Predictors of chronic ankle instability after an index lateral ankle sprain: A systematic review

Abstract Objective: To answer the following clinical questions: (1) Is poor postural control associated with increased risk of a lateral ankle sprain? (2) Is postural control adversely affected after acute lateral ankle sprain? (3) Is postural control adversely affected in those with chronic ankle instability? Data Sources: PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Study Selection: Only studies assessing postural control measures in participants on a stable force plate performing the modified Romberg test were included. To be included, a study had to address at least 1 of the 3 clinical questions stated above and provide adequate results for calculation of effect sizes or odds ratios where applicable. Data Extraction: We calculated odds ratios with 95% confidence intervals for studies assessing postural control as a risk factor for lateral ankle sprains. Effect sizes were estimated with the Cohen d and associated 95% confidence intervals for comparisons of postural control performance between healthy and injured groups, or healthy and injured limbs, respectively. Data Synthesis: Poor postural control is most likely associated with an increased risk of sustaining an acute ankle sprain. Postural control is impaired after acute lateral ankle sprain, with deficits identified in both the injured and uninjured sides compared with controls. Although chronic ankle instability has been purported to be associated with altered postural control, these impairments have not been detected consistently with the use of traditional instrumented measures. Conclusions: Instrumented postural control testing on stable force plates is better at identifying deficits that are associated with an increased risk of ankle sprain and that occur after acute ankle sprains than at detecting deficits related to chronic ankle instability.

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Ultrasound measures of intrinsic foot muscle size and motor activation following lateral ankle sprain and chronic ankle instability. A cross-sectional study.

10.1101/2020.07.27.20163220 ◽

2020 ◽

Author(s):

John J Fraser ◽

Rachel M Koldenhoven ◽

Jay Hertel

Keyword(s):

Young Adults ◽

Ankle Sprain ◽

Ankle Instability ◽

Linear Regression Analysis ◽

Chronic Ankle Instability ◽

Cross Sectional ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Intrinsic Foot Muscle ◽

Injury Status

Objectives: To assess the effects of ankle injury status on intrinsic foot muscle (IFM) size at rest and during contraction in young adults with and without a history of lateral ankle sprain (LAS) and chronic ankle instability (CAI). Methods: Foot Posture Index (FPI), Foot Mobility Magnitude (FMM), and ultrasonographic cross-sectional area of the abductor hallucis (AbdH), flexor digitorum brevis (FDB), quadratus plantae (QP), and flexor hallucis brevis (FHB) were assessed at rest, and during non-resisted and resisted contraction in 22 healthy (13 females, BMI: 22.5±3.2, FPI: 4.2±3.9, FMM: 2.5±1.8), 17 LAS (9 females, BMI: 24.1±3.7, FPI: 2.5±3.4, FMM: 2.7±1.7), 21 Copers (13 females, BMI: 23.7±2.9, FPI: 3.6±4.1, FMM: 1.8±1.3), and 20 CAI (15 females, BMI: 25.1±4.5, FPI: 4.4±3.6., FMM: 2.3±1.1). Results: A multiple linear regression analysis assessing group, sex, BMI, FPI, and FMM on resting and contracted IFM size found sex (p<.001), BMI (p=.01), FPI (p=.05), and FMM*FPI interaction (p=.008) accounted for 19% of the variance (p=.002) in resting AbdH measures. Sex (p<.001) and BMI (p=.02) explained 24% of resting FDB measures (p<.001). Having a recent LAS (p=.03) and FMM (p=.02) predicted 11% of non-resisted QP contraction measures (p=.04), with sex (p<.001) explaining 13% of resting QP measures (p=.02). Both sex (p=.01) and FMM (p=.03) predicted 16% of resting FDB measures (p=.01). There were no other statistically significant findings. Conclusions: IFM resting ultrasound measures were primarily determined by sex, BMI, and foot phenotype and not injury status. The clinical utility of these IFM ultrasonographic assessments in young adults with LAS and CAI may be limited.

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Single Leg Hop Landing Analysis in Patients with Chronic Ankle Instability, Lateral Ankle Sprain Copers, and Healthy Individuals

10.30707/etd2019.rine.j ◽

2019 ◽

Author(s):

Jordyn Ashlyn Rine

Keyword(s):

Ankle Sprain ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Healthy Individuals ◽

Lateral Ankle Sprain ◽

Lateral Ankle

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Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability

The American Journal of Sports Medicine ◽

10.1177/0363546516628870 ◽

2016 ◽

Vol 44 (4) ◽

pp. 995-1003 ◽

Cited By ~ 100

Author(s):

Cailbhe Doherty ◽

Chris Bleakley ◽

Jay Hertel ◽

Brian Caulfield ◽

John Ryan ◽

...

Keyword(s):

Ankle Sprain ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

First Time

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Lateral Ankle Sprain and Chronic Ankle Instability

Foot & Ankle Specialist ◽

10.1177/1938640014539813 ◽

2014 ◽

Vol 7 (4) ◽

pp. 298-326 ◽

Cited By ~ 48

Author(s):

Takumi Kobayashi ◽

Kazuyoshi Gamada

Keyword(s):

Postural Control ◽

Ankle Sprain ◽

Ankle Instability ◽

Scientific Evidence ◽

Chronic Ankle Instability ◽

Ligament Injury ◽

High Recurrence Rate ◽

Contributing Factors ◽

Lateral Ankle Sprain ◽

Lateral Ankle

Many studies investigated the contributing factors of chronic ankle instability, but a consensus has not yet been obtained. The objective of this critical review is to provide recent scientific evidence on chronic ankle instability, including the epidemiology and pathology of lateral ankle sprain as well as the causative factors of chronic ankle instability. We searched MEDLINE from 1964 to December 2013 using the terms ankle, sprain, ligament, injury, chronic, functional, mechanical, and instability. Lateral ankle sprain shows a very high recurrence rate and causes considerable economic loss due to medical care, prevention, and secondary disability. During the acute phase, patients with ankle sprain demonstrate symptoms such as pain, range of motion deficit, postural control deficit, and muscle weakness, and these symptoms may persist, leading to chronic ankle instability. Although some agreement regarding the effects of chronic ankle instability with deficits in postural control and/or concentric eversion strength exists, the cause of chronic ankle instability remains controversial.Levels of Evidence: Therapeutic Level IV: Review of Level IV studies

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