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Kowalczyk M, Truszczyńska-Baszak A. The impact of fatigue on dynamic balance in coopers athletes with chronic ankle instability. Sci Rep 2024; 14:23101. [PMID: 39367043 PMCID: PMC11452648 DOI: 10.1038/s41598-024-73908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 09/23/2024] [Indexed: 10/06/2024] Open
Abstract
Athletes who have successfully regained high sports performance despite prior inversion injuries, and who do not have persistent symptoms, are referred to as "copers" in the literature. The aim of the study was to assess dynamic stability under fatigue in patients with chronic ankle instability in comparison to healthy controls. We conducted a case - controlled study on a group of 60 young, physically active individuals aged 29.8 ± 4.6. They were divided into 3 groups: I - unilateral ankle instability n = 14, II - bilateral ankle instability n = 15, III - no ankle instability, n = 31. All participants filled out questionnaires on the health, the FADI and FADI-S. The study protocol consisted of a dynamic stability measurements by Biodex Balance System, followed by a fatigue test, followed by the series of the same measurements. General stability index value before and value after fatigue test did not differ significantly. The differences between groups in measurements taken before fatigue test (F (2.49) = 1.59; p = 0.214; ηp2 = 0.06) and after fatigue test also proved insignificant (F (2.49) = 1.28; p = 0.286; ηp2 = 0.05). The incidence of structural ankle instability did not affect functional stability. "Copers" had efficient neural-muscular control in dynamic stabilography tests.
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Affiliation(s)
- Małgorzata Kowalczyk
- Department of Physiotherapy, Józef Piłsudski University of Physical Education in Warsaw, ul. Marymoncka 34, 00-968, Warsaw, Poland
| | - Aleksandra Truszczyńska-Baszak
- Department of Physiotherapy, Józef Piłsudski University of Physical Education in Warsaw, ul. Marymoncka 34, 00-968, Warsaw, Poland.
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2
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Clark NC. Sensorimotor control of functional joint stability: Scientific concepts, clinical considerations, and the articuloneuromuscular cascade paradigm in peripheral joint injury. Musculoskelet Sci Pract 2024; 74:103198. [PMID: 39362022 DOI: 10.1016/j.msksp.2024.103198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Revised: 09/22/2024] [Accepted: 09/28/2024] [Indexed: 10/05/2024]
Abstract
Human movement depends on sensorimotor control. Sensorimotor control refers to central nervous system (CNS) control of joint stability, posture, and movement, all of which are effected via the sensorimotor system. Given the nervous, muscular, and skeletal systems function as an integrated "neuromusculoskeletal system" for the purpose of executing movement, musculoskeletal conditions can result in a cascade of impairments that affect negatively all three systems. The purpose of this article is to revisit concepts in joint stability, sensorimotor control of functional joint stability (FJS), joint instability, and sensorimotor impairments contributing to functional joint instability. This article differs from historical work because it updates previous models of joint injury and joint instability by incorporating more recent research on CNS factors, skeletal muscle factors, and tendon factors. The new 'articuloneuromuscular cascade paradigm' presented here offers a framework for facilitating further investigation into physiological and biomechanical consequences of joint injury and, in turn, how these follow on to affect physical activity (functional) capability. Here, the term 'injury' represents traumatic joint injury with a focus is on peripheral joint injury. Understanding the configuration of the sensorimotor system and the cascade of post-injury sensorimotor impairments is particularly important for clinicians reasoning rational interventions for patients with mechanical instability and functional instability. Concurrently, neurocognitive processing and neurocognitive performance are also addressed relative to feedforward neuromuscular control of FJS. This article offers itself as an educational resource and scientific asset to contribute to the ongoing research and applied practice journey for developing optimal peripheral joint injury rehabilitation strategies.
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Affiliation(s)
- Nicholas C Clark
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK, United Kingdom.
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3
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Beyraghi Z, Khanmohammadi R, Hadian MR. Reduction in preparatory brain activity preceding gait initiation in individuals with chronic ankle instability: A movement-related cortical potential study. Eur J Neurosci 2024; 60:5284-5299. [PMID: 39149917 DOI: 10.1111/ejn.16501] [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: 05/11/2024] [Revised: 07/18/2024] [Accepted: 07/25/2024] [Indexed: 08/17/2024]
Abstract
Evidence suggests that chronic ankle instability (CAI) is not merely a peripheral musculoskeletal injury but should be recognized as a neurophysiological dysfunction. This reflects a paradigm shift from focusing on peripheral structural changes to emphasizing the central nervous system. However, changes in cortical activity during functional activities remain poorly understood. Thus, this study aimed to compare preparatory brain activity during gait initiation (GI) through movement-related cortical potentials (MRCPs) in individuals with CAI and healthy subjects. The proactive components of MRCPs, including contingent negative variation (CNV) and event-related desynchronization (ERD), were measured using electroencephalography. The primary outcomes were late CNV amplitude, CNV peak amplitude, CNV peak time, and alpha/beta ERD. The results indicated that the late CNV amplitude was significantly lower in the CAI group compared to the healthy group at the Fz and Cz electrodes (P < 0.001). The CAI group also demonstrated lower CNV peak amplitude at the Fz, Cz, and Pz electrodes (P < 0.0025). Additionally, in the CAI group, signals peaked earlier at the Cz electrode (P = 0.002). Furthermore, alpha ERD at Pz was significantly lower in the CAI group than in the healthy group (P = 0.003), suggesting diminished preparatory brain activity during GI in CAI subjects. Recognizing CAI as a condition involving both peripheral and central dysfunctions highlights the importance of a multidisciplinary approach in treatment and rehabilitation. This approach should target brain activity in addition to peripheral structures, potentially leading to improved long-term outcomes for patients.
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Affiliation(s)
- Zivar Beyraghi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Hadian
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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Sasun AR, Babar T, Dadgal R. Effectiveness of Ankle Proprioceptive Neuromuscular Facilitation Techniques in Restoring the Biomechanical Integrity of the Ankle Following Plantar Fasciitis: An Experimental Study. Cureus 2024; 16:e64371. [PMID: 39130914 PMCID: PMC11317122 DOI: 10.7759/cureus.64371] [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: 04/07/2024] [Accepted: 07/11/2024] [Indexed: 08/13/2024] Open
Abstract
Background Recent studies have highlighted the role of the central nervous system in modulating pain perception and the movement patterns associated with plantar fasciitis. Neurological changes, such as altered sensorimotor control and cortical reorganization, may contribute to the persistence of symptoms and the recurrence of the condition. Integrating neurorehabilitation techniques may enhance outcomes and reduce the risk of recurrence. Physiotherapy exercises such as ankle proprioceptive neuromuscular facilitation, foot doming exercises, balance exercises, towel curl exercises, and stretching exercises were given to check the impact of physiotherapy interventions on ankle muscle instability and dynamic balance following plantar fasciitis. Method An experimental investigation was carried out at the outpatient department of Acharya Vinoba Bhave Rural Hospital. A total of 71 participants were assigned arbitrarily, employing a straightforward random sampling procedure. Each participant received treatment for six weeks, with five weekly sessions. Result The results demonstrated significant findings. The pre- and post-test score results are as follows: visual analogue scale scores (t=1.619, p=0.0001), weight-bearing lunge test scores (t=24.36, p=0.0001*), and functional reach test scores (t=24.36, p=0.0001). Conclusion We conclude that physiotherapy exercises such as ankle proprioceptive neuromuscular facilitation (PNF), foot doming exercises, strengthening exercises, toe spreading exercises, towel curl exercises, and stretching exercises are effective in reducing pain and ascertaining dynamic balance in plantar fasciitis. The rehabilitation program significantly improved ankle biomechanical integrity and muscle strength, allowed functional recovery, and reduced pain. Future studies should focus on investigating the long-term effects of PNF therapies. For better patient outcomes, clinicians should consider incorporating ankle PNF exercises into their therapy regimens.
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Affiliation(s)
- Anam R Sasun
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Tejal Babar
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
| | - Ragini Dadgal
- Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, IND
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Mendez-Rebolledo G, Guzmán-Venegas R, Cruz-Montecinos C, Watanabe K, Calatayud J, Martinez-Valdes E. Individuals with chronic ankle instability show altered regional activation of the peroneus longus muscle during ankle eversion. Scand J Med Sci Sports 2024; 34:e14535. [PMID: 37957808 DOI: 10.1111/sms.14535] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023]
Abstract
Individuals with chronic ankle instability (CAI) present muscular weakness and potential changes in the activation of the peroneus longus muscle, which likely explains the high recurrence of ankle sprains in this population. However, there is conflicting evidence regarding the role of the peroneus longus activity in CAI, possibly due to the limited spatial resolution of the surface electromyography (sEMG) methods (i.e., bipolar sEMG). Recent studies employing high-density sEMG (HD-sEMG) have shown that the peroneus longus presents differences in regional activation, however, it is unknown whether this regional activation is maintained under pathological conditions such as CAI. This study aimed to compare the myoelectric activity, using HD-sEMG, of each peroneus longus compartment (anterior and posterior) between individuals with and without CAI. Eighteen healthy individuals (No-CAI group) and 18 individuals with CAI were recruited. In both groups, the center of mass (COM) and the sEMG amplitude at each compartment were recorded during ankle eversion at different force levels. For the posterior compartment, the sEMG amplitude of CAI group was significantly lower than the No-CAI group (mean difference = 5.6% RMS; 95% CI = 3.4-7.6; p = 0.0001). In addition, it was observed a significant main effect for group (F1,32 = 9.608; p = 0.0040) with an anterior displacement of COM for the CAI group. These findings suggest that CAI alters the regional distribution of muscle activity of the peroneus longus during ankle eversion. In practice, altered regional activation may impact strengthening programs, prevention, and rehabilitation of CAI.
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Affiliation(s)
- Guillermo Mendez-Rebolledo
- Laboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Rodrigo Guzmán-Venegas
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo (LIBFE), Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | - Carlos Cruz-Montecinos
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Science, Chukyo University, Toyota, Japan
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Chung S, Rodriguez A, Alijanpour E, McCann RS. Effects of A Single Balance Training Session on Neural Excitability in Individuals With Chronic Ankle Instability. J Sport Rehabil 2023; 32:847-854. [PMID: 37558224 DOI: 10.1123/jsr.2023-0024] [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: 01/24/2023] [Revised: 05/03/2023] [Accepted: 06/08/2023] [Indexed: 08/11/2023]
Abstract
CONTEXT Individuals with chronic ankle instability (CAI) demonstrate reduced spinal reflex modulation and corticospinal excitability of the soleus, which may contribute to decreased balance performance. OBJECTIVE To determine the effects of a single session of balance training on Spinal-reflexive excitability modulation and corticospinal excitability in those with CAI. DESIGN Randomized controlled trials. SETTING Research laboratory. PARTICIPANTS Thirty participants with CAI were randomly assigned to the balance training (BAL) or control (CON) group. MAIN OUTCOME MEASURES Modulation of soleus spinal-reflexive excitability was measured by calculating relative change in normalized Hoffmann reflexes (ratio of the H-reflex to the M-wave) from prone to single-leg standing. Corticospinal excitability was assessed during single-leg stance using transcranial magnetic stimulation, outcomes of which included active motor threshold (AMT), motor evoked potential, and cortical silent period (CSP). Balance performance was measured with center of pressure velocity in anterior to posterior and medial to lateral directions. Separate 2 × 2 repeated-measures analyses of variance were employed to determine the effect of group (BAL and CON) and time (baseline and posttraining) on each dependent variable. RESULTS There were significant group by time interactions in the modulation of soleus spinal-reflexive excitability (F1,27 = 4.763, P = .04); CSP at 100% AMT (F1,27 = 4.727, P = .04); and CSP at 120% AMT (F1,27 = 16.057, P < .01). A large effect size suggests increased modulation of spinal-reflexive excitability (d = 0.81 [0.03 to 1.54]) of the soleus in BAL compared with CON at posttest, while CSP at 100% (d = 0.95 [0.17 to 1.70]) and 120% AMT (d = 1.10 [0.29 to 1.84]) was reduced in BAL when compared with CON at posttest. CONCLUSION After a single session of balance training, individuals with CAI initiated increases in spinal reflex modulation and corticospinal excitability of the soleus. Thus, individuals with CAI who undergo balance training exhibit positive neural adaptations that are linked to improvements in balance performance.
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Affiliation(s)
- Sunghoon Chung
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA,USA
| | | | - Elham Alijanpour
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA,USA
| | - Ryan S McCann
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA,USA
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Tan J, Li J, Lei J, Lu S, Feng Y, Ma T, Luan L, Adams R, Song Y, Han J, Zou Y. Effects of whole-body vibration on sensorimotor deficits and brain plasticity among people with chronic ankle instability: a study protocol for a single-blind randomized controlled trial. BMC Sports Sci Med Rehabil 2023; 15:88. [PMID: 37464427 DOI: 10.1186/s13102-023-00698-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Chronic ankle instability (CAI) is a form of musculoskeletal disease that can occur after a lateral ankle sprain, and it is characterized by pain, recurrent ankle sprains, a feeling of "giving way" at the ankle joint, and sensorimotor deficits. There has been increasing evidence to suggest that plastic changes in the brain after the initial injury play an important role in CAI. As one modality to treat CAI, whole-body vibration (WBV) has been found to be beneficial for treating the sensorimotor deficits accompanying CAI, but whether these benefits are associated with brain plasticity remains unknown. Therefore, the current study aims to investigate the effect of WBV on sensorimotor deficits and determine its correlation with plastic changes in the brain. METHODS The present study is a single-blind randomized controlled trial. A total of 80 participants with CAI recruited from the university and local communities will be divided into 4 groups: whole-body vibration and balance training (WBVBT), balance training (BT), whole-body vibration (WBV), and control group. Participants will be given the WBV intervention (25-38 Hz, 1.3-2 mm, 3-time per week, 6-week) supervised by a professional therapist. Primary outcome measures are sensorimotor function including strength, balance, proprioception and functional performance. Brain plasticity will be evaluated by corticomotor excitability, inhibition, and representation of muscles, as measured by transcranial magnetic stimulation. Activation of brain areas will be assessed through functional near-infrared spectroscopy. Secondary outcome measures are self-reported functional outcomes involving the Cumberland Ankle Instability Tool and the Foot and Ankle Ability Measure. All tests will be conducted before and after the WBV intervention, and at 2-week follow-up. Per‑protocol and intention-to-treat analysis will be applied if any participants withdraw. DISCUSSION This is the first trial to investigate the role of brain plasticity in sensorimotor changes brought by WBV for individuals with CAI. As plastic changes in the brain have been an increasingly important aspect in CAI, the results of the current study can provide insight into the treatment of CAI from the perspective of brain plasticity. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR2300068972); registered on 02 March 2023.
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Affiliation(s)
- Jingwang Tan
- Department of Sport and Exercise Science, College of Education, Zhejiang University, 886 Yuhangtang Road, Zhejiang, 310058, Hangzhou, China
| | - Jiatao Li
- Department of Sport and Exercise Science, College of Education, Zhejiang University, 886 Yuhangtang Road, Zhejiang, 310058, Hangzhou, China
| | - Jianbin Lei
- Department of Sport and Exercise Science, College of Education, Zhejiang University, 886 Yuhangtang Road, Zhejiang, 310058, Hangzhou, China
| | - Shuyi Lu
- Department of Sport and Exercise Science, College of Education, Zhejiang University, 886 Yuhangtang Road, Zhejiang, 310058, Hangzhou, China
| | - Yongjian Feng
- Department of Sport and Exercise Science, College of Education, Zhejiang University, 886 Yuhangtang Road, Zhejiang, 310058, Hangzhou, China
| | - Tao Ma
- School of Elite Sport, Shanghai University of Sport, Shanghai, China
| | - Lijiang Luan
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Yagang Song
- Department of Physical Education Teaching, Shanghai Sanda University, Shanghai, China
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, 279 Zhouzhu Highway, Shanghai, 201318, China.
- Faculty of Health, Arts and Design, Swinburne University of Technology, VIC, Hawthorn, Australia.
| | - Yu Zou
- Department of Sport and Exercise Science, College of Education, Zhejiang University, 886 Yuhangtang Road, Zhejiang, 310058, Hangzhou, China.
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Maricot A, Dick E, Walravens A, Pluym B, Lathouwers E, De Pauw K, Verschueren J, Roelands B, Meeusen R, Tassignon B. Brain Neuroplasticity Related to Lateral Ankle Ligamentous Injuries: A Systematic Review. Sports Med 2023; 53:1423-1443. [PMID: 37155129 DOI: 10.1007/s40279-023-01834-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Lateral ankle sprains are the most common ankle injuries in sports and have the highest recurrence rates. Almost half of the patients experiencing lateral ankle sprains develop chronic ankle instability. Patients with chronic ankle instability experience persistent ankle dysfunctions and detrimental long-term sequelae. Changes at the brain level are put forward to explain these undesirable consequences and high recurrence rates partially. However, an overview of possible brain adaptations related to lateral ankle sprains and chronic ankle instability is currently lacking. OBJECTIVE The primary purpose of this systematic review is to provide a comprehensive overview of the literature on structural and functional brain adaptations related to lateral ankle sprains and in patients with chronic ankle instability. METHODS PubMed, Web of Science, Scopus, Embase, EBSCO-SPORTDiscus and Cochrane Central Register of Controlled Trials were systematically searched until 14 December, 2022. Meta-analyses, systematic reviews and narrative reviews were excluded. Included studies investigated functional or structural brain adaptations in patients who experienced a lateral ankle sprain or with chronic ankle instability and who were at least 18 years of age. Lateral ankle sprains and chronic ankle instability were defined following the recommendation of the International Ankle Consortium. Three authors independently extracted the data. They extracted the authors' name, publication year, study design, inclusion criteria, participant characteristics, the sample size of the intervention and control groups, methods of neuroplasticity testing, as well as all means and standard deviations of primary and secondary neuroplasticity outcomes from each study. Data reported on copers were considered as part of the control group. The quality assessment tool for observational and cross-sectional studies was used for the risk of bias assessment. This study is registered on PROSPERO, number CRD42021281956. RESULTS Twenty articles were included, of which only one investigated individuals who experienced a lateral ankle sprain. In all studies combined, 356 patients with chronic ankle instability, 10 who experienced a lateral ankle sprain and 46 copers were included. White matter microstructure changes in the cerebellum have been related to lateral ankle sprains. Fifteen studies reported functional brain adaptations in patients with chronic ankle instability, and five articles found structural brain outcomes. Alterations in the sensorimotor network (precentral gyrus and supplementary motor area, postcentral gyrus and middle frontal gyrus) and dorsal anterior cingulate cortex were mainly found in patients with chronic ankle instability. DISCUSSION The included studies demonstrated structural and functional brain adaptations related to lateral ankle sprains and chronic ankle instability compared to healthy individuals or copers. These adaptations correlate with clinical outcomes (e.g. patients' self-reported function and different clinical assessments) and might contribute to the persisting dysfunctions, increased re-injury risk and long-term sequelae seen in these patients. Thus, rehabilitation programmes should integrate sensorimotor and motor control strategies to cope with neuroplasticity related to ligamentous ankle injuries.
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Affiliation(s)
- Alexandre Maricot
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Emilie Dick
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Annemiek Walravens
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bert Pluym
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Elke Lathouwers
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Kevin De Pauw
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Jo Verschueren
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bart Roelands
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Romain Meeusen
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bruno Tassignon
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.
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Kunugi S, Hirono T, Yoshimura A, Holobar A, Watanabe K. Association between force fluctuation during isometric ankle abduction and variability of neural drive in peroneus muscles. J Electromyogr Kinesiol 2023; 70:102780. [PMID: 37126978 DOI: 10.1016/j.jelekin.2023.102780] [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: 01/22/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 05/03/2023] Open
Abstract
Analyzing motor unit (MU) activities of peroneus muscles may reveal the causes of force control deficits of ankle eversion. This study aimed to examine peroneus muscles' MU discharge characteristics and associations between force fluctuation and variability of the neural drive in healthy participants. Thirty-one healthy males participated in this study. MU activities were identified from high-density surface electromyography of peroneus muscles during ankle eversion at 15 and 30% of maximal voluntary contraction (MVC). Participants increased the contraction level until reaching the target and held it for 15 s. The central 10 s of the hold phase were used for analysis. A cumulative spike train (CST) was calculated using MU firings. Variabilities of the force and CST are represented by the coefficient of variation (CoV). Spearman's rank correlation coefficient was used to assess the association between CoV of force and CoV of CST. For 15 and 30 % MVC trials, CoV of force was 1.86 ± 1.59 and 1.57 ± 1.26%, and CoV of CST was 5.01 ± 3.24 and 4.51 ± 2.78%, respectively. The correlation was significant at 15% (rho = 0.27, p < 0.001) and 30% (rho = 0.32, p < 0.001) MVC. Our findings suggest that in peroneus muscles, force fluctuation weakly to moderately correlates with neural drive variability.
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Affiliation(s)
- Shun Kunugi
- Center for General Education, Aichi Institute of Technology, 1247 Yachigusa, Yakusa-cho, Toyota-shi, Aichi 470-0392, Japan; Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University 101 Tokodachi, Kaizu-cho, Toyota-shi, Aichi 470-0393, Japan.
| | - Tetsuya Hirono
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University 101 Tokodachi, Kaizu-cho, Toyota-shi, Aichi 470-0393, Japan
| | - Akane Yoshimura
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University 101 Tokodachi, Kaizu-cho, Toyota-shi, Aichi 470-0393, Japan
| | - Aleš Holobar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Koroška cesta 46, 2000 Maribor, Slovenia
| | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, Chukyo University 101 Tokodachi, Kaizu-cho, Toyota-shi, Aichi 470-0393, Japan
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10
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Darendeli A, Ertan H, Cuğ M, Wikstrom E, Enoka RM. Comparison of EMG activity in shank muscles between individuals with and without chronic ankle instability when running on a treadmill. J Electromyogr Kinesiol 2023; 70:102773. [PMID: 37058920 DOI: 10.1016/j.jelekin.2023.102773] [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: 11/10/2022] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
Changes in movement capabilities after an injury to the ankle may impose adaptations in the peripheral and central nervous system. The purpose of our study was to compare the electromyogram (EMG) profile of ankle stabilizer muscles and stride-time variation during treadmill running in individuals with and without chronic ankle instability (CAI). Recreationally active individuals with (n = 12) and without (n = 15) CAI ran on a treadmill at two speeds. EMG activity of four shank muscles as well as tibial acceleration data were recorded during the running trials. EMG amplitude, timing of EMG peaks, and variation in stride-time were analyzed from 30 consecutive stride cycles. EMG data were time-normalized to stride duration and amplitude was normalized relative to the appropriate maximal voluntary contraction (MVC) task. Individuals with CAI had similar EMG amplitudes and peak timing, but an altered order of peak EMG activity in ankle stabilizer muscles, a significantly greater EMG amplitude for PL with an increase in speed, and a greater stride-time variability during treadmill running compared with individuals who had no history of ankle sprains. The results of our study indicate that individuals with CAI exhibit altered activation strategies for ankle stabilizer muscles when running on a treadmill.
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Affiliation(s)
- Abdulkerim Darendeli
- Faculty of Sport Sciences, Sivas Cumhuriyet University, Sivas, Turkey; Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.
| | - Hayri Ertan
- Faculty of Sport Sciences, Eskisehir Technical University, Eskisehir, Turkey
| | - Mutlu Cuğ
- Faculty of Sport Sciences, Kocaeli University, Kocaeli, Turkey
| | - Erik Wikstrom
- MOTION Science Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Roger Maro Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.
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11
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The Relationship Between Health-Related Quality of Life and Lower-Extremity Visuomotor Reaction Time in Young Adult Women Following Ankle Sprain. J Sport Rehabil 2023; 32:433-439. [PMID: 36848899 DOI: 10.1123/jsr.2022-0199] [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: 05/25/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 03/01/2023]
Abstract
CONTEXT Many individuals who sustain a lateral ankle sprain (LAS) fail to return to prior activity due to residual symptoms; and report elevated levels of injury-related fear, decreased function, and decreased health-related quality of life (HRQOL). Additionally, individuals with history of LAS exhibit deficits in neurocognitive functional measures like visuomotor reaction time (VMRT), which contributes to worse patient-reported outcome scores. The aim of this study was to examine the relationship between HRQOL and lower-extremity (LE) VMRT in individuals with LAS history. DESIGN Cross-sectional. METHODS Young adult female volunteers with history of LAS (n = 22; age = 24 [3.5] y; height = 163.1 [9.8] cm; mass = 65.1 [11.5] kg; and time since last LAS = 67.8 [50.5] mo) completed HRQOL outcomes including the following: (1) Tampa Scale of Kinesiophobia-11, (2) Fear-Avoidance Beliefs Questionnaire, (3) Penn State Worry Questionnaire, (4) modified Disablement in the Physically Active Scale, and (5) Foot and Ankle Disability Index (FADI). Additionally, participants completed a LE-VMRT task by responding to a visual stimulus using their foot to deactivate light sensors. Participants completed trials bilaterally. Separate Spearman rho correlations were performed to assess the relationship between patient-reported outcomes assessing constructs of HRQOL and LE-VRMT bilaterally. Significance was set at P < .05. RESULTS There was a strong, significant negative correlation between FADI-Activities of Daily Living (ρ = -.68; P = .002) and FADI-Sport (ρ = -.76; P = .001) scores and injured limb LE-VMRT; moderate, significant negative correlations between the uninjured limb LE-VMRT and FADI-Activities of Daily Living (ρ = -.60; P = .01) and FADI-Sport (ρ = -.60; P = .01) scores; and moderate, significant positive correlations between the injured limb LE-VMRT and modified Disablement in the Physically Active Scale-Physical Summary Component (ρ = .52; P = .01) and modified Disablement in the Physically Active Scale-Total (ρ = .54; P = .02) scores. All other correlations were not statistically significant. CONCLUSIONS Young adult women with history of LAS demonstrated an association between self-reported constructs of HRQOL and LE-VMRT. As LE-VMRT is a modifiable injury risk factor, future studies should examine the effectiveness of interventions designed to improve LE-VMRT and the impact on self-reported HRQOL.
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12
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Spinal Reflex Excitability of Lower Leg Muscles Following Acute Lateral Ankle Sprain: Bilateral Inhibition of Soleus Spinal Reflex Excitability. Healthcare (Basel) 2022; 10:healthcare10071171. [PMID: 35885698 PMCID: PMC9315602 DOI: 10.3390/healthcare10071171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 12/22/2022] Open
Abstract
Neural changes in the ankle stabilizing muscles following ankle sprains are thought to be one contributing factor to persistent ankle dysfunction. However, empirical evidence is limited. Therefore, we aimed to examine spinal reflex excitability of lower leg muscles following acute ankle sprains (AAS). We performed a case-control study with 2 groups consisting of 30 young adults with AAS and 30 aged-matched uninjured controls. Hoffmann reflex (H-reflex) testing was performed to estimate spinal reflex excitability of lower leg muscles: soleus, fibularis longus (FL), tibialis anterior (TA). Maximal H-reflex (Hmax) and motor responses (Mmax) were determined by delivering a series of electrical stimuli at the sciatic nerve. Hmax/Mmax ratios were calculated to represent normalized spinal reflex excitability. Separate group-by-limb analyses of variance (ANOVA) with repeated measures found there were no significant interactions for any of the muscles (SL: F1,56 = 0.95, p = 0.33, FL: F1,51 = 0.65, p = 0.42, TA: F1,51 = 1.87, p = 0.18), but there was a significant main effect of group in the soleus (F1,56 = 6.56, p = 0.013), indicating the Hmax/Mmax ratio of soleus in the AAS group was significantly lower bilaterally (AAS = 0.56 ± 0.19, control = 0.68 ± 0.17, p = 0.013), with no significant group differences in the other muscles (FL: F1,51 = 0.26, p = 0.61, TA: F1,51 = 0.93, p = 0.34). The bilateral inhibition of the soleus spinal reflex excitability following AAS may be significant in that it may explain bilateral sensorimotor deficits (postural control deficits) following unilateral injury, and provide insights into additional therapies aimed at the neural change.
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13
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Alterations in Cortical Activation among Soccer Athletes with Chronic Ankle Instability during Drop-Jump Landing: A Preliminary Study. Brain Sci 2022; 12:brainsci12050664. [PMID: 35625050 PMCID: PMC9139920 DOI: 10.3390/brainsci12050664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/03/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Chronic ankle instability (CAI) is a common peripheral joint injury and there is still no consensus on the mechanisms. It is necessary to investigate electrocortical parameters to provide clinical insight into the functional alterations of brain activity after an ankle sprain, which would greatly affect the implementation of rehabilitation plans. The purpose of this study was to assess cortical activation characteristics during drop-jump landing among soccer athletes with CAI. Methods: A total of 24 participants performed the drop-jump landing task on a force platform while wearing a 64-channel EEG system. The differences of power spectral density (PSD) in theta and alpha (alpha-1 and alpha-2) bands were analyzed between two groups (CAI vs. CON) and between two limbs (injured vs. healthy). Results: CAI participants demonstrated significantly higher theta power at the frontal electrode than that in healthy control individuals (F(1,22) = 7.726, p = 0.011, η2p = 0.260). No difference in parietal alpha-1 and alpha-2 power was found between groups (alpha-1: F(1,22) = 0.297, p = 0.591, η2p = 0.013; alpha-2: F(1,22) = 0.118, p = 0.734, η2p = 0.005). No limb differences were presented for any frequency band in selected cortical areas (alpha-1: F(1,22) = 0.149, p = 0.703, η2p = 0.007; alpha-2: F(1,22) = 0.166, p = 0.688, η2p = 0.007; theta: F(1,22) = 2.256, p = 0.147, η2p = 0.093). Conclusions: Theta power at the frontal cortex was higher in soccer athletes with CAI during drop-jump landing. Differences in cortical activation provided evidence for an altered neural mechanism of postural control among soccer athletes with CAI.
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14
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Chung YC, Chen CY, Chang CM, Lin YL, Liao KK, Lin HC, Chen WY, Yang YR, Shih YF. Altered corticospinal excitability of scapular muscles in individuals with shoulder impingement syndrome. PLoS One 2022; 17:e0268533. [PMID: 35576229 PMCID: PMC9109916 DOI: 10.1371/journal.pone.0268533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/02/2022] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study is to assess and compare corticospinal excitability in the upper and lower trapezius and serratus anterior muscles in participants with and without shoulder impingement syndrome (SIS). Fourteen participants with SIS, and 14 without SIS were recruited through convenient sampling in this study. Transcranial magnetic stimulation assessment of the scapular muscles was performed while the participants were holding their arm at 90 degrees scaption. The motor-evoked potential (MEP), active motor threshold (AMT), latency of MEP, cortical silent period (CSP), activated area and center of gravity (COG) of cortical mapping were compared between groups using the Mann-Whitney U tests. The SIS group demonstrated following significances, higher AMTs of the lower trapezius (SIS: 0.60 ± 0.06; Comparison: 0.54 ± 0.07, p = 0.028) and the serratus anterior (SIS: 0.59 ± 0.04; Comparison: 0.54 ± 0.06, p = 0.022), longer CSP of the lower trapezius (SIS: 62.23 ± 22.87 ms; Comparison: 45.22 ± 14.64 ms, p = 0.019), and posteriorly shifted COG in the upper trapezius (SIS: 1.88 ± 1.06; Comparison: 2.76 ± 1.55, p = 0.048) and the serratus anterior (SIS: 2.13 ± 1.02; Comparison: 3.12 ± 1.88, p = 0.043), than the control group. In conclusion, participants with SIS demonstrated different organization of the corticospinal system, including decreased excitability, increased inhibition, and shift in motor representation of the scapular muscles.
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Affiliation(s)
- Ya-Chu Chung
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chao-Ying Chen
- School of Physical Therapy, Chang Gung University, Tao-Yuan City, Taiwan
| | - Chia-Ming Chang
- Department of Physical Therapy, China Medical University, Taichung, Taiwan
| | - Yin-Liang Lin
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kwong-Kum Liao
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiu-Chen Lin
- Department of Physical Therapy, China Medical University, Taichung, Taiwan
| | - Wen-Yin Chen
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Fen Shih
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
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15
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Diekfuss JA, Grooms DR, Nissen KS, Coghill RC, Bonnette S, Barber Foss KD, Dudley JA, Berz K, Logan K, Gubanich P, Saltman AJ, Slutsky-Ganesh AB, Hansen E, Leach J, Yuan W, Myer GD. Does central nervous system dysfunction underlie patellofemoral pain in young females? Examining brain functional connectivity in association with patient-reported outcomes. J Orthop Res 2022; 40:1083-1096. [PMID: 34379343 DOI: 10.1002/jor.25152] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 02/07/2021] [Accepted: 07/14/2021] [Indexed: 02/04/2023]
Abstract
Patellofemoral pain (PFP) is defined as retro- or peri-patellar knee pain without a clear structural abnormality. Unfortunately, many current treatment approaches fail to provide long-term pain relief, potentially due to an incomplete understanding of pain-disrupted sensorimotor dysfunction within the central nervous system. The purposes of this study were to evaluate brain functional connectivity in participants with and without PFP, and to determine the relationship between altered brain functional connectivity in association with patient-reported outcomes. Young female patients with PFP (n = 15; 14.3 ± 3.2 years) completed resting-state functional magnetic resonance imaging (rs-fMRI) and patient-reported outcome measures. Each patient with PFP was matched with two controls (n = 30, 15.5 ± 1.4 years) who also completed identical rs-fMRI testing. Six bilateral seeds important for pain and sensorimotor control were created, and seed-to-voxel analyses were conducted to compare functional connectivity between the two groups, as well as to determine the relationship between connectivity alterations and patient-reported outcomes. Relative to controls, patients with PFP exhibited altered functional connectivity between regions important for pain, psychological functioning, and sensorimotor control, and the connectivity alterations were related to perceived disability, dysfunction, and kinesiophobia. The present results support emergent evidence that PFP is not localized to structural knee dysfunction, but may actually be resultant to altered central neural processes. Clinical significance: These data provide potential neuro-therapeutic targets for novel therapies aimed to reorganize neural processes, improve neuromuscular function, and restore an active pain-free lifestyle in young females with PFP.
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Affiliation(s)
- Jed A Diekfuss
- Emory Sports Performance and Research Center, Flowery Branch, Georgia, USA.,Department of Orthopaedics, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Dustin R Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, Ohio, USA.,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA.,Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA
| | - Katharine S Nissen
- The SPORT Center, Division of Sports Medicine, Cincinnati Children Hospital Medical Center, Cincinnati, Ohio, USA
| | - Robert C Coghill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatric Pain Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Scott Bonnette
- The SPORT Center, Division of Sports Medicine, Cincinnati Children Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kim D Barber Foss
- Emory Sports Performance and Research Center, Flowery Branch, Georgia, USA
| | - Jonathan A Dudley
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Kate Berz
- The SPORT Center, Division of Sports Medicine, Cincinnati Children Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kelsey Logan
- The SPORT Center, Division of Sports Medicine, Cincinnati Children Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Paul Gubanich
- The SPORT Center, Division of Sports Medicine, Cincinnati Children Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Anna J Saltman
- Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Alexis B Slutsky-Ganesh
- Emory Sports Performance and Research Center, Flowery Branch, Georgia, USA.,Department of Orthopaedics, Emory University, School of Medicine, Atlanta, Georgia, USA
| | - Emma Hansen
- Brown University, Providence, Rhode Island, USA
| | - James Leach
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Gregory D Myer
- Emory Sports Performance and Research Center, Flowery Branch, Georgia, USA.,Department of Orthopaedics, Emory University, School of Medicine, Atlanta, Georgia, USA.,Emory Sports Medicine Center, Atlanta, Georgia, USA.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
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16
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Effects of Instrument Assisted Soft-Tissue Mobilization on Dynamic Balance in Those with Chronic Ankle Instability. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Our objective was to examine the effectiveness of IASTM application to the FL on dynamic balance in individuals with CAI. Fifteen individuals (seven females, eight males, age = 26.07 ± 9.18 years, mass = 87.33 ± 24.07 kg, height = 178.83 ± 12.83 cm) with CAI, as determined by the Ankle Instability Instrument (AII) volunteered to participate. Participants completed two counterbalanced sessions (experimental and control), and we recorded measurements at two time points (pre- and post-). The application of IASTM to the FL muscle was carried out using Técnica Gavilán® instruments for 90 s during the intervention, and participants sat for 2 min during the control session. Dynamic balance was assessed using the Y-balance test (YBT). The interaction between session and time for anterior reach was significant (F1,14 = 5.26, p = 0.04, η2 = 0.27). Post-hoc tests revealed farther reach distances at post-test (71.02 ± 9.45 cm) compared to pre-test (66.57 ± 10.87 cm) when IASTM was applied (p = 0.02, Mean Difference = 4.45 cm, CI95 = 0.71–8.19 cm, Cohen’s d = 0.44). The interaction between session and time was not significant for posteromedial (F1,14 = 0.25, p = 0.62, η2 = 0.02, 1 − β = 0.08) or posterolateral reaches (F1,14 = 1.17, p = 0.30, η2 = 0.08, 1 − β = 0.17). The application of IASTM to the FL improved anterior reach of the YBT, but not posterolateral or posteromedial reaches in individuals with CAI. However, the 4.45 cm increase in anterior reach could have clinical implications for improved function.
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17
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Shen Y, Wang W, Wang Y, Yang L, Yuan C, Yang Y, Wu F, Wang J, Deng Y, Wang X, Liu H. Not Only in Sensorimotor Network: Local and Distant Cerebral Inherent Activity of Chronic Ankle Instability—A Resting-State fMRI Study. Front Neurosci 2022; 16:835538. [PMID: 35197822 PMCID: PMC8859266 DOI: 10.3389/fnins.2022.835538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/26/2022] Open
Abstract
BackgroundIncreasing evidence has proved that chronic ankle instability (CAI) is highly related to the central nervous system (CNS). However, it is still unclear about the inherent cerebral activity among the CAI patients.PurposeTo investigate the differences of intrinsic functional cerebral activity between the CAI patients and healthy controls (HCs) and further explore its correlation with clinical measurement in CAI patients.Materials and MethodsA total of 25 CAI patients and 39 HCs were enrolled in this study. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to detect spontaneous cerebral activity. The metrics of amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of the two groups were compared by two-sample t-test. The brain regions that demonstrated altered functional metrics were selected as the regions of interest (ROIs). The functional connectivity (FC) was analyzed based on the ROIs. The Spearman correlation was calculated between rs-fMRI metrics and clinical scale scores.ResultsCompared with HCs, CAI patients showed higher ALFF and ReHo values in the right postcentral gyrus, the right precentral gyrus, and the right middle frontal gyrus, while lower fALFF values in the orbital-frontal cortex (OFC, p < 0.01 after correction). Increasing FC between the right precentral gyrus and the right postcentral gyrus while decreasing FC between the right precentral gyrus and the anterior cingulum cortex (ACC), the right middle frontal gyrus and the left middle temporal gyrus, and the OFC and left inferior parietal lobule (IPL) was observed. In addition, in the CAI group, the ReHo value negatively correlated with the Cumberland Ankle Instability Tool score in the right middle frontal gyrus (r = −0.52, p = 0.007).ConclusionThe CAI patients exhibited enhanced and more coherent regional inherent neuronal activity within the sensorimotor network while lower regional inherent activity in pain/emotion modulation related region. In addition, the information exchanges were stronger within the sensorimotor network while weaker between distant interhemispheric regions. Besides, the increased inherent activity in the right middle frontal gyrus was related to clinical severity. These findings may provide insights into the pathophysiological alteration in CNS among CAI patients.
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Affiliation(s)
- Yiyuan Shen
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiwei Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yin Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Liqin Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Chengjie Yuan
- Department of Orthopedic, Huashan Hospital, Fudan University, Shanghai, China
| | - Yang Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Fei Wu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Junlong Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Deng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- Department of Orthopedic, Huashan Hospital, Fudan University, Shanghai, China
- Xu Wang,
| | - Hanqiu Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Hanqiu Liu,
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18
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Terada M, Kosik KB, McCann RS, Drinkard C, Gribble PA. Corticospinal activity during a single-leg stance in people with chronic ankle instability. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:58-66. [PMID: 32866712 PMCID: PMC8847849 DOI: 10.1016/j.jshs.2020.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/22/2020] [Accepted: 07/22/2020] [Indexed: 05/25/2023]
Abstract
PURPOSE The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls. METHODS Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task. RESULTS Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to lateral ankle sprain copers (CSP100%: p = 0.003; MEP120%: p = 0.044) and controls (CSP100%: p = 0.041; MEP120%: p = 0.006). CONCLUSION This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI. Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.
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Affiliation(s)
- Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan.
| | - Kyle B Kosik
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY 40536-0200, USA
| | - Ryan S McCann
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA 23529, USA
| | | | - Phillip A Gribble
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY 40536-0200, USA
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19
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Kim H, Palmieri-Smith R, Kipp K. Muscle force contributions to ankle joint contact forces during an unanticipated cutting task in people with chronic ankle instability. J Biomech 2021; 124:110566. [PMID: 34171680 DOI: 10.1016/j.jbiomech.2021.110566] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/26/2021] [Accepted: 06/07/2021] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to compare muscle force contributions to ankle joint compression and anteroposterior shear forces between people with chronic ankle instability (CAI) and healthy controls (CON) during an unanticipated cutting task. Eleven people with CAI and 11 CON performed an unanticipated cutting task as three-dimensional motion capture, ground reaction force (GRF), and muscle activation data were collected. A musculoskeletal modeling was used to calculate talocrural joint compression and anteroposterior shear forces and parse out the contributions to these forces from ankle-spanning muscles and from GRF. Independent t-tests were used for statistical analysis. People with CAI exhibited greater anterior shear force peaks during early (p = 0.048, d = 0.98) and late (p = 0.017,d = 1.21) stance compared to CON. The difference in early stance shear force appeared to arise from greater GRF contribution (p = 0.026, d = 1.12) in CAI group, whereas the difference in late stance shear force appeared to arise from greater contribution of lateral gastrocnemius (p = 0.026, d = 1.12), medial gastrocnemius (p = 0.048, d = 0.98), tibialis posterior (p = 0.017, d = 1.22), fibularis brevis (p = 0.035, d = 1.05), and fibularis longus (p = 0.023, d = 1.15). People with CAI exhibit greater anterior shear, but not compressive forces in talocrural joint during an unanticipated cutting task. The differences in anterior shear force were the result of passive and active contributions from GRF during early stance and lower leg muscles during late stance, respectively.
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Affiliation(s)
- Hoon Kim
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
| | - Riann Palmieri-Smith
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Orthopaedic and Rehabilitation Biomechanics Laboratory, University of Michigan, Ann Arbor, MI, USA
| | - Kristof Kipp
- Department of Physical Therapy - Program in Exercise Science, Marquette University, Milwaukee, WI, USA
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20
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Cerqueira MS, Maciel DG, Barboza JAM, Centner C, Lira M, Pereira R, De Brito Vieira WH. Effects of low-load blood flow restriction exercise to failure and non-failure on myoelectric activity: a meta-analysis. J Athl Train 2021; 57:402-417. [PMID: 34038945 DOI: 10.4085/1062-6050-0603.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To compare the short- and long-term effects of low load blood flow restriction (LL-BFR) versus low- (LL-RT) or high-load (HL-RT) resistance training with free blood flow on myoelectric activity, and investigate the differences between failure and non-failure protocols. DATA SOURCE We identified sources by searching the MEDLINE/PUBMED, CINAHL, WEB OF SCIENCE, CENTRAL, SCOPUS, SPORTDiscus, and PEDro electronic databases. STUDY SELECTION We screened titles and abstracts of 1048 articles using our inclusion criteria. A total of 39 articles were selected for further analysis. DATA EXTRACTION Two reviewers independently assessed the methodological quality of each study and extracted data from studies. A meta-analytic approach was used to compute standardized mean differences (SMD ± 95% confidence intervals (CI)). Subgroup analyses were conducted for both failure or non-failure protocols. DATA SYNTHESIS The search identified n = 39 articles that met the inclusion criteria. Regarding the short-term effects, LL-BFR increased muscle excitability compared with LL-RT during non-failure exercises (SMD 0.61, 95% CI 0.34 to 0.88), whereas HL-RT increased muscle excitability compared with LL-BFR regardless of voluntary failure (SMD -0.61, 95% CI -1.01 to 0.21) or not (SMD -1.13, CI -1.94 to -0.33). Concerning the long-term effects, LL-BFR increased muscle excitability compared with LL-RT during exercises performed to failure (SMD 1.09, CI 0.39 to 1.79). CONCLUSIONS Greater short-term muscle excitability levels are observed in LL-BFR than LL-RT during non-failure protocols. Conversely, greater muscle excitability is present during HL-RT compared with LL-BFR, regardless of volitional failure. Furthermore, LL-BFR performed to failure increases muscle excitability in the long-term compared with LL-RT.
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Affiliation(s)
- Mikhail Santos Cerqueira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Daniel Germano Maciel
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Jean Artur Mendonça Barboza
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany; Praxisklinik Rennbahn, Muttenz, Switzerland,
| | - Maria Lira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
| | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequié, Bahia, Brazil,
| | - Wouber Hérickson De Brito Vieira
- Neuromuscular Performance Analysis Laboratory - Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil,
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Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG80. [PMID: 33789434 DOI: 10.2519/jospt.2021.0302] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.
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22
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Knuckles AM, Torp DM, Hubbard-Turner T, Donovan L, Thomas AC. Multi-axis destabilisation device influences plantar pressure distribution in adults with chronic ankle instability. Sports Biomech 2021; 21:501-516. [PMID: 33779500 DOI: 10.1080/14763141.2021.1896773] [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: 10/21/2022]
Abstract
Patients with chronic ankle instability (CAI) walk with increased lateral plantar pressure, precipitating future injuries. Gait retraining to medially shift plantar pressure may prevent recurrent injury. We assessed if a multi-axis destabilisation device changed plantar pressure and muscle activity in patients with CAI during walking. Twelve adults with CAI (age: 23.6 ± 5.0 years; body mass index: 26.7 ± 4.5 kg/m2) participated. Insole plantar pressure and electro-myography were collected synchronously during treadmill walking. The destabilisation device had a half-sphere under both the rearfoot and forefoot. Two 30s walking trials were recorded at baseline, first without and second with the destabilisation device. After 20 min of walking with the destabilisation device, two 30s post-walking trials were collected, first with and second without the destabilisation device. The middle 10 steps of each trial were extracted, plantar pressure quantified, and data averaged across steps for repeated measures ANOVA analysis. Electromyographic data wereextracted from 50 ms pre- through 200 ms post-initial contact. The centre of pressure shifted medially during destabilisation device use (P < 0.002) versus baseline. This shift was notretained upon device removal. Thus, the device capably shifts plantar pressure while worn. Its effects beyond a single sessionare unknown.
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Affiliation(s)
- Allison M Knuckles
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Danielle M Torp
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Tricia Hubbard-Turner
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Luke Donovan
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Abbey C Thomas
- Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA
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23
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Rodríguez-Sanz D, García-Sánchez A, Becerro-de-Bengoa-Vallejo R, Martínez-Jiménez EM, Calvo-Lobo C, Fernández-Carnero J, Losa-Iglesias ME, López-López D. Eyes-Open Versus Eyes-Closed Somatosensory Motor Balance in Professional Soccer Players With Chronic Ankle Instability: A Case-Control Study. Orthop J Sports Med 2021; 9:2325967120983606. [PMID: 33763496 PMCID: PMC7944533 DOI: 10.1177/2325967120983606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Chronic ankle instability (CAI) is a condition defined by certain structural and functional deficits in the ankle joint complex after acute ankle injury. These deficits include pathological joint laxity, impaired postural control, and decreased strength and neuromuscular control. Purpose: To compare an eyes-open versus an eyes-closed balance training protocol in professional soccer players with CAI. Study Design: Cohort study; Level of evidence, 2. Methods: For this study, we evaluated 19 players from 2 professional soccer teams in Madrid, Spain, all of whom had CAI. Participants from both teams were randomly assigned to an eyes-open group (n = 9) or eyes-closed group (n = 10). All participants completed 4 weeks of a supervised exercise protocol consisting of 3 sessions per week. Members of both the eyes-open and eyes-closed groups performed the same exercise protocol in the same order of execution. At the end of the protocol, the participants were assessed for pain (visual analog scale), ankle dorsiflexion range of motion (weightbearing lunge test), dynamic stability (Star Excursion Balance Test), and fear of movement and reinjury (Tampa Scale for Kinesiophobia). We compared results both before and after balance training and between the eyes-open and eyes-closed balance training groups. Results: Statistically significant differences were found for all of the assessed variables before and after balance training. No statistically significant differences were found between the eyes-closed and eyes-open groups on any variable. Conclusion: In the current study, eyes-closed balance training was not more effective than eyes-open balance training for CAI in professional soccer players.
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Affiliation(s)
- David Rodríguez-Sanz
- Facultad de enfermería Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - Eva María Martínez-Jiménez
- Facultad de enfermería Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.,Faculty of Sports, Universidad Europea de Madrid, Spain.,Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, Spain.,Nursing and Stomatology Department, Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain.,Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain.,Investigation performed at Universidad Complutense de Madrid, Madrid, Spain
| | - César Calvo-Lobo
- Facultad de enfermería Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Marta Elena Losa-Iglesias
- Nursing and Stomatology Department, Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
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Kosik KB, Terada M, McCann RS, Drinkard CP, Gribble PA. Association between corticospinal inhibition and active dorsiflexion range of motion in patients with chronic ankle instability. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kyle B. Kosik
- Department of Athletic Training & Clinical Nutrition University of Kentucky Lexington KY USA
| | - Masafumi Terada
- Department of Sport and Health Science Ritsumeikan University Kyoto Japan
| | - Ryan S. McCann
- School of Physical Therapy & Athletic Training Old Dominion University Norfolk VA USA
| | | | - Phillip A. Gribble
- Department of Athletic Training & Clinical Nutrition University of Kentucky Lexington KY USA
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25
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Jagodinsky AE, Angles R, Wilburn C, Weimar WH. Lower-Extremity Motor Synergies in Individuals With and Without Chronic Ankle Instability. J Appl Biomech 2020; 36:416-422. [PMID: 32932229 DOI: 10.1123/jab.2019-0398] [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: 12/19/2019] [Revised: 05/21/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022]
Abstract
Current theoretical models suggest that ankle sprain copers exhibit movement adaptations contributing to the avoidance of chronic ankle instability. However, few studies have examined adaptations at the level of biomechanical motor synergies. The purpose was to examine characteristics of the support moment synergy between individuals with chronic ankle instability, copers, and healthy individuals. A total of 48 individuals participated in the study. Lower-extremity kinetics and variability in the moment of force patterns were assessed during the stance phase of walking trials. The copers exhibited reductions in the support moment during the load response and preswing phase compared with the chronic ankle instability group, as well as during the terminal stance and preswing phase compared the healthy group. The copers also exhibited reductions in the hip extensor moment and ankle plantarflexion moment compared with healthy and chronic ankle instability groups during intervals of stance phase. Variability of the support moment and knee moment was greater in the copers compared with the chronic ankle instability group. Dampening of the support moment and select joint moments exhibited by the copers may indicate an adaptive mechanism to mitigate loading perturbations on the previously injured ankle. Heightened motor variability in copers may be indicative of a more adaptable motor synergy compared with individuals with chronic ankle instability.
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26
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Raisbeck LD, Diekfuss JA, Rhea CK. Does an External Focus Improve Single-Leg Jump Distance for Individuals With Chronic Ankle Instability? ACTA ACUST UNITED AC 2020. [DOI: 10.3928/19425864-20191106-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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27
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Sarvestan J, Aghaie Ataabadi P, Svoboda Z, Kovačikova Z, Needle AR. Ankle-knee coupling responses to ankle Kinesio™ taping during single-leg drop landings in collegiate athletes with chronic ankle instability. J Sports Med Phys Fitness 2020; 61:582-591. [PMID: 33092324 DOI: 10.23736/s0022-4707.20.11264-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Ankle Kinesio-taping (KT) is being globally used an intervention to provide the ankle joint complex with sufficient support against sudden excessive mechanical stress during various activities. However, its effects on proximal joints are unclear. This study investigated the impact of ankle KT on ankle-knee joint coupling in sagittal, frontal and transverse planes. METHODS Adopting a pretest post-test study design, 30 collegiate athletes with chronic ankle instability performed 3 single-leg drop landings in each non-taped and Kinesio-taped conditions and their movement kinematics were recorded using 6 optoelectronic cameras. RESULTS The ankle angular velocities in sagittal (P=0.038, d=0.64) and transverse planes (P=0.001, d=0.95) decreased after KT application, while the knee internal rotation velocities increased (P=0.020, d=0.51). The coupling angles revealed that the ankle movement ratios significantly decreased in 3 planes in comparison with knee movement ratios. CONCLUSIONS Outcomes of this study illustrated that application of ankle KT leaves the individuals with a stiffer ankle joint, which increases the mechanical stresses to this joint and decreases its stiffness in absorbing the applied shocks. Further, ankle KT application resulted in more knee internal rotation moments and may increase the risk of knee injuries during landing after a long-term usage in patients with instability ankle sprain.
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Affiliation(s)
- Javad Sarvestan
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic -
| | - Peyman Aghaie Ataabadi
- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Zdeněk Svoboda
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| | - Zuzana Kovačikova
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
| | - Alan R Needle
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
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Centner C, Lauber B. A Systematic Review and Meta-Analysis on Neural Adaptations Following Blood Flow Restriction Training: What We Know and What We Don't Know. Front Physiol 2020; 11:887. [PMID: 32848843 PMCID: PMC7417362 DOI: 10.3389/fphys.2020.00887] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/30/2020] [Indexed: 12/21/2022] Open
Abstract
Objective: To summarize the existing evidence on the long-term effects of low-load (LL) blood flow restricted (BFR) exercise on neural markers including both central and peripheral adaptations. Methods: A systematic review and meta-analysis was conducted according to the PRISMA guidelines. The literature search was performed independently by two reviewers in the following electronic databases: PubMed, Web of Science, Scopus and CENTRAL. The systematic review included long-term trials investigating the effects of LL-BFR training in healthy subjects and compared theses effects to either LL or high-load (HL) training without blood flow restriction. Results: From a total of N = 4499 studies, N = 10 studies were included in the qualitative synthesis and N = 4 studies in a meta-analysis. The findings indicated that LL-BFR resulted in enhanced levels of muscle excitation compared to LL training with pooled effect sizes of 0.87 (95% CI: 0.38-1.36). Compared to HL training, muscle excitation following LL-BFR was reported as either similar or slightly lower. Differences between central activation between LL-BFR and LL or HL are less clear. Conclusion: The summarized effects in this systematic review and meta-analysis highlight that BFR training facilitates neural adaptations following LL training, although differences to conventional HL training are less evident. Future research is urgently needed to identify neural alterations following long-term blood flow restricted exercise.
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Affiliation(s)
- Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Benedikt Lauber
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany.,Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
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29
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Suttmiller AM, McCann RS. Neural excitability of lower extremity musculature in individuals with and without chronic ankle instability: A systematic review and meta-analysis. J Electromyogr Kinesiol 2020; 53:102436. [DOI: 10.1016/j.jelekin.2020.102436] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 03/23/2020] [Accepted: 05/27/2020] [Indexed: 11/24/2022] Open
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30
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Herb CC, Blemker S, Saliba S, Hart J, Hertel J. Chronic ankle instability patients exhibit higher variability in lower extremity joint-coupling variability during drop vertical jumps. J Biomech 2020; 99:109479. [PMID: 31744598 DOI: 10.1016/j.jbiomech.2019.109479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/27/2019] [Accepted: 10/30/2019] [Indexed: 12/26/2022]
Abstract
Chronic ankle instability (CAI) has been associated with biomechanical alterations during landing tasks. While joint coupling differences have been reported during gait in patients with CAI, there is no known research assessing joint coupling during a drop-vertical jumping (DVJ). Joint coupling variability measure may provide information on the sensorimotor health of these patients. The purpose of this study was to compare lower extremity joint coupling variability during a DVJ between patients with CAI and controls. Twenty-eight young, active individuals (CAI:n = 14, Control:n = 14) participated in the study. A 3D motion capture system was used to collect kinematics during 15 drop-vertical jump trials. A vector coding analysis was used to assess the variability in the following joint couples: knee sagittal-ankle frontal, knee sagittal-ankle sagittal, hip frontal-ankle frontal, and hip frontal-ankle sagittal. The CAI group had higher joint coupling variability in hip frontal-ankle sagittal, knee sagittal-ankle frontal and knee sagittal-ankle sagittal planes both prior to and following ground contact during the drop vertical jumps. These changes indicate potential adaptations to the constraint of CAI and the task of the DVJ. Higher variability may reflect an attempt by the subjects to explore alternate movement strategies or reflect poor sensorimotor control strategies. Clinicians should consider the challenges of DVJ during rehabilitation as they create a unique task constraint.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitation Sciences, Highland Heights, KY, USA.
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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31
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Motoneuron Function Does not Change Following Whole-Body Vibration in Individuals With Chronic Ankle Instability. J Sport Rehabil 2019; 28:614-622. [PMID: 30222478 DOI: 10.1123/jsr.2017-0364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 07/20/2018] [Accepted: 07/22/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Following a lateral ankle sprain, ∼40% of individuals develop chronic ankle instability (CAI), characterized by recurrent injury and sensations of giving way. Deafferentation due to mechanoreceptor damage postinjury is suggested to contribute to arthrogenic muscle inhibition (AMI). Whole-body vibration (WBV) has the potential to address the neurophysiologic deficits accompanied by CAI and, therefore, possibly prevent reinjury. OBJECTIVE To determine if an acute bout of WBV can improve AMI and proprioception in individuals with CAI. DESIGN AND PARTICIPANTS The authors examined if an acute bout of WBV can improve AMI and proprioception in individuals with CAI with a repeated-measures design. A total of 10 young adults with CAI and 10 age-matched healthy controls underwent a control, sham, and WBV condition in randomized order. SETTING Biomechanics laboratory. INTERVENTION WBV. MAIN OUTCOME MEASURES Motoneuron pool recruitment was assessed via Hoffmann reflex (H-reflex) in the soleus. Proprioception was evaluated using ankle joint position sense at 15° and 20° of inversion. Both were assessed prior to, immediately following, and 30 minutes after the intervention (pretest, posttest, and 30mPost, respectively). RESULTS Soleus maximum H-reflex:M-response (H:M) ratios were 25% lower in the CAI group compared with the control group (P = .03). Joint position sense mean constant error did not differ between groups (P = .45). Error at 15° in the CAI (pretest 0.8 [1.6], posttest 2.0 [2.8], 30mPost 2.0 [1.9]) and control group (pretest 0.8 [2.0], posttest 0.6 [2.9], 30mPost 0.5 [2.1]) did not improve post-WBV. Error at 20° did not change post-WBV in the CAI (pretest 1.3 [1.7], posttest 1.0 [2.4], 30mPost 1.5 [2.2]) or control group (pretest -0.3 [3.0], posttest 0.8 [2.1], 30mPost 0.6 [1.8]). CONCLUSION AMI is present in the involved limb of individuals with CAI. The acute response following a single bout of WBV did not ameliorate the presence of AMI nor improve proprioception in those with CAI.
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Decreased supraspinal control and neuromuscular function controlling the ankle joint in athletes with chronic ankle instability. Eur J Appl Physiol 2019; 119:2041-2052. [DOI: 10.1007/s00421-019-04191-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 07/13/2019] [Indexed: 12/26/2022]
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Changes in Spinal and Corticospinal Excitability in Patients with Chronic Ankle Instability: A Systematic Review with Meta-Analysis. J Clin Med 2019; 8:jcm8071037. [PMID: 31315231 PMCID: PMC6678466 DOI: 10.3390/jcm8071037] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 12/26/2022] Open
Abstract
The objective of this systematic review with meta-analysis was to determine alterations in spinal and corticospinal excitability of ankle muscles in patients with chronic ankle instability (CAI) compared to uninjured controls. Independent researchers performed comprehensive literature searches of electronic databases and included studies that compared groups with and without CAI and investigated neural excitability with Hoffmann reflex (H-reflex) and/or transcranial magnetic stimulation (TMS). A fixed-effect meta-analysis was conducted to determine group differences for (1) soleus and fibularis maximal H-reflex (Hmax)/maximal M-wave (Mmax)-ratios, and (2) soleus and fibularis longus cortical motor thresholds (CMTs). Seventeen studies were included in the current meta-analysis. They showed that the Hmax/Mmax-ratios of the soleus and the fibularis longus in the CAI group were significantly lower than those in the uninjured control group (soleus: d = −0.41, p < 0.001; fibularis longus: d = −0.27, p = 0.04). There was no evidence for changes in the CMT. This systematic review is the first to demonstrate evidence that patients with CAI present decreased spinal reflex excitability in the soleus and fibularis longus. However, there is no evidence of changes in supraspinal excitability when considering only the CMT. The latter result needs to be interpreted with caution as all except one study demonstrate some changes at the supraspinal level with CAI.
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Abstract
Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the need to expand the evaluation of ankle instability beyond the acute time point. Physical assessments of the injured ankle should be similar, regardless of whether this is the initial lateral ankle sprain or the patient has experienced multiple sprains. To this point, a thorough injury history of the affected ankle provides important information during the clinical examination. The physical examination should assess the talocrural and subtalar joints, and clinicians should be aware of efficacious diagnostic tools that provide information about the status of injured structures. As patients progress into the subacute and return-to-activity phases after injury, comprehensive assessments of lateral ankle-complex instability will identify any disease and patient-oriented outcome deficits that resemble chronic ankle instability, which should be addressed with appropriate interventions to minimize the risk of developing long-term, recurrent ankle instability.
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Affiliation(s)
- Phillip A Gribble
- Department of Athletic Training and Clinical Nutrition, College of Health Sciences, University of Kentucky, Lexington
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35
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Abstract
Lateral ankle sprains (LASs) are among the most common injuries incurred during participation in sport and physical activity, and it is estimated that up to 40% of individuals who experience a first-time LAS will develop chronic ankle instability (CAI). Chronic ankle instability is characterized by a patient's being more than 12 months removed from the initial LAS and exhibiting a propensity for recurrent ankle sprains, frequent episodes or perceptions of the ankle giving way, and persistent symptoms such as pain, swelling, limited motion, weakness, and diminished self-reported function. We present an updated model of CAI that aims to synthesize the current understanding of its causes and serves as a framework for the clinical assessment and rehabilitation of patients with LASs or CAI. Our goal was to describe how primary injury to the lateral ankle ligaments from an acute LAS may lead to a collection of interrelated pathomechanical, sensory-perceptual, and motor-behavioral impairments that influence a patient's clinical outcome. With an underpinning of the biopsychosocial model, the concepts of self-organization and perception-action cycles derived from dynamic systems theory and a patient-specific neurosignature, stemming from the Melzack neuromatrix of pain theory, are used to describe these interrelationships.
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Affiliation(s)
- Jay Hertel
- Department of * Kinesiology, University of Virginia, Charlottesville.,Department of Orthopaedic Surgery, University of Virginia, Charlottesville
| | - Revay O Corbett
- Department of * Kinesiology, University of Virginia, Charlottesville
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36
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Rosen AB, Yentes JM, McGrath ML, Maerlender AC, Myers SA, Mukherjee M. Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control. J Athl Train 2019; 54:718-726. [PMID: 31162942 PMCID: PMC6602391 DOI: 10.4085/1062-6050-448-17] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Chronic ankle instability (CAI) is characterized by repetitive ankle sprains and perceived instability. Whereas the underlying cause of CAI is disputed, alterations in cortical motor functioning may contribute to the perceived dysfunction. OBJECTIVE To assess differences in cortical activity during single-limb stance among control, coper, and CAI groups. DESIGN Cross-sectional study. SETTING Biomechanics laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 31 individuals (10 men, 21 women; age = 22.3 ± 2.4 years, height = 169.6 ± 9.7 cm, mass = 70.6 ± 11.6 kg), who were classified into control (n = 13), coper (n = 7), and CAI (n = 11) groups participated in this study. INTERVENTION(S) Participants performed single-limb stance on a force platform for 60 seconds while wearing a 24-channel functional near-infrared spectroscopy system. Oxyhemoglobin (HbO2) changes in the supplementary motor area (SMA), precentral gyrus, postcentral gyrus, and superior parietal lobe were measured. MAIN OUTCOME MEASURE(S) Differences in averages and standard deviations of HbO2 were assessed across groups. In the CAI group, correlations were analyzed between measures of cortical activation and Cumberland Ankle Instability Tool (CAIT) scores. RESULTS No differences in average HbO2 were present for any cortical areas. We observed differences in the standard deviation for the SMA across groups; specifically, the CAI group demonstrated greater variability than the control (r = 0.395, P = .02; 95% confidence interval = 0.34, 0.67) and coper (r = 0.38, P = .04; 95% confidence interval = -0.05, 0.69) groups. We demonstrated a strong correlation that was significant in the CAI group between the CAIT score and the average HbO2 of the precentral gyrus (ρ = 0.64, P = .02) and a strong correlation that was not significant between the CAIT score and the average HbO2 of the SMA (ρ = 0.52, P = .06). CONCLUSIONS The CAI group displayed large differences in SMA cortical-activation variability. Greater variations in cortical activation may be necessary for similar static postural-control outcomes among individuals with CAI. Consequently, variations in cortical activation for these areas provide evidence for an altered neural mechanism of postural control among populations with CAI.
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Affiliation(s)
- Adam B. Rosen
- School of Health and Kinesiology, University of Nebraska, Omaha
| | | | - Melanie L. McGrath
- Department of Health and Human Performance, University of Montana, Missoula
| | | | - Sara A. Myers
- Department of Biomechanics, University of Nebraska, Omaha
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TERADA MASAFUMI, JOHNSON NATHAN, KOSIK KYLE, GRIBBLE PHILLIP. Quantifying Brain White Matter Microstructure of People with Lateral Ankle Sprain. Med Sci Sports Exerc 2019; 51:640-646. [DOI: 10.1249/mss.0000000000001848] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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38
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THE EFFECT OF BRACING AND BALANCE TRAINING ON ANKLE SPRAIN INCIDENCE AMONG ATHLETES: A SYSTEMATIC REVIEW WITH META-ANALYSIS. Int J Sports Phys Ther 2018. [PMID: 30038824 DOI: 10.26603/ijspt20180379] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Ankle sprains are common musculoskeletal injuries in the athletic population that have been addressed with prevention strategies that include bracing and balance training. Many authors have examined ankle sprain incidence after bracing or balance training in athletes at different levels of competition and in various sports. No systematic review has analyzed the results of both interventions. Purpose The purpose of this review was to compare the effect of balance training and bracing in reducing the incidence and relative risk of ankle sprains in competitive athletes, with or without prior injury, across different sports. Design Systematic review, with meta-analysis. Methods A literature search of four databases was conducted for randomized control trials that reported ankle sprain incidence published from 2005 through 2016. Included articles studied high school, college, or professional level athletes with or without a history of a prior sprain, who received bracing or balance training as an intervention compared to a non-intervention control group. Methodological study quality was assessed by two reviewers using the PEDro scale, with scores ≥5 considered moderate quality. Group incidence and relative risk were determined to assess the preventative effect of bracing or balance training compared to control. Results From 1832 total citations, 71 full-text articles were reviewed, and eight articles were included in the study. Methodological quality of the available evidence contained in the systematic review was moderate. Five studied the effect of balance training, two studied the effect of bracing, and one studied the effect of bracing and balance training compared to the control condition. In all eight studies, athletes in the control condition did not receive any intervention. Athletes who wore braces had fewer ankle sprains (p=0.0037) and reduced their risk of sprains by 64% (RR=0.36) compared to controls, based on analysis of 3,581 subjects. Athletes performing balance training had fewer ankle sprains (p=0.0057) and reduced their risk by 46% (RR=0.54) compared to controls, based on analysis of 3,577 subjects. Conclusion The findings of the current systematic review and meta-analysis support the use of bracing and balance training to reduce the incidence and relative risk of ankle sprains in athletic populations. Clinicians can utilize this information to educate their patients on wearing a brace or performing balance training exercises to decrease the risk of an ankle sprain. Level of evidence Level 1a.
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Kim KM, Best TM, Aiyer A. How Do Athletes with Chronic Ankle Instability Suffer from Impaired Balance? An Update on Neurophysiological Mechanisms. Curr Sports Med Rep 2018; 16:309-311. [PMID: 28902750 DOI: 10.1249/jsr.0000000000000407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Kyung-Min Kim
- 1Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL; 2Family Medicine, Kinesiology, UHealth Sports Medicine Institute, University of Miami/Miller School of Medicine, Miami, FL; and 3Department of Orthopaedics, University of Miami/Miller School of Medicine, Miami, FL
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Kosik KB, Terada M, Drinkard CP, McCann RS, Gribble PA. Potential Corticomotor Plasticity in Those with and without Chronic Ankle Instability. Med Sci Sports Exerc 2017; 49:141-149. [PMID: 27501358 DOI: 10.1249/mss.0000000000001066] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Quantifying corticomotor alterations is important to understand the neurophysiological mechanisms that likely contribute to the neuromuscular control deficits observed in patients with chronic ankle instability (CAI). Corticomotor output mapping provides further insight into the changes within the motor cortex and identifies potential changes in the area of the motor cortex associated with selected muscles. Therefore, this investigation compared the corticomotor map output for the fibularis longus (FL) muscle in patients with and without CAI. METHODS Eighteen CAI patients and 16 healthy controls (HC) volunteered. Transcranial magnetic stimulation was used to map the motor cortex's representation of the FL. The normalized average of three motor evoked potentials at 100% of active motor threshold intensity was recorded for each scalp site on a 6 × 6 cm grid. Corticomotor output map was compared between groups through 1) the size of the corticomotor map area, 2) the volume of the corticomotor map, and 3) the location of cortical representation. Independent t-tests were used to assess group differences in each mapping outcome variable. Cohen's d effect sizes along with 95% confidence intervals were calculated using the pooled SD values. RESULTS CAI patients exhibited less map volume (P = 0.018, CAI = 8.2 ± 3.2 cm mV vs HC = 11.3 ± 3.9 cm mV) and map area (P = 0.046, CAI = 12.8 ± 6.0 cm vs HC: 17.4 ± 6.9 cm) compared with HC. CONCLUSIONS The smaller map area and volume suggest a more concentrated area of neurons communicating with the FL muscle in patients with CAI. Consequently, motor cortical cells on the border of the FL excitation area are less committed to the proper function of the FL muscle and may be recruited by other surrounding areas. This may explain altered movement strategies that lead to ankle reinjury.
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Affiliation(s)
- Kyle B Kosik
- 1Department of Rehabilitation Sciences, Division of Athletic Training, University of Kentucky, Lexington, KY; and 2College of Sport and Health Sciences Ritsumeikan University, Kusatsu, Shiga-ken, JAPAN
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Abstract
Context: Neuromuscular alterations are a major causal factor of primary and secondary injuries. Though injury prevention programs have experienced some success, rates of injuries have not declined, and after injury, individuals often return to activity with functionality below clinical recommendations. Considering alternative therapies to the conventional concentric exercise approach, such as one that can target neuromuscular injury risk and postinjury alterations, may provide for more effective injury prevention and rehabilitation protocols. Evidence Acquisition: Peer-reviewed sources available on the Web of Science and MEDLINE databases from 2000 through 2016 were gathered using searches associated with the keywords eccentric exercise, injury prevention, and neuromuscular control. Hypothesis: Eccentric exercise will reduce injury risk by targeting specific neural and morphologic alterations that precipitate neuromuscular dysfunction. Study Design: Clinical review. Level of Evidence: Level 4. Results: Neuromuscular control is influenced by alterations in muscle morphology and neural activity. Eccentric exercise beneficially modifies several underlying factors of muscle morphology (fiber typing, cross-sectional area, working range, and pennation angle), and emerging evidence indicates that eccentric exercise is also beneficial to peripheral and central neural activity (alpha motorneuron recruitment/firing, sarcolemma activity, corticospinal excitability, and brain activation). Conclusion: There is mounting evidence that eccentric exercise is not only a therapeutic intervention influencing muscle morphology but also targets unique alterations in neuromuscular control, influencing injury risk.
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Affiliation(s)
- Lindsey K Lepley
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Adam S Lepley
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - James A Onate
- School of Health and Rehabilitative Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Dustin R Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, Ohio.,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, Ohio
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Central Nervous System Adaptation After Ligamentous Injury: a Summary of Theories, Evidence, and Clinical Interpretation. Sports Med 2016; 47:1271-1288. [DOI: 10.1007/s40279-016-0666-y] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Ultrasonography Comparison of Peroneus Muscle Cross-sectional Area in Subjects With or Without Lateral Ankle Sprains. J Manipulative Physiol Ther 2016; 39:635-644. [DOI: 10.1016/j.jmpt.2016.09.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/21/2015] [Accepted: 02/10/2016] [Indexed: 11/19/2022]
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Terada M, Bowker S, Hiller CE, Thomas AC, Pietrosimone B, Gribble PA. Quantifying levels of function between different subgroups of chronic ankle instability. Scand J Med Sci Sports 2016; 27:650-660. [DOI: 10.1111/sms.12712] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 12/26/2022]
Affiliation(s)
- M. Terada
- College of Sport and Health Science; Ritsumeikan University; Shiga Japan
| | - S. Bowker
- Kent State University; Kent Ohio USA
| | - C. E. Hiller
- Faculty of Health Sciences University of Sydney; Lidcombe New South Wales Australia
| | - A. C. Thomas
- Department of Kinesiology; University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - B. Pietrosimone
- Department of Exercise and Sport Science; University of North Carolina at Chapel Hill; Chapel Hill North Carolina USA
| | - P. A. Gribble
- Department of Rehabilitation Science; University of Kentucky; Lexington Kentucky USA
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Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DTP, Hertel J, Hiller CE, Kaminski TW, McKeon PO, Refshauge KM, Verhagen EA, Vicenzino BT, Wikstrom EA, Delahunt E. Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 2016; 50:1496-1505. [PMID: 27259753 DOI: 10.1136/bjsports-2016-096189] [Citation(s) in RCA: 312] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 02/06/2023]
Abstract
Lateral ankle sprains (LASs) are the most prevalent musculoskeletal injury in physically active populations. They also have a high prevalence in the general population and pose a substantial healthcare burden. The recurrence rates of LASs are high, leading to a large percentage of patients with LAS developing chronic ankle instability. This chronicity is associated with decreased physical activity levels and quality of life and associates with increasing rates of post-traumatic ankle osteoarthritis, all of which generate financial costs that are larger than many have realised. The literature review that follows expands this paradigm and introduces emerging areas that should be prioritised for continued research, supporting a companion position statement paper that proposes recommendations for using this summary of information, and needs for specific future research.
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Affiliation(s)
- Phillip A Gribble
- University of Kentucky, College of Health Sciences, Lexington, Kentucky, USA
| | - Chris M Bleakley
- Department of Life and Health Sciences, Ulster University, Jordanstown, Carrickfergus, UK
| | - Brian M Caulfield
- University College Dublin, Insight Centre for Data Analytics, Dublin, Ireland
| | - Carrie L Docherty
- Indiana University, School of Public Health, Bloomington, Indiana, USA
| | | | - Daniel Tik-Pui Fong
- National Centre for Sport and Exercise Medicine-East Midlands, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Jay Hertel
- Departments of Kinesiology and Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Claire E Hiller
- University of Sydney, College of Health, Sydney, New South Wales, Australia
| | - Thomas W Kaminski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Patrick O McKeon
- Department of Exercise and Sport Sciences, Ithaca College, Ithaca, New York, USA
| | | | - Evert A Verhagen
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Bill T Vicenzino
- University of Queensland, School of Health and Rehabilitation Sciences: Physiotherapy, Brisbane, Queensland, Australia
| | - Erik A Wikstrom
- Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eamonn Delahunt
- University College Dublin, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
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Terada M, Bowker S, Thomas AC, Pietrosimone B, Hiller CE, Gribble PA. Corticospinal Excitability and Inhibition of the Soleus in Individuals With Chronic Ankle Instability. PM R 2016; 8:1090-1096. [PMID: 27208398 DOI: 10.1016/j.pmrj.2016.04.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/24/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding the mechanisms of neurophysiological alterations with chronic ankle instability (CAI) may be essential in the development of the most-effective intervention programs to treat neuromuscular dysfunction in patients with CAI. Specifically, the presence of CAI may be associated with an altered supraspinal mechanism within the central nervous system to inhibit neural drive to the undamaged soleus surrounding the injured ankle joint. OBJECTIVE To investigate the influence of CAI on corticospinal excitability and inhibition of the soleus. DESIGN A single-blinded, case-control study. SETTING Research laboratory. PARTICIPANTS Sixteen participants with self-reported CAI and 17 healthy control participants volunteered. METHODS Transcranial magnetic stimulation was used to assess corticospinal excitability and inhibition of the soleus muscle. Active motor threshold (AMT), defined as the lowest stimulator intensity required to elicit a peak-to-peak motor-evoked potential (MEP) amplitude ≥100 μV in at least four of 8 trials, was found to assess corticospinal excitability of the soleus. Eight stimuli were delivered at 120% of AMT, and peak-to-peak MEP amplitudes were recorded for each trial. The amplitude of 8 MEPs at 120% of AMP were averaged and normalized to the maximum M-response. Cortical silent period (CSP) was measured as the distance from the end of the MEP to a return of the mean electromyographic signal plus 2 times the standard deviation of the baseline (prestimulus) electromyographic signal. The ratio of the CSP to the MEP at 120% AMT (CSP:MEP120) were calculated to assess corticospinal inhibition. RESULTS The CAI group had a greater CSP:MEP120 ratio compared with the control group (P = .02). No significant differences between groups were observed for AMT (P = .67) and normalized MEP at 120% of AMT (P = .42). CONCLUSIONS The greater CSP:MEP120 ratio in participants with CAI suggests an altered balance in corticospinal inhibition and excitability to the soleus of the CAI cohort. Future research is needed to determine the role of corticospinal inhibition in physical and self-reported function in patients with CAI. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, 1-1-1 Nojihigashi, Integration Core 602, Kusatsu-shi, Shiga-ken, 525-8577, Japan(∗).
| | | | - Abbey C Thomas
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC(‡)
| | - Brian Pietrosimone
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC(§)
| | - Claire E Hiller
- Faculty of Health Sciences, University of Sydney, New South Wales, Australia(¶)
| | - Phillip A Gribble
- Department of Rehabilitation, University of Kentucky, Lexington, KY(#)
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