Prevalence of Chronic Ankle Instability in French Paratroopers

Abstract Introduction Ankle sprain is the most common musculoskeletal injury in the physically active population (up to 50% of sports injuries) and is common in the general population with about one ankle sprain per 10 000 person-days worldwide. It is an even more frequent pathology in the military population with a prevalence of five to eight times higher than in the civilian population. In the general population, 20 to 74% of sprains are complicated by chronic ankle instability. No studies estimate this prevalence in a French military population. The main objective of our study was, therefore, to estimate the prevalence of chronic ankle instability in French paratroopers. Materials and Methods The study was carried out in a French parachute regiment over a period of 1 year during periodic medical examinations. To diagnose chronic ankle instability, we used the criteria defined by the International Ankle Consortium in 2013 and two questionnaires that this consortium recommended (FAAM and IdFAI). Results Chronic ankle instability has a prevalence of 43.1% after an ankle sprain with a total of 2.3% among paratroopers, which is comparable to data in the literature. After their first sprain, 23.1% of subjects did not consult a health professional and 47.6% of subjects did not receive physiotherapy. Conclusions Physiotherapy is the basis of care, both for prevention and treatment of chronic ankle instability. It is necessary to raise awareness of this injury among the military and to encourage their adherence to treatment in order to preserve the operational capabilities of combat units. Subsequently, further studies are needed to expand the study population to provide a more comprehensive view of the impact of this injury on the military. Studies concerning the management of chronic ankle instability adapted to the military population would also be relevant.

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Injury-Related Fear in Individuals With and Without Chronic Ankle Instability: A Systematic Review

Journal of Sport Rehabilitation ◽

10.1123/jsr.2021-0015 ◽

2021 ◽

pp. 1-10

Author(s):

Ashley M.B. Suttmiller ◽

Ryan S. McCann

Keyword(s):

Systematic Review ◽

Ankle Sprain ◽

Methodological Quality ◽

Ankle Instability ◽

Evidence Synthesis ◽

Chronic Ankle Instability ◽

Fear Avoidance ◽

Physically Active ◽

Fear Avoidance Beliefs ◽

Fear Avoidance Beliefs Questionnaire

Context: Injury-related fear has recently been recognized to exist in ankle sprain populations. It is unclear, however, if injury-related fear levels differ between those who develop chronic ankle instability (CAI) and those who do not and the best tools for assessing these differences. Objective: The purpose of this study was to conduct a comprehensive systematic review investigating differences in injury-related fear between individuals with and without CAI. Evidence Acquisition: Relevant studies from CINAHL Plus with full text, PubMed, and SPORTDiscus through November 2020 were included. All studies used the Tampa Scale of Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, or Athlete Fear Avoidance Questionnaire as either a descriptor or a main outcome and provided comparison data between a CAI group and ankle sprain copers (COP) or controls (CON). The authors independently assessed methodological quality using the modified Downs and Black Quality Index. Studies were then grouped by between-group comparisons including CAI and CON, CAI and COP, and COP and CON. The authors calculated Hedge g effect sizes and 95% confidence intervals to examine group differences. Evidence Synthesis: A total of 11 studies were included in this review. In total, 8 studies provided data for the CAI and CON comparison, 7 for CAI and COP comparisons, and 4 for COP and CON comparisons. Methodological quality scores ranged from 60.0% to 86.7%, with 2 high-, and 9 moderate-quality studies. Overall, the evidence suggests that physically active individuals with CAI report higher levels of injury-related fear when compared with both COP and CON. Although limited, ankle sprain COP do not seem to differ from CON. Conclusion: Available evidence emphasizes the importance of injury-related fear in individuals who develop chronicity after ankle sprain injury. The Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia are useful for the identification of injury-related fear in individuals after sustaining an ankle sprain and should be used to inform rehabilitation strategies and to monitor efficacy in fear reduction.

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The epidemiology of chronic ankle instability with perceived ankle instability- a systematic review

Journal of Foot and Ankle Research ◽

10.1186/s13047-021-00480-w ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Chiao-I Lin ◽

Sanne Houtenbos ◽

Yu-Hsien Lu ◽

Frank Mayer ◽

Pia-Maria Wippert

Keyword(s):

Ankle Sprain ◽

Sports Injuries ◽

Ankle Instability ◽

Sports Injury ◽

Chronic Ankle Instability ◽

Risk Of Bias ◽

Ankle Sprains ◽

Exclusion Criteria ◽

Wide Range ◽

History Of

Abstract Background Chronic ankle instability, developing from ankle sprain, is one of the most common sports injuries. Besides it being an ankle issue, chronic ankle instability can also cause additional injuries. Investigating the epidemiology of chronic ankle instability is an essential step to develop an adequate injury prevention strategy. However, the epidemiology of chronic ankle instability remains unknown. Therefore, the purpose of this study was to investigate the epidemiology of chronic ankle instability through valid and reliable self-reported tools in active populations. Methods An electronic search was performed on PubMed and Web of Science in July 2020. The inclusion criteria for articles were peer-reviewed, published between 2006 and 2020, using one of the valid and reliable tools to evaluate ankle instability, determining chronic ankle instability based on the criteria of the International Ankle Consortium, and including the outcome of epidemiology of chronic ankle instability. The risk of bias of the included studies was evaluated with an adapted tool for the sports injury review method. Results After removing duplicated studies, 593 articles were screened for eligibility. Twenty full-texts were screened and finally nine studies were included, assessing 3804 participants in total. The participants were between 15 and 32 years old and represented soldiers, students, athletes and active individuals with a history of ankle sprain. The prevalence of chronic ankle instability was 25%, ranging between 7 and 53%. The prevalence of chronic ankle instability within participants with a history of ankle sprains was 46%, ranging between 9 and 76%. Five included studies identified chronic ankle instability based on the standard criteria, and four studies applied adapted exclusion criteria to conduct the study. Five out of nine included studies showed a low risk of bias. Conclusions The prevalence of chronic ankle instability shows a wide range. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of chronic ankle instability are required. The epidemiology of CAI should be prospective. Factors affecting the prevalence of chronic ankle instability should be investigated and clearly described.

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Treatment of Chronic Ankle Instability in the Military Population: A Systematic Review

Foot & Ankle Specialist ◽

10.1177/19386400211068239 ◽

2022 ◽

pp. 193864002110682

Author(s):

Ezra Goodrich ◽

Bryan Vopat ◽

Ashley Herda

Keyword(s):

Patient Population ◽

Military Service ◽

English Language ◽

Ankle Instability ◽

Case Reports ◽

Treatment Strategies ◽

Chronic Ankle Instability ◽

Lateral Ligament ◽

Military Population ◽

The Military

Background The high incidence of ankle sprain within the military sets the stage for prevalent chronic ankle instability. The purpose of this review was to compare and evaluate chronic ankle instability treatment strategies in the military population. Methods Electronic databases were systematically searched in accordance with the Preferred Reporting Items for Systematic Reviews guidelines for English-language, human studies with a military patient population that had been diagnosed with and treated for chronic ankle instability. Exclusion criteria were animal, cadaver, and review studies and case reports. Results Eight studies met the inclusion criteria, representing 695 military service members—625 males (89.9%) and 70 females (10.1%)—and 4 treatment strategies: Broström-related procedures, modified Watson-Jones procedure, Colville’s technique, and anatomic lateral ligament reconstruction using semitendinosus tendon allograft. The percentage of satisfactory outcomes was 100% for Colville’s technique, and ranged from 73.2% to 94.7% for Broström-related procedures and 72% to 80% for the modified Watson-Jones procedure. Mean American Orthopaedic Foot and Ankle Society scores, anterior drawer displacement, talar tilt, and visual analogue scale scores were also reported. Conclusion This review demonstrates that the Bröstrom procedure has consistently satisfactory outcomes within the military population, and Colville’s technique is another promising option for this patient population but would require additional studies to support this claim. Levels of Evidence: Level IV

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Comparison of the effect of foot orthoses on Star Excursion Balance Test performance in patients with chronic ankle instability

Prosthetics and Orthotics International ◽

10.1177/0309364618792718 ◽

2018 ◽

Vol 43 (1) ◽

pp. 6-11 ◽

Cited By ~ 3

Author(s):

Faezeh Abbasi ◽

Mahmood bahramizadeh ◽

Mohammad Hadadi

Keyword(s):

Ankle Sprain ◽

Ankle Instability ◽

Dynamic Balance ◽

Chronic Ankle Instability ◽

Textured Surface ◽

Foot Orthoses ◽

Textured Surfaces ◽

Balance Test ◽

Star Excursion Balance Test ◽

Foot Orthosis

Background: Chronic ankle instability as a prevalent consequence of ankle sprain causes various impairments such as balance and postural control deficits. Foot orthoses are one of the common interventions for rehabilitation of patients with chronic ankle instability. Objectives: To investigate the effect of custom-molded foot orthoses with textured surfaces on dynamic balance of chronic ankle instability patients and to compare their effects with other types of foot orthoses. Study design: This is a repeated measure design. Methods: A total of 30 participants were recruited based on the guideline introduced by the International Ankle Consortium. The effect of prefabricated, custom-molded, and custom-molded with textured surface foot orthoses was evaluated on dynamic balance by the Star Excursion Balance Test. Normalized reach distances in anteromedial, medial, and posteromedial directions of the test were computed to be used for statistical analysis. Results: The foot orthoses increased reach distances compared to the no-orthosis conditions in all three directions. The custom-molded with textured surface foot orthosis has significant differences compared with prefabricated foot orthosis ( p = 0.001) in all measured directions and with custom-molded foot orthosis ( p < 0.01) in medial and posteromedial directions. Conclusion: Foot orthoses improve reach distances in patients with chronic ankle instability. Custom-molded with textured surface foot orthosis has a more pronounced effect compared with other foot orthoses. Clinical relevance The custom-molded foot orthosis with textured surface could be an effective device to improve dynamic balance in chronic ankle instability (CAI) patients. It may be considered as an efficient intervention to reduce ankle sprain recurrence in these individuals, although further research should be conducted.

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Effects of Textured Balance Board Training in Adolescent Ballet Dancers With Ankle Pathology

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0052 ◽

2019 ◽

Vol 28 (6) ◽

pp. 584-592 ◽

Cited By ~ 1

Author(s):

Nili Steinberg ◽

Roger Adams ◽

Oren Tirosh ◽

Janet Karin ◽

Gordon Waddington

Keyword(s):

Ankle Sprain ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Textured Surface ◽

Ballet Dancers ◽

Discrimination Ability ◽

Board Training ◽

Ankle Proprioception ◽

Balance Board ◽

Group 1

Context:Ankle sprains are common among adolescent ballet dancers and may be attributed to inadequate ankle proprioception. Thus, a short period of training utilizing proprioceptive activities requires evaluation.Objective:To assess training conducted for 3 or 6 weeks on a textured-surface balance board using ankle proprioception scores for ballet dancers with and without chronic ankle instability, and with and without previous ankle sprain (PAS).Design:Intervention study.Setting:The Australian Ballet School.Participants:Forty-two ballet dancers, aged 14–18 years.Interventions:Dancers randomized into 2 groups: group 1 undertook 1 minute of balance board training daily for 3 weeks; group 2 undertook the same training for 6 weeks.Main Outcome Measures:Preintervention, Cumberland Ankle Instability Tool questionnaire data were collected, and PAS during the last 2 years was reported. Active ankle inversion movement discrimination ability was tested immediately pre and post intervention and at 3 and 4 weeks.Results:Ankle discrimination acuity scores improved over time for both groups, with a performance decline associated with the early cessation of training for group 1 (P = .04). While dancers with PAS had significantly worse scores at the first test, before balance board training began (P < .01), no significant differences in scores at any test occasion were found between dancers with and without chronic ankle instability. A significantly faster rate of improvement in ankle discrimination ability score over the 4 test occasions was found for dancers with PAS (P = .002).Conclusions:Three weeks of textured balance board training improved the ankle discrimination ability of ballet dancers regardless of their reported level of chronic ankle instability and at a faster rate for dancers with PAS. Previous ankle sprain was associated with a lower level of ankle discrimination ability; however, following 3 weeks of balance board training, previously injured dancers had significantly improved their ankle discrimination acuity scores.

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Local Boy, East Coast Sensibilities

Beyond Ethnicity ◽

10.21313/hawaii/9780824869885.003.0009 ◽

2018 ◽

Author(s):

Christopher Joseph Lopa

Keyword(s):

Hip Hop ◽

East Coast ◽

Historical Trauma ◽

The United States ◽

Military Population ◽

Mentorship Program ◽

Transient Nature ◽

Black Art ◽

The Military ◽

The Impact

This chapter was written from the perspective of a Hawaii resident who identifies as Black and local. My upbringing is explored including the cultural forces that shaped me and the impact that the portion of my upbringing on the East Coast has had on rounding out my Black worldview. This chapter also address challenges to the growth of the Hawaii based African American community including a lack of education about the pre and post-missionary presence of Blacks in Hawaii, the geographic isolation, the transient nature of the State’s largest portion of the Blacks: Service Members in the United States the Military. The struggle of local Black folks to connect to the Black Military population secondary to isolation fostered by base housing and the impact of the Military’s role in historical trauma related to the illegal overthrow of the Hawaiian Monarchy. Solutions to the issue of Black community cohesion are explored throughout the remainder of the chapter. They include a Cultural Mentorship program for Hawai‘i’s Black Youth, connections to Black art and popular culture and it’s adaption in Hawaii (with a particular focus on reggae and Hip-Hop as the key conduits for identifying and facilitating Black Cultural impact in Hawaii).

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Myopericarditis: recognition and impact in the military population

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2018-001056 ◽

2018 ◽

Vol 165 (6) ◽

pp. 451-453

Author(s):

Jessica R Bailey ◽

A Loftus ◽

R J C Allan

Keyword(s):

Chest Pain ◽

Sudden Onset ◽

British Army ◽

Military Population ◽

Operational Capability ◽

Army Officer ◽

Viral Illness ◽

The Military ◽

The Impact

We present a case of a fit and well British Army officer with sudden-onset chest pain following a viral illness, on a background of arduous skiing over an 8-week period. This resulted in a 6-month downgrade with no clearly defined plan for return to full fitness and deployability. The diagnosis and differentiation of myopericarditis from other causes of chest pain is reviewed. The treatment and management of myopericarditis is summarised and commentary is made on the paucity of evidence underpinning the return to fitness guidelines. The impact of this condition primarily affecting young fit individuals, commonly exacerbated by viral illness and arduous activity, is discussed in the context of individual employability and operational capability in a military setting.

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