The Immediate Effects of Ankle Joint Mobilization on Ankle Musculotendinous Stiffness in Individuals With Chronic Ankle Instability

2020 ◽  
pp. 1-5
Author(s):  
M. Spencer Cain ◽  
Kyeongtak Song ◽  
J. Troy Blackburn ◽  
Kimmery Migel ◽  
Erik A. Wikstrom
Keyword(s):  
Ankle Joint ◽  
Ankle Instability ◽  
Change Score ◽  
Chronic Ankle Instability ◽  
Minimal Detectable Change ◽  
Plantar Flexor ◽  
Joint Mobilization ◽  
Before And After ◽  
Damped Oscillation ◽  
Musculotendinous Stiffness

Ankle joint mobilization has been shown to be effective at improving outcomes in those with chronic ankle instability (CAI), but the neuromuscular mechanisms are still unknown. We aimed to determine the immediate effect of a single Grade III anterior-to-posterior ankle joint mobilization bout on ankle musculotendinous stiffness (MTS) in those with CAI. Seventeen CAI participants had plantar flexor and fibularis MTS assessed before and after a 5-min joint mobilization treatment. MTS outcomes were estimated using the damped oscillation method. Fibularis (0.25 ± 0.41 N/m/kg, p = .028) but not plantar flexor MTS (−2.18 ± 14.35 N/m/kg, p = .539) changed following mobilization and exceeded the calculated minimal detectable change score (0.12 N/m/kg). Increased fibularis MTS may represent a neuromuscular mechanism by which ankle joint mobilizations improve postural control in those with CAI.

scholarly journals Six Sessions of Anterior-to-Posterior Ankle Joint Mobilizations Improve Patient-Reported Outcomes in Patients With Chronic Ankle Instability: A Critically Appraised Topic

2019 ◽  
Vol 28 (4) ◽  
pp. 381-384
Author(s):  
Erik A. Wikstrom ◽  
Sajad Bagherian ◽  
Nicole B. Cordero ◽  
Kyeongtak Song
Keyword(s):  
Ankle Joint ◽  
Patient Reported Outcomes ◽  
Ankle Instability ◽  
Patient Reported Outcome ◽  
Chronic Ankle Instability ◽  
Bottom Line ◽  
Joint Mobilization ◽  
Patient Reported ◽  
Improve Patient

Clinical Scenario: Chronic ankle instability (CAI) is a complex musculoskeletal condition that results in sensorimotor and mechanical alterations. Manual therapies, such as ankle joint mobilizations, are known to improve clinician-oriented outcomes like dorsiflexion range of motion, but their impact on patient-reported outcomes remains less clear. Focused Clinical Question: Do anterior-to-posterior ankle joint mobilizations improve patient-reported outcomes in patients with chronic ankle instability? Summary of Key Findings: Three studies (2 randomized controlled trials and 1 prospective cohort) quantified the effect of at least 2 weeks of anterior-to-posterior ankle joint mobilizations on improving patient-reported outcomes immediately after the intervention and at a follow-up assessment. All 3 studies demonstrated significant improvements in at least 1 patient-reported outcome immediately after the intervention and at the follow-up assessment. Clinical Bottom Line: At least 2 weeks of ankle joint mobilization improves patient-reported outcomes in patients with chronic ankle instability, and these benefits are retained for at least a week following the termination of the intervention. Strength of Recommendation: Strength of recommendation is grade A due to consistent good-quality patient-oriented evidence.

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.

Effect of Plantar Flexor and Dorsiflexor Fatigue on Unilateral Postural Control

1993 ◽  
Vol 9 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Thomas M. Lundin ◽  
Jon W. Feuerbach ◽  
Mark D. Grabiner
Keyword(s):  
Ankle Joint ◽  
Postural Sway ◽  
Plantar Flexor ◽  
Plantar Flexors ◽  
Joint Injury ◽  
Balance System ◽  
Fatigue Protocol ◽  
Before And After ◽  
Ankle Muscle ◽  
Male Subjects

The purpose of this study was to determine the effect of plantar flexor and dorsiflexor fatigue on postural sway amplitude during unilateral, or one-legged, stance. It was hypothesized that plantar flexor and dorsiflexor fatigue would increase unilateral postural sway amplitude. Eight uninjured male subjects participated in pre- and postfatigue unilateral stability tests. Selected parameters describing medial-lateral (ML) and anterior-posterior (AP) postural sway were measured on a Chattecx Balance System before and after an isokinetic fatigue protocol. The fatigue protocol resulted in a significant increase in ML postural sway amplitude (p< 0.05) and an increase in AP sway amplitude (p= 0.065). Previously, links have been established between increased postural sway amplitude and ankle joint injury. Thus, fatigue of the plantar flexors and dorsiflexors, which increased postural sway amplitude, may render the ankle joint susceptible to injury. Induced ankle muscle fatigue may represent a valid paradigm to study the causes of traumatic ankle joint injury.

Characterizing Lower Extremity Movement Scores Before and After Fatigue in Collegiate Athletes With Chronic Ankle Instability

2018 ◽  
Vol 23 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Sajad Bagherian ◽  
Nader Rahnama ◽  
Erik A. Wikstrom ◽  
Micheal A. Clark ◽  
Faroogh Rostami
Keyword(s):  
Lower Extremity ◽  
Ankle Instability ◽  
Collegiate Athletes ◽  
Movement Patterns ◽  
Chronic Ankle Instability ◽  
Sensorimotor Function ◽  
Functional Movement ◽  
Before And After ◽  
Increased Sensitivity ◽  
Heel Lift

Sensorimotor function is impaired in chronic ankle instability (CAI) patients. CAI patients have an increased sensitivity to fatigue relative to controls. Few investigations have quantified functional movement scores in CAI patients or the effect of fatigue on such scores. Therefore, we characterized functional movement scores before and after fatigue in 40 collegiate athletes with CAI. Three movement patterns (double-limb squat, double-limb squat with heel lift, and single-limb squat) were completed before and after fatigue and scored using Fusionetics®. All Fusionetics scores were higher (worse) after fatigue. The results demonstrate that functional movement scores were sensitive to fatigue.

Joint mobilization and static stretching for individuals with chronic ankle instability – A pilot study

2019 ◽  
Vol 23 (1) ◽  
pp. 194-201
Author(s):  
Chase M. Feldbrugge ◽  
Megan M. Pathoomvanh ◽  
Cameron J. Powden ◽  
Matthew C. Hoch
Keyword(s):  
Pilot Study ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Static Stretching ◽  
Joint Mobilization

scholarly journals Talar Cartilage Deformation and Spatiotemporal Gait Patterns in Individuals with and without Chronic Ankle Instability.

2021 ◽  
Author(s):  
Kyle B. Kosik ◽  
Matthew C. Hoch ◽  
Rae L. Allison ◽  
Katherine A. Bain ◽  
Stacey Slone ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Ankle Instability ◽  
Imaging Modality ◽  
Cost Effective ◽  
Chronic Ankle Instability ◽  
Exercise Protocol ◽  
Walking Gait ◽  
Gait Parameters ◽  
Before And After

ABSTRACT Context: Research has demonstrated individuals with chronic ankle instability (CAI) present with alterations in the compositional structure of the talar articular cartilage. These alterations likely influence how the talar cartilage responds to loading associated with activities of daily living, such as walking. Ultrasonography has emerged as an alternative imaging modality to assess the amount of cartilage deformation in response to loading because it can be clinically accessible and cost-effective for routine measurements. Objective: To compare talar cartilage deformation in response to a standardized exercise protocol between those with and without chronic ankle instability. Secondly, to examine the association between spatiotemporal walking gait parameters and cartilage deformation. Design: Case-control. Setting: Research Laboratory. Patients or Other Participants: A volunteer sample of 24 participants with self-reported CAI (age = 23.2 ± 3.9 years; BMI = 25.1 ± 3.7 kg/m2) and 24 un-injured controls (age = 24.3 ± 2.9 years; BMI = 22.9 ± 2.8 kg/m2). Main Outcome Measure(s): Spatiotemporal walking gait was first assessed from five self-selected trials using an electronic walkway with data sampled at 120Hz. An 8-to-13MHz linear-array ultrasound transducer placed transversely in line with the medial and lateral malleoli captured three images before and after a standardized loading protocol consisting of 30 single and double-limb squats, 2-minute single-limb balance and 10 single-leg drops from a 40cm height box. Results: After controlling for body mass index, participants with chronic ankle instability had greater deformation compared to the un-injured controls (p=0.034). No other significant between group differences were observed (p&gt;0.05). No significant partial correlations were observed between talar cartilage deformation and spatiotemporal gait parameters when controlling for body mass index (p&gt;0.05). Conclusions: Individuals with CAI had greater talar cartilage deformation in response to a standardized exercise protocol than controls. The amount of talar cartilage deformation was not associated with spatiotemporal walking gait.

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