Gluteus medius dysfunction in females with chronic ankle instability is consistent at different walking speeds

IntroductionBackground: Lateral ankle sprain (LAS) is the most common musculoskeletal injuries in sport and general population. The goal of the present study was to observe the effectiveness of dry needling (DN) in gluteus medius muscle in patients with chronic ankle instability (CAI).Material and methodsA two-arm (1:1), single-blinded (participants), randomized clinical trial was performed in 40 subjects with chronic ankle instability and were divided in two groups: intervention group who received one session of dry needling in the most hyperalgesic gluteus medius myofascial trigger point (MTrP), (n = 20) and control group (n = 20). Dynamic balance, pain intensity, pain pressure threshold (PPT) and ankle dorsiflexion range of motion (ROM) were assessed at baseline, post-intervention and a 1-week follow up.ResultsThe experimental group reported significant differences with respect to the control group for the anterior and medial dynamic balance (p = .001), PPT -ATL (p = .002) and ankle dorsiflexion ROM (p = .001).ConclusionsThe findings of the present study suggested that the DN in the most hyperalgesic MTrP of the Gmed muscle may increase the anterior and medial dynamic balance, ankle ROM and PPT-ATL at short-term in individuals with CAI. Pain intensity benefits were reported in both groups. Future studies should consider DN as a possible intervention in conjunction with a physical therapy program for individuals with CAI.

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Gluteal Activity During Gait in Patients With Chronic Ankle Instability Following Rehabilitation: A Randomized Controlled Trial

Journal of Sport Rehabilitation ◽

10.1123/jsr.2021-0148 ◽

2021 ◽

pp. 1-7

Author(s):

Alexandra F. DeJong Lempke ◽

Rachel M. Koldenhoven ◽

Abbis H. Jaffri ◽

Jay Hertel

Keyword(s):

Randomized Controlled Trial ◽

Repeated Measures ◽

Gait Cycle ◽

Ankle Instability ◽

Controlled Trial ◽

Gluteus Maximus ◽

Gluteus Medius ◽

Chronic Ankle Instability ◽

Initial Contact ◽

Randomized Controlled

Context: Ankle positioning gait biofeedback (GBF) has improved ankle inversion for patients with chronic ankle instability. However, the effects on proximal deficits remain unknown. The purpose of this study was to determine the effects of impairment-based rehabilitation with GBF and without biofeedback on gluteal activity during walking in patients with chronic ankle instability. Design: Randomized controlled trial. Methods: Eighteen patients with chronic ankle instability (14 women and 4 men; age 22 [4] y; height 171 [10] cm; mass 71.6 [13.8] kg) were recruited from a university setting, following International Ankle Consortium guidelines. Patients were randomly allocated to GBF or without biofeedback groups (N = 9 per group). Both groups performed 4 weeks of exercises and treadmill walking. The GBF group alone received feedback on frontal ankle positioning at initial contact during walking. Ultrasound videos of the gluteus maximus and medius were recorded during walking at baseline and follow-up by a blinded clinician. Gluteal activity ratios were obtained at each 10% of the gait cycle. Statistical parametric mapping repeated-measures analysis of variance were used to compare groups and time points. Results: Both groups demonstrated significantly increased gluteus medius activity across the gait cycle compared with baseline (P < .01, mean differences: 0.13–0.21, Hedge g: 0.97–1.89); however, there were no significant between-group differences. There were no statistically significant changes noted for the gluteus maximus. No adverse events were observed. Conclusions: Impairment-based rehabilitation led to increased gluteus medius activity, but GBF did not provide any additional improvement to this parameter. Clinicians may consider implementing impairment-based strengthening interventions to improve gluteus medius function during gait for patients with CAI.

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