scholarly journals Bilateral Proprioceptive Evaluation in Individuals With Unilateral Chronic Ankle Instability

2017 ◽  
Vol 52 (4) ◽  
pp. 360-367 ◽  
Author(s):  
Andreia S. P. Sousa ◽  
João Leite ◽  
Bianca Costa ◽  
Rubim Santos
Keyword(s):  
Outcome Measure ◽  
Ankle Instability ◽  
Position Sense ◽  
Chronic Ankle Instability ◽  
Joint Position Sense ◽  
Control Group ◽  
Injured Limb ◽  
History Of ◽  
Ankle Proprioception ◽  
Force Sense

Context:  Despite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. Objective:  To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. Design:  Cohort study. Setting:  Research laboratory center in a university. Patients or Other Participants:  Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. Main Outcome Measure(s):  Ankle active and passive joint position sense, kinesthesia, and force sense. Results:  We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P < .001): the FAI group demonstrated increased error versus the control group (injured limb: P < .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). Conclusions:  Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense.

Motoneuron Function Does not Change Following Whole-Body Vibration in Individuals With Chronic Ankle Instability

2019 ◽  
Vol 28 (6) ◽  
pp. 614-622 ◽  
Author(s):  
Dana M. Otzel ◽  
Chris J. Hass ◽  
Erik A. Wikstrom ◽  
Mark D. Bishop ◽  
Paul A. Borsa ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Whole Body Vibration ◽  
Position Sense ◽  
Chronic Ankle Instability ◽  
Joint Position Sense ◽  
Whole Body ◽  
Control Group ◽  
Joint Position ◽  
Acute Bout ◽  
Body Vibration

Context: Following a lateral ankle sprain, ∼40% of individuals develop chronic ankle instability (CAI), characterized by recurrent injury and sensations of giving way. Deafferentation due to mechanoreceptor damage postinjury is suggested to contribute to arthrogenic muscle inhibition (AMI). Whole-body vibration (WBV) has the potential to address the neurophysiologic deficits accompanied by CAI and, therefore, possibly prevent reinjury. Objective: To determine if an acute bout of WBV can improve AMI and proprioception in individuals with CAI. Design and Participants: The authors examined if an acute bout of WBV can improve AMI and proprioception in individuals with CAI with a repeated-measures design. A total of 10 young adults with CAI and 10 age-matched healthy controls underwent a control, sham, and WBV condition in randomized order. Setting: Biomechanics laboratory. Intervention: WBV. Main Outcome Measures: Motoneuron pool recruitment was assessed via Hoffmann reflex (H-reflex) in the soleus. Proprioception was evaluated using ankle joint position sense at 15° and 20° of inversion. Both were assessed prior to, immediately following, and 30 minutes after the intervention (pretest, posttest, and 30mPost, respectively). Results: Soleus maximum H-reflex:M-response (H:M) ratios were 25% lower in the CAI group compared with the control group (P = .03). Joint position sense mean constant error did not differ between groups (P = .45). Error at 15° in the CAI (pretest 0.8 [1.6], posttest 2.0 [2.8], 30mPost 2.0 [1.9]) and control group (pretest 0.8 [2.0], posttest 0.6 [2.9], 30mPost 0.5 [2.1]) did not improve post-WBV. Error at 20° did not change post-WBV in the CAI (pretest 1.3 [1.7], posttest 1.0 [2.4], 30mPost 1.5 [2.2]) or control group (pretest −0.3 [3.0], posttest 0.8 [2.1], 30mPost 0.6 [1.8]). Conclusion: AMI is present in the involved limb of individuals with CAI. The acute response following a single bout of WBV did not ameliorate the presence of AMI nor improve proprioception in those with CAI.

scholarly journals Surgical Reconstruction with the Remnant Ligament Improves Joint Position Sense as well as Functional Ankle Instability: A 1-Year Follow-Up Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kamizato Iwao ◽  
Deie Masataka ◽  
Fukuhara Kohei
Keyword(s):  
Ankle Instability ◽  
Intervention Group ◽  
Position Sense ◽  
Joint Position Sense ◽  
Surgical Reconstruction ◽  
Functional Improvement ◽  
Control Group ◽  
Joint Position ◽  
Functional Ankle Instability ◽  
Significant Difference

Introduction. Chronic functional instability—characterized by repeated ankle inversion sprains and a subjective sensation of instability—is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament.Materials and Methods. We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire.Results and Discussion. There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

scholarly journals Relationship between Joint Position Sense, Force Sense, and Muscle Strength and the Impact of Gymnastic Training on Proprioception

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Bartłomiej Niespodziński ◽  
Andrzej Kochanowicz ◽  
Jan Mieszkowski ◽  
Elżbieta Piskorska ◽  
Małgorzata Żychowska
Keyword(s):  
Muscle Strength ◽  
Elbow Joint ◽  
Position Sense ◽  
Joint Position Sense ◽  
Control Group ◽  
Joint Position ◽  
The Impact ◽  
The Relationship ◽  
Force Sense

The aims of this study were (1) to assess the relationship between joint position (JPS) and force sense (FS) and muscle strength (MS) and (2) to evaluate the impact of long-term gymnastic training on particular proprioception aspects and their correlations. 17 elite adult gymnasts and 24 untrained, matched controls performed an active reproduction (AR) and passive reproduction (PR) task and a force reproduction (FR) task at the elbow joint. Intergroup differences and the relationship between JPS, FS, and MS were evaluated. While there was no difference in AR or PR between groups, absolute error in the control group was higher during the PR task (7.15 ± 2.72°) than during the AR task (3.1 ± 1.93°). Mean relative error in the control group was 61% higher in the elbow extensors than in the elbow flexors during 50% FR, while the gymnast group had similar results in both reciprocal muscles. There was no linear correlation between JPS and FS in either group; however, FR was negatively correlated with antagonist MS. In conclusion, this study found no evidence for a relationship between the accuracy of FS and JPS at the elbow joint. Long-term gymnastic training improves the JPS and FS of the elbow extensors.

scholarly journals Short and Medium Latency Responses in Participants With Chronic Ankle Instability

2018 ◽  
Vol 53 (7) ◽  
pp. 679-686 ◽  
Author(s):  
Andreia S. P. Sousa ◽  
Isabel Valente ◽  
Ana Pinto ◽  
Tiago Soutelo ◽  
Márcia Silva
Keyword(s):  
Postural Stability ◽  
Case Control Study ◽  
Outcome Measure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Injured Limb ◽  
Postural Adjustments ◽  
Postural Responses ◽  
Control Study

Context:  The determinant role of medium latency responses (MLRs) during compensatory postural adjustments in postural stability and the lack of clarity about the mechanisms behind chronic ankle instability (CAI) sustain the hypothesis that these postural responses are impaired in this condition. However, to the best of our knowledge, no authors have assessed MLRs in patients with CAI; most of the research regarding compensatory postural adjustments has been directed at the timing of short latency responses (SLRs). Objective:  To evaluate bilateral compensatory postural responses, including SLRs and MLRs, in response to a unilateral simulated ankle-sprain mechanism in participants with CAI. Design:  Case-control study. Setting:  Laboratory. Patients or Other Participants:  Twenty-four participants with CAI and 20 controls. Intervention(s):  Bilateral electromyography of the peroneus longus (PL), peroneus brevis, tibialis anterior (TA), and soleus (SOL) muscles was collected during a unilateral sudden-inversion perturbation (30°). Main Outcome Measure(s):  Muscle-onset activations and magnitudes of SLRs and MLRs in the support and perturbed positions. Results:  Participants with CAI showed (1) later-onset activation of the TA and SOL in the uninjured limb and bilateral decreases in the magnitude of the TA MLR in the support position, (2) increased magnitude of the PL MLR in the uninjured limb in the support and perturbed positions, and (3) increased magnitude of the PL SLR and MLR in the injured limb in the perturbed position. Conclusions:  Chronic ankle instability was associated with later TA and SOL activation in the uninjured limb and bilaterally decreased magnitude of the TA MLR in the support position.

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.

scholarly journals The Acute Effect of Cryotherapy on Muscle Strength and Shoulder Proprioception

2017 ◽  
Vol 26 (6) ◽  
pp. 497-506 ◽  
Author(s):  
Rui Torres ◽  
Filipa Silva ◽  
Vera Pedrosa ◽  
João Ferreira ◽  
Alexandre Lopes
Keyword(s):  
Muscle Strength ◽  
Position Sense ◽  
Joint Position Sense ◽  
Passive Movement ◽  
Control Group ◽  
Joint Position ◽  
Maximal Force ◽  
Force Sense ◽  
Crushed Ice ◽  
Ice Pack

Context:Cryotherapy, a common intervention used by clinicians, poses several benefits in managing acute injuries. However, cooling muscle tissue can interfere with muscular properties and the sensory-motor system.Objective:The aim of this study was to analyze the influence of cryotherapy with a crushed-ice pack on shoulder proprioception concerning joint position sense, force sense, the threshold for detecting passive movement, and maximal force production.Design:A randomized, double-blind controlled trial.Participants:48 healthy women aged 22.6 ± 0.4 y with a mean body mass index of 22.8 ±0.37 kg/m2 and a percentage of body fat of 15.4 ± 1.5%.Methods:In the experimental group, a crushed-ice pack was applied to the shoulder for 15 min, whereas participants in the control group applied a sandbag at skin temperature, also for 15 min. An isokinetic dynamometer was used to assess maximal voluntary contraction, force sense, joint position sense, and the threshold for detecting passive movement.Results:Paired sample t tests revealed that maximal voluntary isometric contraction decreased significantly after cryotherapy (P ≤ .001), or approximately 10% of the reduction found in both muscular groups assessed. Shoulder position sense (P < .001) and the threshold for detecting passive movement (P = .01 and P = .01 for lateral and medial shoulder rotator muscles, respectively) also suffered significant impairment. Nevertheless, no significant differences emerged in force sense at 20% and 50% of maximal force reproduction (P = .41 and P = .10 for lateral rotator muscles at 20% and 50%, respectively; and P = .20 and P = .09 for medial rotator muscles at 20% and 50%, respectively).Conclusion:Applying a crushed-ice pack to the shoulder for 15 min negatively affected muscle strength and impaired shoulder proprioception by decreasing joint position sense and the threshold for detecting passive movement.

scholarly journals The changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Broström procedure for chronic ankle instability

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110520
Author(s):  
Seung-Myung Choi ◽  
Byung-Ki Cho ◽  
Woo-Sung Park ◽  
Kyung-Jei Woo
Keyword(s):  
Postural Control ◽  
Functional Performance ◽  
Ankle Instability ◽  
Position Sense ◽  
Chronic Ankle Instability ◽  
Joint Position Sense ◽  
Joint Position ◽  
Hop Test ◽  
Performance Ability ◽  
Modified Broström Procedure

Purpose: Residual functional ankle instability regardless of the restoration of mechanical stability after the lateral ligament repair or reconstruction can cause recurrent sprain. The purpose of this study was to identify the sequential changes of joint-position sense, peroneal strength, postural control, and functional performance ability after the modified Broström procedure (MBP) for chronic ankle instability. Methods: A total of 46 patients (46 ankles) who underwent the MBP for chronic ankle instability were eligible for this study and were followed up for 1 year postoperatively. The changes of joint-position sense and peroneal strength were periodically evaluated with an isokinetic dynamometer. Postural control ability was evaluated using a one-leg stance test with eyes closed. The functional performance ability examination comprised a one-leg hop test, a six-meter hop test, and a cross three-meter hop test. Results: The error in joint-position sense significantly improved from a mean 4.3° to 2.8° ( p < 0.001). Peak torque for eversion significantly improved from a mean 18.2 Nm to 21.2 Nm ( p = 0.024). Balance retention time significantly improved from a mean 4.7 s to 6.4 s ( p < 0.001). Among the functional performance tests, only the one-leg hop test showed a significant improvement postoperatively ( p = 0.031). At 1 year postoperatively, the recovery ratios compared to the unaffected ankle were 67.9% in joint-position sense ( p < 0.001), 86.9% in peroneal strength ( p = 0.012), and 74.4% in postural control ( p < 0.001), with significant side-to-side differences. Conclusion: Although joint-position sense, peroneal strength, postural control, and functional performance ability were significantly improved after the MBP, recovery ratios compared to the unaffected ankle were insufficient up to 1 year postoperatively. Level of Evidence: Level IV (prospective case series)

Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images

2021 ◽  
pp. 107110072199707
Author(s):  
Yasunari Ikuta ◽  
Tomoyuki Nakasa ◽  
Junichi Sumii ◽  
Akinori Nekomoto ◽  
Nobuo Adachi
Keyword(s):  
Ankle Instability ◽  
Ct Images ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Mri Findings ◽  
Calcaneofibular Ligament ◽  
Level Of Evidence ◽  
Strong Negative Correlation

Background: Rotational ankle instability (RAI) is associated with the faster onset of severe ankle osteoarthritis via dysfunction of the anterior talofibular ligament, calcaneofibular ligament, and deltoid ligament. No specific clinical examination is available for RAI, and diagnostic imaging has limitations in evaluating ligament degradation. This study investigated the deltoid ligament degeneration using Hounsfield unit (HU) values on computed tomography (CT) images. Methods: Patients were enrolled in this retrospective analysis if they had undergone magnetic resonance imaging (MRI) and CT scans of the ankle. The chronic ankle instability (CAI) group comprised 20 ankles with CAI (9 men, 11 women; mean age, 28.7 years) and the control group comprised 28 ankles (16 men, 12 women, mean age, 41.3 years). The average HU values of the deep posterior tibiotalar ligament (dPTL) that constitutes the deltoid ligament were measured on coronal CT images, and MRI results were used as a reference. All patients were subdivided based on the MRI findings of dPTL injury such as fascicular disruption, irregularity, and the loss of striation. Results: A strong negative correlation was identified between age and HU values for all patients (Spearman ρ = −0.63; P < .001). The mean HU values of the dPTL for participants aged <60 years were 81.0 HU for the control group (21 ankles) and 69.5 HU for the CAI group ( P = .0075). No significant differences in the HU values were observed for the dPTL among the MRI subgroups. Conclusion: In addition to the conventional imaging examination such as stress radiographs and MRI, HU measurements of CT images could be useful for quantitatively and noninvasively evaluating degenerative changes in the deltoid ligament for CAI patients to assist the diagnosis of RAI. Level of Evidence: Level III. case-control study.

Muscle Strength Deficit though Intact Proprioception after Lateral Ankle Sprain without Persistent Instability

2021 ◽  
Author(s):  
Adel M. Madkhali ◽  
Shibili Nuhmani
Keyword(s):  
Ankle Sprain ◽  
Peak Torque ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Cohen’S D ◽  
History Of ◽  
Cohen's D

Abstract Background Lateral ankle sprain is one of the most common injuries in competitive sports. Previous studies which investigated muscle strength and proprioception (joint position sense) focused on subjects who sustained ankle sprain with instability. It is also important to investigate strength deficits and proprioception in subjects with a history of ankle sprain without instability. Therefore the aim of the study is to investigate proprioception and muscle strength deficits in athletes with lateral ankle sprain. Methods Twenty-four male athletes with a history of lateral ankle sprain and 24 age-matched controls (mean age of 22.42±4.13 years, mean height of 173±5.73 cm, and mean weight of 71.20±7.55 Kg) participated in this cross-sectional study. Peak torque and peak torque ratio at speeds of 30 and 120°/s for concentric and eccentric ankle inversion/eversion were evaluated using an isokinetic dynamometer. The joint position sense of the ankle joint was evaluated using an active angle reproduction test. Result Peak torque produced was significantly less in subjects with history of ankle sprain in concentric inversion 30°/s(t(47)=4.11; p=0.000, Cohen’s d=1.29), concentric inversion 120°/s (t(47)=3.01; p=0.006, Cohen’s d=1.13), concentric eversion 30°/s (t(47)=3.85; p=0.001, Cohen’s d=1.24) and concentric eversion 120°/s (t(47)=3.15; p=0.005, Cohen’s d=1.09). At the same time there was no significant difference observed in eccentric eversion peak torque in both speed (eccentric eversion 30°/s p=0.079; eccentric eversion 120°/s p=0.867) between experimental and control group. No significant difference was found in the joint position sense in the maximal active inversion −5° position (p=0.312) and the 15° inversion position (P=0.386) between both group. Conclusion The study’s results reported a significantly less peak torque of invertors and evertors during concentric movements in athletes with history of ankle sprain. At the same time, no significant difference reported in the evertor/invertor peak torque ratio, and active joint position sense between the 2 groups.

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