Segmental Spinal Reflex Adaptations Associated With Chronic Ankle Instability

2008 ◽  
Vol 89 (10) ◽  
pp. 1991-1995 ◽  
Author(s):  
JoEllen M. Sefton ◽  
Charlie A. Hicks-Little ◽  
Tricia J. Hubbard ◽  
Mark G. Clemens ◽  
Christopher M. Yengo ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Spinal Reflex

The Immediate Effects of an Anterior-To-Posterior Talar Mobilization on Neural Excitability, Dorsiflexion Range of Motion, and Dynamic Balance in Patients With Chronic Ankle Instability

2014 ◽  
Vol 23 (4) ◽  
pp. 351-359 ◽  
Author(s):  
Matthew Harkey ◽  
Michelle McLeod ◽  
Ashley Van Scoit ◽  
Masafumi Terada ◽  
Michael Tevald ◽  
...  
Keyword(s):  
Postural Control ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Corticospinal Excitability ◽  
Spinal Reflex ◽  
Control Group ◽  
Joint Mobilization ◽  
Grade Iii

Context:Altered neuromuscular function and decreased dorsiflexion range of motion (DFROM) have been observed in patients with chronic ankle instability (CAI). Joint mobilizations are indicated for restoring DFROM and dynamic postural control, yet it remains unknown if a mobilization can alter neuromuscular excitability in muscles surrounding the ankle.Objective:To determine the immediate effects of a Maitland grade III anterior-to-posterior joint mobilization on spinal-reflex and corticospinal excitability in the fibularis longus (FL) and soleus (SOL), DFROM, and dynamic postural control.Design:Single-blinded randomized control trial.Setting:Research laboratory.Patients:30 patients with CAI randomized into a mobilization (n = 15) or control (n = 15) group.Intervention:Maitland grade III anterior-to-posterior joint mobilization.Main Outcome Measures:Spinal-reflex excitability was measured with the Hoffmann reflex, while corticospinal excitability was evaluated with transcranial magnetic stimulation. DFROM was measured seated with the knee extended, and dynamic postural control was quantified with the Star Excursion Balance Test. Separate 2 × 2 repeated-measures ANOVAs were performed for each outcome measure. Dependent t tests were used to evaluate individual differences within groups in the presence of significance.Results:Spinal-reflex and corticospinal excitability of the SOL and FL were not altered in the mobilization or control group (P > .05). DFROM increased immediately after the mobilization (P = .05) but not in the control group, while dynamic postural control was unchanged in both groups (P > .05).Conclusion:A single joint-mobilization treatment was efficacious at restoring DFROM in participants with CAI; however, excitability of spinal reflex and corticospinal pathways at the ankle and dynamic postural control were unaffected.

scholarly journals Changes in Spinal and Corticospinal Excitability in Patients with Chronic Ankle Instability: A Systematic Review with Meta-Analysis

2019 ◽  
Vol 8 (7) ◽  
pp. 1037 ◽  
Author(s):  
Kyung-Min Kim ◽  
Joo-Sung Kim ◽  
David Cruz-Díaz ◽  
Seungho Ryu ◽  
Minsoo Kang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ankle Instability ◽  
Meta Analysis ◽  
Chronic Ankle Instability ◽  
H Reflex ◽  
Corticospinal Excitability ◽  
Spinal Reflex ◽  
Control Group ◽  
Neural Excitability ◽  
Ankle Muscles

The objective of this systematic review with meta-analysis was to determine alterations in spinal and corticospinal excitability of ankle muscles in patients with chronic ankle instability (CAI) compared to uninjured controls. Independent researchers performed comprehensive literature searches of electronic databases and included studies that compared groups with and without CAI and investigated neural excitability with Hoffmann reflex (H-reflex) and/or transcranial magnetic stimulation (TMS). A fixed-effect meta-analysis was conducted to determine group differences for (1) soleus and fibularis maximal H-reflex (Hmax)/maximal M-wave (Mmax)-ratios, and (2) soleus and fibularis longus cortical motor thresholds (CMTs). Seventeen studies were included in the current meta-analysis. They showed that the Hmax/Mmax-ratios of the soleus and the fibularis longus in the CAI group were significantly lower than those in the uninjured control group (soleus: d = −0.41, p < 0.001; fibularis longus: d = −0.27, p = 0.04). There was no evidence for changes in the CMT. This systematic review is the first to demonstrate evidence that patients with CAI present decreased spinal reflex excitability in the soleus and fibularis longus. However, there is no evidence of changes in supraspinal excitability when considering only the CMT. The latter result needs to be interpreted with caution as all except one study demonstrate some changes at the supraspinal level with CAI.

Fibular taping does not alter lower extremity spinal reflex excitability in individuals with chronic ankle instability

2015 ◽  
Vol 25 (2) ◽  
pp. 253-259 ◽  
Author(s):  
Terry L. Grindstaff ◽  
Michael J. Hanish ◽  
Todd J. Wheeler ◽  
Curtis R. Basnett ◽  
Daniel J. Miriovsky ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Spinal Reflex ◽  
Reflex Excitability

scholarly journals Neural Excitability and Joint Laxity in Chronic Ankle Instability, Coper, and Control Groups

2016 ◽  
Vol 51 (4) ◽  
pp. 336-343 ◽  
Author(s):  
Samantha Bowker ◽  
Masafumi Terada ◽  
Abbey C. Thomas ◽  
Brian G. Pietrosimone ◽  
Claire E. Hiller ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Spinal Reflex ◽  
Hoffmann Reflex ◽  
Neural Excitability ◽  
Reflex Excitability ◽  
Total Displacement ◽  
Ankle Arthrometer ◽  
Healthy Control ◽  
And Control

Neuromuscular and mechanical deficiencies are commonly studied in participants with chronic ankle instability (CAI). Few investigators have attempted to comprehensively consider sensorimotor and mechanical differences among people with CAI, copers who did not present with prolonged dysfunctions after an initial ankle sprain, and a healthy control group.Context: To determine if differences exist in spinal reflex excitability and ankle laxity among participants with CAI, copers, and healthy controls.Objective: Case-control study.Design: Research laboratory.Setting: Thirty-seven participants with CAI, 30 participants categorized as copers, and 26 healthy control participants.Patients or Other Participants: We assessed spinal reflex excitability of the soleus using the Hoffmann reflex protocol. Participants' ankle laxity was measured with an instrumented ankle arthrometer. The maximum Hoffmann reflex : maximal muscle response ratio was calculated. Ankle laxity was measured as the total displacement in the anterior-posterior directions (mm) and total rotation in the inversion and eversion directions (°).Main Outcome Measure(s): Spinal reflex excitability was diminished in participants with CAI compared with copers and control participants (P = .01). No differences were observed among any of the groups for ankle laxity.Results: Changes in the spinal reflex excitability of the soleus that likely affect ankle stability were seen only in the CAI group, yet no mechanical differences were noted across the groups. These findings support the importance of finding effective ways to increase spinal reflex excitability for the purpose of treating neural excitability dysfunction in patients with CAI.Conclusion:

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