scholarly journals Alterations in Neuromuscular Control at the Knee in Individuals With Chronic Ankle Instability

2014 ◽  
Vol 49 (5) ◽  
pp. 599-607 ◽  
Author(s):  
Masafumi Terada ◽  
Brian G. Pietrosimone ◽  
Phillip A. Gribble
Keyword(s):  
Confidence Interval ◽  
Effect Size ◽  
Muscle Activation ◽  
Sagittal Plane ◽  
Ankle Instability ◽  
Force Plate ◽  
Neuromuscular Control ◽  
Chronic Ankle Instability ◽  
Electromyographic Activity ◽  
Vastus Medialis

Context: Few authors have assessed neuromuscular knee-stabilization strategies in individuals with chronic ankle instability (CAI) during functional activities. Objective: To investigate the influence of CAI on neuromuscular characteristics around the knee during a stop-jump task. Design: Case-control study. Setting: Research laboratory. Participants or Other Participants: A total of 19 participants with self-reported unilateral CAI and 19 healthy control participants volunteered for this study. Intervention(s): Participants performed double-legged, vertical stop-jump tasks onto a force plate, and we measured muscle activation around the knee of each limb. Main Outcome Measure(s): We calculated the integrated electromyography for the vastus medialis oblique, vastus lateralis, medial hamstrings, and lateral hamstrings muscles during the 100 ms before and after initial foot contacts with the force plate and normalized by the ensemble peak electromyographic value. Knee sagittal-plane kinematics were also analyzed during a stop-jump task. Results: Compared with control participants, the CAI group demonstrated greater prelanding integrated electromyographic activity of the vastus medialis oblique (CAI = 52.28 ± 11.25%·ms, control = 43.90 ± 10.13%·ms, t36 = 2.41, P = .021, effect size = 0.78, 95% confidence interval = 0.11, 1.43) and less knee-flexion angle at the point of initial foot contact (CAI = 7.81° ± 8.27°, control = 14.09° ± 8.7°, t36 = −2.28, P = .029, effect size = −0.74, 95% confidence interval = −1.38, −0.07) and at 100 ms post–initial foot contact (CAI = 51.36° ± 5.29°, control = 58.66° ± 7.66°, t36 = −3.42, P = .002, effect size = −1.11, 95% confidence interval = −1.77, −0.40). No significant results were noted for the other electromyographic measures. Conclusions: We found altered feed-forward patterns of the vastus medialis oblique and altered postlanding knee sagittal-plane kinematics in the CAI group. These observations may provide insight regarding sensorimotor characteristics that may be associated with CAI.

scholarly journals Ultrasound Imaging of the Gluteal Muscles During the Y-Balance Test in Individuals With or Without Chronic Ankle Instability

2020 ◽  
Vol 55 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Alexandra F. DeJong ◽  
L. Colby Mangum ◽  
Jay Hertel
Keyword(s):  
Ultrasound Imaging ◽  
Muscle Activation ◽  
Sagittal Plane ◽  
Ankle Instability ◽  
Gluteus Maximus ◽  
Chronic Ankle Instability ◽  
Mean Difference ◽  
Control Group ◽  
Quiet Stance ◽  
Balance Test

Context Impairments in dynamic postural control and gluteal muscle activation have been associated with the development of symptoms related to long-term injury, which are characteristic of chronic ankle instability (CAI). Ultrasound imaging (USI) provides a visual means to explore muscle thickness throughout movement; however, USI functional-activation ratios (FARs) of the gluteal muscles during dynamic balance exercises have not been investigated. Objective To determine differences in gluteus maximus and gluteus medius FARs using USI, Y-Balance Test (YBT) performance, and lower extremity kinematics in individuals with or without CAI. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants Twenty adults with CAI (10 men, 10 women; age = 21.70 ± 2.32 years, height = 172.74 ± 11.28 cm, mass = 74.26 ± 15.24 kg) and 20 adults without CAI (10 men, 10 women; age = 21.20 ± 2.79 years, height = 173.18 ± 15.16 cm, mass = 70.89 ± 12.18 kg). Intervention(s) Unilateral static ultrasound images of the gluteal muscles during quiet stance and to the point of maximum YBT reach directions were obtained over 3 trials. Hip, knee, and ankle sagittal-plane kinematics were collected with motion-capture software. Main Outcome Measure(s) Gluteal thickness was normalized to quiet stance to yield FARs for each muscle in each YBT direction. We averaged normalized reach distances and obtained average peak kinematics. Independent t tests, mean differences, and Cohen d effect sizes were calculated to determine group differences for all outcome measures. Results The CAI group had anterior-reach deficits compared with the control group (mean difference = 4.37%, Cohen d = 0.77, P = .02). The CAI group demonstrated greater anterior gluteus maximus FARs than the control group (mean difference = 0.08, Cohen d = 0.57, P = .05). Conclusions The CAI group demonstrated YBT reach deficits and alterations in proximal muscle activation. Increased reliance on the gluteus maximus during dynamic conditions may contribute to distal joint dysfunction in this population.

scholarly journals Effect of ultrasound-guided percutaneous neuromodulation in ankle instability: a case study

2019 ◽  
Vol 02 (02) ◽  
pp. 100-101
Author(s):  
Rodríguez Rosal M. ◽  
Sánchez Sixto A. ◽  
Álvarez Barbosa F. ◽  
Yáñez Álvarez A.
Keyword(s):  
Effect Size ◽  
Center Of Pressure ◽  
Tibial Nerve ◽  
Ankle Instability ◽  
Center Of Mass ◽  
Force Plate ◽  
Chronic Ankle Instability ◽  
Balance Test ◽  
Eyes Closed ◽  
Eyes Open

Abstract Background and Aims Ankle proprioception can be tested in many ways. Some studies have found improvements in individuals with chronic ankle instability after receiving treatment and training proprioceptive acuity and speed. Currently, there is a scarcity of evidence concerning percutaneous neuromodulation. The first findings were reported in the post-surgical stage after total knee arthroplasty and in neural improvements and symptoms in patients with hyperactive bladder. Aim To evaluate the effectiveness of percutaneous neuromodulation on the tibial nerve for the improvement of various proprioception parameters in patients with chronic ankle instability. Material and Methods Five men (age: 24.8 ± 4.9 years; height: 1.78 ± 0.08 m; weight: 86 ± 9.8 kg) with chronic ankle instability, who regularly practiced sports activities participated in the present study. People who had undergone an injury in the previous three months were excluded from the speed. Currently, there is a scarcity of evidence concerning test before and immediately after percutaneous neuromodulation. A single leg balance test was performed with eyes open and closed, maintaining the single-legged position on a force plate during 30 seconds (Accupower; AMTI, Watertown, MA) registering 1000 Hz. The displacement of the center of pressure (DOT) was determined based on the distances of its antero-posterior axes (DOT_AP) and medio-lateral (DOT_ML). Furthermore, the amplitudes of anteroposterior and mediolateral displacement were evaluated (ACPap and ACPml). The posterior tibial nerve was stimulated under ultrasound guidance using a 100 Vpp current, with a pulse width of 250 μs and a repetition frequency of 2 to 10 Hz. The process was performed on three occasions during 30 seconds, with an intensity that was acknowledged by the patient but which did not go beyond a score of 3 in the visual analog scale (VAS). The means and standard deviations were calculated for all variables. The effect size was calculated establishing the confidence interval at 90% and the probability of the change being significant was qualitatively calculated. Results A decrease was found in the ACPap (Pre-test eyes open: 5.42 ± 0.62 and eyes closed: 15.99 ± 0.60; Post-test eyes open 4.05 ± 0.36 and eyes closed 10.33 ± 0.49) after the neuromodulation intervention on the tibial nerve. This was a significant change and a “possible” effect size was found in the closed eyes condition (-0.54; ± 0.72), according to Hopkins. For the remaining variables, no significant differences were observed. Conclusions A decreased displacement of the center of mass was found in the antero-posterior axis after performing the neuromodulation technique on the tibial nerve in patients with chronic ankle instability.

scholarly journals Extended Use of Kinesiology Tape and Balance in Participants With Chronic Ankle Instability

2016 ◽  
Vol 51 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Kristen Jackson ◽  
Janet E. Simon ◽  
Carrie L. Docherty
Keyword(s):  
Confidence Interval ◽  
Outcome Measure ◽  
Ankle Instability ◽  
Neuromuscular Control ◽  
Chronic Ankle Instability ◽  
Mean Difference ◽  
Control Group ◽  
Balance Deficits ◽  
Kinesiology Tape ◽  
Balance Error

Context Participants with chronic ankle instability (CAI) have been shown to have balance deficits related to decreased proprioception and neuromuscular control. Kinesiology tape (KT) has been proposed to have many benefits, including increased proprioception. Objective To determine if KT can help with balance deficits associated with CAI. Design Cohort study. Setting Research laboratory. Patients or Other Participants Thirty participants with CAI were recruited for this study. Intervention(s) Balance was assessed using the Balance Error Scoring System (BESS). Participants were pretested and then randomly assigned to either the control or KT group. The participants in the KT group had 4 strips applied to the foot and lower leg and were instructed to leave the tape on until they returned for testing. All participants returned 48 hours later for another BESS assessment. The tape was then removed, and all participants returned 72 hours later to complete the final BESS assessment. Main Outcome Measure(s) Total BESS errors. Results Differences between the groups occurred at 48 hours post–application of the tape (mean difference = 4.7 ± 1.4 errors, P < .01; 95% confidence interval = 2.0, 7.5) and at 72 hours post–removal of the tape (mean difference = 2.3 ± 1.1 errors, P = .04; 95% confidence interval = 0.1, 4.6). Conclusions The KT improved balance after it had been applied for 48 hours when compared with the pretest and with the control group. One of the most clinically important findings is that balance improvements were retained even after the tape had been removed for 72 hours.

Alterations in Quadriceps Neurologic Complexity After Anterior Cruciate Ligament Reconstruction

2020 ◽  
pp. 1-6
Author(s):  
Steven M. Davi ◽  
Colleen K. Woxholdt ◽  
Justin L. Rush ◽  
Adam S. Lepley ◽  
Lindsey K. Lepley
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Vastus Lateralis ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Electromyographic Activity ◽  
Vastus Medialis ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Context: Traditionally, quadriceps activation failure after anterior cruciate ligament reconstruction (ACLR) is estimated using discrete isometric torque values, providing only a snapshot of neuromuscular function. Sample entropy (SampEn) is a mathematical technique that can measure neurologic complexity during the entirety of contraction, elucidating qualities of neuromuscular control not previously captured. Objective: To apply SampEn analyses to quadriceps electromyographic activity in order to more comprehensively characterize neuromuscular deficits after ACLR. Design: Cross-sectional. Setting: Laboratory. Participants: ACLR: n = 18; controls: n = 24. Interventions: All participants underwent synchronized unilateral quadriceps isometric strength, activation, and electromyography testing during a superimposed electrical stimulus. Main Outcome Measures: Group differences in strength, activation, and SampEn were evaluated with t tests. Associations between SampEn and quadriceps function were evaluated with Pearson product–moment correlations and hierarchical linear regressions. Results: Vastus medialis SampEn was significantly reduced after ACLR compared with controls (P = .032). Vastus medialis and vastus lateralis SampEn predicted significant variance in activation after ACLR (r2 = .444; P = .003). Conclusions: Loss of neurologic complexity correlates with worse activation after ACLR, particularly in the vastus medialis. Electromyographic SampEn is capable of detecting underlying patterns of variability that are associated with the loss of complexity between key neurophysiologic events after ACLR.

Acceleration and Jerk After a Jump Stabilization Task in Individuals With and Without Chronic Ankle Instability

2021 ◽  
pp. 1-6
Author(s):  
Kyle B. Kosik ◽  
Kathryn Lucas ◽  
Matthew C. Hoch ◽  
Jacob T. Hartzell ◽  
Katherine A. Bain ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Vertical Jump ◽  
Chronic Ankle Instability ◽  
Mean Difference ◽  
Vertical Jump Height ◽  
Study Participants ◽  
Third Derivative ◽  
Control Study

Studies have demonstrated that individuals with chronic ankle instability (CAI) have diminished dynamic stability. Jerk-based measures have been utilized to examine dynamic balance because of their ability to quantify changes in acceleration and may provide an understanding of the postural corrections that occur during stabilizing following a jumping task. The purpose of this study was to compare acceleration and jerk following a jump stabilization task between individuals with CAI and the uninjured controls. Thirty-nine participants volunteered to participate in this case control study. Participants completed a jump stabilization task requiring them to jump off 2 feet, touch a marker set at 50% of their maximal vertical jump height, land on a single limb, and maintain balance for 3 seconds. Acceleration was calculated as the second derivative, and jerk was calculated as the third derivative of the displacement of the resultant vector position. Participants with CAI had greater acceleration (mean difference = 55.6 cm/s2; 95% confidence interval, 10.3 to 100.90; P = .017) and jerk compared with the uninjured controls (mean difference = 1804.5 cm/s3; 95% confidence interval, 98.7 to 3510.3; P = .039). These results suggest that individuals with CAI made faster and more frequent active postural control corrections to regain balance following a jump compared with the uninjured controls.

Chronic Ankle Instability Does Not Influence Tibiofemoral Contact Forces During Drop Landings Using a Musculoskeletal Model

2019 ◽  
Vol 35 (6) ◽  
pp. 426-430
Author(s):  
Yumeng Li ◽  
He Wang ◽  
Kathy J. Simpson
Keyword(s):  
Ankle Instability ◽  
Force Plate ◽  
Compressive Force ◽  
Musculoskeletal Model ◽  
Chronic Ankle Instability ◽  
Contact Forces ◽  
Group Differences ◽  
Camera Motion ◽  
Tilted Surface ◽  
Force Peak

The purpose of the study was to compare the tibiofemoral contact forces of participants with chronic ankle instability versus controls during landings using a computer-simulated musculoskeletal model. A total of 21 female participants with chronic ankle instability and 21 pair-matched controls performed a drop landing task on a tilted force plate. A 7-camera motion capture system and 2 force plates were used to test participants’ lower-extremity biomechanics. A musculoskeletal model was used to calculate the tibiofemoral contact forces (femur on tibia). No significant between-group differences were observed for the peak tibiofemoral contact forces (P = .25–.48) during the landing phase based on paired t tests. The group differences ranged from 0.05 to 0.58 body weight (BW). Most participants demonstrated a posterior force (peak,  ∼1.1 BW) for most duration of the landing phase and a medial force (peak, ∼0.9 BW) and large compressive force (peak, ∼10 BW) in the landing phase. The authors conclude that chronic ankle instability may not be related to the increased tibiofemoral contact forces or knee injury mechanisms during landings on the tilted surface.

scholarly journals Gait Kinematics After Taping in Participants With Chronic Ankle Instability

2014 ◽  
Vol 49 (3) ◽  
pp. 322-330 ◽  
Author(s):  
Lisa Chinn ◽  
Jay Dicharry ◽  
Joseph M. Hart ◽  
Susan Saliba ◽  
Robert Wilder ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Gait Cycle ◽  
Sagittal Plane ◽  
Ankle Instability ◽  
Knee Kinematics ◽  
Chronic Ankle Instability ◽  
Mean Difference ◽  
Ankle Sprains ◽  
Lateral Ankle ◽  
Gait Kinematics

Context: Chronic ankle instability is characterized by repetitive lateral ankle sprains. Prophylactic ankle taping is a common intervention used to reduce the risk of ankle sprains. However, little research has been conducted to evaluate the effect ankle taping has on gait kinematics. Objective: To investigate the effect of taping on ankle and knee kinematics during walking and jogging in participants with chronic ankle instability. Design: Controlled laboratory study. Setting: Motion analysis laboratory. Patients or Participants: A total of 15 individuals (8 men, 7 women; age = 26.9 ± 6.8 years, height = 171.7 ± 6.3 cm, mass = 73.5 ± 10.7 kg) with self-reported chronic ankle instability volunteered. They had an average of 5.3 ± 3.1 incidences of ankle sprain. Intervention(s): Participants walked and jogged in shoes on a treadmill while untaped and taped. The tape technique was a traditional preventive taping procedure. Conditions were randomized. Main Outcome Measure(s): Frontal-plane and sagittal-plane ankle and sagittal-plane knee kinematics were recorded throughout the entire gait cycle. Group means and 90% confidence intervals were calculated, plotted, and inspected for percentages of the gait cycle in which the confidence intervals did not overlap. Results: During walking, participants were less plantar flexed from 64% to 69% of the gait cycle (mean difference = 5.73° ± 0.54°) and less inverted from 51% to 61% (mean difference = 4.34° ± 0.65°) and 76% to 81% (mean difference = 5.55° ± 0.54°) of the gait cycle when taped. During jogging, participants were less dorsiflexed from 12% to 21% (mean difference = 4.91° ± 0.18°) and less inverted from 47% to 58% (mean difference = 6.52° ± 0.12°) of the gait cycle when taped. No sagittal-plane knee kinematic differences were found. Conclusions: In those with chronic ankle instability, taping resulted in a more neutral ankle position during walking and jogging in shoes on a treadmill. This change in foot positioning and the mechanical properties of the tape may explain the protective aspect of taping in preventing lateral ankle sprains.

Sign in / Sign up

Export Citation Format

Share Document