scholarly journals Abnormal Gutter Geometry as a Risk Factor of Chronic Ankle Instability

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Yuki Tochigi ◽  
Masato Ogawa ◽  
Masataka Kakihana ◽  
Satoru Ozeki
Keyword(s):  
Risk Factor ◽  
Ankle Instability ◽  
Side Wall ◽  
Chronic Ankle Instability ◽  
Reference Points ◽  
Opening Angle ◽  
Talar Dome ◽  
Significant Difference ◽  
Side Walls ◽  
Wall Geometry

Category: Ankle, Sports Introduction/Purpose: Abnormalities in the tibial plafond geometry, such as varus deformity or insufficient talar anterior coverage, have been recognized as the congenital risk factors of chronic ankle instability (CAI) and eventual osteoarthritis (OA) development. Given that the gutter articulations are playing a substantial role in ankle stability, presumably, geometrical abnormality of these articulations also increases such risks, though this concept has not been well addressed to date. Our recent study (2016 AOFAS Annual Summer Meeting) revealed that OA ankles are frequently (>50%) marked by excessive anterior and/or inferior opening of the talar side-walls. The present study examined whether or not CAI cases share these geometrical characteristic, so as to identify a risk factor that predispose ankles to CAI and eventual OA development. Methods: Clinical multi-detector computed tomography (MDCT) images, from 29 symptomatic CAI cases who were indicated for surgical repair or reconstruction of the lateral ligaments, and from 54 asymptomatic non-degenerative (control) ankles, were selected for 3-D morphometric evaluation of the talar dome side-wall geometry. Using a DICOM viewer, a local coordinate system for each ankle was established using talar landmarks. Then, on a transverse section at 3-5 mm distal to the superior aspect of the talar trochlea, the angle between the medial and lateral side-wall tangential lines (regressed from five cortical surface reference points for each) was measured as the “anterior opening angle.” Similarly, the “inferior opening angle” was measured on a mid-coronal section. Differences between groups were statistically tested using a t-test. Results: The anterior opening angles in CAI cases (mean +/- SD: 11.9 +/- 4.4 degrees) were significantly larger (p < 0.001) than in control cases (7.4 +/- 3.4). Defining the range of mean +/- 2SD in Control as “normal” (Figure 1), 9 out of 29 CAI cases (31%) had excessive anterior opening of the talar side-wall surfaces. Although the inferior opening angle did not exhibit significant difference between the groups (28.5 +/- 9.6 in CAI versus 25.5 +/- 5.9 in Control, p = 0.082). Defining the range of mean +/- 2SD in Control as “normal” (Figure 1), 4 CAI cases (14%) had excessive inferior opening. In total, 12 out of 29 CAI cases (41%) had abnormal talar side-wall geometry. Conclusion: These data suggest that a certain fraction of CAI ankles feature abnormal geometrical characteristics consistent with OA ankles, i.e. excessive anterior and/or inferior opening of the talar dome side-walls. Given that none of the CAI cases had remarkable degenerative or traumatic deformities, these characteristics are arguably congenital. Theoretically, the posteriorly narrower shape of the talar trochlea would reduce talocurural congruity in plantar flexion, while the inferiorly wider shape itself would reduce coronal plane stability. These geometrical abnormalities appear to predispose ankles to CAI. For such ankles, aggressive surgical stabilization may forestall OA development following lateral ligament injuries.

scholarly journals Talar and Subtalar T1ρ Relaxation Times in Limbs with and without Chronic Ankle Instability

Cartilage ◽  
2021 ◽  
pp. 194760352199462
Author(s):  
Kyeongtak Song ◽  
Brian Pietrosimone ◽  
Joshua N. Tennant ◽  
Daniel B. Nissman ◽  
Katherine M. Dederer ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Relaxation Times ◽  
Chronic Ankle Instability ◽  
Talar Dome ◽  
Contralateral Limb ◽  
Secondary Purpose ◽  
Healthy Control ◽  
Control Limb ◽  
Proteoglycan Content ◽  
Magnetic Resonance Imaging Mri

Objective The primary aim was to determine differences in talocrural and subtalar joint (STJ) articular cartilage composition, using T1ρ magnetic resonance imaging (MRI) relaxation times, between limbs in individuals with unilateral chronic ankle instability (CAI) and compare with an uninjured control. Our secondary purpose was to determine the association between talocrural and STJ composition in limbs with and without CAI. Design T1ρ MRI relaxation times were collected on 15 CAI (11 females, 21.13 ± 1.81 years, body mass index [BMI] = 23.96 ± 2.74 kg/m2) and 15 uninjured control individuals (11 females, 21.07 ± 2.55 years, BMI = 24.59 ± 3.44 kg/m2). Talocrural cartilage was segmented manually to identify the overall talar dome. The SJT cartilage was segmented manually to identify the anterior, medial, and posterior regions of interest consistent with STJ anatomical articulations. For each segmented area, a T1ρ relaxation time mean and variability value was calculated. Greater T1ρ relaxation times were interpreted as decreased proteoglycan content. Results Individuals with CAI demonstrated a higher involved limb talocrural T1ρ mean and variability relative to their contralateral limb ( P < 0.05) and the healthy control limb ( P < 0.05). The CAI-involved limb also had a higher posterior STJ T1ρ mean relative to the healthy control limb ( P < 0.05). In healthy controls ( P < 0.05), but not the CAI-involved or contralateral limbs (p>0.05), talocrural and posterior STJ composition measures were positively associated. Conclusions Individuals with CAI have lower proteoglycan content in both the talocrural and posterior STJ in their involved limbs relative to the contralateral and a healthy control limb. Cartilage composition findings may be consistent with the early development of posttraumatic osteoarthritis.

scholarly journals Influence of Foot Progression Angle on Center of Pressure During Stair Ascending in Subjects With Chronic Ankle Instability

2021 ◽  
Vol 15 ◽  
pp. 350-354
Author(s):  
Jung-Hyun Ban ◽  
Tae-Ho Kim
Keyword(s):  
Center Of Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Foot Progression Angle ◽  
Significant Difference ◽  
The Stability ◽  
Neutral Posture ◽  
Criteria For Selection ◽  
Anterior Posterior ◽  
Selection Of

The purpose of this study was to identify changes in the center of pressure during stair ascending in subjects with chronic ankle instability while different angles of foot are applied. The subjects of this study were 20 male and female adults with chronic ankle instability were selected from among the employees of D Hospital in Daegu Metropolitan City. The criteria for selection of subjects with chronic ankle instability were those who felt wobbling in the ankle joint and scored not higher than 24 points in a test using the Cumberland Ankle Instability Tool (CAIT). The subjects carried out stair ascending in neutral, toe-in and toe-out postures, respectively, and changes in the center of pressure (COP) were compared and analyzed. The results of this study, no statistically significant difference appeared in the comparison between the toe-in posture and neutral posture or between the neutral posture and the toe-out posture but medial/lateral movements of the center of pressure showed significant differences between the toe-in and toe-out postures. In addition, the total travel range and the moving range of the center of pressure, the average velocity, and the anterior/posterior movements of the center of pressure showed no statistically significant difference among all three postures. As a result, it could be seen that when adults with chronic ankle instability climb the stairs, the toe-in posture reduce the medial/lateral movements of the center of pressure thereby increasing the stability of the ankle and effectively preventing re-injuries.

scholarly journals The Effect of Cognitive Task on Postural Control Dynamic Regularity of Athletes With Chronic Ankle Instability When Standing on an Unstable Surface

2021 ◽  
Vol 15 (3) ◽  
pp. 161-168
Author(s):  
Shahab Asgari ◽  
◽  
Esmaeel Ebrahimi Takamjani ◽  
Reza Salehi ◽  
Soheil Mansour Sohani ◽  
...  
Keyword(s):  
Postural Control ◽  
Ankle Instability ◽  
Cognitive Task ◽  
Force Plate ◽  
Sample Entropy ◽  
Chronic Ankle Instability ◽  
Dual Task Condition ◽  
Control Behavior ◽  
Unstable Surface ◽  
Significant Difference

Background and Objectives: Postural control disorder is a common complication in patients with Chronic Ankle Instability (CAI). The present study aimed to investigate the effect of dual cognitive task on postural control behavior with regard to the Center of Pressure (CoP) signal regularity while standing on an unstable surface in athletes with CAI. Methods: In the present study, 58 men participated in two groups of healthy and patients with CAI. The CoP signal was examined in 4 different unstable states on the wobble board located at the center of the force plate. The regularity of the signals recorded from the force plate was investigated using sample entropy in two directions: anterior-posterior and medial-lateral. Results: In both groups, there was a significant difference in CoP’s sample entropy signal when performing a cognitive task with a postural task (P<0.001). There was a significant difference between the two groups in the cognitive task and the single task in the anteroposterior direction while standing on two legs. Conclusion: During dual tasks, the patients with CAI have a more dynamic regularity in the CoP signal than their normal counterparts. In the dual-task condition, more irregularities are observed in the CoP signal of healthy individuals. In unstable conditions, patients with CAI decrease the adaptability of postural control behavior with increasing CoP signal regularity.

scholarly journals Comparison of the Psychological Profile of Ankle Sprain Between Coper and Chronic Ankle Instability Individuals: Cross-sectional Study

2021 ◽  
Author(s):  
Shima Babakhanian ◽  
Mohammad Hani Mansori ◽  
Mohammad Karimizadeh Ardakani ◽  
Homa Naderifar
Keyword(s):  
Goal Setting ◽  
Sports Injuries ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Mental Practice ◽  
Self Report ◽  
Mental Skills ◽  
Cross Sectional ◽  
Self Confidence ◽  
Significant Difference

Abstract Background: The aim of this study was to compare the psychological parameters in Coper individuals and people with chronic ankle instability (CAI).Methods: This study was a cross-sectional and comparative study. Sixty elite athletes, from multiple athletic disciplines, who have suffered from lateral ankle sprains at least once in the last two years, were selected as research subjects and were divided into two groups: Copers (n = 30) and CAI (n = 30). Classification of CAI, and coper groups were done by AJFAT, CAIT and FAAM self-report questionnaires. Athletes' psychological characteristics were measured using the Ottawa Mental Skills Assessment Tool (OMSAT-3). Multivariate analysis of variance (MANOVA) and independent t-test were used to evaluate the differences between groups at a significance level of 0.05. Results: The results showed there was a significant difference between the two groups in Goal setting, Self-confidence, Commitment, Relaxation, Fear control and Coping with stress, Focusing, Refocusing, and Mental practice (P <0.05). And Coper athletes scored higher than ankle instability athletes. But there were no significant differences between the two groups in the following parameters: Inactivation, Imagery, and Competition planning skills (P <0.05).Conclusion: The findings showed that athletes with CAI scored lower than Coper athletes on psychological exams. Given the importance of prioritizing the mental components of goal setting, imagery, relaxation, activation, and self-confidence, the design of the competition should be a priority for rehabilitation. Therefore, coaches and sports experts are recommended to focus and improve mental skills in athletes who suffer from sports injuries, to reduce the occurrence of repetitive sports injuries.

The Effects of a Semi-Rigid Brace or Taping on Talocrural and Subtalar Kinematics in Chronic Ankle Instability

2014 ◽  
Vol 7 (6) ◽  
pp. 471-477 ◽  
Author(s):  
Takumi Kobayashi ◽  
Masayuki Saka ◽  
Eiichi Suzuki ◽  
Naohito Yamazaki ◽  
Makoto Suzukawa ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Ankle Instability ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Case Series ◽  
Chronic Ankle Instability ◽  
Cross Sectional ◽  
Anterior Translation ◽  
Computed Tomography Images ◽  
Significant Difference

Background. A semi-rigid brace or taping is often used to prevent giving-ways in the joint with chronic ankle instability (CAI). However, it remains unknown whether the application of a semi-rigid brace or taping modifies abnormal kinematics in CAI joints. The objective of this study was to determine if the application of a semi-rigid brace or taping of the ankle normalizes abnormal weight-bearing kinematics in CAI joints during ankle internal rotation in plantar flexion. Methods. A total of 14 male patients with unilateral CAI (mean age 21.1 ± 2.5 years) were enrolled. Three-dimensional bone models created from the computed tomography images were matched to the fluoroscopic images to compute the 6 degrees-of-freedom talocrural, subtalar, and ankle joint complex (AJC) kinematics for the healthy and contralateral CAI joints, as well as for CAI joints with a brace or taping. Selected outcome measures were talocrural anterior translation, talocrural internal rotation, and subtalar internal rotation. Results. There was no significant difference in talocrural anterior translation and internal rotation induced by applying either a semi-rigid brace or taping ( P > .05). For subtalar internal rotation, there was a tendency toward restoration of normal kinematics in CAI joints after applying a semi-rigid brace or taping. However, the difference was not significant ( P > .05). Discussion. Application of a semi-rigid brace or taping had limited effects on the CAI joint during weight-bearing ankle internal rotation in plantar flexion. Further studies using a variety of testing conditions should be conducted in the future. Levels of Evidence: Therapeutic, Level IV: Cross-Sectional Case Series

scholarly journals Comparison of Electromyographic Activity of Anterior Tibial Muscles and Long Fibular in Athletes With and Without Chronic Ankle Instability

2020 ◽  
Vol 22 (4) ◽  
pp. 260-264
Author(s):  
Giovanna Piai Cezar ◽  
Barbara Pasqualino Fachin ◽  
Christiane de Souza Guerino Macedo
Keyword(s):  
Surface Electromyography ◽  
Ankle Instability ◽  
Functional Limitation ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Electromyographic Activity ◽  
Ankle Sprains ◽  
Muscle Recruitment ◽  
Significant Difference ◽  
Anterior Tibial

AbstractChronic ankle instability (ICT) is common in jumping sports, may alter muscle recruitment, result in functional limitations and recurrence of sprains in this joint. The purpose of the study was to compare the muscle recruitment of the anterior tibial and long fibular muscles of athletes with and without chronic ankle instability by means of surface electromyography. Thirty-four athletes were recruited, divided into instability group (GI: n=14) and control group (GC: n=20), of both sexes and from different sport modalities, aged between 18 and 27 years old, history of ankle sprain in the last 12 months and functional limitation established by the Cumberland Ankle Instability (CAIT) questionnaire, the recruitment of the anterior tibial and long fibular muscles was analyzed by surface electromyography during the lunge exercise. The results for GI and GC were, respectively: age 21.3±2.88 and 22.4±3.25, height 1.77±0.10 and 1.74±0.08, CAIT 17[12.2-19] and 29.5 [27-30] (p<0.001). The anterior tibial and long fibular muscle recruitment in GI was 111.1[62.5-165.4] and 68.2±29, respectively and in GC 106.8[79.8-230.5] and 54.4±26.4, without significant difference. ICT did not interfere in the recruitment of the anterior tibial and long fibular muscles during the lunge exercise in athletes. Keywords: Ankle. Sprains and Strains. Health Evaluation. ResumoA instabilidade crônica do tornozelo (ICT) é comum em esportes de saltos, pode alterar o recrutamento muscular, resultar em limitações funcionais e recidivas de entorses nesta articulação. O objeto do estudo foi comparar o recrutamento muscular dos músculos tibial anterior e fibular longo de atletas com e sem instabilidade crônica de tornozelo por meio da eletromiografia de superfície. Foram recrutados 34 atletas, divididos em grupo instabilidade (GI: n=14) e grupo controle (GC: n=20), de ambos os sexos e de diferentes modalidades esportivas, com idade entre 18 e 27 anos, história de entorse de tornozelo nos últimos 12 meses e limitação funcional estabelecida pelo questionário Cumberland Ankle Instability (CAIT), o recrutamento dos músculos tibial anterior e fibular longo foi analisado pela eletromiografia de superfície durante o exercício de agachamento afundo. Os resultados para GI e GC foram, respectivamente: idade 21,3±2,88 e 22,4±3,25, altura 1,77±0,10 e 1,74±0,08, CAIT 17[12,2–19] e 29,5 [27-30] (p<0,001). O recrutamento muscular do tibial anterior e fibular longo no GI foi 111,1[62,5-165,4] e 68,2±29, respectivamente e no GC 106,8[79,8-230,5] e 54,4±26,4, sem diferença significativa. A ICT não interferiu no recrutamento dos músculos tibial anterior e fibular longo durante a realização do exercício de agachamento afundo em atletas. Palavras-chave: Tornozelo. Entorses e Distensões. Avaliação em Saúde

Abnormal gutter geometry as a risk factor of chronic ankle instability

2017 ◽  
Vol 23 ◽  
pp. 4
Author(s):  
Y. Tochigi ◽  
M. Ogawa ◽  
M. Kakihana ◽  
S. Ozeki
Keyword(s):  
Risk Factor ◽  
Ankle Instability ◽  
Chronic Ankle Instability

Comparison of the Strength and Electromyography of the Evertor Muscles With and Without Toe Flexion in Patients With Chronic Ankle Instability

2020 ◽  
Vol 41 (4) ◽  
pp. 479-485
Author(s):  
Sun-hee Ahn ◽  
Ui-jae Hwang ◽  
Gyeong-tae Gwak ◽  
Hwa-ik Yoo ◽  
Oh-yun Kwon
Keyword(s):  
Interaction Effect ◽  
Muscle Activity ◽  
Significant Interaction ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Metatarsal Bone ◽  
Significant Interaction Effect ◽  
Healthy Group ◽  
Peroneus Longus ◽  
Significant Difference

Background: Weakness of evertor strength is controversial in chronic ankle instability (CAI). Ankle evertor muscles are attached to the toe joints as well as to the metatarsal bone. Therefore, it is necessary to consider toe joint position for the measurement of evertor strength. The purpose of this study was to compare ankle evertor strength and muscle activity during eversion with and without toe flexion (TF) in individuals with CAI and individuals in a healthy group. Methods: Fifteen subjects with CAI and 15 healthy subjects participated in this study. Isometric ankle evertor strength and muscle activity of the peroneus longus (PL), peroneus brevis (PB), and extensor digitorum longus (EDL) were measured during eversion with and without TF. Results: The results indicated a significant interaction effect in evertor strength ( P = .03) and no significant interaction effect on EMG of the PL ( P = .08), PB ( P = .12), and EDL ( P = .28). However, measurements of muscle activity of the PL and PB between eversion with and without TF revealed a significant difference in the CAI group ( P < .01) and no significant difference in the healthy group (PL: P = .07; PB: P = .13). Conclusion: The results indicated that subjects with CAI had increased EDL compensation and reduced selective activation of the PL and PB during eversion. Clinical Relevance: Our findings suggest that clinicians should consider the activation of EDL when training the evertor of patients with CAI.

scholarly journals EFFECTS OF ATHLETIC TAPING ON PERFORMANCE OF BASKETBALL ATHLETES WITH CHRONIC ANKLE INSTABILITY

2018 ◽  
Vol 24 (6) ◽  
pp. 477-482 ◽  
Author(s):  
Luiza Cammerer Gehrke ◽  
Leonardo Ximenes Londero ◽  
Renata Fanfa Loureiro-Chaves ◽  
Henrique Hahn Souza ◽  
Gabriel Pizetta de Freitas ◽  
...  
Keyword(s):  
Functional Performance ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Joint Stability ◽  
Balance Test ◽  
Joint Stress ◽  
Athletic Tape ◽  
Significant Difference

ABSTRACT Introduction: Ankle sprains are recurrent injuries in basketball, hence more and more athletes are taping their ankles to promote joint stability, aiming at improving dynamic balance and, consequently, functional performance. Objective: To verify the effects of elastic and rigid athletic taping on the functional performance and level of comfort of basketball players with chronic ankle instability. Methods: Twenty-one athletes aged between 18 and 30 years (mean age 23.7 ± 3.2) with chronic ankle instability (CAI), verified using the Cumberland Ankle Instability Tool, were selected to take part in this study. The Star Excursion Balance Test (SEBT) and the Figure-of-8 hop test (F8) were applied unilaterally to assess functional performance, considering the ankle of greater instability in three situations: without athletic taping, with rigid athletic taping and with elastic athletic taping. A draw was held to determine the order in which the tests (held over a number of days) would be applied. A questionnaire was conducted to assess comfort on the same day the athletic tapes were applied. Results: There was no significant difference between the tests in any direction of the SEBT, but there was a significant difference in F8 between the rigid athletic taping x control and elastic athletic taping x control situations. In addition, the elastic athletic tape was considered significantly more comfortable than the rigid athletic tape. Conclusion: Athletic taping appears to effectively improve the dynamic balance and functional performance of athletes with CAI only in activities that cause considerable joint stress, as is the case in F8. Elastic athletic tape appears to be just as effective as rigid athletic tape in these situations, in addition to being a significantly more comfortable alternative. Levef of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.

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