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Yalfani A, Azizian M, Gholami-Borujeni B. Adding Neurofeedback Training to Neuromuscular Training for Rehabilitation of Chronic Ankle Instability: A 3-Arm Randomized Controlled Trial. Sports Health 2024; 16:797-807. [PMID: 38149335 PMCID: PMC11346238 DOI: 10.1177/19417381231219198] [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: 12/28/2023] Open
Abstract
BACKGROUND Neurofeedback training (NFT) can aid in the treatment of the abnormal patterns of the brain brought on by physical injury, enhancing cognitive and behavioral abilities. The present study aimed to compare the effectiveness of combining neuromuscular training (NMT) and NFT (NMT+NFT) with NMT alone in rehabilitating athletes with chronic ankle instability (CAI). HYPOTHESIS NMT+NFT will be more effective than NMT alone. STUDY DESIGN A 3-arm, single-blind randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS A total number of 62 athletes, aged 18 to 25 years, with CAI, participated in this study. The study subjects were allocated randomly to 3 groups: 21 cases in the control group, 21 cases in the combination group (CG) receiving NMT+NFT, and 20 cases in the neuromuscular group (NG) practicing NMT alone, undergoing exercises related to their groups for 8 weeks. Data were recorded and analyzed before and after the 8-week training program. The primary outcome measures were postural sway indices; secondary outcomes included ankle proprioception and biopsychosocial indices. RESULTS NMT+NFT was more effective than NMT alone in terms of improving postural control during single- and 2-legged standing positions under the conditions of eyes closed and eyes open, proprioception at 20° of plantar flexion, as well as anxiety and depression in athletes with CAI. However, the findings revealed that NMT+NFT and NMT alone could both improve such indices. CONCLUSION NMT+NFT as a treatment protocol improved postural control, ankle proprioception, anxiety, and depression greater than NMT alone. CLINICAL RELEVANCE A combined protocol of NFT and NMT led to greater improvement compared with NMT alone. NFT was recommended as an adjunct therapy in the rehabilitation of athletes suffering from CAI.
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Affiliation(s)
- Ali Yalfani
- Department of Sport Rehabilitation, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran
| | - Masoud Azizian
- Department of Sport Rehabilitation, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran
| | - Behnam Gholami-Borujeni
- Department of Sport Biomechanics and Motor Behavior, Faculty of Sport Sciences, University of Mazandaran, Mazandaran, Babolsar, Iran
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Flore Z, Hambly K, De Coninck K, Welsch G. A Rehabilitation Algorithm After Lateral Ankle Sprains in Professional Football (Soccer): An Approach Based on Clinical Practice Guidelines. Int J Sports Phys Ther 2024; 19:910-922. [PMID: 38966831 PMCID: PMC11221331 DOI: 10.26603/001c.120205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/20/2024] [Indexed: 07/06/2024] Open
Abstract
Lateral ankle sprain (LAS) is one of the most common types of injury in professional football (soccer) players with high risk of recurrence. The rehabilitation after LAS in professional football players is often still time-based and relies on anecdotal experience of clinicans. There is still a lack of utilization of criteria-based rehabilitation concepts after LAS in professional football. The aims of this clinical commentary are (1) to critically discuss the need for criteria-based rehabilitation concepts after LAS in professional football players, (2) to highlight the current lack of these approaches and (3) to present a novel clinical guideline-based rehabilitation algorithm. Short time-loss (15 days) and high recurrence rate (17%) raise the question of trivialization of LAS in professional football. Despite consequences for many stakeholders involved (players, teams, clubs, insurers), there is still a lack of of criteria-based, step-by-step approaches. The use of a criteria-based rehabilitation approach might reduce the high recurrence rate after LAS in professional football players and will lead, in turn, to increased long-term player availability. Practical experiences of he authors demonstrate the feasibility of such an approach. The effectiveness of this novel rehabilitation algorithm remains to be evaluated in future studies. Level of Evidence: 5.
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Affiliation(s)
- Zacharias Flore
- School of Sport and Exercise SciencesUniversity of Kent
- Medical Department1. FC Magdeburg
| | - Karen Hambly
- School of Sport and Exercise SciencesUniversity of Kent
| | | | - Götz Welsch
- UKE-AthleticumUniversity Medical Center Hamburg-Eppendorf
- Department of Trauma and Orthopaedic SurgeryUniversity Medical Center Hamburg-Eppendorf
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3
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Liu X, He M, Hu R, Chen Z. Randomized controlled trial study of intelligent rehabilitation training system for functional ankle instability. Sci Rep 2024; 14:4996. [PMID: 38424225 PMCID: PMC10904850 DOI: 10.1038/s41598-024-55555-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/25/2024] [Indexed: 03/02/2024] Open
Abstract
To investigate the intervention effect of an intelligent rehabilitation training system on patients with functional ankle instability (FAI) and to advance the research to optimise the effect of FAI rehabilitation training. Thirty-four FAI patients who participated in this trial in Guilin City from April 2023 to June 2023 were recruited as research subjects, and all subjects were randomly divided into the control group (n = 17) and the observation group (n = 17). Both groups received the conventional rehabilitation training intervention for 6 weeks, and the observation group received the additional training using the intelligent rehabilitation training system training invented by our team. Visual analogue scale (VAS), ankle active mobility, ankle muscle strength and Y-balance test (YBT) were assessed before and after treatment. Two-way repeated measures ANOVA shows that the interaction effect between time and group of VAS scores was significant (F = 35.644, P < 0.05). The interaction effect between time and group of plantar flexion mobility was significant (F = 23.948, P < 0.05), the interaction effect between time and group of dorsiflexion mobility was significant (F = 6.570, P < 0.05), the interaction effect between time and group of inversion mobility was significant (F = 8.360, P < 0.05), the interaction effect between time and group of eversion mobility was significant (F = 10.113, P < 0.05). The interaction effect between time and group of inversion muscle strength was significant (F = 18.107, P < 0.05). The interaction effect between time and group of YBT scores was significant (F = 33.324, P < 0.05). The Intelligent Rehabilitation Training System can effectively reduce pain in FAI patients, improve joint range of motion, increase inversion strength, and improve dynamic balance of the affected limb.
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Affiliation(s)
- Xiaolong Liu
- School of Life and Environmental Science, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China
- School of Electronic Engineering and Automation, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China
- Rehabilitation College, Guilin Life and Health Career Technical College, Guilin, 541001, Guangxi, China
| | - Mengxiao He
- School of Physical Education and Health, Guilin University, Guilin, 541006, Guangxi, China
| | - Rongbo Hu
- Credo Robotics GmbH, Bajuwarenstrasse 47, 94315, Straubing, Germany
- Department of System Design Engineering, Keio University, Yokohama, Kanagawa, 223-8522, Japan
| | - Zhencheng Chen
- School of Life and Environmental Science, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China.
- School of Electronic Engineering and Automation, Guilin University of Electronic Technology, Guilin, 541004, Guangxi, China.
- Guangxi Colleges and Universities Key Laboratory of Biomedical Sensors and Intelligent Instruments, Guilin, 541004, Guangxi, China.
- Guangxi Engineering Technology Research Center of Human Physiological Information Noninvasive Detection, Guilin, 541004, Guangxi, China.
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Gerdesmeyer L, Vester J, Schneider C, Wildemann B, Frank C, Schultz M, Seilheimer B, Smit A, Kerkhoffs G. Topical Treatment Is Effective and Safe for Acute Ankle Sprains: The Multi-Center Double-Blind Randomized Placebo-Controlled TRAUMED Trial. J Clin Med 2024; 13:841. [PMID: 38337536 PMCID: PMC10856131 DOI: 10.3390/jcm13030841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Topical NSAIDs are widely used to treat ankle sprains. Traumed (Tr14) gel is a multicomponent formulation, demonstrating inflammation-resolution properties. METHODS This multicenter, double-blind trial investigated the efficacy and safety of Tr14 gel versus placebo gel and non-inferiority versus 1% diclofenac gel, applied 3×/day for 7 days after acute lateral ankle sprain (EudraCT Number: 2016-004792-50). The primary outcome was AUC for pain on passive movement, assessed by VAS from baseline to Days 4 and 7. RESULTS The trial population included 625 patients aged 18 to 78 years. The AUC scores were 187.88 and 200.75 on Day 4 (p = 0.02) and 294.14 and 353.42 on Day 7 (p < 0.001) for Tr14 and placebo, respectively. For Tr14 compared to diclofenac, the AUC scores were 187.50 and 197.19 on Day 4 (p = 0.3804) and 293.85 and 327.93 on Day 7 (p = 0.0017), respectively. On the FAAM-ADL subscale, Tr14 was superior to placebo and non-inferior to diclofenac at all time points. Time to 50% pain improvement was lowest for Tr14 (6.0 days), compared to placebo (7.1 days) and diclofenac (7.0 days). Adverse events were uncommon and minor. CONCLUSIONS Tr14 gel is effective and safe in acute ankle sprains, compared to placebo gel and diclofenac gel, and has faster pain resolution. TRIAL REGISTRATION The trial was registered in clinicaltrialsregister.eu, EudraCT number 2016-004792-50 on 07.06.2017.
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Affiliation(s)
- Ludger Gerdesmeyer
- Orthopedics and Trauma Surgery, Kiel Municipal Hospital, 24116 Kiel, Germany
| | | | | | - Britt Wildemann
- Experimental Trauma Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany
| | | | | | | | - Alta Smit
- Heel GmbH, 76532 Baden-Baden, Germany
| | - Gino Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Ekenros L, Fridén C, von Rosen P. Experiences of rehabilitation in young elite athletes: an interview study. BMJ Open Sport Exerc Med 2023; 9:e001716. [PMID: 37937307 PMCID: PMC10626772 DOI: 10.1136/bmjsem-2023-001716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/09/2023] Open
Abstract
Even though injuries are common in elite youth sports, rehabilitation experiences are limited explored in young athletes. This study explored rehabilitation experiences in athletes with a previous injury studying at sports high schools. Twenty-six (14/12 females/males) young elite athletes (age 15-19 years) from 11 individual/team sports were interviewed in focus groups about the rehabilitation experiences following a sports injury. Data were analysed using content analysis. The results led to four main categories identified: 'High-quality rehabilitation', 'Lack of communication between healthcare and coach', 'Various consequences of injury' and 'No clear path to accessing rehabilitation'. The athletes valued that the healthcare providers had high expertise, were clear and signalled secureness and confidence. It was also important to receive help with rehabilitation as rapidly as possible. The athletes perceived that they felt responsible for providing information regarding rehabilitation progression between healthcare providers and their coach. It was also challenging not to be able to participate in training and competition while injured - causing a sense of frustration and fear of falling behind their peer athletes in terms of development and performance. The athletes described that no well-defined medical teams at the sports high schools were available- instead medical help was offered in several other ways. Based on our findings, the collaboration and communication between the healthcare providers and coaches need to be improved, addressing the rehabilitation content, progress and access to rehabilitation. Through these actions, the rehabilitation process will be more adjusted to the needs of young elite athletes.
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Affiliation(s)
- Linda Ekenros
- Department of Neurobiology, Care Sciences, and Society (NVS), Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Fridén
- Department of Neurobiology, Care Sciences, and Society (NVS), Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- School of Health, Care and Social Welfare, Physiotherapy, Mälardalen University, Mälardalen, Västerås, Sweden
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences, and Society (NVS), Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
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Piatti M, Mosca A, Omeljaniuk RJ, Turati M, Gaddi D, Bigoni M. Comparison of isometric strength in rotator cuff and scapulothoracic muscles between elite volleyball athletes versus non-athletes. J Sports Med Phys Fitness 2023; 63:1138-1145. [PMID: 37539668 DOI: 10.23736/s0022-4707.23.14912-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Volleyball is an exceptionally popular global sport that involves repetitive, rapid, powerful and wide overhead movements, which can seriously alter normal shoulder kinematics. A recognized hallmark of shoulder muscle balance is the ratio of shoulder external (ER) and internal (IR) rotators. By extension, objective measurement of shoulder muscles' strength could help identify at risk athletes and preempt those injuries by engaging in prescriptive strength training programs. METHODS This cross-sectional study measured the isometric strengths of 1) shoulder internal and external rotator muscles, as well as the 2) supraspinatus, 3) rhomboid, and 4) middle and inferior trapezius muscles, in addition to calculation of ER:IR ratios, in professional volleyball players as well as in non-athletes. Measurements were made for dominant- and non-dominant upper limbs, in different position of the body (supine and orthostatic) and in different position of upper limb (adducted and abducted position). Our subject population included 11 male professional volleyball players as well as 14 healthy male orthopedic interns from Orthopedics and Trauma school of University of Milano Bicocca. Strengths were assessed by a handheld dynamometer. Each subject's isometric strength was assessed in triplicate in each limb position through a "make test" procedure; the greatest of each triplicate value was the accepted measure of isometric strength. RESULTS We observed a gradient in muscle strength in the scapulothoracic complex in both groups; the rhomboid, middle trapezius, and lower trapezius ranked from greatest to least strength, respectively. The data suggest also that intrarotators are stronger in rotation adducted position than in rotation abducted position; however, extrarotators seem to be weaker in rotation adducted position than in rotation abducted position. There is also some indication that force development is enhanced in the supine position compared with the orthostatic position. CONCLUSIONS Our findings indicate a scapulothoracic strength gradient with a rank order of strength of the rhomboid>middle trapezius>lower trapezius. The data further suggest that volleyball players have stronger intrarotation in rotation adducted position than in the rotation abducted position, while extra rotation shows the opposite trend. Finally, our data suggest that force development is greater in the supine position compared to the orthostatic position.
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Affiliation(s)
- Massimiliano Piatti
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
- Powervolley Milano, Milan, Italy
| | - Angelo Mosca
- Powervolley Milano, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | | | - Marco Turati
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy -
- Powervolley Milano, Milan, Italy
- Department of Pediatric Orthopedic Surgery, University Hospital Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
- Department of Orthopedics, IRCCS San Gerardo dei Tentori, Monza, Monza-Brianza, Italy
| | - Diego Gaddi
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Marco Bigoni
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
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Ammendolia A, de Sire A, Lippi L, Ammendolia V, Spanò R, Reggiani A, Invernizzi M, Marotta N. Cryo plus Ultrasound Therapy, a Novel Rehabilitative Approach for Football Players with Acute Lateral Ankle Injury Sprain: A Pilot Randomized Controlled Trial. Sports (Basel) 2023; 11:180. [PMID: 37755857 PMCID: PMC10537008 DOI: 10.3390/sports11090180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Acute lateral ankle sprains are common injuries among athletes, but the optimal treatment strategies in elite athletes are still debated. This proof-of-concept study aimed to assess the impact of cryo-ultrasound therapy on the short-term recovery of football players with acute lateral ankle sprains. METHODS Semi-professional football players with grade I or II lateral ankle sprains were randomly assigned to the experimental group (receiving cryo-ultrasound therapy combined with conventional physical therapy) or control group (sham cryo-ultrasound therapy combined with conventional physical therapy). Pain intensity and physical functioning were assessed by the Numeric Rating Scale (NRS) and Foot and Ankle Disability Index (FADI) at baseline (T0) at the end of treatment (T1), after one month (T2), and two months after treatment (T3). RESULTS After the study intervention, significant between groups differences were reported in terms of pain relief (NRS: 4.08 ± 1.29 vs. 5.87 ± 1.19; p = 0.003) and physical function (FADI: 50.9 ± 10.3 vs. 38.3 ± 11.5; p = 0.021). However, no significant between group differences were reported at T2 and T3. No adverse effects were reported. CONCLUSIONS Cryo-ultrasound therapy combined with conventional physical therapy can accelerate recovery and early return to sport in elite football players with acute lateral ankle sprains. While this study contributes valuable insights into the potential benefits of cryo-ultrasound therapy, further investigations with a longer follow-up are needed to validate and optimize the application of physical agent modalities in the management of ankle injuries.
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Affiliation(s)
- Antonio Ammendolia
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (V.A.); (R.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (V.A.); (R.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Integrated Activities Research and Innovation Department (DAIRI), Translational Medicine, Hospital SS. Antonio Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Valerio Ammendolia
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (V.A.); (R.S.)
| | - Riccardo Spanò
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (V.A.); (R.S.)
| | - Andrea Reggiani
- Physical and Rehabilitative Medicine, Casa di Cura La Madonnina, 20122 Milan, Italy;
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (M.I.)
- Integrated Activities Research and Innovation Department (DAIRI), Translational Medicine, Hospital SS. Antonio Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Nicola Marotta
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Physical and Rehabilitative Medicine, Department of Experimental and Clinical Medicine, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
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8
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Marín Fermín T, Al-Dolaymi AA, D'Hooghe P. Acute Ankle Sprain in Elite Athletes: How to Get Them Back to the Game? Foot Ankle Clin 2023; 28:309-320. [PMID: 37137625 DOI: 10.1016/j.fcl.2022.12.007] [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: 05/05/2023]
Abstract
Despite the high frequency of ankle sprains, the ideal management is controversial, and a significant percentage of patients sustaining an ankle sprain never fully recover. There is strong evidence that residual disability of ankle joint injury is often caused by an inadequate rehabilitation and training program and early return to sports. Therefore, the athlete should start their criteria-based rehabilitation and gradually progress through the programmed activities, including cryotherapy, edema relief, optimal weight-bearing management, range of motion exercises for ankle dorsiflexion improvement, triceps surae stretching, isometric exercises and peroneus muscles strengthening, balance and proprioception training, and bracing/taping.
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Affiliation(s)
- Theodorakys Marín Fermín
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar.
| | - Ayyoub A Al-Dolaymi
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar
| | - Pieter D'Hooghe
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar
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Pan Y, Hu Q, Yang Y, Nie H, Yin C, Wei H, Tai Y, Liu B, Shen Z, He X, Fang J, Liu B. Characterization of pain-related behaviors and gene expression profiling of peripheral sensory ganglia in a mouse model of acute ankle sprain. Front Behav Neurosci 2023; 17:1189489. [PMID: 37304762 PMCID: PMC10248128 DOI: 10.3389/fnbeh.2023.1189489] [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: 03/19/2023] [Accepted: 04/28/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Lateral ankle sprain (LAS) is a very common type of joint injury. It occurred with high incidence among general population and especially among individuals participating sports and outdoor activities. A certain proportion of individuals who once developed LAS may suffer persistent ankle pain that affects daily activities. However, the mechanisms underlying LAS-induced pain still remained largely unknown. Methods We established a LAS mouse model and systematically evaluated the pain-related behaviors in this mouse model. RNA sequencing (RNA-Seq), combined with bioinformatics analysis, was undertaken to explore gene expression profiles. Immunostaining was used to study glial cell and neuron activation in ipsilateral spinal cord dorsal horn (SCDH) of LAS model mice. Ibuprofen was used to treat LAS model mice. Results The LAS model mice developed obvious signs of mechanical and heat hypersensitivities as well as gait impairments in ipsilateral hind paws. Besides, LAS model mice developed signs of pain-related emotional disorder, including pain-induced aversion. By RNA-Seq, we were able to identify certain differentially expressed genes and signaling pathways that might contribute to pain mechanisms of LAS mouse model. In addition, LAS model mice showed increased c-Fos and p-ERK immunoreactivity as well as astrocyte and microglia overactivation in ipsilateral spinal cord dorsal horn, indicating central sensitization might occur. Finally, LAS model mice respond to ibuprofen, a drug clinically used to treat ankle sprain pain. Conclusion Our study found LAS model mice may be used as a preclinical animal model for screening novel targets or therapies for ankle sprain. Thus, the study may further help to understand molecular mechanisms contributing to ankle sprain-induced pain.
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Affiliation(s)
- Yushuang Pan
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qimiao Hu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yunqin Yang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Huimin Nie
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chengyu Yin
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Huina Wei
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Tai
- Academy of Chinese Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Boyu Liu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zui Shen
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaofen He
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jianqiao Fang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Boyi Liu
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
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10
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Turati M, Boerci L, Piatti M, Russo L, Rigamonti L, Buonanotte F, Courvoisier A, Zatti G, Piscitelli D, Bigoni M. Meniscal Allograft Transplants in Skeletally Immature Patients: A Systematic Review of Indications and Outcomes. Healthcare (Basel) 2023; 11:healthcare11091312. [PMID: 37174854 PMCID: PMC10178226 DOI: 10.3390/healthcare11091312] [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: 02/03/2023] [Revised: 04/22/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Meniscal lesions in skeletally immature patients can lead to joint degradation and knee instability. Meniscal allograft transplant (MAT) surgery is a solution to maintain knee stability. There is a lack of consensus on MAT surgery outcomes in pediatric patients. A systematic review was conducted according to the PRISMA guidelines. PubMed, Scopus and EMBASE databases were searched from 1965 to June 2022. Studies were evaluated using the Newcastle-Ottawa Scale (NOS). Three studies were selected, and 58 patients were included (mean age 15.9 years) in total. The lateral meniscus was involved in 82.8% of all MAT surgeries. Post-meniscectomy syndrome and discoid meniscus were the main indications for MAT surgery. All studies reported improved subjective clinical scores and levels of sport after the surgery. The complication rate was 27.5%. Partial meniscectomy, meniscus knot removal, chondral defect treatment and lysis of adhesions were the most frequent procedures performed during reoperation. MAT surgery can improve clinical outcomes in pediatric patients with strictly selected indications. MAT surgery is safe when there are no limb asymmetries or malalignments, but it remains a challenging procedure with a high complication rate. Long-term follow-up is needed for definitive statements on the use of MAT in skeletally immature patients.
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Affiliation(s)
- Marco Turati
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy
- Orthopedic Department, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Department of Paediatric Orthopedic Surgery, Hopital Couple Enfants, Grenoble Alpes University, 38700 Grenoble, France
| | - Linda Boerci
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy
| | - Massimiliano Piatti
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Department of Orthopaedic and Trauma, Policlinico San Pietro Hospital, 24036 Ponte San Pietro, Italy
| | - Laura Russo
- Department of Biotechnology and Biosciences, University of Milano Bicocca, 20126 Milano, Italy
| | - Luca Rigamonti
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Department of Orthopaedic and Trauma, Policlinico San Pietro Hospital, 24036 Ponte San Pietro, Italy
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Francesco Buonanotte
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy
| | - Aurelien Courvoisier
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Department of Paediatric Orthopedic Surgery, Hopital Couple Enfants, Grenoble Alpes University, 38700 Grenoble, France
| | - Giovanni Zatti
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy
- Orthopedic Department, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Marco Bigoni
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy
- Orthopedic Department, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Department of Orthopaedic and Trauma, Policlinico San Pietro Hospital, 24036 Ponte San Pietro, Italy
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Zhang Y, Wang X, Wang X, Cao J, Wang H, Zhang F. Allogeneic tendons in the treatment of malunited lateral malleolar avulsion fractures with chronic lateral ankle instability. BMC Musculoskelet Disord 2023; 24:273. [PMID: 37038121 PMCID: PMC10084655 DOI: 10.1186/s12891-023-06390-1] [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: 08/13/2022] [Accepted: 03/31/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND The aim of this study is to report our institution's experience regarding the application of allogeneic tendons for the reconstruction of malunited lateral malleolar avulsion fractures with chronic lateral ankle instability. METHODS This retrospective study included 34 (34 ankles) patients surgically treated for malunited lateral malleolar avulsion fractures with chronic lateral ankle instability from January 2016 to December 2019. All patients underwent allogeneic tendon reconstruction. The pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) scores、Karlsson Ankle Functional Scores (KAFS) and visual analogue scale (VAS) scores were used to evaluate the functional recovery of the ankle joint. The final follow-up, based on radiographic assessment, including talar tilt and anterior talar translation, was performed to evaluate the stability of the postoperative ankle joints. RESULTS Thirty-two patients (32 ankles) returned for final clinical and radiologic follow-up at an average of 29 (range 24-35) months and 2 patients (2 ankles) were lost to follow-up. The preoperative talus inclination angle (13.6 ± 1.9°) and anterior displacement (9.6 ± 2.8 mm) were re-examined under X-ray and found to be reduced to 3.4 ± 1.2° and 3.8 ± 1.1 mm, respectively (p<0.01). The AOFAS scores increased from 58.5 ± 4.0 to 90.9 ± 3.8 and the Karlsson scores improved from 52.2 ± 3.6 to 89.8 ± 4.5, which was obviously better and the difference was statistically significant (P < 0.01). The VAS scores were significantly reduced from a preoperative mean of 6.8 ± 1.0 to 2.8 ± 0.9 postoperatively (p<0.01). CONCLUSION In this population and with this follow-up, the application of allogeneic tendons to treat malunited lateral malleolar avulsion fractures combined with chronic lateral ankle instability appeared safe and effective.
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Affiliation(s)
- Yu Zhang
- Department of Foot and Ankle Orthopaedics Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Xin Wang
- Department of Foot and Ankle Orthopaedics Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Xiaomeng Wang
- Department of Foot and Ankle Orthopaedics Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Jianming Cao
- Department of Foot and Ankle Orthopaedics Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Huijuan Wang
- Department of Histology and Embryology, Hebei Medical University, Shijiazhuang, 050017, Hebei, China
| | - Fengqi Zhang
- Department of Foot and Ankle Orthopaedics Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.
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A User-Friendly Nonmotorized Device for Ankle Rehabilitation. ROBOTICS 2023. [DOI: 10.3390/robotics12020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The ankle is formed by several joints, and it is the union of the lower leg with the foot. Its main function is to perform dorsiflexion and plantar flexion movements. Many people are affected by ankle problems. These problems can be due to simple factors, but they can also be a sign of a more serious impairment that can lead to the need for ankle rehabilitation. Thus, this paper presents a novel, fairly simple nonmotorized device for ankle rehabilitation. The design of the novel device is based on the crank–rocker mechanism, activated by the patient’s upper limb, allowing the execution of the ankle flexion range. The dimensions of the device were found using a differential evolution algorithm considering the ankle movement limits, the link stress, and singularity configurations. Graphic simulations were performed to validate the mathematical model. A prototype was constructed, and the angular ankle movement was verified. The device is easy to operate and low-cost, and in the future, it may be a tool for ankle rehabilitation.
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