scholarly journals Knee and Ankle Position, Anterior Drawer Laxity, and Stiffness of the Ankle Complex

2008 ◽  
Vol 43 (3) ◽  
pp. 242-248 ◽  
Author(s):  
John E. Kovaleski ◽  
Phillip M. Norrell ◽  
Robert J. Heitman ◽  
J. Marcus Hollis ◽  
Albert W. Pearsall

Abstract Context: Anterior drawer testing of the ankle is commonly used to diagnose lateral ligamentous instability. Our hypothesis was that changing knee and ankle positions would change the stability of the ankle complex during anterior drawer testing. Objectives: To assess the effects of knee and ankle position on anterior drawer laxity and stiffness of the ankle complex. Design: A repeated-measures design with knee and ankle position as independent variables. Setting: University research laboratory. Patients or Other Participants: Bilateral ankles of 10 female (age  =  19.8 ± 1.1 years) and 10 male (age  =  20.8 ± 1.2 years) collegiate athletes were tested. Intervention(s): Each ankle complex underwent loading using an ankle arthrometer under 4 test conditions consisting of 2 knee positions (90° and 0° of flexion) and 2 ankle positions (0° and 10° of plantar flexion [PF]). Main Outcome Measure(s): Recorded anterior laxity (mm) and stiffness (N/mm). Results: Anterior laxity of the ankle complex was maximal with the knee positioned at 90° of flexion and the ankle at 10° of PF when compared with the knee positioned at 0° of flexion and the ankle at 10° or 0° of PF (P < .001), whereas ankle complex stiffness was greatest with the knee positioned at 0° of flexion and the ankle at 0° of PF (P < .009). Conclusions: Anterior drawer testing of the ankle complex with the knee positioned at 90° of flexion and the ankle at 10° of PF produced the most laxity and the least stiffness. These findings indicate that anterior drawer testing with the knee at 90° of flexion and the ankle at 10° of PF may permit better isolation of the ankle capsuloligamentous structures.

2010 ◽  
Vol 90 (1) ◽  
pp. 55-66 ◽  
Author(s):  
Trisha M. Kesar ◽  
Ramu Perumal ◽  
Angela Jancosko ◽  
Darcy S. Reisman ◽  
Katherine S. Rudolph ◽  
...  

Background Foot drop is a common gait impairment after stroke. Functional electrical stimulation (FES) of the ankle dorsiflexor muscles during the swing phase of gait can help correct foot drop. Compared with constant-frequency trains (CFTs), which typically are used during FES, novel stimulation patterns called variable-frequency trains (VFTs) have been shown to enhance isometric and nonisometric muscle performance. However, VFTs have never been used for FES during gait. Objective The purpose of this study was to compare knee and ankle kinematics during the swing phase of gait when FES was delivered to the ankle dorsiflexor muscles using VFTs versus CFTs. Design A repeated-measures design was used in this study. Participants Thirteen individuals with hemiparesis following stroke (9 men, 4 women; age=46–72 years) participated in the study. Methods Participants completed 20- to 40-second bouts of walking at their self-selected walking speeds. Three walking conditions were compared: walking without FES, walking with dorsiflexor muscle FES using CFTs, and walking with dorsiflexor FES using VFTs. Results Functional electrical stimulation using both CFTs and VFTs improved ankle dorsiflexion angles during the swing phase of gait compared with walking without FES (X̅±SE=−2.9°±1.2°). Greater ankle dorsiflexion in the swing phase was generated during walking with FES using VFTs (X̅±SE=2.1°±1.5°) versus CFTs (X̅±SE=0.3±1.3°). Surprisingly, dorsiflexor FES resulted in reduced knee flexion during the swing phase and reduced ankle plantar flexion at toe-off. Conclusions The findings suggest that novel FES systems capable of delivering VFTs during gait can produce enhanced correction of foot drop compared with traditional FES systems that deliver CFTs. The results also suggest that the timing of delivery of FES during gait is critical and merits further investigation.


2002 ◽  
Vol 10 (4) ◽  
pp. 489-503 ◽  
Author(s):  
George J. Salem ◽  
Man-Ying Wang ◽  
Susan Sigward

In order to obtain joint-specific baseline strength characteristics in older adults, clinicians and researchers must have knowledge regarding the relative stability of the various strength tests (the strength difference between repeated measures) and the number of prebaseline practice sessions required to obtain consistent data. To address these needs, the relative multiple-test stability and reliability associated with lower extremity isokinetic and 1-repetition-maximum (1RM) strength measures were assessed in a sample of older adults (N= 30, 65.2 ± 6.3 years), over 4 weeks (T1-T4). Isokinetic ankle plantar-flexion (30°/s) strength and 1RM ankle plantar-flexion, leg-press, and knee-flexion strength exhibited poor stability between Weeks T1 and T2 but stabilized between Weeks T2 and T3 and Weeks T3 and T4. The measures exhibited low incidence of injury and induced low levels of residual muscle soreness. Findings suggest that the 1RM measures require at least 1 prebaseline training session in order to establish consistent baseline performance and are more reliable than isokinetic ankle plantar-flexion tests.


2015 ◽  
Vol 114 (4) ◽  
pp. 2328-2339 ◽  
Author(s):  
Logan S. James ◽  
Jon T. Sakata

Understanding the factors that predict and guide variation in behavioral change can lend insight into mechanisms of motor plasticity and individual differences in behavior. The performance of adult birdsong changes with age in a manner that is similar to rapid context-dependent changes to song. To reveal mechanisms of vocal plasticity, we analyzed the degree to which variation in the direction and magnitude of age-dependent changes to Bengalese finch song could be predicted by variation in context-dependent changes. Using a repeated-measures design, we found that variation in age-dependent changes to the timing, sequencing, and structure of vocal elements (“syllables”) was significantly predicted by variation in context-dependent changes. In particular, the degree to which the duration of intersyllable gaps, syllable sequencing at branch points, and fundamental frequency of syllables within spontaneous [undirected (UD)] songs changed over time was correlated with the degree to which these features changed from UD song to female-directed (FD) song in young-adult finches (FDyoung). As such, the structure of some temporal features of UD songs converged over time onto the structure of FDyoung songs. This convergence suggested that the FDyoung song could serve as a stable target for vocal motor plasticity. Consequently, we analyzed the stability of FD song and found that the temporal structure of FD song changed significantly over time in a manner similar to UD song. Because FD song is considered a state of heightened performance, these data suggest that age-dependent changes could reflect practice-related improvements in vocal motor performance.


2009 ◽  
Vol 18 (3) ◽  
pp. 389-397 ◽  
Author(s):  
Carrie L. Docherty ◽  
Katherine Rybak-Webb

Context:Joint arthrometers have been developed to help determine the severity of ligament sprains.Objective:To establish intratester and intertester reliability of the talar inversion and anterior drawer tests using the LigMaster.Design:Intratester reliability was investigated using a repeated-measures design. Intertester reliability was investigated using 2 different clinicians testing subjects on the same day.Setting:Athletic training research laboratory. Participants: Thirty participants volunteered for this study.Main Outcome Measurements:Anterior displacement and talar inversion were measured using the LigMaster.Results:Intrarater reliability was .74 for the talar inversion test and .65 for the anterior drawer test. Interrater reliabilities for the talar inversion and anterior drawer tests were .76 and .81, respectively.Conclusions:The LigMaster joint arthrometer is a reliable tool for measuring talar inversion and anterior displacement at the ankle.


Methodology ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Pablo Livacic-Rojas ◽  
Guillermo Vallejo ◽  
Paula Fernández ◽  
Ellián Tuero-Herrero

Abstract. Low precision of the inferences of data analyzed with univariate or multivariate models of the Analysis of Variance (ANOVA) in repeated-measures design is associated to the absence of normality distribution of data, nonspherical covariance structures and free variation of the variance and covariance, the lack of knowledge of the error structure underlying the data, and the wrong choice of covariance structure from different selectors. In this study, levels of statistical power presented the Modified Brown Forsythe (MBF) and two procedures with the Mixed-Model Approaches (the Akaike’s Criterion, the Correctly Identified Model [CIM]) are compared. The data were analyzed using Monte Carlo simulation method with the statistical package SAS 9.2, a split-plot design, and considering six manipulated variables. The results show that the procedures exhibit high statistical power levels for within and interactional effects, and moderate and low levels for the between-groups effects under the different conditions analyzed. For the latter, only the Modified Brown Forsythe shows high level of power mainly for groups with 30 cases and Unstructured (UN) and Autoregressive Heterogeneity (ARH) matrices. For this reason, we recommend using this procedure since it exhibits higher levels of power for all effects and does not require a matrix type that underlies the structure of the data. Future research needs to be done in order to compare the power with corrected selectors using single-level and multilevel designs for fixed and random effects.


2020 ◽  
Author(s):  
Resti Tito Villarino ◽  
Christopher Arcay ◽  
Maria Concepcion Temblor

BACKGROUND Hypertension is a serious health issue and a major cardiovascular disease and stroke risk factor. In hypertensive patients, various health educational models have been used to improve their lifestyle, but the findings are inconsistent. OBJECTIVE The study assessed the effects of a lifestyle intervention program using modified Beliefs, Attitude, Subjective Standards, Enabling Factors (BASNEF) model among non-adherent hypertensive respondents in relation to the introduction of a lifestyle intervention program in the management of hypertension. METHODS This is a quantitative quasi-experimental research particularly utilizing a repeated-measures design of within-subjects approach on the 50 non-adherent patients diagnosed with essential hypertension at Moalboal, Cebu, Philippines in 2019. The respondents received five sessions of trainings based on modified BASNEF model. The Morisky Medication Adherence instrument was used. The first phase included a demographic questionnaire and the last phase comprised the evaluation of the program. Frequencies, percentages, means and standard deviations for descriptive statistics while t-test, repeated measures, ANOVA, and Pearson product moment correlation for inferential statistics. RESULTS The result indicated that the phase 1 mean (146.5) of the systolic readings differ significantly from the phase 4 mean (134.92) of the systolic readings. However, since these two means came from phases that were not consecutive, the result, as a whole, did not show a significant decrease or change when analyzed chronologically from one phase to the next. CONCLUSIONS The study has established that BASNEF model approach can be an effective BP management technique.


Biology ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 48
Author(s):  
Junya Saeki ◽  
Soichiro Iwanuma ◽  
Suguru Torii

The structure of the first toe is independent of that of the other toes, while the functional difference remains unclear. The purpose of this study was to investigate the difference in the force generation characteristics between the plantar-flexion of the first and second–fifth metatarsophalangeal joints (MTPJs) by comparing the maximal voluntary plantar-flexion torques (MVC torque) at different MTPJs and ankle positions. The MVC torques of the first and second–fifth MTPJs were measured at 0°, 15°, 30°, and 45° dorsiflexed positions of the MTPJs, and at 20° plantar-flexed, neutral, and 20° dorsiflexed positions of the ankle. Two-way repeated measures analyses of variance with Holm’s multiple comparison test (MTPJ position × ankle position) were performed. When the MTPJ was dorsiflexed at 0°, 15°, and 30°, the MVC torque of the first MTPJ when the ankle was dorsiflexed at 20° was higher than that when the ankle was plantar-flexed at 20°. However, the ankle position had no significant effect on the MVC torque of the second–fifth MTPJ. Thus, the MVC torque of the first MTPJ was more affected by the ankle position than the second–fifth MTPJs.


2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.


Author(s):  
Nuno Batalha ◽  
Jose A. Parraca ◽  
Daniel A. Marinho ◽  
Ana Conceição ◽  
Hugo Louro ◽  
...  

The purpose of this study was to analyze the acute effects of a standardized water training session on the shoulder rotators strength and balance in age group swimmers, in order to understand whether a muscle-strengthening workout immediately after the water training is appropriate. A repeated measures design was implemented with two measurements performed before and after a standardized swim session. 127 participants were assembled in male (n = 72; age: 16.28 ± 1.55 years, height: 174.15 ± 7.89 cm, weight: 63.97 ± 6.51 kg) and female (n = 55; age: 15.29 ± 1.28 years, height: 163.03 ± 7.19 cm, weight: 52.72 ± 5.48 kg) cohorts. The isometric torque of the shoulder internal (IR) and external (ER) rotators, as well as the ER/IR ratios, were assessed using a hand-held dynamometer. Paired sample t-tests and effect sizes (Cohen’s d) were used (p ≤ 0.05). No significant differences were found on the shoulder rotators strength or balance in males after training. Females exhibited unchanged strength values after practice, but there was a considerable decrease in the shoulder rotators balance of the non-dominant limb (p < 0.01 d = 0.366). This indicates that a single practice seems not to affect the shoulders strength and balance of adolescent swimmers, but this can be a gender specific phenomenon. While muscle-strengthening workout after the water session may be appropriate for males, it can be questionable regarding females. Swimming coaches should regularly assess shoulder strength levels in order to individually identify swimmers who may or may not be able to practice muscle strengthening after the water training.


2017 ◽  
Vol 3 (3) ◽  
pp. 88-93 ◽  
Author(s):  
Maureen Anne Jersby ◽  
Paul Van-Schaik ◽  
Stephen Green ◽  
Lili Nacheva-Skopalik

BackgroundHigh-Fidelity Simulation (HFS) has great potential to improve decision-making in clinical practice. Previous studies have found HFS promotes self-confidence, but its effectiveness in clinical practice has not been established. The aim of this research is to establish if HFS facilitates learning that informs decision-making skills in clinical practice using MultipleCriteria DecisionMaking Theory (MCDMT).MethodsThe sample was 2nd year undergraduate pre-registration adult nursing students.MCDMT was used to measure the students’ experience of HFS and how it developed their clinical decision-making skills. MCDMT requires characteristic measurements which for the learning experience were based on five factors that underpin successful learning, and for clinical decision-making, an analytical framework was used. The study used a repeated-measures design to take two measurements: the first one after the first simulation experience and the second one after clinical placement. Baseline measurements were obtained from academics. Data were analysed using the MCDMT tool.ResultsAfter their initial exposure to simulation learning, students reported that HFS provides a high-quality learning experience (87%) and supports all aspects of clinical decision-making (85%). Following clinical practice, the level of support for clinical decision-making remained at 85%, suggesting that students believe HFS promotes transferability of knowledge to the practice setting.ConclusionOverall, students report a high level of support for learning and developing clinical decision-making skills from HFS. However, there are no comparative data available from classroom teaching of similar content so it cannot be established if these results are due to HFS alone.


Sign in / Sign up

Export Citation Format

Share Document