Developing a framework for ankle function: a delphi study

Comparison of maximum strength, proprioceptive, dynamic balance, maximum joint angle between two groups classified through the ankle instability instrument

[Purpose] The purpose of this study is to figure out the information obtainable from ankle instability instrument (AII) survey among various factors related to the ankle instability. [Participants and Methods] This study targeted on 34 participants, divided the participants into stability group and instability group based on AII survey results, and measured the maximum isometric contraction, proprioception, dynamic balance, and maximum joint angles. The independent t-test was used. [Results] The maximum isometric contraction showed significance in the plantar flexion while the proprioceptive sense showed significance in both dorsiflexion and plantar flexion. The dynamic balanced showed significance in the anterior direction while the maximum joint angles showed significance in the dorsiflexion. [Conclusion] According to the results, the participants who were classified as ankle instability patients based on AII survey results involved problems in the maximum isometric contraction, proprioception, dynamic balance, and maximum joint angles.

Comparison of maximum strength, proprioceptive, dynamic balance, maximum joint angle of stability and instability ankle by Cumberland Ankle Instability Tool

[Purpose] The purpose of this study was to investigate the factors of ankle instability by using Cumberland ankle instability tool (CAIT), which have been frequently used as ankle instability tools. The participants were divided into the normal ankle group and the instability ankle group. Maximum strength, proprioception, dynamic balance and maximum rage of joint motion were compared in order to find out factors of instability in the questionnaires. [Participants and Methods] A total of 44 participants were classified into the control (CON) group and the chronic ankle instability (CAI) group according to questionnaire types. Muscle strength, proprioception, dynamic balance and maximum joint angle were measured. The independent t-test was used. [Results] In the case of maximum ankle strength, it showed significance in CON group and CAI group ankle dorsiflexion and plantarflexion. In proprioception, it showed significance in CON group and CAI group. In dynamic balance, it showed significance in anterior (ANT) direction of the CON group and CAI group. Maximum joint angle produced significance in dorsiflexion of CON group and CAI group. [Conclusion] Information on maximum strength, proprioception, dynamic balance of anterior direction, and maximum joint angle of dorsiflexion is available through questionnaire CAIT.

Description of the surgical technique for condylectomy with minimally invasive surgery to treat interdigital helomas on the lesser toes: a Delphi study

BACKGROUND

Descriptions of the techniques for condylectomies via minimally invasive surgery (MIS) to treat interdigital helomas of the lesser toes are scarce in the literature. This study aimed to define and describe this surgical technique.

METHODS

This observational study was performed using the Delphi method. We collected the anonymous opinions of a multidisciplinary international panel of ten experts by answering a 43-items questionnaire via e-mail. Statements with an average score ≥ 3 were included in the next round, as were those in which none of the three statements reached the minimum score of 3 within the same item.

RESULTS

Response rate: 90%. Three rounds were needed to reach consensus on proposed items. A new statement that combined two statements was proposed in round 3. Eleven recommendations regarding the incision and instruments used to perform this surgical technique were obtained based on the expert consensus.

CONCLUSIONS

A longitudinal incision to the distal pulp of the toe or an incision to the centre of the plantar aspect of the head of the proximal phalanx should be performed according to the affectation, and a Beaver 64 scalpel blade, a blunt elevator and a Shannon-Isham burr are the most acceptable tools for this kind of surgery.

Evaluation of functional ankle instability assessed by an instrumented wobble board

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.