scholarly journals The Effect of Peroneal Muscle Strength on Functional Outcomes After the Modified Broström Procedure for Chronic Ankle Instability

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0019
Author(s):  
Byung-Ki Cho ◽  
Seung-myung Choi
Keyword(s):  
Muscle Strength ◽  
Functional Outcomes ◽  
Ankle Instability ◽  
Peak Torque ◽  
Chronic Ankle Instability ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Patient Reported ◽  
Functional Outcome Measures ◽  
Modified Broström Procedure

Category: Sports Introduction/Purpose: Although the peroneal muscle is known to be a major dynamic lateral stabilizer of the ankle, few informations are available regarding the changes of muscle strength and relationship with the outcomes after lateral ligaments repair surgery. The purpose of this study was to identify the effects of peroneal strength on the validated functional outcome measures after the modified Broström procedure(MBP) for chronic ankle instability. Methods: Forty-one patients (41 ankles) underwent MBP using suture anchors were eligible and followed up to 2 years postoperatively. Functional evaluation consisted of the Foot and Ankle Outcome Score(FAOS), Foot and Ankle Ability Measure(FAAM). The changes of peroneal strength were evaluated using isokinetic dynamometer. Differences in the functional outcomes between the 3 groups divided according to recovery rate of peroneal strength were analysed. Results: Peak torque and total work for eversion in 60º/sec angular velocity significantly improved from a mean 8.1 Nm, 5.2 Nm preoperatively to 11.4 Nm, 6.9 Nm at postoperative 2 years, respectively (P < .001, P = .038). Deficit ratio of peak torque for eversion significantly improved from a mean 38.6% to 17.4%, and a significant side to side difference was found (P = .011). There were no significant differences in FAOS, FAAM, and measurements of stress radiograph between the 3 groups. Conclusion: Although restoration of peroneal strength postoperatively was about 82.6% of unaffected ankle, patient-reported function in daily and sport activities were satisfactorily improved. Postoperative isokinetic strength of the peroneus demonstrated no statistically significant effects on the functional outcomes after MBP.

The Effect of Peroneal Muscle Strength on Functional Outcomes After the Modified Broström Procedure for Chronic Ankle Instability

2017 ◽  
Vol 39 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Byung-Ki Cho ◽  
Ji-Kang Park ◽  
Seung-Myung Choi ◽  
Nelson F. SooHoo
Keyword(s):  
Muscle Strength ◽  
Functional Outcomes ◽  
Ankle Instability ◽  
Case Series ◽  
Peak Torque ◽  
Chronic Ankle Instability ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Patient Reported ◽  
Modified Broström Procedure

Background: Although the peroneal muscles are known to be the major dynamic lateral stabilizers of the ankle, little information is available regarding the change in muscle strength and relation with the outcomes after lateral ligament repair surgery. The purpose of this study was to identify the effects of peroneal strength on the validated functional outcome measures after the modified Broström procedure (MBP) for chronic ankle instability. Methods: Forty-one patients (41 ankles) who underwent MBP using suture anchors were eligible and followed up to 2 years postoperatively. Functional evaluation consisted of the Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). The changes of peroneal strength were evaluated using an isokinetic dynamometer. Differences in the functional outcomes between the 3 groups divided according to the recovery rate of peroneal strength were analyzed. Results: Peak torque and total work for eversion in 60 degrees/s angular velocity significantly improved from a mean 8.1 and 5.2 Nm preoperatively to 11.4 and 6.9 Nm at postoperative 2 years, respectively ( P < .001, P = .038). The deficit ratio of peak torque for eversion significantly improved from a mean 38.6% to 17.4%, and a significant side-to-side difference was found ( P = .011). There were no significant differences in FAOS, FAAM, and measurements of stress radiograph between the 3 groups. Conclusions: Although restoration of peroneal strength postoperatively was about 82.6% of the unaffected ankle, patient-reported function in daily and sport activities were satisfactorily improved. Postoperative isokinetic strength of the peroneals demonstrated no statistically significant effects on the functional outcomes after MBP. Level of Evidence: Level III, prospective comparative case series.

Isometric Hip Strength and Patient-Reported Outcomes of Individuals With and Without Chronic Ankle Instability

2021 ◽  
pp. 1-7
Author(s):  
Katherine A. Bain ◽  
Paige A. Clawson ◽  
Stacey A. Slone ◽  
Phillip A. Gribble ◽  
Johanna M. Hoch ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Peak Torque ◽  
Group Differences ◽  
Foot And Ankle ◽  
Fear Avoidance ◽  
Hip Strength ◽  
Fear Avoidance Beliefs ◽  
Patient Reported ◽  
Ability Measure ◽  
Fear Avoidance Beliefs Questionnaire

Context: Strength deficits and decreased scores on generic, dimension-specific, and region-specific health-related quality of life (HRQL) PRO measures are commonly documented among individuals with chronic ankle instability (CAI). However, it is unknown if there is a relationship between hip strength and self-reported patient-reported outcome (PRO) scores. Objective: To compare isometric peak torque for hip-extension (H-EXT) and hip-abduction (H-ABD), as well as PRO scores between CAI, lateral ankle sprain copers (LAS copers), and uninjured controls (UC). The secondary purpose was to examine the relationship between isometric hip peak torque and PROs in participants with CAI. Design: Cross-sectional. Setting: Laboratory. Participants: Sixty-three individuals, 45 women (23.02 [3.83] y, 165.91 [7.55] cm, 67.28 [11.95] kg) and 18 men (26.28 [5.43] y, 179.28 [9.01] cm, 83.87 [13.26] kg), grouped as uninjured control (n = 26), LAS coper (n = 15), or CAI (n = 22). Main Outcome Measures: The Foot and Ankle Ability Measure was used to assess region-specific HRQL. The Fear Avoidance Beliefs Questionnaire was used to assess injury-related fear. The Disablement in Physically Active was used to assess global HRQL. Isometric peak torque was measured with a handheld dynamometer for H-EXT and H-ABD. Results: No group differences were observed for H-ABD (P = .34) or H-EXT (P = .35). The CAI group had significantly worse scores on all PROs compared with LAS coper (P < .001) and HC (P < .001). Moderate–weak correlations were found between H-ABD and Foot and Ankle Ability Measure—activities of daily living (P = .047; ρ = .392) and Foot and Ankle Ability Measure-Sport (P = .013; ρ = .482) and H- EXT and Fear Avoidance Beliefs Questionnaire-Work (P = .007; ρ = −.517). Conclusions: Individuals with CAI displayed lower HRQL based on worse scores on generic, dimension-specific, and region-specific PROs compared with LAS copers and uninjured controls. There were no significant between-group differences for H-EXT and H-ABD isometric peak torque production, but there was a moderate positive relationship between isometric H-ABD and self-reported ankle disability in individuals with CAI.

scholarly journals The Effects of Lateral Ligaments Augmentation Using Suture-tape on Functional Ankle Instability

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0014
Author(s):  
Byung-Ki Cho ◽  
Seung-myung Choi
Keyword(s):  
Postural Control ◽  
Functional Outcomes ◽  
Ankle Instability ◽  
Peak Torque ◽  
Functional Ankle Instability ◽  
Unaffected Side ◽  
Lateral Ligaments ◽  
Patient Reported ◽  
Final Followup ◽  
Suture Tape

Category: Sports Introduction/Purpose: Although lateral ligaments augmentation using suture-tape has been effective for restoration of mechanical ankle stability, few data are available regarding changes of peroneal strength, proprioception and postural control. The aim of this study was to determine effects of suture-tape augmentation on functional ankle instability (FAI). Methods: Twenty-four patients that underwent suture-tape augmentation were eligible and were followed more than two years postoperatively. Functional outcomes were evaluated with the Cumberland Ankle Instability Tool (CAIT), Foot and Ankle Ability Measure (FAAM). Changes of peroneal strength, proprioception and postural control were analyzed with an isokinetic dynamometer and a modified Romberg test. Results: CAIT and FAAM significantly improved to average 27.2 points, 86.7 points at final followup. Peak torque for eversion in 60º/sec angular velocity significantly improved to 10.6 Nm at final followup. Deficit ratio of peak torque for eversion significantly improved from mean 39.5% to 20.9%, and significant side to side difference was revealed (P < .001). There were no significant differences in joint position sense. A significant improvement in balance retention time was revealed at final followup and relative deficit ratio compared to unaffected side was 30.9%. Conclusion: Patient-reported functional outcomes significantly improved after lateral ligaments augmentation using suture-tape. Although this procedure demonstrated significant effects on FAI based on improvement of isokinetic peroneal strength and postural control, recovery rates compared to the unaffected side were insufficient at the intermediate-term followup. In addition, there was no significantly positive effect on proprioception of the ankle.

Development of the Quick-FAAM: A Preliminary Shortened Version of the Foot and Ankle Ability Measure for Chronic Ankle Instability

2016 ◽  
Vol 21 (4) ◽  
pp. 45-50 ◽  
Author(s):  
Matthew C. Hoch ◽  
Johanna M. Hoch ◽  
Megan N. Houston
Keyword(s):  
Internal Consistency ◽  
Ankle Instability ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Chronic Ankle Instability ◽  
Foot And Ankle ◽  
Study Objective ◽  
Patient Reported ◽  
Administration Time ◽  
Ability Measure

The study objective was to develop a shortened version of the Foot and Ankle Ability Measure (FAAM) for individuals with chronic ankle instability (CAI). Forty individuals with CAI completed the FAAM Activities of Daily Living and Sport subscales and the Short Form-12. Analyses were completed for item reduction followed by dimensionality, coverage redundancy, and internal consistency of a reduced-item instrument. Validity was examined through correlations with the original FAAM and Short Form-12. A 12-item FAAM was created which demonstrated strong internal consistency and convergent/divergent validity. The Quick-FAAM may provide an alternative patient-reported outcome for CAI which requires less administration time.

scholarly journals Prognosis of Medial Gutter Osteoarthritis Combined with Chronic Ankle Instability

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0018
Author(s):  
Byung-Ki Cho ◽  
Seung-myung Choi
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Arthroscopic Debridement ◽  
Foot And Ankle ◽  
Middle Aged ◽  
Ankle Pain ◽  
Aged Patients ◽  
Modified Broström Procedure ◽  
Arthritic Changes

Category: Ankle Arthritis Introduction/Purpose: Although the frequent intraarticular pathologies associated with recurrent ankle sprains are well known, informations regarding treatment method for arthritic changes in the medial gutter are still insufficient. This study was performed to evaluate the intermediate-term clinical and radiological outcomes following modified Broström procedure and arthroscopic debridement in the middle-aged patients. Methods: Twenty-two patients with medial gutter osteoarthritis related to chronic lateral ankle instability were followed for more than 3 years after surgical treatment. All patients showed medial joint space narrowing of Takakura stage 2. The clinical evaluation consisted of the American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) for medial ankle pain during walking, and Foot and Ankle Ability Measure (FAAM). Results: Mean AOFAS and FAAM scores significantly improved from 51.2 and 45.7 points preoperatively to 80.3 and 78.4 points at final followup, respectively (P < .001). Although mean pain-VAS significantly improved from 6.8 points to 3.5 points (P < .001), 8 patients (36.4%) complained of discomfort at gait with considerable pain ≥ 4 points. There was only 1 patient (4.5%) with recurrent ankle instability, while 6 patients (27.3%) showed a progression in arthritis stage. Conclusion: Modified Broström procedure concomitant with arthroscopic debridement for medial gutter osteoarthritis secondary to chronic ankle instability is not effective enough to treat the medial ankle pain and functional impairment. Alternative treatment strategies for middle-aged cohort with arthritic changes are needed to improve the clinical outcomes and to prevent a progressive osteoarthritis.

scholarly journals Exercise-Based Rehabilitation and Manual Therapy Compared With Exercise-Based Rehabilitation Alone in the Treatment of Chronic Ankle Instability: A Critically Appraised Topic

2020 ◽  
Vol 29 (5) ◽  
pp. 684-688 ◽  
Author(s):  
Bridget M. Walsh ◽  
Katherine A. Bain ◽  
Phillip A. Gribble ◽  
Matthew C. Hoch
Keyword(s):  
Manual Therapy ◽  
Ankle Instability ◽  
Patient Reported Outcome ◽  
Chronic Ankle Instability ◽  
Current Evidence ◽  
Bottom Line ◽  
Patient Reported ◽  
Outcome Scores ◽  
The Difference ◽  
Improve Patient

Clinical Scenario: Patients with chronic ankle instability (CAI) commonly display lower levels of self-reported function and health-related quality of life. Several rehabilitation interventions, including manual therapy, have been investigated to help CAI patients overcome these deficits. However, it is unclear if the addition of manual therapy to exercise-based rehabilitation is more effective than exercise-based rehabilitation alone. Clinical Question: Does incorporating manual therapy with exercise-based rehabilitation improve patient-reported outcomes when compared with exercise-based rehabilitation alone? Summary of Key Findings: The literature was searched for articles that examined the difference in outcomes for patients with CAI between manual therapy with exercise-based rehabilitation and exercise-based rehabilitation alone. A total of 3 peer-reviewed randomized controlled trials were identified. Two articles demonstrated improved patient-reported outcome scores following the incorporation of manual therapy with exercise-based rehabilitation, whereas one study found no statistically significant differences between interventions. Clinical Bottom Line: The current evidence suggests that incorporating manual therapy in addition to exercised-based rehabilitation may improve patient-reported outcome scores in patients with CAI. Strength of Recommendation: In accordance with the Strength of Recommendation Taxonomy, the grade of A is recommended due to consistent evidence from high-quality studies.

scholarly journals Wobble-Board Balance Intervention to Decrease Symptoms and Prevent Reinjury in Athletes With Chronic Ankle Instability: An Exploration Case Series

2020 ◽  
Vol 55 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Cynthia J. Wright ◽  
Stacey L. Nauman ◽  
Jon C. Bosh
Keyword(s):  
Intercollegiate Athletics ◽  
Ankle Instability ◽  
Case Series ◽  
Chronic Ankle Instability ◽  
Global Rating ◽  
Ankle Sprains ◽  
Intercollegiate Athletes ◽  
Patient Reported ◽  
Balance Intervention ◽  
Increasing Function

Controlled research has shown that a single-exercise wobble-board intervention is effective at reducing symptoms and increasing function in patients with chronic ankle instability. However, the effectiveness of this protocol has not been documented in a realistic intercollegiate athletics environment. Eight intercollegiate athletes with chronic ankle instability participated in an 8-week (3 sessions/wk) wobble-board intervention. In a realistic environment, this simple intervention was feasible to implement and resulted in meaningful improvements in patient-reported stability for more than half of the patients (5 of 8) but only improved the global rating of function and pain for a minority of the patients (2 of 8 and 3 of 8, respectively). Not all patients experienced equal symptom reduction; however, no new ankle sprains occurred during the intervention.

The Effect of Dry Needling on Patient-Reported Outcomes in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

2019 ◽  
Vol 24 (5) ◽  
pp. 186-192
Author(s):  
Jennifer F. Mullins ◽  
Arthur J. Nitz ◽  
Matthew C. Hoch
Keyword(s):  
Patient Reported Outcomes ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
The Other ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Dry Needling ◽  
Bottom Line ◽  
Patient Reported

Clinical Scenario: Chronic ankle instability (CAI) and its associated recurrent sprains, feelings of instability, and decreased function occur in approximately 40% of individuals that suffer an ankle sprain. Despite these continued deficits, more effective treatment has yet to be established. Decreased sensorimotor function has been associated with CAI and may be amenable to dry needling treatment, thereby improving patient-reported outcomes (PROs). Focused Clinical Question: Does dry needling improve PROs in individuals with CAI? Summary of Key Findings: Two studies were identified that examined dry needling in participants with CAI. One of the two studies reported improvements in PROs (PEDro score 7/10) while the other study did not identify any changes (PEDro score 9/10). The inconsistent results were likely related to different treatment durations and follow-up timelines across the included evidence. Clinical Bottom Line: Based on the included studies, there is inconsistent evidence that dry needling can improve PROs in individuals with CAI. Strength of Recommendation: Utilizing the Strength of Recommendation Taxonomy (SORT) guidelines, level B evidence exists to recommend dry needling treatment to improve PROs for individuals with CAI.

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