The Effect of Axial Load on the In Vivo Anterior Drawer Test of the Ankle Joint Complex

2000 ◽  
Vol 21 (5) ◽  
pp. 420-426 ◽  
Author(s):  
Wen Liu ◽  
Murray E. Maitland ◽  
Benno M. Nigg
Keyword(s):  
Ankle Joint ◽  
Axial Load ◽  
Plantar Flexion ◽  
Correlation Coefficients ◽  
Displacement Curve ◽  
Ankle Sprains ◽  
Mechanical Instability ◽  
Anterior Drawer ◽  
Anterior Drawer Test

The anterior drawer test is commonly used in the diagnosis of ankle joint mechanical instability. However, the effect of axial load on the anterior drawer test has not been examined in vivo. The purpose of the study was to assess the effect of axial load on passive anterior instability, and on the diagnostic measurement of the anterior drawer instability of the ankle joint complex. A total of 21 subjects with various degrees of ankle sprains were tested on a device that could continuously record applied anterior force and the resultant displacement of the rear-foot. Anterior drawer flexibility of the ankle joint complex in a neutral dorsi/plantar flexion position was quantified on both feet for all subjects without and with an axial load (385 N). Flexibility of the ankle joint complex in anterior drawer was defined as the slope of a linear load-displacement curve (which fitted test data with high correlation coefficients (r>0.991)). With axial load, anterior drawer flexibility was significantly reduced by 28.8% compared to that without axial load. The difference in anterior drawer flexibility between injured and intact ankles significantly decreased with axial load. An axial load increased the stability of ankle joint complex. However, axial load reduced the sensitivity of anterior drawer test to mechanical instability of the ankle joint complex.

scholarly journals Semi-rigid brace and taping decrease variability of the ankle joint position sense

2014 ◽  
Vol 20 (4) ◽  
pp. 448-453 ◽  
Author(s):  
Márcia Barbanera ◽  
Flávia de Andrade e Souza Mazuchi ◽  
José Paulo Berretta Batista ◽  
Janaina de Moura Ultremare ◽  
Juliana da Silva Iwashita ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Plantar Flexion ◽  
Target Position ◽  
Absolute Error ◽  
Position Sense ◽  
Joint Position Sense ◽  
Ankle Sprains ◽  
Joint Position ◽  
Experimental Conditions ◽  
Ankle Brace

The present study investigated the effect of taping and the semi-rigid ankle brace on ankle joint position sense. Sixteen healthy women (20.8 ± 2.3 years old) actively placed the ankle in a target position. The experimental conditions were: 1) wearing no orthosis device, 2) using semi-rigid brace, and 3) wearing ankle taping. Absolute error (AE) and variable error (VE) were calculated to obtain the joint position sense. We found an interaction effect between condition and target angle at 15o of plantar flexion for the variable VE, which showed smaller errors during the use of taping and semi-rigid brace. In conclusion, the use of ankle joint orthoses, whether taping or semi-rigid brace, decrease the variability of the position sense at 15o of plantar flexion, potentially decreasing ankle sprains occurrence.

Ligament fibre recruitment and forces for the anterior drawer test at the human ankle joint

2003 ◽  
Vol 36 (3) ◽  
pp. 363-372 ◽  
Author(s):  
F. Corazza ◽  
J.J. O’Connor ◽  
A. Leardini ◽  
V. Parenti Castelli
Keyword(s):  
Ankle Joint ◽  
Anterior Drawer ◽  
Anterior Drawer Test ◽  
Human Ankle

Anterior Drawer Test for Acute Anterior Talofibular Ligament Injuries of the Ankle: How Much Load Should be Applied during the Test?

2003 ◽  
Vol 31 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Harukazu Tohyama ◽  
Kazunori Yasuda ◽  
Yasumitu Ohkoshi ◽  
Bruce D. Beynnon ◽  
Per A. Renstrom
Keyword(s):  
Cadaver Study ◽  
Ankle Injuries ◽  
Ligament Injury ◽  
Normal Displacement ◽  
Anterior Talofibular Ligament ◽  
Anterior Drawer ◽  
Anterior Drawer Test ◽  
Ankle Ligament ◽  
Anterior Posterior

Background: There is a lack of consensus regarding the magnitude of load for performing the anterior drawer test in evaluating acute ankle injuries. Purpose: To determine how much load should be applied during the anterior drawer test to detect the integrity of the anterior talofibular ligament. Methods: First, the anterior-posterior load-displacement response of nine cadaveric ankles was measured. Second, anterior displacement of the ankle was measured at 30 and 60 N of anterior load in 14 patients with acute tears of the anterior talofibular ligament. Results: In the cadaver study, the increased displacement by sectioning of the ligament measured at 10, 20, 30, and 40 N of anterior load were significantly greater than those measured at 60 N. In vivo examination of the subjects without anesthesia demonstrated that the injured-to-normal displacement value at 30 N of anterior load was significantly greater than the value at 60 N. Conclusions: This study suggests that a large magnitude of anterior load is not necessary to detect the integrity of the ligament during the anterior drawer test. Clinical Relevance: When evaluating the integrity of the anterior talofibular ligament in cases of acute ankle ligament injury, a relatively low-magnitude load should be applied.

Reliability of Achilles Tendon Moment Arm Measured In Vivo Using Freehand Three-Dimensional Ultrasound

2017 ◽  
Vol 33 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Steven J. Obst ◽  
Lee Barber ◽  
Ashton Miller ◽  
Rod S. Barrett
Keyword(s):  
Achilles Tendon ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Lateral Malleolus ◽  
Medial Malleolus ◽  
Minimal Detectable Change ◽  
Ultrasound Images ◽  
Moment Arm

This study investigated reliability of freehand three-dimensional ultrasound (3DUS) measurement of in vivo human Achilles tendon (AT) moment arm. Sixteen healthy adults were scanned on 2 separate occasions by a single investigator. 3DUS scans were performed over the free AT, medial malleolus, and lateral malleolus with the ankle passively positioned in maximal dorsiflexion, mid dorsiflexion, neutral, mid plantar flexion and maximal plantar flexion. 3D reconstructions of the AT, medial malleolus, and lateral malleolus were created from manual segmentation of the ultrasound images and used to geometrically determine the AT moment arm using both a straight (straight ATMA) and curved (curved ATMA) tendon line-of-action. Both methods were reliable within- and between-session (intra-class correlation coefficients > 0.92; coefficient of variation < 2.5 %) and revealed that AT moment arm increased by ∼ 7 mm from maximal dorsiflexion (∼ 41mm) to maximal plantar flexion (∼ 48 mm). Failing to account for tendon curvature led to a small overestimation (< 2 mm) of AT moment arm that was most pronounced in ankle plantar flexion, but was less than the minimal detectable change of the method and could be disregarded.

scholarly journals Quantitative Measurement of the Ankle Joint Anterior Drawer Test Using Ultrasonography

2010 ◽  
Vol 25 (4) ◽  
pp. 499-503
Author(s):  
Masahiro YOSHIDA ◽  
Kazuhiro SUGAWARA ◽  
Makoto YOSHIDA ◽  
Keigo TANIGUCHI ◽  
Masaki KATAYOSE
Keyword(s):  
Ankle Joint ◽  
Quantitative Measurement ◽  
Anterior Drawer ◽  
Anterior Drawer Test

Ankle Joint Proprioception and Postural Control in Basketball Players with Bilateral Ankle Sprains

2005 ◽  
Vol 33 (8) ◽  
pp. 1174-1182 ◽  
Author(s):  
Amy S. N. Fu ◽  
Christina W. Y. Hui-Chan
Keyword(s):  
Standard Deviation ◽  
Postural Control ◽  
Ankle Joint ◽  
Postural Sway ◽  
Plantar Flexion ◽  
Ankle Sprains ◽  
Sensory Organization Test ◽  
Basketball Players ◽  
Dynamic Posturography ◽  
Sensory Organization

Background Deficiencies in ankle proprioception and standing balance in basketball players with multiple ankle sprains have been reported in separate studies. However, the question of how ankle proprioceptive inputs and postural control in stance are related is still unclear. Hypothesis Ankle repositioning errors and the amount of postural sway in stance are increased in basketball players with multiple ankle sprains. Study Design Controlled laboratory study. Methods Twenty healthy male basketball players and 19 male basketball players who had suffered bilateral ankle sprains within the past 2 years were examined. Both groups were similar in age. Passive ankle joint repositioning errors at 5° of plantar flexion were used to test for ankle joint proprioception. The Sensory Organization Test was applied with dynamic posturography to assess postural sway angle under 6 sensory conditions. Results A significant increase in ankle repositioning errors was demonstrated in basketball players with bilateral ankle sprains (P < .05). The mean errors in the right and left ankles were increased from 1.0° (standard deviation, 0.4°) and 0.8° (standard deviation, 0.2°), respectively, in the healthy players to 1.4° (standard deviation, 0.7°) and 1.1° (standard deviation, 0.5°) in the injured group. A significant increase in the amount of postural sway in the injured subjects was also found in conditions 1, 2, and 5 of the Sensory Organization Test (P < .05). Furthermore, there were positive associations between averaged errors in repositioning both ankles and postural sway angles in conditions 1, 2, and 3 of the Sensory Organization Test (r = 0.39-0.54, P < .05). Conclusions Ankle repositioning errors and postural sway in stance increased in basketball players with multiple ankle sprains. A positive relationship was found between these 2 variables. Clinical Relevance Such findings highlight the need for the rehabilitation of patients with multiple ankle sprains to include proprioceptive and balance training.

Quantitative Evaluation of Ankle Instability Using a Capacitance-Type Strain Sensor

2021 ◽  
pp. 107110072199671
Author(s):  
Atsushi Teramoto ◽  
Kousuke Iba ◽  
Yasutaka Murahashi ◽  
Hiroaki Shoji ◽  
Kento Hirota ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Anterior Talofibular Ligament ◽  
Calcaneofibular Ligament ◽  
Radiographic Images ◽  
Anterior Drawer ◽  
Anterior Drawer Test ◽  
History Of ◽  
The Mean

Background: Manual evaluation is an important method for assessing ankle instability, but it is not quantitative. Capacitance-type sensors can be used to measure the distance on the basis of the capacitance value. We applied the sensor to the noninvasive device for measuring ankle instability and showed its utility. Methods: First, 5 ankles embalmed by Thiel’s method were used in an experiment using a cadaver. The capacitance-type sensor was fixed alongside the anterior talofibular ligament (ATFL) of a specially made brace, and the anterior drawer test was performed. The test had been performed for the intact ankle, with the ATFL transected and with both the ATFL and calcaneofibular ligament (CFL) transected. The anterior drawer distance was calculated by the sensor. Intra- and interinvestigator reliability were also analyzed. Next, as a clinical study, a brace with a sensor was fitted to 22 ankles of 20 patients with a history of ankle sprain. An anterior drawer test at a load of 150 N was conducted using a Telos stress device. The anterior drawer distances measured by the sensor and based on radiographic images were then compared. Results: The mean anterior drawer distances were 3.7 ± 1.0 mm for the intact cadavers, 6.1 ± 1.6 mm with the ATFL transected ( P < .001), and 7.9 ± 1.8 mm with the ATFL and CFL transected ( P < .001). The intrainvestigator intraclass correlation coefficients (ICCs) were 0.862 to 0.939, and the interinvestigator ICC was 0.815. In the experiments on patients, the mean anterior drawer distance measured by the sensor was 2.9 ± 0.9 mm, and it was 2.7 ± 0.9 mm for the radiographic images. The correlation coefficient between the sensor and the radiographic images was 0.843. Conclusion: We quantitatively evaluated anterior drawer laxity using a capacitance-type sensor and found it had high reproducibility and strongly correlated with stress radiography measurements in patients with ankle instability. Capacitance-type sensors can be used for the safe, simple, and accurate evaluation of ankle instability.

scholarly journals Effect of Kinesio Taping on Ankle Joint Kinematics During Landing on Stable and Unstable Surfaces in Ankle Sprain and Health Persons

2021 ◽  
Vol 10 (3) ◽  
pp. 522-531
Author(s):  
Mohammad Baghbani ◽  
◽  
Mohammadtaghi Amiri-Khorasani ◽  
Abdolhamid Daneshjoo ◽  
◽  
...  
Keyword(s):  
Ankle Joint ◽  
Ankle Sprain ◽  
Repeated Measures ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Joint Kinematics ◽  
Ankle Sprains ◽  
Ankle Ligaments ◽  
Kinesio Tape ◽  
Kinesio Taping

Background and Aims: Landing is a typical sports motion that can create impact force 2-12 times of body weight, and finally, it’s one of the main reasons for non-contact injuries in ankle ligaments. Specialized. The usual effects of Kinesio tape include increasing proprioception, health direction of joints, reducing pain, and raising pressure on nervous tissue. The study aimed to investigate the effect of Kinesio taping on ankle joint kinematics during landing on stiff and soft surfaces in ankle sprain and healthy persons. Methods: The method of the present study was quasi-experimental with a two-group design in control groups (without ankle sprain) and experimental (with an ankle sprain). A total of 30 male students of the Shahid Bahonar University of Kerman were purposefully and accessibly selected and divided into two groups with (15 students) and without ankle sprains (15 students). Then, they performed both landing operations on stable and unstable surfaces, with and without Kinesio tape. Maximum dorsi and plantar flexion, supination, pronation and maximum ankle angular velocity parameters were recorded by a three-dimensional motion analysis system. Statistical analysis was performed using independent t-test and repeated measures analysis of variance at the significant level of 0.05. Results: There was no significant reduction in plantar flexion of the ankle in healthy and twisted individuals while landing on stable and unstable surfaces with and without Kinesio tape (P≤0.07), but there was a significant reduction in the dorsiflexion in both groups(P≤0.001). On the other hand, there was no significant decrease in pronation (P≤0.66), but there was a significant decrease in foot supination (P≤0.001). Conclusion: Generally, Kinesio tape in recovery ankle movement is offered to persons for ankle sprain. Thus recommendation landing exercises fare with more flexion angle and less knee joint valgus and more dorsiflexion angle at ankle joint and preferable on the unstable surfaces.

Musculoskeletal modeling of total ankle arthroplasty using force-dependent kinematics for predicting in vivo joint mechanics

2019 ◽  
Vol 234 (2) ◽  
pp. 210-222 ◽  
Author(s):  
Yanwei Zhang ◽  
Zhenxian Chen ◽  
Hongmou Zhao ◽  
Xiaojun Liang ◽  
Cheng Sun ◽  
...  
Keyword(s):  
Body Weight ◽  
Ankle Joint ◽  
Plantar Flexion ◽  
Contact Forces ◽  
Total Ankle Arthroplasty ◽  
Musculoskeletal Modeling ◽  
Patient Specific ◽  
Joint Mechanics ◽  
Ankle Arthroplasty

In vivo load and motion in the ankle joint play a key role in the understanding of the failure mechanism and function outcomes of total ankle arthroplasty. However, a thorough understanding of the biomechanics of the ankle joint in daily activities is lacking. The objective of this study was to develop a novel lower extremity musculoskeletal multibody dynamics model with total ankle arthroplasty considering the 6 degrees of freedom of the ankle joint motions and the deformable contact mechanics of the implant, based on force-dependent kinematics method. A patient who underwent total ankle arthroplasty surgery was considered. The walking gait data of the patient was measured in a gait laboratory and used as the input for the patient-specific musculoskeletal modeling. The predictions from the musculoskeletal model of total ankle arthroplasty included dorsiflexion–plantar flexion, inversion–eversion, internal–external rotation, anterior–posterior translation, inferior–superior translation, and medial–lateral translation of the tibiotalar joint, the ankle contact forces, the muscle activations, and the ligament forces. The magnitudes and tendencies of the predicted results were all within reasonable ranges, as compared with the data available in the literature. The predicted peak total ankle contact force was 6.55 body weight. In addition, the peak contact forces of the lateral and medial compartments were 4.22 body weight and 2.59 body weight, respectively. This study provides a potential new platform for the design of a better ankle prosthesis, the improvement of the operation techniques of the clinicians, and the accelerated postoperative recovery of the patients.

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