Impaired control of weight bearing ankle inversion in subjects with chronic ankle instability

2014 ◽  
Vol 29 (4) ◽  
pp. 439-443 ◽  
Author(s):  
R. Terrier ◽  
K. Rose-Dulcina ◽  
B. Toschi ◽  
N. Forestier
Keyword(s):  
Ankle Instability ◽  
Weight Bearing ◽  
Chronic Ankle Instability ◽  
Ankle Inversion ◽  
Impaired Control

scholarly journals People with chronic ankle instability benefit from brace application in highly dynamic change of direction movements

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Patrick Fuerst ◽  
Albert Gollhofer ◽  
Markus Wenning ◽  
Dominic Gehring
Keyword(s):  
Ankle Joint ◽  
Repeated Measures ◽  
Ankle Instability ◽  
Dynamic Change ◽  
Chronic Ankle Instability ◽  
Mechanical Resistance ◽  
Healthy Controls ◽  
Neuromuscular Activation ◽  
Ankle Inversion ◽  
Ankle Brace

Abstract Background The application of ankle braces is an effective method for the prevention of recurrent ankle sprains. It has been proposed that the reduction of injury rates is based on the mechanical stiffness of the brace and on beneficial effects on proprioception and neuromuscular activation. Yet, how the neuromuscular system responds to the application of various types of ankle braces during highly dynamic injury-relevant movements is not well understood. Enhanced stability of the ankle joint seems especially important for people with chronic ankle instability. We therefore aimed to analyse the effects of a soft and a semi-rigid ankle brace on the execution of highly dynamic 180° turning movements in participants with and without chronic ankle instability. Methods Fifteen participants with functional ankle instability, 15 participants with functional and mechanical ankle instability and 15 healthy controls performed 180° turning movements in reaction to light signals in a cross-sectional descriptive laboratory study. Ankle joint kinematics and kinetics as well as neuromuscular activation of muscles surrounding the ankle joint were determined. Two-way repeated measures analyses of variance and post-hoc t-tests were calculated. Results Maximum ankle inversion angles and velocities were significantly reduced with the semi-rigid brace in comparison to the conditions without a brace and with the soft brace (p ≤ 0.006, d ≥ 0.303). Effect sizes of these reductions were larger in participants with chronic ankle instability than in healthy controls. Furthermore, peroneal activation levels decreased significantly with the semi-rigid brace in the 100 ms before and after ground contact. No statistically significant brace by group effects were found. Conclusions Based on these findings, we argue that people with ankle instability in particular seem to benefit from a semi-rigid ankle brace, which allows them to keep ankle inversion angles in a range that is comparable to values of healthy people. Lower ankle inversion angles and velocities with a semi-rigid brace may explain reduced injury incidences with brace application. The lack of effect of the soft brace indicates that the primary mechanism behind the reduction of inversion angles and velocities is the mechanical resistance of the brace in the frontal plane.

The Effect of 2 Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability

2017 ◽  
Vol 26 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Cameron J. Powden ◽  
Kathleen K. Hogan ◽  
Erik A. Wikstrom ◽  
Matthew C. Hoch
Keyword(s):  
Postural Control ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Weight Bearing ◽  
Chronic Ankle Instability ◽  
Physical Contact ◽  
Future Research ◽  
Talocrural Joint ◽  
Sham Condition

Context:Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI).Objective:Examine the immediate effects of talocrural joint traction in those with CAI.Design:Blinded, crossover.Setting:Laboratory.Participants:Twenty adults (14 females; age = 23.80 ± 4.02 y; height = 169.55 ± 12.38 cm; weight = 78.34 ± 16.32 kg) with self-reported CAI participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥2 episodes of giving way in the previous 3 mo, answering “yes” to ≥4 questions on the Ankle Instability Instrument, and ≤24 on the Cumberland Ankle Instability Tool.Intervention:Subjects participated in 3 sessions in which they received a single treatment session of sustained traction (ST), oscillatory traction (OT), or a sham condition in a randomized order. Interventions consisted of four 30-s sets of traction with 1 min of rest between sets. During ST and OT, the talus was distracted distally from the ankle mortise to the end-range of accessory motion. ST consisted of continuous distraction and OT involved 1-s oscillations between the mid and end-range of accessory motion. The sham condition consisted of physical contact without force application. Preintervention and postintervention measurements of weight-bearing dorsiflexion, dynamic balance, and static single-limb balance were collected.Main Outcome Measures:The independent variable was treatment (ST, OT, sham). The dependent variables included pre-to-posttreatment change scores for the WBLT (cm), normalized SEBTAR (%), and time-to-boundary (TTB) variables(s). Separate 1-way ANOVAs examined differences between treatments for each dependent variable. Alpha was set a priori at P < .05.Results:No significant treatment effects were identified for any variables.Conclusion:A single intervention of ST or OT did not produce significant changes in weight-bearing dorsiflexion range of motion or postural control in individuals with CAI. Future research should investigate the effects of repeated talocrural traction treatments and the effects of this technique when combined with other manual therapies.

Altered Ankle Kinematics and Shank-Rear-Foot Coupling in Those with Chronic Ankle Instability

2009 ◽  
Vol 18 (3) ◽  
pp. 375-388 ◽  
Author(s):  
Lindsay K. Drewes ◽  
Patrick O. McKeon ◽  
Gabriele Paolini ◽  
Patrick Riley ◽  
D. Casey Kerrigan ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Ankle Instability ◽  
External Rotation ◽  
Chronic Ankle Instability ◽  
Initial Contact ◽  
3 Dimensional ◽  
Joint Coupling ◽  
Ankle Inversion ◽  
Ankle Kinematics ◽  
Phase Angles

Context:Kinematic patterns during gait have not been extensively studied in relation to chronic ankle instability (CAI).Objective:To determine whether individuals with CAI demonstrate altered ankle kinematics and shank-rear-foot coupling compared with controls during walking and jogging.Design:Case control.Setting:Motion-analysis laboratory.Participants:7 participants (3 men, 4 women) suffering from CAI (age 24.6 ± 4.2 y, height 172.6 ± 9.4 cm, mass 70.9 ± 8.1 kg) and 7 (3 men, 4 women) healthy, matched controls (age 24.7 ± 4.5 y, height 168.2 ± 5.9 cm, mass 66.5 ± 9.8 kg).Interventions:Subjects walked and jogged on a treadmill while 3-dimensional kinematics of the lower extremities were captured.Main Outcome Measures:The positions of rear-foot inversion–eversion and shank rotation were calculated throughout the gait cycle. Continuous relative-phase angles between these segments were calculated to assess coupling.Results:The CAI group demonstrated more rear-foot inversion and shank external rotation during walking and jogging. There were differences between groups in shank-rear-foot coupling during terminal swing at both speeds.Conclusions:Altered ankle kinematics and joint coupling during the terminal-swing phase of gait may predispose a population with CAI to ankle-inversion injuries. Less coordinated movement during gait may be an indication of altered neuromuscular recruitment of the musculature surrounding the ankle as the foot is being positioned for initial contact.

Effect of weight-bearing overload using elastic tubing on balance and functional performance in athletes with chronic ankle instability

2018 ◽  
Vol 33 (5) ◽  
pp. e229-e236
Author(s):  
G.R. Melam ◽  
A.A. Alhusaini ◽  
V. Perumal ◽  
S. Buragadda ◽  
A. Albarrati ◽  
...  
Keyword(s):  
Functional Performance ◽  
Ankle Instability ◽  
Weight Bearing ◽  
Chronic Ankle Instability

scholarly journals Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function

2017 ◽  
Vol 52 (4) ◽  
pp. 325-331 ◽  
Author(s):  
Erik A. Wikstrom ◽  
Patrick O. McKeon
Keyword(s):  
Ankle Instability ◽  
Weight Bearing ◽  
Treatment Success ◽  
Chronic Ankle Instability ◽  
Response Analysis ◽  
Controlled Clinical Trial ◽  
Foot And Ankle ◽  
Minimally Clinically Important Difference ◽  
Medicine Research ◽  
Ability Measure

Context:  Therapeutic modalities that stimulate sensory receptors around the foot-ankle complex improve chronic ankle instability (CAI)–associated impairments. However, not all patients have equal responses to these modalities. Identifying predictors of treatment success could improve clinician efficiency when treating patients with CAI. Objective:  To conduct a response analysis on existing data to identify predictors of improved self-reported function in patients with CAI. Design:  Secondary analysis of a randomized controlled clinical trial. Setting:  Sports medicine research laboratories. Patients or Other Participants:  Fifty-nine patients with CAI, which was defined in accordance with the International Ankle Consortium recommendations. Intervention(s):  Participants were randomized into 3 treatment groups (plantar massage [PM], ankle-joint mobilization [AJM], or calf stretching [CS]) that received six 5-minute treatments over 2 weeks. Main Outcome Measure(s):  Treatment success, defined as a patient exceeding the minimally clinically important difference of the Foot and Ankle Ability Measure–Sport (FAAM–S). Results:  Patients with ≤5 recurrent sprains and ≤82.73% on the Foot and Ankle Ability Measure had a 98% probability of having a meaningful FAAM–S improvement after AJM. As well, ≥5 balance errors demonstrated 98% probability of meaningful FAAM–S improvements from AJM. Patients &lt;22 years old and with ≤9.9 cm of dorsiflexion had a 99% probability of a meaningful FAAM–S improvement after PM. Also, those who made ≥2 single-limb–stance errors had a 98% probability of a meaningful FAAM–S improvement from PM. Patients with ≤53.1% on the FAAM–S had an 83% probability of a meaningful FAAM–S improvement after CS. Conclusions:  Each sensory-targeted ankle-rehabilitation strategy resulted in a unique combination of predictors of success for patients with CAI. Specific indicators of success with AJM were deficits in self-reported function, single-limb balance, and &lt;5 previous sprains. Age, weight-bearing–dorsiflexion restrictions, and single-limb balance deficits identified patients with CAI who will respond well to PM. Assessing self-reported sport-related function can identify CAI patients who will respond positively to CS.

Neuromuscular control in individuals with chronic ankle instability: A comparison of unexpected and expected ankle inversion perturbations during a single leg drop-landing

2019 ◽  
Vol 64 ◽  
pp. 133-141 ◽  
Author(s):  
Jeffrey D. Simpson ◽  
Ethan M. Stewart ◽  
Alana J. Turner ◽  
David M. Macias ◽  
Samuel J. Wilson ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Neuromuscular Control ◽  
Chronic Ankle Instability ◽  
Ankle Inversion ◽  
Drop Landing

The Effects of a Semi-Rigid Brace or Taping on Talocrural and Subtalar Kinematics in Chronic Ankle Instability

2014 ◽  
Vol 7 (6) ◽  
pp. 471-477 ◽  
Author(s):  
Takumi Kobayashi ◽  
Masayuki Saka ◽  
Eiichi Suzuki ◽  
Naohito Yamazaki ◽  
Makoto Suzukawa ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Ankle Instability ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Case Series ◽  
Chronic Ankle Instability ◽  
Cross Sectional ◽  
Anterior Translation ◽  
Computed Tomography Images ◽  
Significant Difference

Background. A semi-rigid brace or taping is often used to prevent giving-ways in the joint with chronic ankle instability (CAI). However, it remains unknown whether the application of a semi-rigid brace or taping modifies abnormal kinematics in CAI joints. The objective of this study was to determine if the application of a semi-rigid brace or taping of the ankle normalizes abnormal weight-bearing kinematics in CAI joints during ankle internal rotation in plantar flexion. Methods. A total of 14 male patients with unilateral CAI (mean age 21.1 ± 2.5 years) were enrolled. Three-dimensional bone models created from the computed tomography images were matched to the fluoroscopic images to compute the 6 degrees-of-freedom talocrural, subtalar, and ankle joint complex (AJC) kinematics for the healthy and contralateral CAI joints, as well as for CAI joints with a brace or taping. Selected outcome measures were talocrural anterior translation, talocrural internal rotation, and subtalar internal rotation. Results. There was no significant difference in talocrural anterior translation and internal rotation induced by applying either a semi-rigid brace or taping ( P > .05). For subtalar internal rotation, there was a tendency toward restoration of normal kinematics in CAI joints after applying a semi-rigid brace or taping. However, the difference was not significant ( P > .05). Discussion. Application of a semi-rigid brace or taping had limited effects on the CAI joint during weight-bearing ankle internal rotation in plantar flexion. Further studies using a variety of testing conditions should be conducted in the future. Levels of Evidence: Therapeutic, Level IV: Cross-Sectional Case Series

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