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Park JM, Han SH, Cho BC, Lee SM, Shin MS, Yu JH, Kim HJ, Noh HD, Cho MS, Kim MK. Enhancing Post-Surgical Rehabilitation Outcomes in Patients with Chronic Ankle Instability: Impact of Subtalar Joint Axis Balance Exercises Following Arthroscopic Modified Broström Operation. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:328. [PMID: 38399615 PMCID: PMC10890246 DOI: 10.3390/medicina60020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: This study aimed to evaluate the effects of subtalar joint axis-based balance exercises on the anterior talofibular ligament (ATFL) thickness, ankle strength, and ankle stability after an arthroscopic modified Broström operation (AMBO) for chronic ankle instability (CAI). Materials and Methods: The study included 47 patients diagnosed with CAI who underwent AMBO and were randomly divided into three groups: control (n = 11), general balance exercise (n = 17), and subtalar joint axis balance exercise (n = 19), regardless of the affected area. Participants in the exercise rehabilitation group performed exercises for 60 min twice a week for six weeks, starting six weeks after AMBO. ATFL thickness, ankle strength, and ankle dynamic stability were measured using musculoskeletal ultrasonography, Biodex, and Y-balance test, respectively, before and after treatment. Results: Compared with the remaining groups, the subtalar joint axis balance exercise group had reduced ATFL thickness (p = 0.000), improved ankle strength for eversion (p = 0.000) and inversion (p = 0.000), and enhanced ankle stability (p = 0.000). Conclusions: The study results suggest that subtalar joint axis-based balance exercises may contribute to the early recovery of the ankle joint after AMBO.
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Affiliation(s)
- Ji-Myeong Park
- Sports Medical Research Center, Daechan Hospital, 590 Inju-daero, Namdong-gu, Incheon 21570, Republic of Korea; (J.-M.P.); (S.-H.H.); (H.-D.N.)
| | - Sang-Ho Han
- Sports Medical Research Center, Daechan Hospital, 590 Inju-daero, Namdong-gu, Incheon 21570, Republic of Korea; (J.-M.P.); (S.-H.H.); (H.-D.N.)
| | - Byeong-Chae Cho
- Nowon Samsung Orthopedics, 456 Nohae-ro, Nowon-gu, Seoul 01762, Republic of Korea; (B.-C.C.); (S.-M.L.)
| | - Se-Min Lee
- Nowon Samsung Orthopedics, 456 Nohae-ro, Nowon-gu, Seoul 01762, Republic of Korea; (B.-C.C.); (S.-M.L.)
| | - Mal-Soon Shin
- Department of Global Sport Studies, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong 30019, Republic of Korea;
| | - Jae-Ho Yu
- Department of Physical Therapy, Sunmoon University, 70, Seonmun-ro 221beon-gil, Tangjeong-myeon, Asan-si 31460, Republic of Korea;
| | - Ho-Jin Kim
- Department of Sports and Exercise Medicine, Biomedical Science, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong 30019, Republic of Korea; (H.-J.K.); (M.-S.C.)
| | - Hyun-Dong Noh
- Sports Medical Research Center, Daechan Hospital, 590 Inju-daero, Namdong-gu, Incheon 21570, Republic of Korea; (J.-M.P.); (S.-H.H.); (H.-D.N.)
| | - Min-Suk Cho
- Department of Sports and Exercise Medicine, Biomedical Science, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong 30019, Republic of Korea; (H.-J.K.); (M.-S.C.)
| | - Myung-Ki Kim
- Department of Global Sport Studies, Korea University, 2511 Sejong-ro, Jochiwon-eup, Sejong 30019, Republic of Korea;
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Wang X, Shao X, Yu R, Wang Y, Deng F, Adams R, Han J. Acute effects of kinesiology tape on dynamic balance control in chronic ankle instability: An exploratory study. Phys Ther Sport 2023; 62:65-70. [PMID: 37399706 DOI: 10.1016/j.ptsp.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To investigate the acute effect of the four-strip kinesiology taping (KT) technique on dynamic balance control in the Y Balance Test (YBT), and to explore the relationship between the YBT and Cumberland Ankle Instability Tool (CAIT) scores in individuals with and without chronic ankle instability (CAI). METHODS 16 CAI and 16 non-CAI participants were involved. Two groups completed the YBT in the no-tape barefoot and the KT condition at random. The CAIT was completed on the first day. Bonferroni test was used to analyze YBT scores in three directions for post hoc analysis. Spearman's correlation was used to analyze the relationship between YBT scores in the no-tape barefoot condition and CAIT scores. RESULTS This KT application significantly improved YBT performance. The YBT scores in the anterior direction (YBT-A), posteromedial direction (YBT-PM), and posterolateral direction (YBT-PL) for the CAI group were significantly improved after taping. However, in the non-CAI group, only YBT-PM score was significantly improved after taping. Three YBT scores were all moderately correlated with the CAIT score. CONCLUSION This KT technique can immediately improve dynamic balance in CAI patients. Dynamic balance performance was moderately related to the degree of self-perceived instability in individuals with and without CAI.
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Affiliation(s)
- Xiaotian Wang
- Department of Orthopedics and Traumatology, Jinhua Hospital of Traditional Chinese Medicine, Jinhua, Zhejiang, China
| | - Xuerong Shao
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Ruoni Yu
- School of Medicine, Jinhua Polytechnic, Jinhua, Zhejiang, China
| | - Yudi Wang
- School of Physical Education and Nursing, Chengdu College of Arts and Sciences, Chengdu, Sichuan, China
| | - Fawei Deng
- Department of Rehabilitation, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Roger Adams
- Research Institute for Sports and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Jia Han
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China; Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, ACT, Australia.
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Dallman J, Wolf MR, Campbell T, Herda T, White J, Tarakemeh A, Vopat BG. Current Definitions of Failure in Lateral Ankle Instability Surgery: A Systematic Review. Am J Sports Med 2023:3635465231153165. [PMID: 36917833 DOI: 10.1177/03635465231153165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND "Failure" is a term that is frequently used to describe an unfavorable outcome for patients who undergo surgical treatment for lateral ankle instability (LAI). A standard definition of failure for the surgical treatment of ankle instability has not been established by clinicians and researchers. PURPOSE To identify the definitions of ankle instability treatment failure that are currently in the literature and to work toward the standardization of the definition. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS A systematic search of MEDLINE, SPORTDiscus, CINAHL, Embase, and Web of Science was conducted to identify clinical studies that included patients who underwent surgical treatment for LAI and included information about surgical failure. Studies with level of evidence 1 to 4 were included in this review. Animal studies, biomechanical studies, cadaveric studies, review articles, and expert opinions were excluded. The included studies were then reviewed for definitions of failure of any surgical procedure that was performed to correct LAI. RESULTS Of the 1200 studies found, 3.5% (42/1200) published between 1984 and 2021 met the inclusion criteria and were analyzed. After reviewing the data, we found numerous definitions were reported in the literature for LAI surgical failure. The most common was recurrent instability (40% [17/42]), followed by rerupture (19% [8/42]). For the original surgical procedure, the anatomic Broström-Gould technique was used most frequently (57% [24/42]). The failure rate of the Broström-Gould technique ranged from 1.1% to 45.2% depending on the definition of failure. CONCLUSION There were multiple definitions of failure for the surgical treatment of LAI, which is one of the reasons why the rate of failure can vary greatly. The literature would benefit greatly from the standardization of the definition of ankle instability treatment failure. This definition should include specific, objective physical examination findings that eliminate the ambiguity surrounding failure.
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Affiliation(s)
| | - Megan R Wolf
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.,Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA
| | - Tanner Campbell
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Trent Herda
- Neuromechanics Laboratory, Department of Health, Sport & Exercise Sciences, University of Kansas, Lawrence, Kansas, USA
| | - Jacob White
- Dykes Library, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Armin Tarakemeh
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Bryan G Vopat
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
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Foster KS, Greenlee TA, Fraser JJ, Young JL, Rhon DI. The Influence of Therapeutic Exercise after Ankle Sprain on the Incidence of Subsequent Knee, Hip, and Lumbar Spine Injury. Med Sci Sports Exerc 2023; 55:177-185. [PMID: 36084225 DOI: 10.1249/mss.0000000000003035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE This study aimed to investigate the burden of knee, hip, and lumbar spine disorders occurring in the year after an ankle sprain and the influence therapeutic exercise (TE) has on this burden. METHODS A total of 33,361 individuals diagnosed with ankle sprain in the Military Health System between 2010 and 2011 were followed for 1 yr. The prevalence of knee, hip, and lumbar care-seeking injuries sustained after sprain was identified. Relationships between demographic groups, ankle sprain type, and use of TE with rate of proximal injuries were evaluated using Cox proportional hazard models to determine hazard rate effect modification by attribute. The observed effect of TE for ankle sprain on rate of injury to proximal joints was evaluated using Kaplan-Meier survival analyses. RESULTS Of the total cohort, 20.5% ( n = 6848) of patients sustained a proximal injury. Specifically, 10.1% of the cohort sustained a knee ( n = 3356), 2.9% a hip ( n = 973), and 10.3% a lumbar injury ( n = 3452). Less than half of the cohort received TE after initial sprain. Patients that did were less likely to have subsequent knee (HR = 0.87, 95% confidence interval [CI] = 0.80-0.94), hip (HR = 0.68, 95% CI = 0.58-0.79), or lumbar (HR = 0.82, 95% CI = 0.76-0.89) injuries. CONCLUSIONS One in five individuals that sought care for an ankle sprain experienced a proximal joint injury in the following year. TE for the management of the initial ankle sprain reduced the likelihood of proximal injury diagnosis and should be considered in treatment plans for return to work and sport protocols after ankle sprains.
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Affiliation(s)
- Kaitlyn S Foster
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX
| | - Tina A Greenlee
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, TX
| | - John J Fraser
- Directorate for Operational Readiness and Health, Naval Health Research Center, San Diego, CA
| | - Jodi L Young
- Doctor of Science Program in Physical Therapy, Bellin College, Green Bay, WI
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Koźlenia D, Domaradzki J. Risk of Single and Multiple Injuries Due to Static Balance and Movement Quality in Physically Active Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912197. [PMID: 36231497 PMCID: PMC9564762 DOI: 10.3390/ijerph191912197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Static balance is a reliable indicator of the musculoskeletal and nervous systems, which is a basis for movement stabilization development. The disorders in this area may increase injury risk (IR). This study investigated the musculoskeletal injury risk due to static balance and movement quality regarding single and multiple injury occurrences in physically active women. METHODS The study sample was 88 women aged 21.48 ± 1.56. The injury data were obtained with a questionnaire, and Deep Squat (DS), In-line lunge (IL), and Hurdle Step (HS) tests were conducted. Static balance was assessed with a stabilometric platform measured center of gravity area circle (AC) and path length (PL) with open (OE) and closed eyes (CE), maintaining a standing position for the 30 s. RESULTS The logistic regression models revealed the general injury occurrence was predicted by AC-CE (OR = 0.70; p = 0.03) and IL (OR = 0.49; p = 0.03), and the two-factor model AC-CE*IL, (OR = 1.40; p < 0.01). When the single injury was predicted by the same factors AC-CE (OR = 0.49; p < 0.01), IL (OR = 0.36; p = 0.01), and AC-CE*IL (OR = 1.58; p < 0.01). CONCLUSION Static balance and movement stability predict musculoskeletal injury risk alone and in one model. A further study is needed to verify the efficiency of indicated factors in prospective terms. Using both quantitative and qualitative tests could be helpful in IR prediction.
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Lee JH, Jung HW, Jung TS, Jang WY. Reliability and usefulness of the single leg heel raise balance test in patients with chronic ankle instability. Sci Rep 2021; 11:20369. [PMID: 34645864 PMCID: PMC8514424 DOI: 10.1038/s41598-021-99466-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/17/2021] [Indexed: 12/26/2022] Open
Abstract
We aimed to analyze the differences in static (including conventional and modified [single-leg heel-raise balance]) and dynamic postural stability and muscle endurance between patients with chronic ankle instability (CAI) and healthy controls, and to determine the reliability and usefulness of the single-leg heel-raise balance test in patients with CAI. In total, 26 patients with CAI and 26 healthy controls were enrolled. Postural stability was assessed using a postural stabilometry system. Muscle endurance was measured in dorsiflexion and plantarflexion using an isokinetic device. Modified static postural stability (P < 0.001) and dynamic postural stability (P < 0.001) were significantly poorer in the affected ankles of patients with CAI than in the controls. Plantarflexion endurance was significantly lower in the affected ankles of the patients with CAI than in the controls (P = 0.023). Modified static postural stability significantly correlated with plantarflexion endurance in both groups (CAI group: r = - 0.470, P = 0.015; healthy controls group: r = - 0.413, P = 0.036). Plantarflexion endurance was a significant risk factor for modified static postural stability in both the CAI group (R2 = 0.221, P = 0.015) and healthy controls (R2 = 0.170, P = 0.036). Given the reliability of the modified static postural stability test, clinicians and therapists should consider using it to assess improvements in postural stability and muscle endurance in patients with CAI before and after rehabilitation.
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Affiliation(s)
- Jin Hyuck Lee
- Department of Sports Medical Center, Korea University College of Medicine Anam Hospital, Seoul, Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul, South Korea
| | | | - Woo Young Jang
- Department of Sports Medical Center, Korea University College of Medicine Anam Hospital, Seoul, Korea. .,Department of Orthopedic Surgery, College of Medicine, Korea University, 73, Inchon‑ro, Seongbuk‑gu, Seoul, 02841, Republic of Korea.
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Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG80. [PMID: 33789434 DOI: 10.2519/jospt.2021.0302] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.
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Molina-Rueda F, Cuesta-Gómez A, Carratalá-Tejada M, Koutsou A, Fernández-González P, Alguacil-Diego IM. Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability. Phys Ther Sport 2020; 47:134-139. [PMID: 33278784 DOI: 10.1016/j.ptsp.2020.11.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To study postural control and muscle activity during the limit of stability test (LOS) in subjects with chronic ankle instability. DESIGN Observational study. SETTING University laboratory. PARTICIPANTS 10 healthy subjects were included in the control group and 10 subjects in the CAI group (age between 18 and 30 years, with history of the multiple ankle "giving way" episodes in the last six months and score ≤24 in the Cumberland Ankle Instability Tool). MAIN OUTCOME MEASURES A computerized dynamic posturography equipment was used for assessing the LOS. The electromyography activity of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG) and peroneus longus (PL) was registered. RESULTS Subjects with CAI had a greater activation in TA to forward (p < .01), forward affected (p = .001), backward affected (p = .007) and backward directions (p < .01); in PL to forward affected (p < .01) and affected directions (p = .001); in MG to forward (p = .023) and affected directions (p < .01) and in SOL to the affected direction (p = .009). We observed restricted excursions and less directional control in subjects with CAI. CONCLUSIONS Subjects with CAI exhibited poorer ability to move their center of gravity within stability limits. In addition, they have an altered ankle muscle activity during LOS test toward the affected ankle joint.
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Affiliation(s)
- Francisco Molina-Rueda
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University, Madrid, Spain; Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Alicia Cuesta-Gómez
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University, Madrid, Spain; Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
| | - María Carratalá-Tejada
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University, Madrid, Spain; Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Aikaterini Koutsou
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University, Madrid, Spain; Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Pilar Fernández-González
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University, Madrid, Spain; Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Isabel María Alguacil-Diego
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University, Madrid, Spain; Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
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