rearfoot angle were significantly associated with a poor postural control on the dynamic platform. CONCLUSIONS Our findings suggest that excessive rearfoot valgus specifically contributes to the deterioration of postural stability in adolescent athletes, and that rearfoot alignment should be evaluated for the adolescent population to prevent sports-related lower extremity injury.
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Affiliation(s)
- Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan. .,Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan.
| | - Tomoyuki Nakasa
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan.,Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Hiromune Obayashi
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Kouki Fukuhara
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Kai Ushio
- Sports Medical Center, Hiroshima University Hospital, Hiroshima, Japan.,Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan
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4
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Guenka LC, Carrasco AC, Pelegrinelli ARM, Silva MF, Dela Bela LF, Moura FA, Cardoso JR. Influence of the medial longitudinal arch of the foot in adult women in ankle isokinetic performance: a cross-sectional study. J Foot Ankle Res 2021; 14:43. [PMID: 34118961 PMCID: PMC8196527 DOI: 10.1186/s13047-021-00479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maintenance of the medial longitudinal arch (MLA) of the foot is fundamental during functional tasks and disorders can lead to clinical alterations. Studies have demonstrated that deficits in ankle isokinetic performance can predispose an individual to lower limb injuries. OBJECTIVES To evaluate the muscular performance of cavus, planus, and normal feet by means of torque/body mass and the isokinetic phases, to generate 3D surface map analysis, and to verify whether there is a relationship between MLA height and arch height flexibility with isokinetic performance. METHODS The sample consisted of 105 healthy adult women, divided into three groups: normal, cavus, and planus. Assessment in concentric mode at 30, 60, and 90 °/s in the dorsiflexion and plantarflexion of the ankle joint were analyzed during the three isokinetic phases (acceleration, sustained velocity, and deceleration). The variables total range of motion, peak of torque (PT), and angle of PT were extracted within the sustained velocity. RESULTS In dorsiflexion at 60 °/s, the phase where the velocicty is sustained (load range phase) was higher in the planus group (MeanDifference=10.9 %; ω2p = 0.06) when compared with the cavus group. Deficits in the peak torque/body mass in dorsiflexion at 60 °/s (cavus feet: MD=-3 N.m/kg; ω2p = 0.06; and planus feet: MD=-1.1 N.m/kg; ω2p = 0.06) were also observed as well as in the 3D surface maps, when compared with the normal group. The flexibility of MLA had a negative correlation of PT at 30 °/s in cavus group. The heigth of MLA had a postive correlation with the PT for the cavus and planus group ate 60 °/s. All other results did not show differences between the groups. CONCLUSIONS The planus groups showed a better capacity of attain and sustained the velocity in dorsiflexion in relation the cavus group. The cavus and planus group had deficts in torque in relation the normal. The correlations were weak between the measures of MLA and PT. Thereby, in general the differences between foot types showed small effect in isokinetic muscle performance measures of the plantar and dorsi flexores. TRIAL REGISTRATION Study design was approved by the IRB (#90238618.8.0000.5231).
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Affiliation(s)
- Leandro C Guenka
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil
| | - Aline C Carrasco
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil.,Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | | | - Mariana F Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil
| | - Laís F Dela Bela
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil.,Universidade Positivo, Curitiba, PR, Brazil
| | - Felipe A Moura
- Laboratory of Applied Biomechanics, Universidade Estadual de Londrina, PR, Londrina, Brazil
| | - Jefferson Rosa Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Av. Robert Koch, 60, 86038-440, Londrina, PR, Brazil.
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Queiroz Dos Santos AN, Lemos T, Duarte Carvalho PH, Ferreira AS, Silva JG. Immediate effects of myofascial release maneuver applied in different lower limb muscle chains on postural sway. J Bodyw Mov Ther 2021; 25:151-156. [PMID: 33714487 DOI: 10.1016/j.jbmt.2020.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/30/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is little evidence about the myofascial release maneuver (MLM) targeting the fascial tissue and its effect on postural balance. This study investigated the immediate effects of the MLM in different lower limb muscle chains on the postural sway of healthy men. METHODS Sixty-three healthy men (27.2 ± 4.7 years) were randomly assigned to 7 groups (n = 9 each) to receive MLM applied to the lower limb muscle chains (anterior, posterior, medial, lateral, anterior/posterior, and medial/lateral) or placebo intervention. Skin pressure during the 3-min MLM was determined by the visual analog scale between 5 and 7 as previously assessed on participants. Posturography analysis of the elliptical area (Area) and average velocity (Vavg) of the center-of-pressure displacement was performed before and immediately after the MLM in single-leg support and with eyes closed. RESULTS A two-way repeated measures analysis of variance showed no interaction effect of factors group and time (Area: p = 0.210, ω2 = 0.004; Vavg: p = 0.358, ω2 < 0.001). Within-factor main effect of time was observed for both Area (p < 0.001, ω2 = 0.038) and Vavg (p < 0.001, ω2 = 0.028), with decreased Area and Vavg after all interventions. No between-factor main effect of group was observed for Area or Vavg (MLM or placebo, p = 0.188 or higher). CONCLUSION MLM applied to the lower limb muscle chains showed no immediate specific effects on postural sway in healthy men. Pre-post effects of MLM were not different from those elicited by a superficial massage. MLM in lower limb muscle chains is not advocated for an immediate improvement of postural balance in this population.
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Affiliation(s)
| | - Thiago Lemos
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro, RJ, Brazil
| | | | - Arthur Sá Ferreira
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro, RJ, Brazil.
| | - Julio Guilherme Silva
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta/UNISUAM, Rio de Janeiro, RJ, Brazil; Department of Physiotherapy, Universidade Federal Do Rio de Janeiro/UFRJ, Rio de Janeiro, RJ, Brazil
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6
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The role of the dominant leg while assessing balance performance. A systematic review and meta-analysis. Gait Posture 2021; 84:66-78. [PMID: 33278778 DOI: 10.1016/j.gaitpost.2020.11.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 10/26/2020] [Accepted: 11/08/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Good balance is a pre-requisite for various activities of daily life and sports. Physiotherapists thus regularly assess and train patient's balance capacities. In order to interpret the test results of unilateral balance tests, a comparison with normative data is common. In patients who had an injury or a surgery, the performance of the injured leg is often compared with performance of the non-injured leg. Nevertheless, it remains unclear if unilateral balance performance differs between the dominant and non- dominant legs. If so, this should take into consideration when interpreting test results. RESEARCH QUESTION This meta-analysis summarized the current evidence to determine if the balance performance of healthy adults was influenced by the leg's dominance. METHODS Articles were searched in PubMed, CINAHL, Cochrane and Embase. Data from studies meeting the pre-defined inclusion criteria were extracted in a standardized form. A meta-analysis was conducted using a random effect model. RESULTS Forty-six studies were included. Their data were allocated in 7 categories of balance tests. Significant differences between the dominant and the non-dominant legs were not found in any of the categories (surface stable, eyes open: -0.04, 95 % CI -0.12 to 0.05, surface stable eyes closed: -0.06, 95 % CI -0.22 to 0.11, surface unstable, eyes open: -0.15, 95 % CI -0.38 to 0.07, surface unstable, eyes closed: -0.06, 95 % CI -0.27 to 0.15, BESS (Balance Error Scoring System): 0.03, 95 % CI -1.09 to 1.14, SEBT (Star Excursion Balance Test)/YBT (Y Balance Test): 0.06, 95 % CI -0.04 to 0.16, jump: 0.04, 95 % CI -0.28 to 0.36). SIGNIFICANCE Results indicate that balance performance is not influenced by the leg's dominance. This means that performances of both legs can be used as reference. Evidence is strong for the one leg stance. However, future studies are needed to confirm our results for stabilization tasks after a jump landing.
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Murphy D, Louw QA, Moloney C, Leibbrandt D, Clifford AM. Hop Performance After Return to Sport in Anterior Cruciate Ligament-Reconstructed Gaelic Football and Hurling Athletes. J Sport Rehabil 2021; 30:707-716. [PMID: 33418539 DOI: 10.1123/jsr.2019-0488] [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: 11/17/2019] [Revised: 07/03/2020] [Accepted: 10/17/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Anterior cruciate ligament (ACL) injuries are among the most severe injuries in the Gaelic Athletic Association. Hop tests measure functional performance after ACL reconstruction as they replicate the key requirements for a match situation. However, research examining functional recovery of ACL-reconstructed Gaelic athletes is lacking. The objective of this study is to determine if athletes restore normal hop symmetry after ACL reconstruction and to examine if bilateral deficiencies persist in hop performance following return to sport. METHODS A cross-sectional design was used to evaluate hop performance of 30 ACL-reconstructed Gaelic athletes who had returned to competition and 30 uninjured controls in a battery of hop tests including a single, 6-m, triple, and triple-crossover hop test. RESULTS In each test, the mean symmetry score of the ACL reconstruction group was above the cutoff for normal performance of 90% adopted by this study (98%, 99%, 97%, and 99% for the single, 6-m, triple, and triple-crossover hop, respectively). No significant differences in absolute hop scores emerged between involved and control limbs, with the exception of the single-hop test where healthy dominant limbs hopped significantly further than ACL-reconstructed dominant limbs (P = .02). No significant deficits were identified on the noninvolved side. CONCLUSIONS The majority of ACL-reconstructed Gaelic athletes demonstrate normal levels of hop symmetry after returning to competition. Suboptimal hop performance can persist on the involved side compared with control limbs. Targeted rehabilitation may be warranted after returning to competition to restore performance to levels of healthy uninjured athletes.
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Beelen PE, Kingma I, Nolte PA, van Dieën JH. The effect of foot type, body length and mass on postural stability. Gait Posture 2020; 81:241-246. [PMID: 32818860 DOI: 10.1016/j.gaitpost.2020.07.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 07/04/2020] [Accepted: 07/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Poor postural stability is associated with chronic ankle instability. Previous research showed an effect of foot type on postural stability. However, the specific effect of supinated feet remains unclear. RESEARCH QUESTION Our study aimed to assess the effect of foot type on postural stability, while taking potential confounding effects of body mass and body height into account. METHODS Forty-three healthy participants between 18 and 40 years old performed barefooted single leg stance tests with eyes open (EO) and closed (EC) on solid ground, and on a balance board (BB). Foot type was determined from pressure recordings during gait, using the arch index. Ground reaction forces were measured using a force plate. Outcome measures were Center of Pressure Velocity (COPV) divided by body height, and the Horizontal Ground Reaction Force (HGRF) divided by body mass. Generalized Estimating Equations models assessed the differences between supinated, normal and pronated feet during EO, EC and on a BB. RESULTS During EO an interaction between supinated feet and body mass showed an increase of COPV with 0.03 × 10-2 1/s per kilogram of mass relative to normal feet (p = .03). During EC this interaction was more pronounced with 0.22 × 10-2 1/s increase per kilogram mass (p < .01). The HGRF did not differ between foot types in any of the conditions. SIGNIFICANCE Supinated feet have a larger increase in COPV compared to normal feet with increasing mass when standing on solid ground during EO and EC. This indicates that people with supinated feet and a higher mass are less stable during single leg stance. LEVEL OF EVIDENCE Level 3, associative study.
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Affiliation(s)
- Paul Erik Beelen
- Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, Noord-Holland, the Netherlands
| | - Idsart Kingma
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Peter A Nolte
- Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, Noord-Holland, the Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands
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Leg asymmetry and muscle function recovery after anterior cruciate ligament reconstruction in elite athletes: a pilot study on slower recovery of the dominant leg. Biol Sport 2020; 37:175-184. [PMID: 32508385 PMCID: PMC7249793 DOI: 10.5114/biolsport.2020.94238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 11/21/2019] [Accepted: 02/03/2020] [Indexed: 12/03/2022] Open
Abstract
The aim of this study was to examine performance in hopping tests in male athletes after anterior cruciate ligament reconstruction (ACLR) in the 4-to-6 months post-surgery period. A total of 36 athletes (24 ACLR and 12 controls) participated in this study. The ACLR group consisted of athletes who had undergone an ACLR on their dominant side (ACL DG n=16) or non-dominant side (ACL NDG n=8). Participants completed the following functional tests: a single-leg hop (SLH), single-leg triple hop (SL3H) and single-leg counter movement jump (SLCMJ), then the limb symmetry index (LSI) was calculated. There were no significant differences between the dominant and the non-dominant legs for all functional tests when comparing the ACL DG and the ACL NDG at 6 months after surgery. At 6 months after ACLR, the LSI of the two legs was within acceptable values, whether the athlete had the operation on their dominant or non-dominant leg (except the mean LSI for the ACL DG in the SLCMJ test). Furthermore, the control group showed higher performances as compared to the ACL group for all variables at 6 months after surgery, despite acceptable LSI. We concluded that an early return to “full participation to training” is not recommended in participants who have undergone an ACLR with patellar tendon grafts.
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Vuurberg G, Altink N, Rajai M, Blankevoort L, Kerkhoffs GMMJ. Weight, BMI and stability are risk factors associated with lateral ankle sprains and chronic ankle instability: a meta-analysis. J ISAKOS 2019; 4:313-327. [PMID: 33835938 DOI: 10.1136/jisakos-2019-000305] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/29/2019] [Accepted: 09/06/2019] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Lateral ankle sprains (LAS) are common in the general population and may lead to chronic ankle instability (CAI). If patients at risk could be identified, they could receive adequate and on-time treatment. OBJECTIVE The purpose of the current review was to identify all reported intrinsic factors associated with sustaining a LAS or progressing to CAI after an initial sprain. EVIDENCE REVIEW PubMed, Embase, MEDline, Cochrane and PEDro were searched for studies published until July 2019. Articles were selected if they included intrinsic factors related to LAS or CAI, subjects of at least 16 years old, and contained a minimum of 10 patients and 10 controls. Studies were excluded if they concerned reviews or case reports, included patients with previous surgical interventions, concomitant injuries or joint pathology other than ankle instability. Quality of included studies was assessed using the Quality in Prognostic Studies tool and quality of evidence was assessed using the GRADEpro tool. In case outcomes were described by at least three studies, data were pooled and assessed by performing a meta-analysis. Based on the pooled data, either a fixed-effects model or random-effects model was selected to correct for the degree of heterogeneity. FINDINGS The search resulted in a total of 4154 studies. After title and abstract screening and subsequent full-text screening, 80 relevant studies were included. Results of the meta-analyses indicated that, compared with healthy controls, patients with LAS had a higher mean body mass index (BMI). In patients with CAI, a higher weight and a longer time to stabilise after performing a task (eg, jumping) were found compared with healthy controls. Other outcomes could not be compared using a meta-analysis due to heterogeneity in outcome measurement and the great number of different outcomes reported. Identification of the risk factors when patients present themselves after a LAS may help to determine which patients are at risk of recurrent sprains or developing CAI. CONCLUSIONS AND RELEVANCE Based on the findings in this review, a higher BMI, and a higher weight and neuromuscular stability deficits may be regarded risk factors for sustaining a LAS or developing CAI, respectively. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Gwendolyn Vuurberg
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands .,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Nienke Altink
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Morteza Rajai
- Orthopaedic surgery, Iran University of Medical Sciences, Tehran, the Islamic Republic of Iran
| | - Leendert Blankevoort
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Gino M M J Kerkhoffs
- Orthopaedic surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
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11
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Laessoe U, Svendsen AW, Christensen MN, Rasmussen JR, Gaml AS. Evaluation of functional ankle instability assessed by an instrumented wobble board. Phys Ther Sport 2018; 35:133-138. [PMID: 30554122 DOI: 10.1016/j.ptsp.2018.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Ankle sprains often lead to a history of recurrent injuries and functional joint instability. This study evaluated a new method for assessing functional impairment in patients with chronic ankle instability. DESIGN Case-control study for construct validation purpose. SETTING The participants were tested during one-leg standing for 20 s on an instrumented wobble board and on a balance platform. PARTICIPANTS Twenty-five young people with previous ankle sprain and an instability score >11 in the "Identification of Functional Ankle Instability questionnaire" and an age-matched control group of 25 healthy individuals. MAIN OUTCOME MEASURES Wobble board variation of tilt angle measured by two accelerometers placed horizontally in the board. RESULTS The variation in angular tilt of the wobble board in the medio-lateral direction (standard deviation of tilt angle) was higher in the group with perceived ankle instability than in the control group: 1.5 (0.7) versus 1.1 (0.3). ICC for intra-tester reliability: 0.87 and correlation with COP area measures from the stable balance platform: 0.64. CONCLUSIONS People with functional ankle instability display poorer postural stability in the medio-lateral direction when challenged on an unstable surface. The instrumented wobble board may serve as a relevant tool in the clinical evaluation of functional ankle stability.
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Affiliation(s)
- Uffe Laessoe
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark; Department of Research and Development, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark.
| | - Anne Weinreich Svendsen
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
| | - Mads Norre Christensen
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
| | - Jacob Rosenkrans Rasmussen
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
| | - Alexander Scharf Gaml
- Physiotherapy Department, University College of Northern Denmark, UCN, Selma Lagerloffsvej 2, DK-9220, Aalborg, Denmark
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12
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Xiao J, Zhang Y, Zhao S, Wang H. Measuring the 3D motion space of the human ankle. Technol Health Care 2017; 25:219-230. [PMID: 28582909 DOI: 10.3233/thc-171324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The 3D motion space of the human ankle is an important area of study in medicine. The 3D motion space can provide significant information for establishing more reasonable rehabilitation procedures and standards of ankle injury care. OBJECTIVE This study aims to measure the 3D motion space of the human ankle and to use mathematical methods to quantify it. METHODS A motion capturing system was used to simultaneously capture the 3D coordinates of points marked on the foot, and convert these coordinate values into rotation angles through trigonometric functions and vectors. The mathematical expression of the ankle's motion space was obtained by screening, arranging, and fitting the converted data. RESULTS The mathematical expression of the 3D motion space of the participants was obtained. We statistically analyzed the data and learned that, in terms of 3D motion space, the right foot is more flexible than the left foot and the female foot is more flexible than the male foot. CONCLUSIONS The adduction and abduction rotation ranges are affected by the plantar flexion or dorsal flexure rotation angles. This relationship can be expressed mathematically, which is significant in the study of the ankle joint.
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Stensdotter AK, Bjerke J, Djupsjöbacka M. Postural sway in single-limb and bilateral quiet standing after unilateral total knee arthroplasty. Gait Posture 2015; 41:769-73. [PMID: 25755019 DOI: 10.1016/j.gaitpost.2015.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 01/30/2015] [Accepted: 02/13/2015] [Indexed: 02/02/2023]
Abstract
AIM To investigate whether total knee arthroplasty (TKA) was associated with stability in single-limb stance and whether reduced stability in single-limb stance was associated with increased postural sway in bilateral quiet standing. METHODS 3D kinematics for center of mass was used to assess postural sway in 23 subjects with TKA and 23 controls. Tests included bilateral quiet standing with and without vision and on a compliant surface, and single-limb stance. RESULTS 30% of the subjects in the TKA group were unable to maintain single-limb stance for 20s on any leg. Of the 70% in the TKA group able to stand on one leg, mean sway velocity in the medio-lateral direction was marginally higher for the prosthetic side (p=.02), but no differences were found between the TKA and the control group in single-limb stance. Performance in bilateral quiet standing was similar in TKA-subjects, able as well as unable to stand on one leg, and controls. Reduced quadriceps strength in the contralateral leg, higher BMI, and older age predicted failure to maintain single-limb stance. CONCLUSION In subjects able to stand on one leg, performance was considered comparable between the prosthetic and contralateral side and between groups. Inability to stand on one leg did not affect postural sway in bilateral quiet standing. The results suggest that inability to maintain single-limb stance is explained by reduced physical capacity rather than the knee condition in itself. The present study emphasizes the importance of physical activity to improve strength and functional capacity.
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Affiliation(s)
- Ann-Katrin Stensdotter
- Department of Community Medicine & Rehabilitation Physiotherapy, Umeå University, Umeå, Sweden; Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
| | - Joakim Bjerke
- Department of Community Medicine & Rehabilitation Physiotherapy, Umeå University, Umeå, Sweden; Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway
| | - Mats Djupsjöbacka
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Sweden
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14
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Winter T, Beck H, Walther A, Zwipp H, Rein S. Influence of a proprioceptive training on functional ankle stability in young speed skaters – a prospective randomised study. J Sports Sci 2014; 33:831-40. [DOI: 10.1080/02640414.2014.964751] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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15
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Lower limb joint motion during a cross cutting movement differs in individuals with and without chronic ankle instability. Phys Ther Sport 2014; 15:242-8. [DOI: 10.1016/j.ptsp.2013.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 11/26/2013] [Accepted: 12/04/2013] [Indexed: 12/26/2022]
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Hershkovich O, Tenenbaum S, Gordon B, Bruck N, Thein R, Derazne E, Tzur D, Shamiss A, Afek A. A large-scale study on epidemiology and risk factors for chronic ankle instability in young adults. J Foot Ankle Surg 2014; 54:183-7. [PMID: 25135102 DOI: 10.1053/j.jfas.2014.06.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Indexed: 02/03/2023]
Abstract
Up to 40% of ankle sprains can result in chronic ankle instability (CAI). The prevalence of CAI and its association with body mass index (BMI) and height in the general young adult population has not been reported. The database records of young adults before recruitment into mandatory military service were studied. Information on the disability codes associated with CAI was retrieved. Logistic regression models were used to assess the association between the BMI and body height with various grades of CAI severity. The study cohort included 829,791 subjects (470,125 males and 359,666 females). The prevalence was 0.7% for mild CAI and 0.4% for severe instability in males and 0.3% and 0.4%, respectively, for females (p < .001). An increased BMI was associated with ankle instability in males (overweight, odds ratio [OR] 1.249, p < .001; obese, OR 1.418, p < .001) and females (overweight, OR 1.989 p < .001; obese, OR 2.754, p < .001). The body height was associated with an increased risk of CAI when the highest height quintile was compared with the lowest height quintile in both males (OR 2.443, p < .001) and females (OR 1.436, p < .001) for all levels of instability severity. The present study has shown a greater prevalence of CAI among males than females in a general healthy young adult population. CAI was associated with an increased BMI and greater body height for all grades of instability severity.
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Affiliation(s)
- Oded Hershkovich
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel HaShomer, Israel; Medical Corps, Israeli Defense Forces, Tel HaShomer, Israel
| | - Shay Tenenbaum
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel HaShomer, Israel.
| | - Barak Gordon
- Medical Corps, Israeli Defense Forces, Tel HaShomer, Israel; Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Nathan Bruck
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel HaShomer, Israel
| | - Ran Thein
- Department of Orthopedic Surgery, Chaim Sheba Medical Center, Tel HaShomer, Israel
| | - Estela Derazne
- Medical Corps, Israeli Defense Forces, Tel HaShomer, Israel; Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Dorit Tzur
- Medical Corps, Israeli Defense Forces, Tel HaShomer, Israel
| | - Ari Shamiss
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel; Central Management, Chaim Sheba Medical Center, Tel HaShomer, Israel
| | - Arnon Afek
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
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17
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Abstract
The purpose of this study was to compare static balance performance and muscle activity during one-leg standing on the dominant and nondominant leg under various sensory conditions with increased levels of task difficulty. Thirty healthy young adults (age: 23 ± 2 years) performed one-leg standing tests for 30 s under three sensory conditions (ie, eyes open/firm ground; eyes open/foam ground [elastic pad on top of the balance plate]; eyes closed/firm ground). Center of pressure displacements and activity of four lower leg muscles (ie, m. tibialis anterior [TA], m. soleus [SOL], m. gastrocnemius medialis [GAS], m. peroneus longus [PER]) were analyzed. An increase in sensory task difficulty resulted in deteriorated balance performance (P< .001, effect size [ES] = .57−2.54) and increased muscle activity (P< .001, ES = .50−1.11) for all but two muscles (ie, GAS, PER). However, regardless of the sensory condition, one-leg standing on the dominant as compared with the nondominant limb did not produce statistically significant differences in various balance (P> .05, ES = .06−.22) and electromyographic (P> .05, ES = .03−.13) measures. This indicates that the dominant and the nondominant leg can be used interchangeably during static one-leg balance testing in healthy young adults.
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18
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Butterworth PA, Landorf KB, Gilleard W, Urquhart DM, Menz HB. The association between body composition and foot structure and function: a systematic review. Obes Rev 2014; 15:348-57. [PMID: 24165357 DOI: 10.1111/obr.12130] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/12/2013] [Accepted: 09/20/2013] [Indexed: 11/26/2022]
Abstract
The aim of this systematic review was to investigate the relationship between body composition and foot structure and function. Six electronic databases (Ovid MEDLINE, Ovid EMBASE, Ovid AMED, CINAHL, Scopus and The Cochrane Library) and reference lists from relevant papers were searched on 2 September 2013. Sixteen papers that reported on the association between body composition and foot structure and function met our inclusion criteria and were reviewed. The evidence indicates that obesity is strongly associated with planus (low-arched) foot posture, pronated dynamic foot function and increased plantar pressures when walking. However, there is limited evidence to support an association between other body composition measures, such as fat mass, with foot structure or function.
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Affiliation(s)
- P A Butterworth
- Department of Podiatry, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia; Lower Extremity and Gait Studies Program, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia
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Hur P, Motawar B, Seo NJ. Muscular responses to handle perturbation with different glove condition. J Electromyogr Kinesiol 2013; 24:159-64. [PMID: 24210794 DOI: 10.1016/j.jelekin.2013.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 09/24/2013] [Accepted: 10/03/2013] [Indexed: 11/26/2022] Open
Abstract
Effect of wearing gloves on timely muscle reaction to stabilize handle perturbation was investigated. Thirteen adults gripped a horizontal overhead handle to which an upward force was applied at a random time. Muscle reaction time, integrated EMGs for eight muscles, and handle displacement were compared among three glove conditions affecting the coefficient of friction (COF=0.32, 0.50, and 0.74 for the polyester glove, bare hand, and latex glove, respectively). Lower COF increased the integrated EMGs and handle displacement until stabilization of the perturbed handle. The low-friction glove resulted in 16% (p=.01) greater muscular effort and 20% (p=.002) greater handle displacement, compared to the high-friction glove. Muscle reaction time was not influenced by glove condition. Cutaneous sensation and reflex eliciting forearm muscle activity appear to play an important role in detecting and responding to the perturbation initially, while the forearm and latissimus dorsi muscles primarily contribute to stabilizing the perturbed handle compared to other shoulder and upper arm muscles. Therefore, low-friction gloves, cutaneous sensory dysfunction, and weakened forearm and latissimus dorsi muscles may jeopardize persons' ability to stabilize a grip of a handle after perturbation.
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Affiliation(s)
- Pilwon Hur
- Department of Industrial and Manufacturing Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
| | - Binal Motawar
- College of Health Science, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Na Jin Seo
- Department of Industrial and Manufacturing Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; College of Health Science, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
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20
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Rein S, Hanisch U, Zwipp H, Fieguth A, Lwowski S, Hagert E. Comparative analysis of inter- and intraligamentous distribution of sensory nerve endings in ankle ligaments: a cadaver study. Foot Ankle Int 2013; 34:1017-24. [PMID: 23456084 DOI: 10.1177/1071100713480862] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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 The aim of this study was to analyze the inter-, intraligamentous, and side-related patterns of sensory nerve endings in ankle ligaments. METHODS A total of 140 ligaments from 10 cadaver feet were harvested. Lateral: calcaneofibular, anterior-, posterior talofibular; sinus tarsi: lateral- (IERL), intermediate-, medial-roots inferior extensor retinaculum, talocalcaneal oblique and canalis tarsi (CTL); medial: tibionavicular (TNL), tibiocalcaneal (TCL), superficial tibiotalar, anterior/posterior tibiotalar portions; syndesmosis: anterior tibiofibular. Following immunohistochemical staining, the innervation and vascularity was analyzed between ligaments of each anatomical complex, left/right feet, and within the 5 levels of each ligament. RESULTS Significantly more free nerve endings were seen in all ligaments as compared to Ruffini, Pacini, Golgi-like, and unclassifiable corpuscles (P ≤ .005). The IERL had significantly more free nerve endings and blood vessels than the CTL (P ≤ .001). No significant differences were seen in the side-related distribution, except for Ruffini endings in right TCL (P = .016) and unclassifiable corpuscles in left TNL (P = .008). The intraligamentous analysis in general revealed no significant differences in mechanoreceptor distribution. CONCLUSIONS The IERL at the entrance of the sinus tarsi contained more free nerve endings and blood vessels, as compared to the deeper situated CTL. Despite different biomechanical functions in the medial and lateral ligaments, the interligamentous distribution of sensory nerve endings was equal. CLINICAL RELEVANCE The intrinsic innervation patterns of the ankle ligaments provides an understanding of their innate healing capacities following injury as well as the proprioception properties in postoperative rehabilitation.
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Affiliation(s)
- Susanne Rein
- University Hospital Carl Gustav Carus, 01307 Dresden, Germany.
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21
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MacLeod TD, Manal K, Silbernagel KG, Snyder-Mackler L, Buchanan TS. Characteristics of human knee muscle coordination during isometric contractions in a standing posture: the effect of limb task. J Electromyogr Kinesiol 2013; 23:1398-405. [PMID: 23790392 DOI: 10.1016/j.jelekin.2013.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 04/22/2013] [Accepted: 05/20/2013] [Indexed: 10/26/2022] Open
Abstract
Different functional roles for the hands have been demonstrated, however leg control is not as well understood. The purpose of the present study was to evaluate bilateral knee neuromuscular control to determine if the limb receiving greater attention would have more well-tuned control compared to an unattended limb. Surface electrodes were placed on seven muscles of each limb, before standing on two force platforms. Visual feedback was given of the forces and moments of the "focus limb," but not the "unattended limb." Static isometric forces were matched with their focus limb, requiring their unattended limb to push in the opposite direction, using a combination of forward-backward-medial-lateral shear forces while muscle activity was collected bilaterally. There was a significant main effect for limb task (p = 0.02), with the medial hamstrings being more specific (p = 0.001) while performing the unattended limb and the lateral hamstring being more well-tuned (p = 0.007) while performing the focus limb task. The focus limb's medial and lateral gastrocnemius were principally active in the forwards direction, but only the unattended limb's lateral gastrocnemius was active in the backwards direction. Findings suggest unique neuromuscular control strategies are used for the legs depending on limb task.
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Affiliation(s)
- Toran D MacLeod
- University of Delaware, Delaware Rehabilitation Institute, 126 Spencer, 130 Academy Street, Newark, DE 19711, USA
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Stensdotter AK, Tengman E, Olofsson LB, Häger C. Deficits in single-limb stance more than 20 years after ACL injury. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2013. [DOI: 10.3109/21679169.2013.791718] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Schmidt R, Becker HP, Rauhut F, Tannheimer M. [Neuromuscular deficits in chronic ankle instability. Frequency and significance - multicenter study]. Unfallchirurg 2013; 117:710-5. [PMID: 23652929 DOI: 10.1007/s00113-013-2392-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The peroneal reaction time (PRT) is used in the assessment of neuromuscular deficits in chronic functional ankle instability. Powered by the Editorial Manager and Preprint Manager from Aries Systems Corporation the present study was conducted to determine the PRT in a large collective of patients with chronic ankle instability because it is unclear if this parameter of neuromuscular deficit is prolonged. In this study 186 patients underwent a diagnostic algorithm consisting of anamnesis, clinical examination, X-ray and determination of the PRT on a tilting platform. A prolonged PRT as a manifestation of a neuromuscular deficit could be detected in the majority of the patients (n = 143, 77%). Comparing the affected and healthy legs 77 patients (41%) showed a significant difference in talar shift (p = 0.002) and talar tilt (p = 0.04) in the radiological stress views. Of these 77 patients only 15 (8%) showed radiological evidence of a mechanical problem. As a consequence of recurring ankle sprains a post-traumatic deficit in proprioception has to be expected in most cases. In general a conservative therapy approach should be followed including specific training to improve neuromuscular and proprioceptive deficits.
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Affiliation(s)
- R Schmidt
- Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland
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24
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Rein S, Hagert E, Hanisch U, Lwowski S, Fieguth A, Zwipp H. Immunohistochemical Analysis of Sensory Nerve Endings in Ankle Ligaments: A Cadaver Study. Cells Tissues Organs 2013; 197:64-76. [DOI: 10.1159/000339877] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2012] [Indexed: 01/25/2023] Open
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Rein S, Fabian T, Zwipp H, Rammelt S, Weindel S. Postural control and functional ankle stability in professional and amateur dancers. Clin Neurophysiol 2011; 122:1602-10. [DOI: 10.1016/j.clinph.2011.01.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 01/06/2011] [Accepted: 01/08/2011] [Indexed: 11/27/2022]
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Rein S, Fabian T, Weindel S, Schneiders W, Zwipp H. The influence of playing level on functional ankle stability in soccer players. Arch Orthop Trauma Surg 2011; 131:1043-52. [PMID: 21331548 DOI: 10.1007/s00402-011-1275-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The aim of this study was to compare the functional ankle stability between professional and amateur soccer players as well as controls. MATERIALS AND METHODS Thirty professional soccer players, 30 amateur soccer players and 30 controls were evaluated. All participants completed a questionnaire. Range of motion (ROM), peroneal reaction time (PRT) and ankle position sense were measured. Balance control was investigated with the Biodex Stability System, measuring the stable level 8 and the unstable level 2. RESULTS Professional soccer players cited significantly more frequent ankle sprains than all other groups (P = 0.002). They showed a significantly decreased dorsiflexion of the right foot (amateur: P = 0.017; controls: P = 0.004), an increased pronation of both feet (amateurs: right: P = 0.0048, left: P = 0.006; controls: right: P = 0.017, left: P = 0.007) and a decreased supination of the left foot in comparison to all other groups (amateurs: P = 0.003; controls: P = 0.004). Balance control showed no significant differences among all groups. Significant differences in angle reproduction were observed between professionals and amateurs for the left ankle joint at the positions of 105° (P = 0.0018) and 140° (P = 0.013). Professionals (P = 0.004) and amateurs (P = 0.001) showed a significantly delayed PRT of the right peroneus longus muscle compared to controls. In addition, the PRT of the right peroneus brevis muscle was significantly increased in professional soccer players in comparison to controls (P = 0.017). CONCLUSIONS Professional soccer players have shown more frequent ankle sprains, limited ROM, and delayed PRT of the right leg which reflects the higher risk of functional ankle instability due to intensified work-related use of feet. Therefore, proprioceptive exercises of the ankle in daily training programs are recommended in order to minimize the risk of ankle injuries and improve functional ankle stability.
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Affiliation(s)
- Susanne Rein
- Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus, Fetscherstrasse 74, Dresden, Germany.
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