Effectiveness of External Orthotic Support on Passive Soft Tissue Resistance of the Chronically Unstable Ankle

1997 ◽  
Vol 18 (3) ◽  
pp. 144-150 ◽  
Author(s):  
H.D. Hartsell ◽  
Sandi J. Spaulding
Keyword(s):  
Repeated Measures ◽  
Ankle Instability ◽  
Healthy Population ◽  
Functional Ankle Instability ◽  
Chronic Instability ◽  
Passive Resistance ◽  
Tissue Resistance ◽  
Resistive Torque ◽  
Resistance Torque ◽  
And Inversion

Functional ankle instability, orthoses, and passive resistive torque tolerated have not been researched. The purpose of the study was to evaluate the passive resistance torque exerted by a flexible and semirigid orthosis for individuals with chronic instability. Twenty-two subjects were evaluated on the passive ankle resistance unit during unbraced, flexible, and semirigid brace conditions. Data from the final three trials for each condition were analyzed using a multiple analysis of variance with repeated measures for resistive torque and inversion range of motion. The semirigid and flexible braces tolerated significantly greater torque forces and less inversion range than the unbraced condition ( P < 0.000). External orthotic support, in particular that of a semirigid orthosis, may be beneficial toward reducing injury or be an effective prophylactic for the healthy population.

Fatigue’s Effect on Eversion Force Sense in Individuals With and Without Functional Ankle Instability

2012 ◽  
Vol 21 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Cynthia J. Wright ◽  
Brent L. Arnold
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Sports Medicine ◽  
Ankle Instability ◽  
Absolute Error ◽  
Ankle Sprains ◽  
Functional Ankle Instability ◽  
Maximal Voluntary Isometric Contraction ◽  
Medicine Research ◽  
Force Sense

Context:Force sense (FS), the proprioceptive ability to detect muscle-force generation, has been shown to be impaired in individuals with functional ankle instability (FAI). Fatigue can also impair FS in healthy individuals, but it is unknown how fatigue affects FS in individuals with FAI.Objective:To assess the effect of fatigue on ankle-eversion force-sense error in individuals with and without FAI. Design: Case control with repeated measures.Setting:Sports medicine research laboratory.Participants:32 individuals with FAI and 32 individuals with no ankle sprains or instability in their lifetime. FAI subjects had a history of ≥1 lateral ankle sprain and giving-way ≥1 episode per month.Interventions:Three eversion FS trials were captured per load (10% and 30% of maximal voluntary isometric contraction) using a load cell before and after a concentric eversion fatigue protocol.Main Outcome Measures:Trial error was the difference between the target and reproduction forces. Constant error (CE), absolute error (AE), and variable error (VE) were calculated from 3 trial errors. A Group × Fatigue × Load repeated-measures ANOVA was performed for each error.Results:There were no significant 3-way interactions or 2-way interactions involving group (all P > .05). CE and AE had a significant 2-way interaction between load and fatigue (CE: F1,62 = 8.704, P = .004; AE: F1,62 = 4.024, P = .049), and VE had a significant main effect for fatigue (F1,62 = 5.130, P = .027), all of which indicated increased FS error with fatigue at 10% load. However, at 30% load only VE increased with fatigue. The FAI group had greater error as measured by AE (F1,62 = 4.571, P = .036) but not CE or VE (P > .05).Conclusions:Greater AE indicates that FAI individuals are less accurate in their force production. Fatigue impaired force sense in all subjects equally. These deficits provide evidence of impaired proprioception with fatigue and in individuals with FAI.

scholarly journals Muscle Spindle Traffic in Functionally Unstable Ankles During Ligamentous Stress

2013 ◽  
Vol 48 (2) ◽  
pp. 192-202 ◽  
Author(s):  
Alan R. Needle ◽  
Swanik Charles B. (Buz) ◽  
William B. Farquhar ◽  
Stephen J. Thomas ◽  
William C. Rose ◽  
...  
Keyword(s):  
Muscle Spindle ◽  
Repeated Measures ◽  
Ankle Instability ◽  
Ankle Sprains ◽  
Ankle Motion ◽  
Ankle Arthrometer ◽  
Joint Forces ◽  
Peripheral Sensory ◽  
And Inversion

Context: Ankle sprains are common in athletes, with functional ankle instability (FAI) developing in approximately half of cases. The relationship between laxity and FAI has been inconclusive, suggesting that instability may be caused by insufficient sensorimotor function and dynamic restraint. Research has suggested that deafferentation of peripheral mechanoreceptors potentially causes FAI; however, direct evidence confirming peripheral sensory deficits has been elusive because previous investigators relied upon subjective proprioceptive tests. Objective: To develop a method for simultaneously recording peripheral sensory traffic, joint forces, and laxity and to quantify differences between healthy ankles and those with reported instability. Design: Case-control study. Setting: University laboratory. Patients or Other Participants: A total of 29 participants (age = 20.9 ± 2.2 years, height = 173.1 ± 8.9 cm, mass = 74.5 ± 12.7 kg) stratified as having healthy (HA, n = 19) or unstable ankles (UA, n = 10). Intervention(s): Sensory traffic from muscle spindle afferents in the peroneal nerve was recorded with microneurography while anterior (AP) and inversion (IE) stress was applied to ligamentous structures using an ankle arthrometer under test and sham conditions. Main Outcome Measure(s): Laxity (millimeters or degrees) and amplitude of sensory traffic (percentage) were determined at 0, 30, 60, 90, and 125 N of AP force and at 0, 1, 2, 3, and 4 Nm of IE torque. Two-factor repeated-measures analyses of variance were used to determine differences between groups and conditions. Results: No differences in laxity were observed between groups (P &gt; .05). Afferent traffic increased with increased force and torque in test trials (P &lt; .001). The UA group displayed decreased afferent activity at 30 N of AP force compared with the HA group (HA: 30.2% ± 9.9%, UA: 17.1% ± 16.1%, P &lt; .05). Conclusions: The amplitude of sensory traffic increased simultaneously with greater ankle motion and loading, providing evidence of the integrated role of capsuloligamentous and musculotendinous mechanoreceptors in maintaining joint sensation. Unstable ankles demonstrated diminished afferent traffic at low levels of force, suggesting the early detection of joint loading may be compromised.

Ankle Strength Deficits in a Cohort of College Athletes With Chronic Ankle Instability

2019 ◽  
Vol 28 (7) ◽  
pp. 752-757 ◽  
Author(s):  
Bethany Wisthoff ◽  
Shannon Matheny ◽  
Aaron Struminger ◽  
Geoffrey Gustavsen ◽  
Joseph Glutting ◽  
...  
Keyword(s):  
Athletic Training ◽  
College Athletes ◽  
Ankle Instability ◽  
Plantar Flexion ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Functional Ankle Instability ◽  
History Of ◽  
Ankle Strength ◽  
And Inversion

Context: Lateral ankle sprains commonly occur in an athletic population and can lead to chronic ankle instability. Objective: To compare ankle strength measurements in athletes who have mechanical laxity and report functional instability after a history of unilateral ankle sprains. Design: Retrospective cohort. Setting: Athletic Training Research Lab. Participants: A total of 165 National Collegiate Athletic Association Division I athletes, 97 males and 68 females, with history of unilateral ankle sprains participated. Main Outcome Measures: Functional ankle instability was determined by Cumberland Ankle Instability Tool scores and mechanical ankle instability by the participant having both anterior and inversion/eversion laxity. Peak torque strength measures, concentric and eccentric, in 2 velocities were measured. Results: Of the 165 participants, 24 subjects had both anterior and inversion/eversion laxity and 74 self-reported functional ankle instability on their injured ankle. The mechanical ankle instability group presented with significantly lower plantar flexion concentric strength at 30°/s (139.7 [43.7] N·m) (P = .01) and eversion concentric strength at 120°/s (14.8 [5.3] N·m) (P = .03) than the contralateral, uninjured ankle (166.3 [56.8] N·m, 17.4 [6.2] N·m, respectively). Conclusion: College athletes who present with mechanical laxity on a previously injured ankle exhibit plantar flexion and eversion strength deficits between ankles.

EVERSION AND INVERSION STRENGTH RATIOS IN SUBJECTS WITH UNILATERAL FUNCTIONAL ANKLE INSTABILITY

2001 ◽  
Vol 33 (5) ◽  
pp. S135 ◽  
Author(s):  
T W. Kaminski ◽  
B D. Buckley ◽  
M E. Powers ◽  
T J. Hubbard ◽  
B M. Hatzel ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Functional Ankle Instability ◽  
Inversion Strength ◽  
And Inversion

Ligament Laxity Following Inversion Injury with and without Chronic Ankle Instability

2008 ◽  
Vol 29 (3) ◽  
pp. 305-311 ◽  
Author(s):  
Tricia J. Hubbard
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Significant Group ◽  
Lateral Ankle ◽  
Anterior Displacement ◽  
Ligament Laxity ◽  
And Inversion

Background: Not all patients develop chronic ankle instability (CAI) after one or more lateral ankle sprains; some seem to heal or adjust to the ankle laxity after injury. Why do some patients develop CAI and others are able to cope and return to normal function? The purpose of this study was to examine ligament laxity between subjects with and without CAI. Materials and Methods: Sixteen subjects with unilateral CAI and 16 subjects without participated in the study. Ligament laxity was measured with an instrumented ankle arthrometer. The arthrometer measured ankle joint motion for anterior/posterior displacement (mm) during loading at 125 N and inversion/eversion rotation (degrees of ROM) during loading at 4000 N/mm. For each dependent variable a 2 × 2 mixed model ANOVA was run with the between factor being group (CAI, No CAI) and the within factor with repeated measures being side (involved, uninvolved). Results: A significant group by side interaction for anterior displacement (F1,30 = 370.085, p < 0.001), and inversion rotation (F1,30 = 7.455, p = 0.010) was found. There was significantly more anterior displacement and inversion rotation for the involved ankles of the CAI group than the involved ankles of the stable group and the uninvolved ankles of the CAI group. Conclusion: Based on the results of this study it appears that the increased anterior displacement and inversion rotation compared to patients without instability may be why subjects develop CAI. Although the patients without instability have a history of more than one lateral ankle sprain, they did not demonstrate increased laxity, which may be the reason why they do not complain of the functional impairment demonstrated in subjects with CAI.

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.

scholarly journals Impact of kinesiophobia on physical function and quality of life in functional ankle instability individuals: an observational study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Prachita P. Walankar ◽  
Vrushali P. Panhale ◽  
Kanchi M. Vyas
Keyword(s):  
Quality Of Life ◽  
Physical Function ◽  
Negative Correlation ◽  
Ankle Instability ◽  
Cross Sectional Study ◽  
Functional Ankle Instability ◽  
Cross Sectional ◽  
Sf 36 ◽  
Related Quality

Abstract Background Functional ankle instability is a common musculoskeletal condition affecting the community. It is characterized by repetitive bouts of giving away, recurrent sprains, and sensation of instability leading to functional deficits in an individual. The present study aimed to assess the influence of kinesiophobia on physical function and quality of life in participants with functional ankle instability. A cross-sectional study was conducted in 30 participants with functional ankle instability. Kinesiophobia was assessed using the 17-item Tampa Scale of Kinesiophobia, physical function using the Foot and Ankle Ability Measure (FAAM) and the FAAM-Sport version (FAAM-S), and quality of life using SF-36. Results The TSK score showed a moderate negative correlation with FAAM-S (r = −0.5, p = 0.005) and a weak negative correlation with SF-36 physical component summary (r = −0.42, p = 0.02). However, TSK showed no significant correlation with FAAM-ADL and SF-36 mental component summary. Conclusion Increased fear of movement, reduced physical function, and health-related quality of life were observed in functional ankle instability individuals. Hence, evaluation of these parameters is imperative in these individuals.

In Vivo Kinematics of Functional Ankle Instability Patients and Lateral Ankle Sprain Copers During Stair Descent

2019 ◽  
Vol 37 (8) ◽  
pp. 1860-1867 ◽  
Author(s):  
Shengxuan Cao ◽  
Chen Wang ◽  
Xin Ma ◽  
Xu Wang ◽  
Jiazhang Huang ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Functional Ankle Instability ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
In Vivo Kinematics ◽  
Stair Descent

A New Dimension in the Study of Human Functional Joint Instability

2012 ◽  
Vol 249-250 ◽  
pp. 1271-1276
Author(s):  
Wen Liu ◽  
Tarang Jain ◽  
Clayton Wauneka
Keyword(s):  
Electrical Stimulation ◽  
Pilot Study ◽  
Joint Instability ◽  
Ankle Instability ◽  
Soft Tissue Injuries ◽  
Functional Ankle Instability ◽  
The Past ◽  
Upright Standing ◽  
Unloading Reaction ◽  
Testing Condition

Functional joint instability is common after joint soft tissue injuries. We present in this report our pilot finding in a study of functional ankle instability. Although past studies have suggested multiple pathological factors for functional ankle instability, none of those factors has been confirmed in the past studies. More importantly, no known factor can provide an explanation for an ankle giving way phenomenon which is a key element in defining a functional ankle instability. In this pilot study, we tested five subjects with functional ankle instability using a dynamic ankle stretching device combined with nociceptive electrical stimulation. Three out of five subjects showed a drastic reaction in which they totally gave up their control of upright standing after their affected ankles were under the combined ankle stretch and nociceptive stimuli. Such drastic reaction was not observed in the same ankles under only the ankle stretch. There was no such drastic reaction in the unaffected ankle under either testing condition. This pilot finding indicates a possibility of a hyper-reactivity to unloading reaction in the ankles with functional ankle instability

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