scholarly journals Muscle Spindle Traffic in Functionally Unstable Ankles During Ligamentous Stress

2013 ◽  
Vol 48 (2) ◽  
pp. 192-202 ◽  
Author(s):  
Alan R. Needle ◽  
Swanik Charles B. (Buz) ◽  
William B. Farquhar ◽  
Stephen J. Thomas ◽  
William C. Rose ◽  
...  
Keyword(s):  
Muscle Spindle ◽  
Repeated Measures ◽  
Ankle Instability ◽  
Ankle Sprains ◽  
Ankle Motion ◽  
Ankle Arthrometer ◽  
Joint Forces ◽  
Peripheral Sensory ◽  
And Inversion

Context: Ankle sprains are common in athletes, with functional ankle instability (FAI) developing in approximately half of cases. The relationship between laxity and FAI has been inconclusive, suggesting that instability may be caused by insufficient sensorimotor function and dynamic restraint. Research has suggested that deafferentation of peripheral mechanoreceptors potentially causes FAI; however, direct evidence confirming peripheral sensory deficits has been elusive because previous investigators relied upon subjective proprioceptive tests. Objective: To develop a method for simultaneously recording peripheral sensory traffic, joint forces, and laxity and to quantify differences between healthy ankles and those with reported instability. Design: Case-control study. Setting: University laboratory. Patients or Other Participants: A total of 29 participants (age = 20.9 ± 2.2 years, height = 173.1 ± 8.9 cm, mass = 74.5 ± 12.7 kg) stratified as having healthy (HA, n = 19) or unstable ankles (UA, n = 10). Intervention(s): Sensory traffic from muscle spindle afferents in the peroneal nerve was recorded with microneurography while anterior (AP) and inversion (IE) stress was applied to ligamentous structures using an ankle arthrometer under test and sham conditions. Main Outcome Measure(s): Laxity (millimeters or degrees) and amplitude of sensory traffic (percentage) were determined at 0, 30, 60, 90, and 125 N of AP force and at 0, 1, 2, 3, and 4 Nm of IE torque. Two-factor repeated-measures analyses of variance were used to determine differences between groups and conditions. Results: No differences in laxity were observed between groups (P > .05). Afferent traffic increased with increased force and torque in test trials (P < .001). The UA group displayed decreased afferent activity at 30 N of AP force compared with the HA group (HA: 30.2% ± 9.9%, UA: 17.1% ± 16.1%, P < .05). Conclusions: The amplitude of sensory traffic increased simultaneously with greater ankle motion and loading, providing evidence of the integrated role of capsuloligamentous and musculotendinous mechanoreceptors in maintaining joint sensation. Unstable ankles demonstrated diminished afferent traffic at low levels of force, suggesting the early detection of joint loading may be compromised.

Ligament Laxity Following Inversion Injury with and without Chronic Ankle Instability

2008 ◽  
Vol 29 (3) ◽  
pp. 305-311 ◽  
Author(s):  
Tricia J. Hubbard
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Significant Group ◽  
Lateral Ankle ◽  
Anterior Displacement ◽  
Ligament Laxity ◽  
And Inversion

Background: Not all patients develop chronic ankle instability (CAI) after one or more lateral ankle sprains; some seem to heal or adjust to the ankle laxity after injury. Why do some patients develop CAI and others are able to cope and return to normal function? The purpose of this study was to examine ligament laxity between subjects with and without CAI. Materials and Methods: Sixteen subjects with unilateral CAI and 16 subjects without participated in the study. Ligament laxity was measured with an instrumented ankle arthrometer. The arthrometer measured ankle joint motion for anterior/posterior displacement (mm) during loading at 125 N and inversion/eversion rotation (degrees of ROM) during loading at 4000 N/mm. For each dependent variable a 2 × 2 mixed model ANOVA was run with the between factor being group (CAI, No CAI) and the within factor with repeated measures being side (involved, uninvolved). Results: A significant group by side interaction for anterior displacement (F1,30 = 370.085, p < 0.001), and inversion rotation (F1,30 = 7.455, p = 0.010) was found. There was significantly more anterior displacement and inversion rotation for the involved ankles of the CAI group than the involved ankles of the stable group and the uninvolved ankles of the CAI group. Conclusion: Based on the results of this study it appears that the increased anterior displacement and inversion rotation compared to patients without instability may be why subjects develop CAI. Although the patients without instability have a history of more than one lateral ankle sprain, they did not demonstrate increased laxity, which may be the reason why they do not complain of the functional impairment demonstrated in subjects with CAI.

Effects of the Subtalar Sling Ankle Taping Technique on Combined Talocrural-Subtalar Joint Motions

2005 ◽  
Vol 26 (3) ◽  
pp. 239-246 ◽  
Author(s):  
Gary B. Wilkerson ◽  
John E. Kovaleski ◽  
Mark Meyer ◽  
Christopher Stawiz
Keyword(s):  
Repeated Measures ◽  
Ankle Instability ◽  
Frontal Plane ◽  
Critical Factor ◽  
Normal Subjects ◽  
Ligament Injury ◽  
Exercise Session ◽  
Ankle Motion ◽  
Ankle Arthrometer ◽  
Joint Motions

Background: The findings of research on the effectiveness of ankle taping for protection against ligament injury have been inconsistent, and the topic remains controversial. The precise orientation of the force vectors created by tension within the various tape strip components of an ankle taping procedure may be a critical factor influencing the degree of motion restraint that is provided. We hypothesized that the addition of the subtalar sling component to the widely recognized standard (Gibney) ankle taping procedure would enhance restraint of ankle motion. This was a controlled laboratory study, with fully repeated measures (subjects served as their own controls). Methods: An ankle arthrometer was used to quantify anteroposterior (AP) translation and frontal plane inversion-eversion (I-E) tilt of the talocrural-subtalar joints under untaped and taped conditions in normal subjects. A 15-minute exercise session was conducted to loosen the tape before measurement of its effect on motion restraint. Results: The ankle taping procedure that incorporated the subtalar sling provided significantly greater restriction of postexercise AP translation (p < 0.001, η2 = 0.63) and postexercise I-E tilt (p < 0.001, η2 = 0.66). Conclusions: The subtalar sling ankle taping procedure provides greater restriction of motions associated with ankle instability than the more widely used Gibney procedure.

Effectiveness of External Orthotic Support on Passive Soft Tissue Resistance of the Chronically Unstable Ankle

1997 ◽  
Vol 18 (3) ◽  
pp. 144-150 ◽  
Author(s):  
H.D. Hartsell ◽  
Sandi J. Spaulding
Keyword(s):  
Repeated Measures ◽  
Ankle Instability ◽  
Healthy Population ◽  
Functional Ankle Instability ◽  
Chronic Instability ◽  
Passive Resistance ◽  
Tissue Resistance ◽  
Resistive Torque ◽  
Resistance Torque ◽  
And Inversion

Functional ankle instability, orthoses, and passive resistive torque tolerated have not been researched. The purpose of the study was to evaluate the passive resistance torque exerted by a flexible and semirigid orthosis for individuals with chronic instability. Twenty-two subjects were evaluated on the passive ankle resistance unit during unbraced, flexible, and semirigid brace conditions. Data from the final three trials for each condition were analyzed using a multiple analysis of variance with repeated measures for resistive torque and inversion range of motion. The semirigid and flexible braces tolerated significantly greater torque forces and less inversion range than the unbraced condition ( P < 0.000). External orthotic support, in particular that of a semirigid orthosis, may be beneficial toward reducing injury or be an effective prophylactic for the healthy population.

Fatigue’s Effect on Eversion Force Sense in Individuals With and Without Functional Ankle Instability

2012 ◽  
Vol 21 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Cynthia J. Wright ◽  
Brent L. Arnold
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Sports Medicine ◽  
Ankle Instability ◽  
Absolute Error ◽  
Ankle Sprains ◽  
Functional Ankle Instability ◽  
Maximal Voluntary Isometric Contraction ◽  
Medicine Research ◽  
Force Sense

Context:Force sense (FS), the proprioceptive ability to detect muscle-force generation, has been shown to be impaired in individuals with functional ankle instability (FAI). Fatigue can also impair FS in healthy individuals, but it is unknown how fatigue affects FS in individuals with FAI.Objective:To assess the effect of fatigue on ankle-eversion force-sense error in individuals with and without FAI. Design: Case control with repeated measures.Setting:Sports medicine research laboratory.Participants:32 individuals with FAI and 32 individuals with no ankle sprains or instability in their lifetime. FAI subjects had a history of ≥1 lateral ankle sprain and giving-way ≥1 episode per month.Interventions:Three eversion FS trials were captured per load (10% and 30% of maximal voluntary isometric contraction) using a load cell before and after a concentric eversion fatigue protocol.Main Outcome Measures:Trial error was the difference between the target and reproduction forces. Constant error (CE), absolute error (AE), and variable error (VE) were calculated from 3 trial errors. A Group × Fatigue × Load repeated-measures ANOVA was performed for each error.Results:There were no significant 3-way interactions or 2-way interactions involving group (all P > .05). CE and AE had a significant 2-way interaction between load and fatigue (CE: F1,62 = 8.704, P = .004; AE: F1,62 = 4.024, P = .049), and VE had a significant main effect for fatigue (F1,62 = 5.130, P = .027), all of which indicated increased FS error with fatigue at 10% load. However, at 30% load only VE increased with fatigue. The FAI group had greater error as measured by AE (F1,62 = 4.571, P = .036) but not CE or VE (P > .05).Conclusions:Greater AE indicates that FAI individuals are less accurate in their force production. Fatigue impaired force sense in all subjects equally. These deficits provide evidence of impaired proprioception with fatigue and in individuals with FAI.

scholarly journals Ankle Bracing and the Neuromuscular Factors Influencing Joint Stiffness

2009 ◽  
Vol 44 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Steven M. Zinder ◽  
Kevin P. Granata ◽  
Sandra J. Shultz ◽  
Bruce M. Gansneder
Keyword(s):  
Health Care Professionals ◽  
Repeated Measures ◽  
Mixed Model ◽  
Ankle Instability ◽  
Ankle Sprains ◽  
Rotational Stiffness ◽  
Maximal Voluntary Isometric Contraction ◽  
Factors Influencing ◽  
Ankle Brace ◽  
Ankle Bracing

Abstract Health care professionals commonly prescribe external stabilization to decrease the incidence and severity of ankle sprains. The mechanism for this decrease is not clearly understood. Examining the effects of ankle bracing on biomechanical stability and influencing factors may provide important information regarding the neuromuscular effects of bracing.Context: To study the effects of 2 different ankle braces on the neuromuscular factors influencing ankle stiffness.Objective: Mixed-model repeated-measures design.Design: Research laboratory.Setting: Twenty-eight physically active participants composing 2 groups: 14 with unilateral functional ankle instability (age  =  26.19 ± 6.46 years, height  =  166.07 ± 12.90 cm, mass  =  69.90 ± 13.46 kg) and 14 with bilaterally stable ankles (age  =  23.76 ± 5.82 years, height  =  174.00 ± 11.67 cm, mass  =  68.60 ± 13.12 kg).Patients or Other Participants: Participants were fitted with surface electromyography electrodes over the peroneus longus, peroneus brevis, tibialis anterior, and soleus muscles. Each participant received transient motion oscillations to his or her ankle on a custom-built medial-lateral swaying cradle in each of 3 conditions: no ankle brace (NB), lace-up brace (LU), and semirigid brace (SR).Intervention(s): Ankle stiffness as measured by the cradle and preactivation levels (percentage of maximal voluntary isometric contraction) of the 4 test muscles.Main Outcome Measure(s): Stiffness levels increased across brace conditions (NB  =  24.79 ± 6.59 Nm/rad, LU  =  28.29 ± 7.05 Nm/rad, SR  =  33.22 ± 8.78 Nm/rad; F2,52  =  66.185, P &lt; .001). No differences were found between groups for rotational stiffness (stable  =  27.36 ± 6.17 Nm/rad, unstable  =  30.18 ± 8.21 Nm/rad; F1,26  =  1.084, P  =  .307). Preactivation levels did not change for any of the tested muscles with the application of an ankle brace (F2,52  =  1.326, P  =  .275).Results: The increase in ankle rotational stiffness with the addition of an ankle brace and the lack of any demonstrable neuromuscular changes suggested ankle braces passively contributed to the stability of the system.Conclusions:

Ankle Strength Deficits in a Cohort of College Athletes With Chronic Ankle Instability

2019 ◽  
Vol 28 (7) ◽  
pp. 752-757 ◽  
Author(s):  
Bethany Wisthoff ◽  
Shannon Matheny ◽  
Aaron Struminger ◽  
Geoffrey Gustavsen ◽  
Joseph Glutting ◽  
...  
Keyword(s):  
Athletic Training ◽  
College Athletes ◽  
Ankle Instability ◽  
Plantar Flexion ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Functional Ankle Instability ◽  
History Of ◽  
Ankle Strength ◽  
And Inversion

Context: Lateral ankle sprains commonly occur in an athletic population and can lead to chronic ankle instability. Objective: To compare ankle strength measurements in athletes who have mechanical laxity and report functional instability after a history of unilateral ankle sprains. Design: Retrospective cohort. Setting: Athletic Training Research Lab. Participants: A total of 165 National Collegiate Athletic Association Division I athletes, 97 males and 68 females, with history of unilateral ankle sprains participated. Main Outcome Measures: Functional ankle instability was determined by Cumberland Ankle Instability Tool scores and mechanical ankle instability by the participant having both anterior and inversion/eversion laxity. Peak torque strength measures, concentric and eccentric, in 2 velocities were measured. Results: Of the 165 participants, 24 subjects had both anterior and inversion/eversion laxity and 74 self-reported functional ankle instability on their injured ankle. The mechanical ankle instability group presented with significantly lower plantar flexion concentric strength at 30°/s (139.7 [43.7] N·m) (P = .01) and eversion concentric strength at 120°/s (14.8 [5.3] N·m) (P = .03) than the contralateral, uninjured ankle (166.3 [56.8] N·m, 17.4 [6.2] N·m, respectively). Conclusion: College athletes who present with mechanical laxity on a previously injured ankle exhibit plantar flexion and eversion strength deficits between ankles.

scholarly journals People with chronic ankle instability benefit from brace application in highly dynamic change of direction movements

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Patrick Fuerst ◽  
Albert Gollhofer ◽  
Markus Wenning ◽  
Dominic Gehring
Keyword(s):  
Ankle Joint ◽  
Repeated Measures ◽  
Ankle Instability ◽  
Dynamic Change ◽  
Chronic Ankle Instability ◽  
Mechanical Resistance ◽  
Healthy Controls ◽  
Neuromuscular Activation ◽  
Ankle Inversion ◽  
Ankle Brace

Abstract Background The application of ankle braces is an effective method for the prevention of recurrent ankle sprains. It has been proposed that the reduction of injury rates is based on the mechanical stiffness of the brace and on beneficial effects on proprioception and neuromuscular activation. Yet, how the neuromuscular system responds to the application of various types of ankle braces during highly dynamic injury-relevant movements is not well understood. Enhanced stability of the ankle joint seems especially important for people with chronic ankle instability. We therefore aimed to analyse the effects of a soft and a semi-rigid ankle brace on the execution of highly dynamic 180° turning movements in participants with and without chronic ankle instability. Methods Fifteen participants with functional ankle instability, 15 participants with functional and mechanical ankle instability and 15 healthy controls performed 180° turning movements in reaction to light signals in a cross-sectional descriptive laboratory study. Ankle joint kinematics and kinetics as well as neuromuscular activation of muscles surrounding the ankle joint were determined. Two-way repeated measures analyses of variance and post-hoc t-tests were calculated. Results Maximum ankle inversion angles and velocities were significantly reduced with the semi-rigid brace in comparison to the conditions without a brace and with the soft brace (p ≤ 0.006, d ≥ 0.303). Effect sizes of these reductions were larger in participants with chronic ankle instability than in healthy controls. Furthermore, peroneal activation levels decreased significantly with the semi-rigid brace in the 100 ms before and after ground contact. No statistically significant brace by group effects were found. Conclusions Based on these findings, we argue that people with ankle instability in particular seem to benefit from a semi-rigid ankle brace, which allows them to keep ankle inversion angles in a range that is comparable to values of healthy people. Lower ankle inversion angles and velocities with a semi-rigid brace may explain reduced injury incidences with brace application. The lack of effect of the soft brace indicates that the primary mechanism behind the reduction of inversion angles and velocities is the mechanical resistance of the brace in the frontal plane.

scholarly journals Preliminary Evidence That Taping Does Not Optimize Joint Coupling of the Foot and Ankle Joints in Patients with Chronic Ankle Instability

2021 ◽  
Vol 18 (4) ◽  
pp. 2029
Author(s):  
Charles Deltour ◽  
Bart Dingenen ◽  
Filip Staes ◽  
Kevin Deschamps ◽  
Giovanni A. Matricali
Keyword(s):  
Cross Correlation ◽  
Ankle Instability ◽  
Correlation Coefficients ◽  
Preliminary Evidence ◽  
Chronic Ankle Instability ◽  
Heel Strike ◽  
Segmental Motion ◽  
Barefoot Running ◽  
Ankle Motion ◽  
Joint Coupling

Background: Foot–ankle motion is affected by chronic ankle instability (CAI) in terms of altered kinematics. This study focuses on multisegmental foot–ankle motion and joint coupling in barefoot and taped CAI patients during the three subphases of stance at running. Methods: Foot segmental motion data of 12 controls and 15 CAI participants during running with a heel strike pattern were collected through gait analysis. CAI participants performed running trials in three conditions: barefoot running, and running with high-dye and low-dye taping. Dependent variables were the range of motion (RoM) occurring at the different inter-segment angles as well as the cross-correlation coefficients between predetermined segments. Results: There were no significant RoM differences for barefoot running between CAI patients and controls. In taped conditions, the first two subphases only showed RoM changes at the midfoot without apparent RoM reduction compared to the barefoot CAI condition. In the last subphase there was limited RoM reduction at the mid- and rearfoot. Cross-correlation coefficients highlighted a tendency towards weaker joint coupling in the barefoot CAI condition compared to the controls. Joint coupling within the taped CAI conditions did not show optimization compared to the barefoot CAI condition. Conclusions: RoM was not significantly changed for barefoot running between CAI patients and controls. In taped conditions, there was no distinct tendency towards lower mean RoM values due to the mechanical restraints of taping. Joint coupling in CAI patients was not optimized by taping.

scholarly journals Sex Differences, Hormone Fluctuations, Ankle Stability, and Dynamic Postural Control

2012 ◽  
Vol 47 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Hayley Ericksen ◽  
Phillip A. Gribble
Keyword(s):  
Menstrual Cycle ◽  
Postural Control ◽  
Repeated Measures ◽  
Balance Test ◽  
Healthy Women ◽  
Ankle Stability ◽  
Ankle Arthrometer ◽  
Main Effect ◽  
Star Excursion Balance Test ◽  
Anterior Posterior

Context: Hormonal fluctuation as a risk factor in anterior cruciate ligament injury has been investigated with conflicting results. However, the influence of hormone fluctuations on ankle laxity and function has not been thoroughly examined. Objective: To examine the potential hormone contributions to ankle laxity and dynamic postural control during the preovulatory and postovulatory phases of the menstrual cycle using an ankle arthrometer and the Star Excursion Balance Test in healthy women. The cohort group consisted of male control participants. Design: Cohort study. Setting: Research laboratory. Patients or Other Participants: Twenty healthy women (age = 23.8 ± 6.50 years, height = 163.88 ± 8.28 cm, mass = 63.08 ± 12.38 kg) and 20 healthy men (age = 23.90 ± 4.15 years, height = 177.07 ± 7.60 cm, mass = 80.57 ± 12.20 kg). Intervention(s): Ankle stability was assessed with anterior-posterior and inversion-eversion loading. Dynamic postural control was assessed with the posteromedial reaching distance of the Star Excursion Balance Test. Main Outcome Measure(s): Female participants used ovulation kits for 3 months to determine the time of ovulation; during their preovulatory and postovulatory phases, they were tested in the laboratory with an ankle arthrometer and the Star Excursion Balance Test. Male participants were tested on similar dates as controls. For each dependent variable, a time by side by sex repeated-measures analysis of variance was performed. Statistical significance was set a priori at P &lt; .05. Results: For anterior-posterior laxity, a side main effect was noted (F1,38 = 10.93, P = .002). For inversion-eversion laxity, a sex main effect was seen (F1,38 = 10.75, P = .002). For the posteromedial reaching task, a sex main effect was demonstrated (F1,38 = 8.72, P = .005). No influences of time on the dependent variables were evident. Conclusions: Although women presented with more ankle inversion-eversion laxity and less dynamic postural control, hormonal fluctuations during the menstrual cycle (preovulatory compared with postovulatory) did not affect ankle laxity or dynamic postural control, 2 factors that are associated with ankle instability.

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