scholarly journals Chronic Ankle Instability: Evolution of the Model

2011 ◽  
Vol 46 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Claire E. Hiller ◽  
Sharon L. Kilbreath ◽  
Kathryn M. Refshauge

Abstract Context: The Hertel model of chronic ankle instability (CAI) is commonly used in research but may not be sufficiently comprehensive. Mechanical instability and functional instability are considered part of a continuum, and recurrent sprain occurs when both conditions are present. A modification of the Hertel model is proposed whereby these 3 components can exist independently or in combination. Objective: To examine the fit of data from people with CAI to 2 CAI models and to explore whether the different subgroups display impairments when compared with a control group. Design: Cross-sectional study. Patients or Other Participants: Community-dwelling adults and adolescent dancers were recruited: 137 ankles with ankle sprain for objective 1 and 81 with CAI and 43 controls for objective 2. Intervention(s): Two balance tasks and time to recover from an inversion perturbation were assessed to determine if the subgroups demonstrated impairments when compared with a control group (objective 2). Main Outcome Measure(s): For objective 1 (fit to the 2 models), outcomes were Cumberland Ankle Instability Tool score, anterior drawer test results, and number of sprains. For objective 2, outcomes were 2 balance tasks (number of foot lifts in 30 seconds, ability to balance on the ball of the foot) and time to recover from an inversion perturbation. The Cohen d was calculated to compare each subgroup with the control group. Results: A total of 56.5% of ankles (n = 61) fit the Hertel model, whereas all ankles (n = 108) fit the proposed model. In the proposed model, 42.6% of ankles were classified as perceived instability, 30.5% as recurrent sprain and perceived instability, and 26.9% as among the remaining groups. All CAI subgroups performed more poorly on the balance and inversion-perturbation tasks than the control group. Subgroups with perceived instability had greater impairment in single-leg stance, whereas participants with recurrent sprain performed more poorly than the other subgroups when balancing on the ball of the foot. Only individuals with hypomobility appeared unimpaired when recovering from an inversion perturbation. Conclusions: The new model of CAI is supported by the available data. Perceived instability alone and in combination characterized the majority of participants. Several impairments distinguished the sprain groups from the control group.

2019 ◽  
Vol 54 (6) ◽  
pp. 671-675 ◽  
Author(s):  
Tricia Hubbard-Turner

Context Despite the prevalence of ankle sprains and the potential for developing chronic ankle instability and ankle osteoarthritis, ankle sprains are often perceived as an innocuous injury. Objective To understand the initial management and treatment sought by patients after a lateral ankle sprain (LAS) and to identify any differences in subjective function and self-reported injury. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants A total of 175 participants with chronic ankle instability (73 men, 102 women; age = 20.9 ± 3.4 years, height = 173.5 ± 13.2 cm, mass = 81.4 ± 24.6 kg) were involved in the study. Main Outcome Measure(s) Participants were administered a questionnaire regarding their initial LAS. All participants also completed the Foot and Ankle Ability Measure (FAAM). The primary questions of interest were (1) Did the participants seek treatment from a medical professional for their initial LAS? (2) Did the participants perform rehabilitation? (3) Was the initial LAS immobilized? and (4) Did the participants use crutches? The other variables measured were scores on the FAAM and the FAAM Sports subscale, total number of ankle sprains, and incidents of giving way. Results Sixty-four percent of participants did not seek medical treatment after their LAS. Those who did not seek medical treatment scored worse on the FAAM (81.21% ± 3.1% versus 89.23% ± 2.8%, P = .03) and the FAAM Sports subscale (72.34% ± 5.3% versus 81.26% ± 3.1%, P = .001). Those not seeking treatment also reported more ankle sprains since the initial injury (4.7 ± 2.4 versus 1.9 ± 0.90, P = .02) and more incidents of giving way each month (3.8 ± 1.9 versus 1.1 ± 0.87, P = .04). Conclusions It is not surprising that those who did not seek medical treatment for their LASs had worse subjective function, more ankle sprains, and more incidents of the ankle giving way. The public needs to be educated on the significance of ankle sprains and the need for medical attention to provide appropriate management. However, we also need to continue to evaluate initial management and rehabilitation to ensure that those who seek treatment receive the best care in order to reduce reinjury rates.


2015 ◽  
Vol 20 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Marjan Someeh ◽  
Ali Asghar Norasteh ◽  
Hassan Daneshmandi ◽  
Abbas Asadi

Context:Ankle sprains or chronic ankle instability (CAI) is common in athletes and a common method for decreasing the effects of ankle instable is using tape.Objective:To determine whether Mulligan ankle taping (MAT) influenced the functional performance (FP) tests in athletes with and without CAI.Design:A cross-sectional study using a within-subject experimental design between four ankle conditions (taped and untaped, athletes with and without CAI).Setting:Research laboratory.Participants:Sixteen professional athletes with unilateral CAI (10 men and 6 women; age 23.2 ± 3 years, height 175.4 ± 10.3 cm, weight 73 ± 14.5 kg, and body mass index 23.8 ± 3.6%) and 16 uninjured professional athletes (10 men and 6 women; age 22.8 ± 1.7 years, height 173.6 ± 12.2 cm, weight 66.4 ± 11.4 kg, and body mass index 22.2 ± 3.3%) volunteered to participant in this study.Intervention:Mulligan ankle taping.Main Outcome Measures:FP tests including single leg hopping course, Figure-of-8 hop and side hop were measured for both the groups in two conditions: taped and untaped.Results:There were significant differences between injured and uninjured athletes in all FP tests (P< .05). MAT significantly improved FP tests in both groups (P< .05).Conclusion:We found that MAT can improve FP tests in athletes with CAI and uninjured athletes. Therefore, it seems that MAT can be an effective method for enhancing athletes’ performance in sports that require lateral movements.


2018 ◽  
Vol 39 (11) ◽  
pp. 853-859 ◽  
Author(s):  
Patrick Fuerst ◽  
Albert Gollhofer ◽  
Heinz Lohrer ◽  
Dominic Gehring

AbstractDespite a considerable amount of research, the deficits causing recurrent sprains in people with chronic ankle instability are still unclear. Changes in frontal plane kinematics and decreased peroneal activation have been proposed as potential underlying mechanisms, but whether people with ankle instability show deficits in control of injury-relevant movements is not well understood. Therefore, the purpose of the present study was to analyse ankle joint kinematics and kinetics as well as neuromuscular activation during dynamic change-of-direction movements. Eighteen participants with functional instability, 18 participants with functional and mechanical instability and 18 healthy controls performed 45° sidestep-cutting and 180° turning movements in reaction to light signals. During sidestep-cutting both instability groups displayed significantly lower inversion angles than controls when the trials with the highest maximum inversion angle of each participant were compared. In turning movements, participants with functional instability presented significantly lower average maximum inversion angles than controls as well as higher peroneal activation before foot strike than participants with both functional and mechanical instability. We theorize that the observed changes in movement kinematics of participants with chronic ankle instability are the result of a protective strategy to limit frontal plane ankle joint loading in potentially harmful situations.


2020 ◽  
Vol 79 ◽  
pp. 183-188
Author(s):  
Somayeh Mohamadi ◽  
Ismail Ebrahimi ◽  
Mahyar Salavati ◽  
Mehdi Dadgoo ◽  
Amir Salar Jafarpisheh ◽  
...  

Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL


2013 ◽  
Vol 40 (2) ◽  
Author(s):  
Ni Ketut Susilawati ◽  
Wayan Sudana ◽  
Eka Putra Setiawan

Background: Noise pollution or noise is an unwanted sound which is disturbing to human beings.However small or soft the sound, if it is undesirable it is considered as noise. Noise induced hearingloss is a sensorineural hearing loss that is commonly encountered second to presbycusis. Purpose: Toknow the effect of traffic noise exposure on hearing impairment to the employees of the Parking DistrictCompany of the Denpasar city and to improve diagnostic detection on hearing impairment caused bynoise. Method: A cross sectional study was conducted at the Parking District Company office. Thepopulations of this study were the employees of the Parking District Company. Samples of this study were the employees who were exposed to traffic noise and control samples were an employee who was unexposed. Samples were selected by simple random sampling. Results: From 40 parking attendants,27 persons (67.5%) aged above 35 years old. The parking attendants who had been working for ten to fifteen years were 36 persons (90%) and no history using ear protection when working. Seven persons(17.5%) had referred DPOAE upon examination with increase hearing threshold on audiogram result.In this study the parking attendants who had hearing deficit induced by noise were 7 persons (17.5%)and only one person (2.5%) in control group. There was a statistically significant effect of traffic noiseto hearing function deficit (p<0.05). Conclusion: Traffic noise has effect in hearing function deficit onthe parking attendants.ORLI Vol. 40 No. 2 Tahun 2010Key words: NIHL, parking attendant, audiometry, DPOAE.


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