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Journal of Athletic Training Aug 2020Researchers have shown that rehabilitation programs incorporating resistance-band and balance-board exercises are effective for improving clinical measures of function... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Researchers have shown that rehabilitation programs incorporating resistance-band and balance-board exercises are effective for improving clinical measures of function and patient-reported outcomes in individuals with chronic ankle instability (CAI). However, whether combining the 2 exercises increases improvement is unknown.
OBJECTIVE
To determine the effectiveness of 3 rehabilitation programs on clinical measures of balance and self-reported function in adolescent patients with CAI.
DESIGN
Randomized controlled clinical trial (Trail Registration Number: ClinicalTrails.gov: NCT03447652).
SETTING
High school athletic training facilities.
PATIENTS OR OTHER PARTICIPANTS
Forty-three patients with CAI (age = 16.37 ± 1.00 years, height = 171.75 ± 12.05 cm, mass = 69.38 ± 18.36 kg) were block randomized into 4 rehabilitation groups.
INTERVENTION(S)
Protocols were completed 3 times per week for 4 weeks. The resistance-band group performed 3 sets of 10 repetitions of ankle plantar flexion, dorsiflexion, inversion, and eversion with a resistance band. The Biomechanical Ankle Platform System group performed 5 trials of clockwise and counterclockwise rotations, changing direction every 10 seconds during each 40-second trial. The combination group completed resistance-band and Biomechanical Ankle Platform System programs during each session. The control group did not perform any exercises.
MAIN OUTCOME MEASURE(S)
Variables were assessed before and after the intervention: time-in-balance test, foot-lift test, Star Excursion Balance Test, side-hop test, figure-8 hop test, Foot and Ankle Ability Measure, and Cumberland Ankle Instability Tool. We conducted 4 separate multivariate repeated-measures analyses of variance, followed by univariate analyses for any findings that were different.
RESULTS
Using the time-in-balance test, foot-lift test, Star Excursion Balance Test (medial, posteromedial, and posterolateral directions), and figure-8 hop test, we detected improvement for each rehabilitation group compared with the control group (P < .05). However, no intervention group was superior.
CONCLUSIONS
All 3 rehabilitation groups demonstrated improvement compared with the control group, yet the evidence was too limited to support a superior intervention. Over a 4-week period, either of the single-task interventions or the combination intervention can be used to combat the residual deficits associated with CAI in an adolescent patient population.
Topics: Adolescent; Ankle; Ankle Injuries; Ankle Joint; Athletic Tape; Exercise Therapy; Female; Humans; Joint Instability; Male; Patient Reported Outcome Measures; Physical Functional Performance; Postural Balance
PubMed: 32577737
DOI: 10.4085/1062-6050-41-19 -
Medicina (Kaunas, Lithuania) Apr 2022Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle... (Meta-Analysis)
Meta-Analysis Review
Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: ("kinesiology tape" OR "tape" OR "taping" OR "elastic taping" OR "kinesio taping" OR "neuro taping") AND (unstable OR instability) AND (ankle OR (ankle OR "ankle sprain" OR "injured ankle" OR "ankle injury")). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI.
Topics: Ankle; Ankle Injuries; Ankle Joint; Athletes; Athletic Tape; Humans; Joint Instability
PubMed: 35630037
DOI: 10.3390/medicina58050620 -
Journal of Athletic Training Jun 2019Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the... (Review)
Review
Given the prevalence of lateral ankle sprains during physical activity and the high rate of reinjury and chronic ankle instability, clinicians should be cognizant of the need to expand the evaluation of ankle instability beyond the acute time point. Physical assessments of the injured ankle should be similar, regardless of whether this is the initial lateral ankle sprain or the patient has experienced multiple sprains. To this point, a thorough injury history of the affected ankle provides important information during the clinical examination. The physical examination should assess the talocrural and subtalar joints, and clinicians should be aware of efficacious diagnostic tools that provide information about the status of injured structures. As patients progress into the subacute and return-to-activity phases after injury, comprehensive assessments of lateral ankle-complex instability will identify any disease and patient-oriented outcome deficits that resemble chronic ankle instability, which should be addressed with appropriate interventions to minimize the risk of developing long-term, recurrent ankle instability.
Topics: Ankle; Ankle Injuries; Ankle Joint; Humans; Joint Instability
PubMed: 31161943
DOI: 10.4085/1062-6050-484-17 -
BioMed Research International 2015Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic... (Review)
Review
Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport.
Topics: Ankle; Ankle Joint; Athletic Performance; Humans; Postural Balance; Proprioception
PubMed: 26583139
DOI: 10.1155/2015/842804 -
Ugeskrift For Laeger Oct 2020Symptomatic ankle arthrosis affects 1-4% of the population, and the most common aetiology is post-traumatic. Symptoms include pain, swelling and reduced range of motion.... (Review)
Review
Symptomatic ankle arthrosis affects 1-4% of the population, and the most common aetiology is post-traumatic. Symptoms include pain, swelling and reduced range of motion. Diagnosis is based on weight-bearing X-rays of the ankle joint, and treatment depends on the arthrosis grade and patient characteristics. Non-operative therapy, i.e. physiotherapy, analgesics, injection therapy and/or braces/orthoses is first-line treatment, as we argue in this review. Arthroscopy can be an effective treatment for some patients, but in case of severe arthrosis, osteotomies, total ankle replacement or arthrodesis may be necessary.
Topics: Ankle; Ankle Joint; Arthrodesis; Humans; Joint Diseases; Osteoarthritis
PubMed: 33046192
DOI: No ID Found -
Journal of Athletic Training Jul 2018Traditional single-limb balance (SLB) and progressive dynamic balance-training programs for those with chronic ankle instability (CAI) have been evaluated in the... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Traditional single-limb balance (SLB) and progressive dynamic balance-training programs for those with chronic ankle instability (CAI) have been evaluated in the literature. However, which training program may be more beneficial is not known.
OBJECTIVE
To investigate the effects of a progressive hop-to-stabilization balance (PHSB) program compared with an SLB program on self-reported function, dynamic postural control, and joint position sense (JPS) where angle and direction were self-reported by participants with CAI.
DESIGN
Randomized controlled clinical trial.
SETTING
A single testing location in a mid-Atlantic state.
PATIENTS OR OTHER PARTICIPANTS
A total of 18 participants (age = 18.38 ± 1.81 years; height = 175.26 ± 6.64 cm; mass = 75.79 ± 12.1 kg) with CAI.
INTERVENTION(S)
Participants were randomly assigned to the PHSB or SLB program. The PHSB and SLB groups pursued their 4-week programs 3 times a week. The PHSB group performed a battery of single-limb hop-to-stabilization exercises, while the SLB group performed a series of SLB exercises. Exercises were advanced throughout the 4 weeks for both groups.
MAIN OUTCOMES MEASURE(S)
Pretest and posttest measurements were the Foot and Ankle Ability Measure (FAAM)-Activities of Daily Living subscale; FAAM-Sports subscale; Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions; and weight-bearing JPS blocks (dorsiflexion, plantar flexion, inversion, eversion).
RESULTS
A significant main effect of time was present for the FAAM-Activities of Daily Living, FAAM-Sports, Star Excursion Balance Test (anterior, posteromedial, and posterolateral directions), and JPS (dorsiflexion, plantar flexion, inversion), as posttest results improved for the PHSB and SLB groups. The main effect of group was significant only for the FAAM-Sports, with the SLB group improving more than the PHSB group.
CONCLUSIONS
Either a 4-week PHSB or SLB can be used in athletes with CAI, as both programs resulted in similar gains.
Topics: Activities of Daily Living; Adolescent; Ankle; Ankle Joint; Athletes; Chronic Disease; Exercise Therapy; Female; Humans; Joint Instability; Male; Postural Balance; Self Report; Single-Blind Method; Young Adult
PubMed: 30192681
DOI: 10.4085/1062-6050-555-16 -
Journal of Athletic Training 2014Ankle-dorsiflexion (DF) range of motion (ROM) may influence movement variables that are known to affect anterior cruciate ligament loading, such as knee valgus and knee...
CONTEXT
Ankle-dorsiflexion (DF) range of motion (ROM) may influence movement variables that are known to affect anterior cruciate ligament loading, such as knee valgus and knee flexion. To our knowledge, researchers have not studied individuals with limited or normal ankle DF-ROM to investigate the relationship between those factors and the lower extremity movement patterns associated with anterior cruciate ligament injury.
OBJECTIVE
To determine, using 2 different measurement techniques, whether knee- and ankle-joint kinematics differ between participants with limited and normal ankle DF-ROM.
DESIGN
Cross-sectional study.
SETTING
Sports medicine research laboratory.
PATIENTS OR OTHER PARTICIPANTS
Forty physically active adults (20 with limited ankle DF-ROM, 20 with normal ankle DF-ROM).
MAIN OUTCOME MEASURE(S)
Ankle DF-ROM was assessed using 2 techniques: (1) nonweight-bearing ankle DF-ROM with the knee straight, and (2) weight-bearing lunge (WBL). Knee flexion, knee valgus-varus, knee internal-external rotation, and ankle DF displacements were assessed during the overhead-squat, single-legged squat, and jump-landing tasks. Separate 1-way analyses of variance were performed to determine whether differences in knee- and ankle-joint kinematics existed between the normal and limited groups for each assessment.
RESULTS
We observed no differences between the normal and limited groups when classifying groups based on nonweight-bearing passive-ankle DF-ROM. However, individuals with greater ankle DF-ROM during the WBL displayed greater knee-flexion and ankle-DF displacement and peak knee flexion during the overhead-squat and single-legged squat tasks. In addition, those individuals also demonstrated greater knee-varus displacement during the single-legged squat.
CONCLUSIONS
Greater ankle DF-ROM assessed during the WBL was associated with greater knee-flexion and ankle-DF displacement during both squatting tasks as well as greater knee-varus displacement during the single-legged squat. Assessment of ankle DF-ROM using the WBL provided important insight into compensatory movement patterns during squatting, whereas nonweight-bearing passive ankle DF-ROM did not. Improving ankle DF-ROM during the WBL may be an important intervention for altering high-risk movement patterns commonly associated with noncontact anterior cruciate ligament injury.
Topics: Adult; Ankle; Ankle Joint; Anterior Cruciate Ligament Injuries; Biomechanical Phenomena; Cross-Sectional Studies; Female; Humans; Joint Diseases; Knee; Knee Injuries; Male; Musculoskeletal Physiological Phenomena; Range of Motion, Articular; Sports Medicine; Weight-Bearing
PubMed: 25144599
DOI: 10.4085/1062-6050-49.3.29 -
Medical Science Monitor : International... Jan 2019BACKGROUND Ankle sprain reduces capacity for neurosensory information processing, and these patients commonly progress to chronic ankle instability (CAI). To address... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND Ankle sprain reduces capacity for neurosensory information processing, and these patients commonly progress to chronic ankle instability (CAI). To address this problem, the short-foot exercise (SFE) may be used. However, there has been no previous research on the neurosensory impact of SFE. Therefore, the aim of this study was to assess improvement of quantitative neurosensory indicators after SFE and to determine the effect of proprioceptive sensory exercise (PSE) in patients with CAI. MATERIAL AND METHODS The present study included 30 adults (age range: 19-29 years; 50% female). Selection criteria for CAI (Cumberland Ankle Instability Tool £24) were implemented, and participants were randomly allocated to 2 groups: SFE (n1=15) and PSE (n2=15). Exercises were conducted 3 times per week for 8 weeks. Measurements of quantitative somatosensory of joint position sense and vibration sensory thresholds, dynamic balance, and ankle instability assessment were evaluated before and after completion of each intervention. Data were analyzed using a repeated- measures analysis of variance. RESULTS In a time-by-group comparison, the SFE group showed a more significant improvement with regards to eversion joint position sense (F1,28=4.543, p<0.05). For vibration sensory threshold, the SFE group showed a more significant improvement (F1,28=8.280, p<0.01). Balance index according to anterio-posterior, mediolateral, and overall index the SFE group a more significant improvement (F1,28=6.666, 4.585, 5.207, p<0.05). And ankle instability SFE group showed a more significant improvement (F1,28=6.890, p<0.05). CONCLUSIONS SFE is more effective than PSE for treating ankle sprain patients. There is a need to develop and promote an effective and controlled exercise program to facilitate the return of ankle sprain patients to normal daily life.
Topics: Adult; Ankle; Ankle Injuries; Ankle Joint; Exercise; Exercise Therapy; Female; Humans; Joint Instability; Male; Physical Therapy Modalities; Postural Balance; Young Adult
PubMed: 30665229
DOI: 10.12659/MSM.912785 -
European Journal of Trauma and... Aug 2021
Topics: Ankle; Ankle Joint; Humans
PubMed: 34324014
DOI: 10.1007/s00068-021-01726-9 -
Sports Health 2022
Topics: Ankle; Ankle Injuries; Ankle Joint; Athletes; Foot Injuries; Humans
PubMed: 35546065
DOI: 10.1177/19417381221089976