Improving Chronic Ankle Instability Patient Reported Outcomes with Sensory-Targeted Ankle Rehabilitation Strategies

2015 ◽  
Vol 47 ◽  
pp. 614
Author(s):  
Kyeongtak Song ◽  
Patrick O. McKeon ◽  
Erik A. Wikstrom
Keyword(s):  
Patient Reported Outcomes ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Patient Reported ◽  
Ankle Rehabilitation ◽  
Rehabilitation Strategies

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.

Joint Stabilization Surgery for Chronic Ankle Instability and Medial Ankle Osteoarthritis: A Critically Appraised Topic

2021 ◽  
pp. 1-5
Author(s):  
Kyle B. Kosik ◽  
Kyeongtak Song ◽  
Phillip A. Gribble ◽  
Matthew C. Hoch ◽  
Arjun Srinath
Keyword(s):  
Clinical Outcomes ◽  
Study Design ◽  
Patient Reported Outcomes ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Bottom Line ◽  
Ankle Osteoarthritis ◽  
Joint Stabilization ◽  
Patient Reported

Clinical Scenario: Patients with chronic ankle instability (CAI) who require surgical intervention are often diagnosed with medial ankle osteoarthritis (OA). Lateral joint stabilization procedures are commonly performed among this patient population to restore bony alignment and improve cartilage loading patterns to increase patient-reported function and mitigate further degenerative changes. Focused Clinical Question: What is the available evidence to support joint stabilization procedures on patient-reported outcomes and progression of radiographic OA among patients with CAI who have medial ankle OA? Summary of Key Findings: An electronic search of relevant databases was performed to identify peer-reviewed articles examining preoperative and postoperative clinical outcomes and radiographic evidence of ankle OA. A total of 3 peer-reviewed articles were retrieved. All 3 articles employed a retrospective case series study design. All 3 articles demonstrated improved patient-reported outcomes at the final follow-up visit. Two articles demonstrated that between 11% and 27% of patients progressed in at least 1stage of radiographic ankle OA between the preoperative assessment and the final follow-up visit (40–56 mo). Clinical Bottom Line: Joint stabilization surgery for patients with CAI and medial ankle OA is associated with improved clinical outcomes and a low rate of worsening radiographic joint degeneration within the first 5 years. Strength of Recommendation: Consistent evidence exists across all 3 articles. However, this evidence is based on a low-quality study design. Therefore, there is a grade-C level of evidence to support joint stabilization for improving patient-reported and radiographic outcomes within the first 5 years after surgery for patients with CAI and medial ankle OA.

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 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.

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