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Xiao S, Shen B, Xu Z, Zhan J, Zhang C, Han J, Fu W. Balance Control Deficits are Associated With Diminished Ankle Force Sense, Not Position Sense, in Athletes with Chronic Ankle Instability. Arch Phys Med Rehabil 2024:S0003-9993(24)01119-5. [PMID: 39009332 DOI: 10.1016/j.apmr.2024.06.019] [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: 12/04/2023] [Revised: 05/28/2024] [Accepted: 06/10/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVES To compare balance control and ankle proprioception between athletes with and without chronic ankle instability (CAI). A further objective was to explore the relationship between balance control performance and ankle proprioception in athletes with CAI. DESIGN Cross-sectional study. SETTINGS Sports Rehabilitation Laboratory. PARTICIPANTS Eighty-eight recreational athletes (47 CAI and 41 healthy control) were recruited. INTERVENTIONS No applicable. MAIN OUTCOME MEASURES Balance control performance was assessed using the sway velocity of the center of the pressure during the one-leg standing tasks. Ankle proprioception, including joint position sense and force sense, were tested using absolute error (AE) associated with joint position reproduction and force reproduction tasks in 4 directions, that is, plantarflexion, dorsiflexion, inversion, and eversion. RESULTS Athletes with CAI performed significantly worse than those without CAI in balance control tasks. In addition, CAI athletes showed significantly worse joint position sense and force sense in all 3 movement directions tested (plantarflexion, inversion, and eversion). Correlation analysis showed that the AE of the plantarflexion force sense was significantly moderately correlated with medial-lateral sway velocity in the one-leg standing with eyes open and closed conditions (r=.372-.403, P=.006-.012), and the AE of inversion force sense was significantly moderately correlated with medial-lateral sway velocity in the one-leg standing with eyes open (r=.345, P=.018) in athletes with CAI, but the joint position sense measures were not (all P>0.05). CONCLUSIONS Athletes with CAI showed significantly impaired balance control performance and diminished ankle proprioception. Deficit in force sense was deemed as a moderate predictor of one-leg standing balance control deficits in athletes with dominant-side injury CAI, whereas ankle position sense may be a small predictor.
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Affiliation(s)
- Songlin Xiao
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Bin Shen
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Zhen Xu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Jianglong Zhan
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Chuyi Zhang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China; Research Institute for Sport and Exercise, University of Canberra, Bruce, Australia.
| | - Weijie Fu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China.
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Hu X, Feng T, Li P, Liao J, Wang L. Bilateral Sensorimotor Impairments in Individuals with Unilateral Chronic Ankle Instability: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2024; 10:33. [PMID: 38589676 PMCID: PMC11001848 DOI: 10.1186/s40798-024-00702-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is manifested by sensorimotor impairments in the sprained ankle, including deficits in sensation, motor function, and central integration or processing. These impairments have a significant impact on physical activities and daily life. Recently, some studies have suggested that bilateral deficits were observed in unilateral CAI, but contradictory evidence disputes this finding. Therefore, the objective of this study was to investigate whether bilateral sensorimotor deficits presented in individuals with unilateral CAI. METHODS Without language restriction, the following databases were retrieved from database inception up until 3 November 2023, including PubMed, WOS, EMBASE, Cochrane, SPORTDiscus and CINAHL. Case-control and cross-sectional studies that investigated bilateral sensorimotor functions in individuals with unilateral CAI were included. Sensorimotor functions contained static and dynamic balance, functional performance, muscle strength and activation, as well as sensation. Outcome measures contained centre-of-pressure parameters, normalised reach distance, activation time and magnitude of muscle, sensory errors and threshold. The risk of bias and quality assessment of included studies were evaluated using a standardised tool recommended by the Cochrane Collaboration and the Epidemiological Appraisal Instrument, respectively. To explore the potential bilateral deficits associated with unilateral CAI, a comprehensive meta-analysis was conducted using Review Manager version 5.4. The analysis compared the injured limb of unilateral CAI with healthy controls and the uninjured limb with healthy controls. The main focus of this study was to investigate the differences between the uninjured limb and healthy controls. A random-effects model was employed and effect sizes were estimated using the standardised mean difference (SMD) with 95% confidence intervals (CIs). Effect sizes were deemed as weak (0.2-0.5), moderate (0.5-0.8), or large (> 0.8). RESULTS A total of 11,442 studies were found; 30 studies were contained in the systematic review and 20 studies were included in the meta-analysis. Compared with healthy controls, those with unilateral CAI presented weak to moderate impairments in their uninjured limbs in static balance with eyes open (SMD = 0.32, 95% CI: 0.08 to 0.56), functional performance (SMD = 0.37; 95% CI: 0.08 to 0.67), kinesthesia (SMD = 0.52; 95% CI: 0.09 to 0.95) and tibialis anterior activation (SMD = 0.60, 95% CI: 0.19 to 1.01). There were no significant differences in other comparisons between the uninjured limb and healthy controls. CONCLUSIONS Patients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinaesthesia. However, further evidence is required to confirm this point due to limited studies included in some analyses and small effect size. REGISTRATION The protocol was registered in the International Prospective Register of Systematic Reviews platform (CRD: 42,022,375,855).
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Affiliation(s)
- Xiaomei Hu
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Tianyi Feng
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Pan Li
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Jingjing Liao
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Ministry of Education, Shanghai, China.
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Rhim HC, Schon JM, Xu R, Nolan D, Ahn J, Short K, Schon LC. Prehabilitation for Patients Undergoing Elective Foot and Ankle Surgery: A Contemporary Review. FOOT & ANKLE ORTHOPAEDICS 2024; 9:24730114241255136. [PMID: 38812567 PMCID: PMC11135079 DOI: 10.1177/24730114241255136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA, USA
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Jason M. Schon
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Raylin Xu
- Harvard Medical School, Boston, MA, USA
| | - David Nolan
- Department of Physical Therapy, Movement, and Rehabilitation Science, Northeastern University, Boston, MA, USA
- Sports Physical Therapy Service, Massachusetts General Hospital, Boston, MA, USA
| | - Jiyong Ahn
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
- Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kelly Short
- Center for Restorative Therapies, Mercy Medical Center, Baltimore, MD, USA
| | - Lew C. Schon
- Director of Orthopaedic Innovation, Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA
- Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, New York University Langone Health, NY, USA
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Liu Y, Dong S, Wang Q, Liu Z, Song Q, Shen P. Deficits in proprioception and strength may contribute to the impaired postural stability among individuals with functional ankle instability. Front Physiol 2024; 15:1342636. [PMID: 38496300 PMCID: PMC10941841 DOI: 10.3389/fphys.2024.1342636] [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: 11/22/2023] [Accepted: 02/12/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose: The correlations of postural stability with proprioception and strength may explain the recurrent sprains among individuals with functional ankle instability (FAI). This study aimed to compare anterior-posterior (AP) and medial-lateral (ML) postural stability, along with ankle proprioception and strength between individuals with and without FAI and investigated their correlations. Methods: Forty participants with FAI and another 40 without FAI were recruited. Their postural stability, represented by time to stabilization (TTS) in the AP (TTSAP) and ML (TTSML) directions, was calculated by the ground reaction force during jumping onto a force plate. Their ankle proprioception and strength during plantarflexion/dorsiflexion and inversion/eversion were measured using a proprioception device and a strength testing system, separately. Results: Individuals with FAI had longer TTSAP (p = 0.015) and TTSML (p = 0.006), larger ankle proprioception thresholds (p = 0.000-0.001), and less strength (p = 0.001-0.017) than those without FAI. Correlations between strength and TTSAP were detected among individuals with (ankle plantarflexion, r = -0.409, p = 0.009) and without FAI (ankle plantarflexion, r = -0.348, p = 0.028; ankle dorsiflexion, r = -0.473, p = 0.002). Correlations of proprioception (ankle inversion, r = 0.327, p = 0.040; ankle eversion, r = 0.354, p = 0.025) and strength (ankle eversion, r = -0.479, p = 0.002) with TTSML were detected among individuals without FAI but not among those with FAI. Conclusion: Individuals with FAI have worse postural stability and proprioception and less strength. Their proprioception and strength decreased to a point where they could not provide sufficient functional assistance to the ML postural stability. Improvements in proprioception and strength may be keys to prevent recurrent ankle sprains among individuals with FAI.
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Affiliation(s)
- Yanhao Liu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Shiyu Dong
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Qi Wang
- College of Sports Human Sciences, Beijing Sport University, Beijing, China
| | - Ziyin Liu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Peixin Shen
- College of Sports and Health, Shandong Sport University, Jinan, China
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Cerbezer N, Çil ET, Subaşı F. The effect of neuromuscular and vestibular-ocular reflex training program on balance, isokinetic muscle strength and proprioception in people with chronic ankle instability. Foot (Edinb) 2023; 56:101992. [PMID: 36913763 DOI: 10.1016/j.foot.2023.101992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/15/2023]
Abstract
OBJECTIVE This study aimed to compare and investigate the effectiveness of neuromuscular exercise combined with vestibular-ocular reflex training and only neuromuscular exercise training on balance, isokinetic muscle strength, and proprioception in chronic ankle instability (CAI). METHOD The study included 20 patients with unilateral CAI. The functional status was evaluated with the Foot and Ankle Ability Measure (FAAM). The star-excursion balance test was used for dynamic balance, and the joint position sense test assessed proprioception. Ankle concentric muscle strength was measured by an isokinetic dynamometer. The subjects were randomly divided into neuromuscular and vestibular-ocular reflex training (VOG, n = 10) and neuromuscular training group (NG, n = 10). Both rehabilitation protocols were applied for four weeks. RESULTS Although VOG had higher means of all parameters, no superiority was found between the two groups in post-treatment results. However, the VOG significantly improved FAAM scores at the sixth-month follow-up than NG (P < .05). In the linear regression analysis, the post-treatment proprioception inversion-eversion for unstable side and FAAM- S were found to be independent factors of FAAM-S scores at the six months follow -up in VOG. Post-treatment isokinetic strength for inversion of unstable side (120 º /s) and FAAM- S were determined as predictor factors of FAAM- S scores at the six months follow -up (p < .05) in NG. CONCLUSION The Neuromuscular combined with vestibular-ocular reflex training protocol effectively managed unilateral CAI. Furthermore, it may be considered an effective strategy for clinical outcomes for a long-term period in terms of functional status.
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Affiliation(s)
- Nilüfer Cerbezer
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Elif Tuğçe Çil
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
| | - Feryal Subaşı
- Yeditepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
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Shi X, Ganderton C, Tirosh O, Adams R, Ei-Ansary D, Han J. Test-retest reliability of ankle range of motion, proprioception, and balance for symptom and gender effects in individuals with chronic ankle instability. Musculoskelet Sci Pract 2023; 66:102809. [PMID: 37354602 DOI: 10.1016/j.msksp.2023.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To determine the reliability of the commonly used musculoskeletal assessments in individuals with chronic ankle instability (CAI). DESIGN Within and between-days test-retest reliability. SETTING University laboratory. PARTICIPANTS Twenty-four individuals with unilateral CAI. METHOD For both sides, ankle dorsiflexion range of motion (DFROM) was assessed by a goniometer and weight-bearing lunge test (WBLT), proprioception by the active movement extent discrimination apparatus (AMEDA), and balance by the Star Excursion Balance Test with anterior (SEBTA), posteromedial (SEBTPM) and posterolateral (SEBTPL) components. All measures were taken at enrollment, after 30 min and one week later. RESULTS For the asymptomatic side, all assessments demonstrated good to excellent reliability, with ICCs (3,1) between 0.8 and 0.96. On the symptomatic side, WBLT, SEBTA and SEBTPM showed excellent reliability, with ICCs (3,1) above 0.90, while SEBTPL, goniometer and AMEDA showed moderate reliability, with the 95% CI of the ICCs (3,1) crossing 0.5. Three-way repeated measures ANOVA showed a side main effect, with asymptomatic worse, for WBLT (F = 16.9, p < 0.001) and SEBTA (F = 5.4, p = 0.03); an overall improving time main effect for SEBTPL (F = 6.9, p = 0.02). Neither a gender main effect nor any interaction effect was found. CONCLUSIONS WBLT, SEBTA and SEBTPM can be strongly recommended for measuring ankle dorsiflexion mobility and dynamic balance for both sides of individuals with unilateral CAI, while only WBLT can be used for side-to-side comparison. The application of a goniometer to measure DFROM, SEBTPL or AMEDA should be done cautiously for this specific cohort, considering their poor to good reliability for the symptomatic side.
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Affiliation(s)
- Xiaojian Shi
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China.
| | - Charlotte Ganderton
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia; College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Oren Tirosh
- School of Health Science, Swinburne University of Technology, Hawthorn, 3122, Victoria, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia
| | - Doa Ei-Ansary
- School of Biomedical Science and Health, Royal Melbourne Institute of Technology University, Bundoora, 3083, Victoria, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China; School of Exercise and Health, Shanghai University of Sport, Shanghai, 200090, China; Research Institute for Sport and Exercise, University of Canberra, ACT2600, Australia.
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Lee H, Han S, Son SJ, Seeley MK, Hopkins JT. Disrupted vision impairs force steadiness and accuracy in chronic ankle instability patients. J Orthop Res 2023; 41:1729-1737. [PMID: 36694291 DOI: 10.1002/jor.25522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/02/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
The primary purpose of this study was to examine the effect of visual disruption on submaximal force steadiness and accuracy among three groups including chronic ankle instability (CAI) patients, lateral ankle sprain copers, and healthy controls. Twenty patients with CAI, 20 copers, and 20 matched-healthy controls volunteered to participate in the study. Submaximal force steadiness and accuracy for evertors, invertors, and hip abductors (10% and 20% of their maximal voluntary isometric contraction) were measured with an isokinetic dynamometer. All groups performed the tasks with and without stroboscopic glasses. The CAI group showed worse steadiness and accuracy in evertors with visual disruption compared to nonvisual disruption (p < 0.0001 and = 0.02, respectively). Relative to the control group, the CAI group showed worse force steadiness and accuracy in evertors (p < 0.0001, both), worse force accuracy in hip abductors (p = 0.02), and the coper group also showed worse accuracy in evertors (p = 0.02). Individuals with CAI demonstrated impaired force steadiness and accuracy in evertors and hip abductors compared to healthy controls. In addition, they tended to rely more on visual feedback during the force steadiness task than copers and healthy controls.
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Affiliation(s)
- Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - Seunguk Han
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - S Jun Son
- CHA Motion Science Lab, Graduate School of Sports Medicine, CHA University, Seongnam-si, Korea
| | - Matthew K Seeley
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
| | - J Ty Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA
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Li J, Qiu F, Legerlotz K. Cross-cultural adaptation and validation of the Chinese version of the ankle joint functional assessment tool (AJFAT) questionnaire. J Foot Ankle Res 2023; 16:22. [PMID: 37098578 PMCID: PMC10131472 DOI: 10.1186/s13047-023-00622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/11/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Ankle joint functional assessment tool (AJFAT) is gradually becoming a popular tool for diagnosing functional ankle instability (FAI). However, due to the lack of standard Chinese versions of AJFAT and reliability and validity tests, the use of AJFAT in the Chinese population is limited. This study aimed to translate and cross-culturally adapt the AJFAT from English into Chinese, and evaluate the reliability and validity of the Chinese version of AJFAT and to investigate its psychometric properties. METHODS The translation and cross-cultural adaptation of AJFAT was performed according to guidelines for cross-cultural adaptation of self-report measures. 126 participants with a history of ankle sprain completed the AJFAT-C twice within 14 days and completed the Cumberland ankle instability tool (CAIT-C) once. Test-retest reliability, internal consistency, ceiling and floor effects, convergent and structure validity and discriminative ability were investigated. RESULTS The test-retest reliability (ICC = 0.91, 95%CI = 0.87-0.94) and internal consistency (Cronbach's alpha = 0.87) of the AJFAT-C were excellent. No ceiling or floor effects were detected. A moderate correlation between the AJFAT-C and the CAIT-C suggested a moderate convergent validity. The AJFAT-C had a two-factor structure: 1. function of the unstable side of the ankle joint (9 items) and 2. symptoms of the unstable side of the ankle (2 items). The ideal cut-off point of the AJFAT-C was calculated as 26 points. CONCLUSION The Chinese version of AJFAT can be considered as a valid and reliable ankle joint function evaluation tool that can be applied in clinical and research work.
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Affiliation(s)
- Jinfeng Li
- Department of Kinesiology, Iowa State University, Ames, IA, 50011, USA
| | - Fanji Qiu
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter Den Linden 6, 10099, Berlin, Germany.
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter Den Linden 6, 10099, Berlin, Germany
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Proprioceptive exercises and their role in improving static and dynamic joint stability in ankle sprains in handball players. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Wang B, Zhang X, Zhu F, Zhu W, Wang X, Jia F, Chen W, Zhang M. A randomized controlled trial comparing rehabilitation with isokinetic exercises and Thera-Band strength training in patients with functional ankle instability. PLoS One 2022; 17:e0278284. [PMID: 36454876 PMCID: PMC9714719 DOI: 10.1371/journal.pone.0278284] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although muscle strength training is a prevalent treatment for patients with functional ankle instability (FAI), previous investigations on the efficacy have yielded conflicting results. OBJECTIVE This study aims to compare the efficacy of 6-week isokinetic strength training and Thera-Band strength training on improving ankle strength, dynamic balance ability, and function in individuals with FAI. METHODS Fifty-two FAI patients were randomized into two treatment groups: an isokinetic strength training (IST, n = 26) group and a Thera-Band resistance training (TBT, n = 26) group. The IST group engaged in isokinetic concentric strength training with inversion, eversion, dorsiflexion, and plantar flexion, whereas the TBT group engaged in progressive resistance training with Thera-Band three times per week for six weeks. Before and after the training, an isokinetic concentric strength test of the involved ankle joint, Star Excursion Balance Test (SEBT), and Cumberland Ankle Instability Tool (CAIT) function assessment were performed. RESULTS After six weeks of intervention, the strength of inversion and eversion was significantly improved in both the IST and TBT groups (p < 0.05), with the IST group exhibiting a significant (p < 0.05) improvement when compared to the TBT group. The SEBT and CAIT results were significantly (p < 0.05) improved in the IST group compared to the TBT group. CONCLUSIONS The six-week of isokinetic strength training is more effective than the Thera-Band progressive resistance training in improving the physical function of FAI patients. CLINICAL TRIAL REGISTRATION NUMBER This randomized controlled clinical trial has been registered in the China Clinical Trial Registry (ChiCTR2100044444) https://www.google.com/search?client=firefox-b-d&q=ChiCTR2100044444.
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Affiliation(s)
- Bin Wang
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Xi Zhang
- Beijing Sport University, Beijing, China
| | - Feilong Zhu
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Weiwei Zhu
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Xinyu Wang
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Fan Jia
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Wei Chen
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
- * E-mail: (WC); (MZ)
| | - Ming Zhang
- The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou Rehabilitation Hospital, Xuzhou, China
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, The Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
- * E-mail: (WC); (MZ)
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Steinberg N, Tenenbaum G, Witchalls J, Waddington G. The impact of unexpected platform perturbation on ankle proprioception ability in static and dynamic starting positions. Gait Posture 2022; 98:167-172. [PMID: 36137355 DOI: 10.1016/j.gaitpost.2022.09.003] [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: 04/19/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 02/02/2023]
Abstract
AIMS To examine the relationship between ankle proprioception and the ability to maintain balance with increased magnitudes of unexpected perturbations; and to compare the participants' ability to maintain balance following perturbations when starting from static and dynamic positions. METHODS Sixty physical education students (average 24.6 years) were tested for proprioception ability (AUC scores) and balance challenges presented on a perturbation treadmill. The degree at which participants lost postural balance was recorded in seven starting positions: standing-eyes-open (SO), standing-eyes-closed (SC), tandem-dominant (TD), tandem non-dominant, (TND) single-leg lateral side perturbation (SLP), single-leg medial side perturbation (SMP), and walking. Perturbation scores were analysed divided by tertiles. Multidimensional Unfolding SPSS Statistics 25 (PREFSCAL) was used to examine the relationships between data sets. RESULTS AUC scores of both dominant and non-dominant legs were significantly correlated with SO (r = 0.316; r = 0.445), SC (r = 0.364; r = 0.413), TD (r = 0.346; r = 0.308), and walking (r = 0.265; r = 0.439), respectively. In the dominant-leg, AUC scores of individuals with below-median SO scores were significantly worse compared to those with median SO scores (p = .046). In the non-dominant leg, individuals with above-median SC had significantly better AUC scores compared to those with lower-than-median SC (p = .008). Those with median and above-median SO and walking achieved better AUC scores than those with below-median (SO: p = .049, p = .004; walking: p = .016, p < .001, respectively). In dimension I, the SLP and SMP were located opposite one another; in dimension II, the TD and TND were located at the upper side, whereas SC, SO and walking were at the lowest side. CONCLUSIONS AUC scores were significantly correlated with the level at which postural balance was lost, whereby the better the proprioception ability, the better the ability to maintain balance. As such, the ability to maintain balance is harder in tandem positions than in standing and walking positions. This ability differed when perturbations were to the lateral or medial sides.
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Affiliation(s)
- Nili Steinberg
- Wingate College of Physical Education and Sports Sciences, Wingate Institute, Netanya, Israel.
| | - Galit Tenenbaum
- Wingate College of Physical Education and Sports Sciences, Wingate Institute, Netanya, Israel
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Australia
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12
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Dai M, Liu X, Yang L, Wang J, Ye F, Zhao H, Duan D, Liu X. Morphologic evaluation of injured and contralateral uninjured ankles in patients with unilateral chronic ankle instability. Br J Radiol 2022; 95:20220155. [PMID: 35766941 PMCID: PMC10996958 DOI: 10.1259/bjr.20220155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/12/2022] [Accepted: 06/20/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the morphological anatomy and abnormalities of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in unilateral chronic ankle instability (CAI). METHODS 22 patients (men: women, 13:9; mean age, 28.95 ± 8.127 years) with unilateral CAI and 18 healthy volunteers (men: women, 9:9, mean age, 28.33 ± 3.678 years) were recruited. MRI scans were divided into Group 1 (22 injured ankles), Group 2 (22 contralateral uninjured ankles), and Group 3 (36 healthy volunteer ankles). The morphologic variables, MRI signal intensity (SI) values were evaluated. RESULTS The ATFL proximal, intermediate, and distal sites and the CFL proximal and distal sites in Group 3 were narrower than those in Group 1 (P <0.05). Both ATFL and CFL in Group 1 were thicker than those in Group 3 (P <0.01). The proximal and intermediate sites of the ATFL and the proximal site of the CFL in Group 3 were narrower than those in Group 2 (P <0.01). The intermediate site of the ATFL and the proximal and distal sites of the CFL in Group 2 were thicker than those in Group 3 (P <0.01). The mean SI values of the ATFL in Group 1 were higher than those in Groups 2 and 3 (P <0.01). The ATFL and CFL SI values were higher in Group 2 than those in Group 3 (P <0.05). CONCLUSION Both the injured and contralateral uninjured ankles had wider ATFL and CFL, more thickness, and higher SI values compared with those of healthy volunteer ankles. ADVANCES IN KNOWLEDGE High-resolution three-dimensional MRI provides a potential tool assisting clinical decision on the treatment and rehabilitation therapy of patients with unilateral CAI.
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Affiliation(s)
- Meng Dai
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
| | - Jiazheng Wang
- MSC Clinical & Technical Solutions, Philips
Healthcare, Beijing,
China
| | - Fang Ye
- Department of Occupational and Environmental Health and
Ministry of Education Key Lab for Environment and Health, School of
Public Health, Tongji Medical College, Huazhong University of Science
and Technology, Wuhan,
China
| | - Hu Zhao
- Department of Human Anatomy, School of Basic Medicine, Tongji
Medical College, Huazhong University of Science and
Technology, Wuhan,
China
| | - Deyu Duan
- Department of Orthopaedics, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Xi Liu
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
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13
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Derby H, Conner NO, Talukder A, Griffith A, Freeman C, Burch R, Simpson JD, Goble DJ, Knight AC, Chander H. Impact of Sub-Clinical and Clinical Compression Socks on Postural Stability Tasks among Individuals with Ankle Instability. Healthcare (Basel) 2022; 10:healthcare10071271. [PMID: 35885797 PMCID: PMC9323572 DOI: 10.3390/healthcare10071271] [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: 06/21/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Compression socks are used by a very diverse group of individuals and may potentially have a greater impact on physically diminished or impaired individuals as opposed to healthy individuals. The purpose of this study was to compare the effects of sub-clinical (SC) and clinical (CL) compression socks among healthy (CON), copers (COP), and individuals with chronic ankle instability (CAI). Postural stability was evaluated in 20 participants (11 males and 9 females) using Balance Tracking System Balance platform (BTrackS™) during the modified clinical test of sensory integration in balance (mCTSIB) and limits of stability (LOS) tests. Postural sway parameters were analyzed using a mixed model repeated measures analysis of variance 3 (group: CON, COP, and CAI) by 3 (compression condition: BF, SC, and CL) × 4 (balance condition: EO, EC, EOF, and ECF) for mCTSIB and a 3 (group: CON, COP, and CAI) by 3 (compression condition: BF, SC, CL) × 4 (balance condition: FL, BL, BR, FR) for LOS. Results revealed significantly greater postural stability with both SC and CL compression socks when compared to barefoot conditions. However, no significant differences were observed among groups for compression socks grades. Both SC and CL compression socks may be effective in increasing postural stability.
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Affiliation(s)
- Hunter Derby
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Starkville, MS 39762, USA; (A.G.); (A.C.K.); (H.C.)
- Correspondence:
| | - Nathan O. Conner
- Department of Human Movement Science, Oakland University, Rochester, MI 48309, USA; (N.O.C.); (D.J.G.)
| | - Amit Talukder
- Department of Human Sciences, Mississippi State University, Starkville, MS 39762, USA; (A.T.); (C.F.)
| | - Aaron Griffith
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Starkville, MS 39762, USA; (A.G.); (A.C.K.); (H.C.)
| | - Charles Freeman
- Department of Human Sciences, Mississippi State University, Starkville, MS 39762, USA; (A.T.); (C.F.)
| | - Reuben Burch
- Department of Industrial and Systems Engineering, Mississippi State University, Starkville, MS 39762, USA;
- Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS 39759, USA
| | - Jeffrey D. Simpson
- Sports Medicine & Neuromechanics Laboratory, Department of Movement Sciences and Health, University of West Florida, Pensacola, FL 32514, USA;
| | - Daniel J. Goble
- Department of Human Movement Science, Oakland University, Rochester, MI 48309, USA; (N.O.C.); (D.J.G.)
| | - Adam C. Knight
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Starkville, MS 39762, USA; (A.G.); (A.C.K.); (H.C.)
| | - Harish Chander
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Starkville, MS 39762, USA; (A.G.); (A.C.K.); (H.C.)
- Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS 39759, USA
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14
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Alteration of ankle proprioceptive threshold during gait in the presence of acute experimental pain. PLoS One 2022; 17:e0263161. [PMID: 35078205 PMCID: PMC8789182 DOI: 10.1371/journal.pone.0263161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/12/2022] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Human gait requires complex somatosensory processing of various inputs such as proprioception. Proprioception can be altered in the presence of pain. This has been shown mostly during controlled tasks, thereby limiting the influence of external perturbations. While controlling the environment is sometimes warranted, it limits the ecological validity of the data. Using robotic orthoses to apply perturbations during movements seems a promising tool to functionally assess proprioception, where the complex somatosensory processing required in real-life situations is at play. The main objective of this study was to compare the proprioceptive threshold of healthy participants during gait in the presence and absence of an acute experimental pain. METHODS 36 healthy participants walked on a treadmill while wearing a robotized ankle-foot orthosis (rAFO) around their right ankle. The rAFO applied torque perturbations of graded magnitudes during the swing phase of gait. Participants had to report the presence/absence of such perturbations, as a measure of proprioceptive threshold. Following initial assessment, they were randomly assigned to one of three experimental groups: Control (no stimulation), Painless (non-nociceptive stimulation) and Painful (nociceptive stimulation). Electrodes placed on the right lateral malleolus delivered an electrical stimulation during the second assessment for Painless and Painful groups. A Kruskal-Wallis was used to compare the percentage of change of the three groups between the two assessments. RESULTS A 31.80±32.94% increase in proprioceptive threshold, representing an increase of 1.3±1.2 Nm in the detection threshold, was observed for the Painful group only (p<0.005), with an effect size of 1.6. CONCLUSION Findings show that the presence of pain at the ankle can alter participants' proprioceptive threshold during gait. Clinical assessment of proprioception should therefore carefully consider the presence of pain when evaluating a patient's performance using clinical proprioceptive test and consider the negative effect of pain on proprioceptive threshold for test interpretation.
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15
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Song K, Jang J, Nolte T, Wikstrom EA. Dynamic reach deficits in those with chronic ankle instability: A systematic review and meta-analysis. Phys Ther Sport 2021; 53:40-50. [PMID: 34808538 DOI: 10.1016/j.ptsp.2021.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this review with meta-analyses was to determine the dynamic reach differences 1) between chronic ankle instability (CAI) and uninjured individuals, 2) between the limbs of an individual with CAI, and 3) between the uninvolved CAI limb and the healthy control limb across all possible reach directions of the Star Excursion Balance Test (SEBT). METHODS PubMed, CINAHL, SPORTDiscus, and Scopus databases were searched up to October 2021. Data were extracted from the retained studies and underwent methodological quality assessment and meta-analysis using random-effect models. RESULTS After screening, 33 articles were included for the analyses. In all possible SEBT reach directions, the CAI group demonstrated significantly decreased normalized dynamic reach distances relative to the uninjured control group (SMDs: -0.66 to -0.48, p ≤ 0.05). Similarly, the involved CAI limb demonstrated significantly decreased normalized dynamic reach distances relative to the uninvolved CAI limb (SMDs: -0.61 to -0.33, p ≤ 0.05). However, no differences were noted between the uninvolved CAI limb and the healthy control limb (SMDs: -0.22 to 0.09, p ≥ 0.13). CONCLUSIONS Our findings were that the involved limb of those with CAI has dynamic postural deficits relative to (i) an uninjured control group and (ii) relative to their uninvolved limb. However, the uninvolved limb of the CAI group does not differ from an uninjured control group in any reach direction.
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Affiliation(s)
- Kyeongtak Song
- Sports Medicine Research Institute, Department of Athletic Training & Clinical Nutrition, University of Kentucky, United States.
| | - Jaeho Jang
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, United States
| | - Tiffanie Nolte
- Department of Health, Athletic Training, Recreation & Kinesiology, Longwood University, United States
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, United States
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16
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Smith MD, Rhodes J, Al Mahrouqi M, MacDonald DA, Vicenzino B. Balance is impaired in symptomatic ankle osteoarthritis: A cross-sectional study. Gait Posture 2021; 90:61-66. [PMID: 34399156 DOI: 10.1016/j.gaitpost.2021.08.002] [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: 12/02/2020] [Revised: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Ankle osteoarthritis (OA) is associated with several physical impairments but investigations into balance impairments in this population are limited. Understanding balance impairments in ankle OA may help inform the management of this condition. RESEARCH QUESTION Does balance overall performance differ between individuals with symptomatic radiographic ankle OA, asymptomatic radiographic ankle OA and healthy controls? Are there any differences in mediolateral or anteroposterior balance, or confidence to perform balance tasks between these groups? METHODS Ninety-six volunteers (31 symptomatic radiographic ankle OA, 41 asymptomatic radiographic ankle OA and 24 healthy controls) completed six static balance tasks: bilateral stance on a firm surface, bilateral stance on foam, and tandem stance, all performed with eyes open and closed. Centre of pressure (COP) data were collected using force plates. Confidence to perform each balance task was collected using an 11-point numerical rating scale. RESULTS Compared to controls, participants with symptomatic radiographic ankle OA had greater COP area when standing on a firm surface, foam and in tandem with eyes closed (all p < 0.05) and greater total COP sway in both firm surface and tandem stance conditions (p < 0.04). Participants with symptomatic ankle OA had greater COP area (p < 0.04) and total COP sway (p = 0.01) than those with asymptomatic ankle OA during tandem stance. Total COP sway and area were similar between asymptomatic ankle OA and control participants. Some differences in mediolateral and anteroposterior balance were identified between groups. Individuals with symptomatic ankle OA had lower confidence to perform the tandem stance eyes closed task compared to controls. SIGNIFICANCE Balance impairments and decreased balance confidence were identified in those with symptomatic radiographic ankle OA compared to asymptomatic individuals with and without radiographic ankle OA. This suggests that balance deficits in ankle OA may be related to symptoms, rather than radiographic evidence of disease.
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Affiliation(s)
- Michelle D Smith
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia.
| | - Jonah Rhodes
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia
| | - Munira Al Mahrouqi
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia; Oman College of Health Sciences, Division of Physiotherapy, Ministry of Health, Muscat, P.O. Box 3720, PC 112, Oman
| | - David A MacDonald
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia; Griffith University, School of Allied Health Sciences, Gold Coast, QLD, 4222, Australia
| | - Bill Vicenzino
- The University of Queensland, School of Health and Rehabilitation Sciences, Division of Physiotherapy, Brisbane, QLD, 4072, Australia
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17
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Park DJ, Kim BJ, Kim YH, Park SY. A three-week intervention emphasized diagonal eccentric contraction on balance and joint position sense and ankle strength in subjects with ankle instability: A randomized controlled trial. J Back Musculoskelet Rehabil 2021; 34:95-101. [PMID: 33104016 DOI: 10.3233/bmr-200058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Problems related to ankle instability, decreased proprioceptive sensation, altered static and dynamic balance abilities are suggested as major representative factors that contribute to the recurrence of ankle sprains. OBJECTIVE To assess the effect of a three-week intervention (intervention emphasizing diagonal eccentric contraction (IEDEC) and intervention of general exercise (IGE)) on static and dynamic balance abilities, ankle strength and joint position sense at pre- and post-intervention, and at two- and three-week post-intervention. METHODS Twenty-five participants with ankle instability, including a history of ankle sprain and recurrent episodes of giving way, were enrolled in the study. They were randomly classified into the IEDEC group (n= 12) and the IGE group (n= 13). Dynamic balance was examined using the Y Balance Test, four-way ankle strength was measured, and the static balance was evaluated using the total displacement of the center of pressure (COP). To identify the joint position error, eversion and inversion of the ankle angle were measured. RESULTS The results revealed significant increases in ankle dynamic stability and strength at two and three weeks post-intervention (p< 0.05). Similarly, the total displacement of the COP differed significantly over time, with a higher COP during the initial measurement than at two and three weeks intervention (p< 0.05) General balance training with IEDEC can improve position sense during ankle inversion (p< 0.05). CONCLUSION General balance training with IEDEC improved the position sense of the inversion. Combined therapeutic intervention, such as with the manual technique, could be a beneficial approach to maximize the treatment effects.
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Affiliation(s)
- Du-Jin Park
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Korea
| | - Byeong-Jo Kim
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dongeui University, Busan, Korea
| | - Yong-Hun Kim
- Department of Physical Therapy, College of Biomedical Science, Masan University, Changwon, Korea
| | - Se-Yeon Park
- Department of Physical Therapy, College of Biomedical Science, Kaya University, Gimhae, Korea
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18
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Chang WD, Chen S, Tsou YA. Effects of Whole-Body Vibration and Balance Training on Female Athletes with Chronic Ankle Instability. J Clin Med 2021; 10:jcm10112380. [PMID: 34071325 PMCID: PMC8198174 DOI: 10.3390/jcm10112380] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
We explored the effects of 6-week whole-body vibration (WBV) and balance training programs on female athletes with chronic ankle instability (CAI). This randomized controlled study involved female athletes with dominant-leg CAI. The participants were randomly divided into three groups: WBV training (Group A), balance training (Group B), and nontraining (control group; Group C). Groups A and B performed three exercise movements (double-leg stance, one-legged stance, and tandem stance) in 6-week training programs by using a vibration platform and balance ball, respectively. The Star Excursion Balance Test (SEBT), a joint position sense test, and an isokinetic strength test were conducted. In total, 63 female athletes with dominant-leg CAI were divided into three study groups (all n = 21). All of them completed the study. We observed time-by-group interactions in the SEBT (p = 0.001) and isokinetic strength test at 30°/s of concentric contraction (CON) of ankle inversion (p = 0.04). Compared with the control group, participants of the two exercise training programs improved in dynamic balance, active repositioning, and 30°/s of CON and eccentric contraction of the ankle invertor in the SEBT, joint position sense test, and isokinetic strength test, respectively. Furthermore, the effect sizes for the assessed outcomes in Groups A and B ranged from very small to small. Female athletes who participated in 6-week training programs incorporating a vibration platform or balance ball exhibited very small or small effect sizes for CAI in the SEBT, joint position sense test, and isokinetic strength test. No differences were observed in the variables between the two exercise training programs.
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Affiliation(s)
- Wen-Dien Chang
- Department of Sport Performance, National Taiwan University of Sport, Taichung 404401, Taiwan;
| | - Shuya Chen
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan;
| | - Yung-An Tsou
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 40402, Taiwan
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung 41354, Taiwan
- Correspondence: ; Tel.: +886-4-2205-3366
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19
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Zhang R, Zhang X, Chen Y, Song W. Current perception threshold testing in chronic ankle instability. BMC Musculoskelet Disord 2021; 22:453. [PMID: 34006258 PMCID: PMC8132381 DOI: 10.1186/s12891-021-04345-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Damage to sensory input is an underlying pathology of chronic ankle instability (CAI). Therefore, it is necessary to evaluate the sensory function of patients with CAI. The present study quantitatively evaluated sensory nerve function in patients with CAI and healthy controls using current perception threshold (CPT) measurements, as well as the influence of sex, age, and body mass index (BMI) on CPT values and the relations between CPT frequencies. METHODS Fifty-nine subjects with CAI and 30 healthy controls participated in this study. CPT values at the anterior talofibular ligament region were recorded on the injured and uninjured sides in CAI patients and on both sides in the healthy control group. Between group differences were compared. The influence of sex, age and BMI on CPT values was evaluated. Correlations between different frequencies were also studied. RESULTS There were no significant differences in age, sex, height, weight or BMI between the CAI and healthy control groups. The CPT values did not show a significant difference by sex. The CPT values did not significantly correlate with age or BMI. Compared to the control group, the CAI group had significantly higher CPT values on the injured and uninjured sides under 250-Hz and 5-Hz electrical stimuli; the difference between the groups was significant (p < 0.01), and the effect size were large. No significant difference was observed under 2000-Hz stimuli. There were correlations between CPT values at different frequencies (p < 0.01), especially 250 Hz and 5 Hz. CONCLUSION The present study revealed increased sensory thresholds in 250-Hz- and 5-Hz-related sensory nerve fibres in the injured and uninjured ankles of patients with CAI. This increase may indicate dysfunction of A-delta and C fibres. Sex, age and BMI did not significantly impact CPT values. There were correlations between CPT values at different frequencies, especially 250 Hz and 5 Hz. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Ran Zhang
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, 45 Changchunjie, Beijing, 100054 China
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Xi Zhang
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Yaping Chen
- Department of Rehabilitation, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing, 100730 China
| | - Weiqun Song
- Department of Rehabilitation, Xuanwu Hospital, Capital Medical University, 45 Changchunjie, Beijing, 100054 China
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20
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Lee H, Son SJ, Kim H, Han S, Seeley M, Hopkins JT. Submaximal Force Steadiness and Accuracy in Patients With Chronic Ankle Instability. J Athl Train 2021; 56:454-460. [PMID: 33150436 DOI: 10.4085/15-20] [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: 12/26/2022]
Abstract
CONTEXT Patients with chronic ankle instability (CAI) have demonstrated sensorimotor impairments. Submaximal force steadiness and accuracy measure sensory, motor, and visual function via a feedback mechanism, which helps researchers and clinicians comprehend the sensorimotor deficits associated with CAI. OBJECTIVE To determine if participants with CAI experienced deficits in hip and ankle submaximal force steadiness and accuracy compared with healthy control participants. DESIGN Case-control study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-one patients with CAI and 21 uninjured individuals. MAIN OUTCOME MEASURE(S) Maximal voluntary isometric contraction (MVIC) and force steadiness and accuracy (10% and 30% of MVIC) of the ankle evertors and invertors and hip abductors were assessed using the central 10 seconds (20%-87% of the total time) of the 3 trials. RESULTS Relative to the control group, the CAI group demonstrated less accuracy of the invertors (P < .001). Across all motions, the CAI group showed less steadiness (P < .001) and less accuracy (P < .01) than the control group at 10% of MVIC. For MVIC, the CAI group displayed less force output in hip abduction than the uninjured group (P < .0001). CONCLUSIONS Patients with CAI were unable to control ongoing fine force (10% and 30% of MVIC) through a feedback mechanism during an active test. These findings suggested that deficits in sensorimotor control predisposed patients with CAI to injury positions because they had difficulty integrating the peripheral information and correcting their movements in relation to visual information.
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Affiliation(s)
- Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - S Jun Son
- Graduate School of Sports Medicine, CHA University, Seongnam-si, Korea
| | - Hyunsoo Kim
- Department of Kinesiology, West Chester University, PA
| | - Seunguk Han
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - Matthew Seeley
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - J Ty Hopkins
- Department of Exercise Sciences, Brigham Young University, Provo, UT
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21
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Ankle and foot mechanics in individuals with chronic ankle instability during shod walking and barefoot walking: A cross-sectional study. Chin J Traumatol 2021; 24:174-179. [PMID: 33757697 PMCID: PMC8173573 DOI: 10.1016/j.cjtee.2021.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/28/2021] [Accepted: 02/12/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE This study evaluated the angular kinematic and moment of the ankle and foot during shod walking and barefoot walking in individuals with unilateral chronic ankle instability (CAI). METHODS Recreational soccer players with unilateral CAI were recruited for this cross sectional study conducted between January and August 2019. A total of 40 participants were screened for eligibility but only 31 met the inclusion criteria based on the methods of Delahunt et al and Gribble et al. Except for 3 participants not attending the evaluation session, 28 participants were finally included. A three dimensional motion analysis system made up of ProReflex motion capture unit and an AMTIb Kistler force plate, embedded in the middle of nine meter walkway, were used to assess the ankle and foot angles and moment during shod walking and barefoot walking conditions. A Statistical Package for Social Sciences (version 20.0) was used to analyze data. RESULTS During shod walking, the ankle joint plantar-flexion range of motion (ROM) at 10% of the gait cycle (GC) and dorsiflexion ROM at 30% of the GC were significantly higher than those during barefoot walking for both feet (p = 0.001, 0.001, 0.027, and 0.036 respectively). The inversion ROM during shod walking was significantly higher than that during barefoot walking for both feet at 10% and 30% of the GC (p = 0.001. 0.001, 0.001, and 0.042 respectively). At 10% of the GC, the eversion moment was significantly higher between barefoot and shod walking for both feet (both p = 0.001). At 30% of the GC, there was no significant difference between shod and barefoot walking plantar-flexion moment of both feet (p = 0.975 and 0.763 respectively), and the eversion moment of both feet (p = 0.116 and 0.101 respectively). CONCLUSION At the early stance, shod walking increases the ankle plantar-flexion and foot inversion ROM, and decreases the eversion moment for both feet in subjects with unilateral CAI. Therefore, the foot wearing condition should be considered during evaluation of ankle and foot kinematics and kinetics.
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22
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Recent Ankle Injury, Sport Participation Level, and Tests of Proprioception. J Sport Rehabil 2021; 28:824-830. [PMID: 30300059 DOI: 10.1123/jsr.2018-0164] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/09/2018] [Accepted: 09/23/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Assessing the effects of ankle injury and sport participation level on ankle proprioceptive sensitivity using a joint position reproduction (JPR) test and an inversion movement extent discrimination test. DESIGN Cross-sectional. SETTING Biomechanics lab. PARTICIPANTS Forty-five student athletes ages 21-30 (mean = 24.8 y). MAIN OUTCOME MEASURES Participants were tested for ankle inversion sensitivity using 2 devices; movement reproduction error was obtained from JPR in a non-weight-bearing (N-WB) state at 10° and 15° of inversion, and an ankle proprioceptive sensitivity score was obtained from the active movement extent discrimination apparatus (AMEDA), representing the ability to differentiate 5 inversion movement extents between 10.5° and 14.5°, with testing in both N-WB and weight-bearing (WB) states. RESULTS For the 34 athletes with no ankle injury in the previous 12 months, the sensitivity scores achieved on the AMEDA were significantly higher (P < .01) than those for the 11 athletes with ankle injury, and the injury effect was significantly greater in WB (P = .01). In JPR testing, the 2.96° error of reproduction for athletes with no recent ankle injury was not significantly different from the 3.36° error for those with ankle injury (P = .46). Correlation of current sport participation level with JPR showed less error for higher-level performers (r = .49, P = .001) but no significant relationship to WB or N-WB AMEDA scores (both P > .61). WB AMEDA scores were significantly higher for athletes who had competed at a higher level of sport competition when <18 years old (r = -.57, P < .001). CONCLUSIONS Previous ankle sprains affected proprioceptive scores on the WB AMEDA and N-WB AMEDA tests, indicating the sensitivity of the AMEDA movement discrimination test to the effects of ankle injury. The correlation between JPR scores and current level of sport participation suggests the sensitivity of the JPR test to current ankle use.
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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: 55] [Impact Index Per Article: 18.3] [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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Xue X, Ma T, Li Q, Song Y, Hua Y. Chronic ankle instability is associated with proprioception deficits: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:182-191. [PMID: 33017672 PMCID: PMC7987558 DOI: 10.1016/j.jshs.2020.09.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/11/2020] [Accepted: 08/10/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Acute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability (CAI). We aimed to explore whether deficits of proprioception, including kinesthesia and joint position sense (JPS), exist in patients with CAI when compared with the uninjured contralateral side and healthy people. We hypothesized that proprioception deficits did exist in patients with CAI and that the deficits varied by test methodologies. METHODS The study was a systematic review and meta-analysis. We identified studies that compared kinesthesia or JPS in patients with CAI with the uninjured contralateral side or with healthy controls. Meta-analyses were conducted for the studies with similar test procedures, and narrative syntheses were undertaken for the rest. RESULTS A total of 7731 studies were identified, of which 30 were included for review. A total of 21 studies were eligible for meta-analysis. Compared with the contralateral side, patients with CAI had ankle kinesthesia deficits in inversion and plantarflexion, with a standardized mean difference (SMD) of 0.41 and 0.92, respectively, and active and passive JPS deficits in inversion (SMD = 0.92 and 0.72, respectively). Compared with healthy people, patients with CAI had ankle kinesthesia deficits in inversion and eversion (SMD = 0.64 and 0.76, respectively), and active JPS deficits in inversion and eversion (SMD = 1.00 and 4.82, respectively). Proprioception deficits in the knee and shoulder of patients with CAI were not statistically significant. CONCLUSION Proprioception, including both kinesthesia and JPS, of the injured ankle of patients with CAI was impaired, compared with the uninjured contralateral limbs and healthy people. Proprioception varied depending on different movement directions and test methodologies. The use of more detailed measurements of proprioception and interventions for restoring the deficits are recommended in the clinical management of CAI.
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Affiliation(s)
- Xiao'ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Tengjia Ma
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qianru Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yujie Song
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Ly K, Michaud L, Lajoie Y. The effects of Kinesiology Tape on static postural control in individuals with functional ankle instability. Phys Ther Sport 2021; 48:146-153. [PMID: 33486407 DOI: 10.1016/j.ptsp.2021.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 01/03/2021] [Accepted: 01/08/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate if applying Kinesiology Tape (KT) on the unstable ankle may improve static postural control in individuals with Functional ankle instability. DESIGN A repeated measured study. Participants performed a series of static quiet bipedal and unipedal stances on a force platform. Measurements were taken at three different times: baseline or no tape, immediately and 24 h after the taping application with the tape remaining on the ankle. SETTING A university's psychomotor laboratory. PARTICIPANTS Twenty young adults with Functional ankle instability aged from 18 to 30 years old. OUTCOME MEASURES Postural control was assessed by four measures derived from the centre of pressure data: Area of 95% Confidence ellipse, standard deviation of displacements, mean velocity and mean power frequency. The analysis of variance (ANOVA) was performed to determine any significant improvement in postural control over time due to KT. RESULTS Only minor changes in mean velocity and MPF in unipedal stances were observed immediately after KT application. However, the overall results indicated statistically insignificant improvements in postural control neither immediately after KT application nor after 24 h. CONCLUSION Results suggest that the use of KT did not affect bipedal and unipedal stances of individuals with functional ankle instability.
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Affiliation(s)
- Kien Ly
- School of Human Kinetics, University of Ottawa, ON, Canada
| | - Lucas Michaud
- School of Human Kinetics, University of Ottawa, ON, Canada
| | - Yves Lajoie
- School of Human Kinetics, University of Ottawa, ON, Canada.
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Bertrand-Charette M, Dambreville C, Bouyer LJ, Roy JS. Systematic review of motor control and somatosensation assessment tests for the ankle. BMJ Open Sport Exerc Med 2020; 6:e000685. [PMID: 32655878 PMCID: PMC7342858 DOI: 10.1136/bmjsem-2019-000685] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 12/26/2022] Open
Abstract
Background/Aim Ankle sprains are frequent musculoskeletal injuries that can lead to sensorimotor deficits provoking long-term instability at the ankle joint. A broad variety of clinical tests currently exist to assess sensorimotor processing, and are commonly clinically referred to as proprioceptive tests. However, there is a discrepancy in the use of the term proprioception when looking at the main outcome of these tests. As identifying specific deficits is important for motor recovery, it is critical for clinicians to select the most appropriate tests. Methods A systematic review of four databases was performed to provide an up-to-date review of the psychometric properties of available tests referred to as proprioceptive tests. Seventy-nine articles on eight ankle proprioceptive tests were included and critically appraised. Data on validity, reliability and responsiveness were extracted from the included articles and synthesised. The tests reviewed were then divided into two categories based on their main outcome: motor control or somatosensation. Results Strong evidence showed that the Star Excursion Balance Test, a motor control test, is capable of differentiating between stable and unstable ankles. Moderate evidence suggests that somatosensation tests, such as Joint Position Sense, are also valid and reliable, but their responsiveness has yet to be evaluated. Conclusions Together, these findings indicate that the Star Excursion Balance Test can be used in the clinic to assess motor control based on its excellent psychometric properties. However, as ankle stability control involves complex sensorimotor interactions, care has to be taken regarding the use of this test as a specific tool for proprioception assessment.
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Affiliation(s)
- Michaël Bertrand-Charette
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
| | - Charline Dambreville
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
| | - Laurent J Bouyer
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada
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Do Grade II Ankle Sprains Have Chronic Effects on the Functional Ability of Ballet Dancers Performing Single-Leg Flat-Foot Stance? An Observational Cross-Sectional Study. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app10010155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Ballet dancers have a higher risk than the general population of ankle sprains. Ankle proprioception is of the utmost importance for executing static and dynamic positions typical of ballet dancing. Ankle sprains can create changes in functional ability that may affect ballet performance. The aim of this cross-sectional observational study is to evaluate if non-professional ballet dancers that were previously injured with a grade II ankle sprain carry a long-term stability deficit in ballet specific positions (passé, arabesque) and in single-leg flat-foot stance, thereby affecting ballet performance. We enrolled 22 amateur female ballet dancers, 11 who previously had a grade II ankle injury and 11 who had no history of ankle injury. Stabilometric data (Center of Pressure Speed and Elipse Area) were assessed with the postural electronic multisensory baropodometer in normal, arabesque, and passè positions with both open and closed eyes. Using an unpaired t-test, we compared healthy and pathological feet of the ankle injury group for a standard monopodalic position and two ballet-specific positions. No difference between pathological and healthy feet of non-professional ballet dancers who suffered grade II ankle injury was detected. According to the parameters considered in this study, grade II ankle sprains seem to have a favorable prognosis in the sample that we evaluated.
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Different Cleat Models Do Not Influence Side Hop Test Performance of Soccer Players with and Without Chronic Ankle Instability. J Hum Kinet 2019; 70:156-164. [PMID: 31915485 PMCID: PMC6942480 DOI: 10.2478/hukin-2019-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The lateral ankle sprain is one of the most common sport injury, representing 10-30% of all musculoskeletal disorders. The lateral ankle sprain is induced by sport gestures involving changes of direction and landing manoeuvres and constitutes a risk factor for the occurrence of chronic ankle instability. Although cleat models and performance have been already explored, no study has evaluated this relationship in athletes with chronic ankle instability. Therefore, the purpose of the study was to analyse the influence of different soccer cleat models on Side Hop Test performance of athletes with and without chronic ankle instability. Thirty-nine athletes were divided into two groups, a chronic ankle instability group (n = 20) and a healthy group (n = 19). Each participant performed the Side Hop Test, executing 10 consecutive jumps on dry artificial grass with 4 cleat models. The Qualisys System and two force platforms were used to analyse the test runtime, the distance travelled and the mean velocity. No statistically significant interaction was observed between the group and the cleat model for all variables evaluated. In addition, no differences were observed between models or groups. In this specific test, performance does not seem to be influenced by different cleat models on dry artificial grass in athletes with and without chronic ankle instability.
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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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Sousa ASP, Valente I, Pinto A, Santos R. Reliability of two methods for identifying the timing of medium latency responses in subjects with and without chronic ankle instability. Sci Rep 2019; 9:3115. [PMID: 30816323 PMCID: PMC6395691 DOI: 10.1038/s41598-019-40073-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/29/2019] [Indexed: 11/09/2022] Open
Abstract
This study aims to: (1) to compare 2 methods of assessing the timing of medium latency responses (MLR), in regard to intrasession reliability and mean values, in subjects with and without chronic ankle instability (CAI), and (2) to analyze the influence of CAI in timing of MLR and in its reliability. Thirty six athletes with (16) and without (20) CAI participated. Bilateral electromyography of peroneus longus (PL), peroneus brevis (PB), tibialis anterior (TA) and soleus (SOL) muscles was collected during a unilateral sudden inversion perturbation to assess the timing of MLR onset, in both standing and perturbed positions, through a baseline-based method and a peak-response-based method. The group without CAI presented higher relative reliability of SOL and peroneal muscles MLR with the peak response-based method than with the baseline-based method. Compared with the group without CAI and in both methods, the group with CAI presented a delayed and less reliable TA MLR, as well decreased coefficient variation of PL MLR in the uninjured limb. In conclusion, regardless of the method subjects with CAI present delayed and less reliable TA MLR while in subjects without CAI the peak response-based method provides higher reliability.
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Affiliation(s)
- Andreia S P Sousa
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal.
| | - Isabel Valente
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
| | - Ana Pinto
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
| | - Rubim Santos
- Área Científica de Física, Escola Superior de Saúde do Porto, Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
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Sousa ASP. Antagonist co-activation during short and medium latency responses in subjects with chronic ankle instability. J Electromyogr Kinesiol 2018; 43:168-173. [PMID: 30352387 DOI: 10.1016/j.jelekin.2018.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/27/2018] [Accepted: 10/14/2018] [Indexed: 01/27/2023] Open
Abstract
PURPOSE This study aims to evaluate bilateral ankle antagonist co-activation during compensatory postural responses, including short latency responses (SLR) and medium latency responses (MLR), in response to a unilateral sudden ankle inversion in subjects with chronic ankle instability (CAI). METHODS Twenty-four participants with CAI and 20 controls participated in the present study. Bilateral eletromyography of peroneus longus (PL), peroneus brevis (PB), tibialis anterior (TA) and soleus (SOL) muscles was collected during a unilateral sudden inversion perturbation (30°) to assess antagonist co-activation of SOL/TA and TA/P pairs during SLR and MLR in both support and perturbed positions. RESULTS Compared to control group, participants with CAI presented: (1) bilateral increased antagonist co-activation of SOL/TA MLR in the support position; and (2) decreased antagonist co-activation of TA/P MLR of uninjured limb in the support position and of injured limb in the perturbed position. CONCLUSIONS CAI involves deregulation of ankle antagonist co-activation of MLR in both injured and uninjured limbs.
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Affiliation(s)
- Andreia S P Sousa
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.
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Sousa ASP, Valente I, Pinto A, Soutelo T, Silva M. Short and Medium Latency Responses in Participants With Chronic Ankle Instability. J Athl Train 2018; 53:679-686. [PMID: 30095302 DOI: 10.4085/1062-6050-120-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT The determinant role of medium latency responses (MLRs) during compensatory postural adjustments in postural stability and the lack of clarity about the mechanisms behind chronic ankle instability (CAI) sustain the hypothesis that these postural responses are impaired in this condition. However, to the best of our knowledge, no authors have assessed MLRs in patients with CAI; most of the research regarding compensatory postural adjustments has been directed at the timing of short latency responses (SLRs). OBJECTIVE To evaluate bilateral compensatory postural responses, including SLRs and MLRs, in response to a unilateral simulated ankle-sprain mechanism in participants with CAI. DESIGN Case-control study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-four participants with CAI and 20 controls. INTERVENTION(S) Bilateral electromyography of the peroneus longus (PL), peroneus brevis, tibialis anterior (TA), and soleus (SOL) muscles was collected during a unilateral sudden-inversion perturbation (30°). MAIN OUTCOME MEASURE(S) Muscle-onset activations and magnitudes of SLRs and MLRs in the support and perturbed positions. RESULTS Participants with CAI showed (1) later-onset activation of the TA and SOL in the uninjured limb and bilateral decreases in the magnitude of the TA MLR in the support position, (2) increased magnitude of the PL MLR in the uninjured limb in the support and perturbed positions, and (3) increased magnitude of the PL SLR and MLR in the injured limb in the perturbed position. CONCLUSIONS Chronic ankle instability was associated with later TA and SOL activation in the uninjured limb and bilaterally decreased magnitude of the TA MLR in the support position.
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Affiliation(s)
- Andreia S P Sousa
- Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Investigação em Reabilitação-Centro de Estudos de Movimento e Actividade Humana, Portugal
| | - Isabel Valente
- Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Investigação em Reabilitação-Centro de Estudos de Movimento e Actividade Humana, Portugal
| | - Ana Pinto
- Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Investigação em Reabilitação-Centro de Estudos de Movimento e Actividade Humana, Portugal
| | - Tiago Soutelo
- Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Investigação em Reabilitação-Centro de Estudos de Movimento e Actividade Humana, Portugal
| | - Márcia Silva
- Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Investigação em Reabilitação-Centro de Estudos de Movimento e Actividade Humana, Portugal
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Sousa ASP, Silva M, Gonzalez S, Santos R. Bilateral compensatory postural adjustments to a unilateral perturbation in subjects with chronic ankle instability. Clin Biomech (Bristol, Avon) 2018; 57:99-106. [PMID: 29966961 DOI: 10.1016/j.clinbiomech.2018.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 05/03/2018] [Accepted: 06/23/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND To evaluate the magnitude of bilateral compensatory postural adjustments in response to a unilateral sudden inversion perturbation in subjects with chronic ankle instability. METHODS 24 athletes with chronic ankle instability (14 with functional ankle instability, 10 with mechanical ankle instability) and twenty controls participated in this study. The bilateral electromyography of ankle muscles was collected during a unilateral sudden ankle inversion to assess the magnitude of subcortical and voluntary compensatory postural adjustments in both the perturbed and the contralateral limb (support limb). FINDINGS In the support position, compared to the control group, the group with functional ankle instability presented decreased compensatory postural adjustments of the tibialis anterior in both the injured and the uninjured limbs in the support position and of the soleus in the uninjured limb. In the side of the perturbation, participants with functional ankle instability presented decreased soleus compensatory postural adjustments in the uninjured limb when compared to the control group. Increased values of soleus and peroneal brevis compensatory postural adjustments were observed in the group with mechanical instability when compared to the control group and to the group with functional ankle instability. INTERPRETATION Subjects with functional ankle instability present bilateral impairment of compensatory postural adjustments of the tibialis anterior in a support position and of the soleus of the uninjured limb regardless of the position. Subjects with mechanical instability present bilateral increase of these adjustments in the peroneal brevis regardless of the position and in the soleus muscle in the side of the perturbation.
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Affiliation(s)
- Andreia S P Sousa
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.
| | - Márcia Silva
- Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
| | - Samuel Gonzalez
- Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
| | - Rubim Santos
- Área Científica de Física, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Investigação em Reabilitação - Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.
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Yahya A, von Behren T, Levine S, Dos Santos M. Pinch aperture proprioception: reliability and feasibility study. J Phys Ther Sci 2018; 30:734-740. [PMID: 29765192 PMCID: PMC5940484 DOI: 10.1589/jpts.30.734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 01/09/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To establish the reliability and feasibility of a novel pinch aperture device to measure proprioceptive joint position sense. [Subjects and Methods] Reliability of the pinch aperture device was assessed in 21 healthy subjects. Following familiarization with a 15° target position of the index finger and thumb, subjects performed 5 trials in which they attempted to actively reproduce the target position without visual feedback. This procedure was repeated at a testing session on a separate date, and the between-session intraclass correlation coefficient (ICC) was calculated. In addition, extensor tendon vibration was applied to 19 healthy subjects, and paired t-tests were conducted to compare performance under vibration and no-vibration conditions. Pinch aperture proprioception was also assessed in two individuals with known diabetic neuropathy. [Results] The pinch aperture device demonstrated excellent reliability in healthy subjects (ICC 0.88, 95% confidence interval 0.70-0.95). Tendon vibration disrupted pinch aperture proprioception, causing subjects to undershoot the target position (18.1 ± 2.6° vs. 14.8° ± 0.76, p<0.001). This tendency to undershoot the target position was also noted in individuals with diabetic neuropathy. [Conclusion] This study describes a reliable, feasible, and functional means of measuring finger proprioception. Further research should investigate the assessment and implications of pinch aperture proprioception in neurological and orthopedic populations.
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Affiliation(s)
- Abdalghani Yahya
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Timothy von Behren
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Shira Levine
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Marcio Dos Santos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center: Mail stop 2002, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
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