Postural control systems in two different functional movements: a comparison of subjects with and without chronic ankle instability

Lower limb squat biomechanics and select clinical measures in chronic ankle instability

BACKGROUND

Individuals with chronic ankle instability often present with clinical and biomechanical abnormalities, however squat biomechanics have not been investigated. The purpose of this study was to compare select clinical assessments and squat biomechanics between individuals with and without chronic ankle instability.

METHODS

Fifteen individuals with chronic ankle instability and a matched control group were studied. A weight-bearing dorsiflexion lunge test, foot posture, and an in-line half-kneeling motor control test for core stability were assessed. Lower limb 3D bilateral and unilateral squat biomechanics were captured. Groups, limbs and squat tasks were compared using an alpha of 0.05.

FINDINGS

Individuals with chronic ankle instability had less static weight-bearing dorsiflexion and failed the core stability test more frequently, but did not differ in foot morphology compared to the controls. When squatting, those with chronic ankle instability demonstrated reduced peak ankle dorsiflexion angles and moments in the involved limb (p < 0.04) during single limb squats and had interlimb differences in ankle dorsiflexion angle as well as hip and knee kinetics (p < 0.04) during double limb squats. In those with chronic ankle instability, there was less overall motion, but higher kinetic demands in single limb versus double leg squatting (p < 0.03).

INTERPRETATION

Individuals with chronic ankle instability had impaired weight-bearing dorsiflexion and showed impaired core stability more often, which accompanied altered squatting mechanics in both variations. Within the limbs with chronic ankle instability, single limb squats showed lesser kinematic demands but higher kinetic demands than double limb squatting.

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

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.

Association Between Functional Movement Screen Scores and Injuries in Male College Basketball Players

Context: The functional movement screen (FMS) is an assessment tool for movement dysfunction, which is used to reduce the risk of injury. Although the relationship between the FMS composite score and injuries has been extensively studied, the association between FMS scores and injuries in only college basketball players remains unknown. Objective: To examine the relationship between the FMS score and injuries in basketball players. Design: Cross-sectional study. Setting: University research laboratory. Participants: Eighty-one male college basketball players (average age 20.1 [1.3] y) participated. Main Outcome Measures: The FMS composite score was calculated from 7 movement tests. The incidence of injuries over a 1-year period prior to the test day was determined based on a questionnaire. Individuals were categorized into 2 groups: injury (with a serious basketball-related injury resulting in the loss of practice and game time for at least 4 wk) and noninjury groups. Mann–Whitney U and chi-square tests were used to evaluate group differences in the composite FMS and 7 movement scores, respectively. Furthermore, the scores significant on univariate analyses were submitted to a multivariate logistic analysis, adjusting for participant characteristics. Results: The composite FMS scores of the 2 groups were not significantly different (P = .38). Among the 7 tasks, only the deep squat and hurdle step showed significant group differences (P = .03 and P = .001, respectively). The multivariate logistic analysis revealed that deep squat (odds ratio, 6.48; 95% confidence interval, 1.23–34.01; P = .03) and hurdle step scores (odds ratio, 25.80; 95% confidence interval, 1.81–368.73; P = .02) were significantly associated with injuries, even after adjustment for participant characteristics. Conclusions: Deep squat and hurdle step scores may be associated with injuries in basketball players. Further research should be conducted to confirm that these 2 scores can predict the incidence of injuries in basketball players.

Corrective Exercises Improve Movement Efficiency and Sensorimotor Function but Not Fatigue Sensitivity in Chronic Ankle Instability Patients: A Randomized Controlled Trial

OBJECTIVE

To investigate the effect of corrective exercises on functional movement patterns, sensorimotor function, self-reported function, and fatigue sensitivity in collegiate athletes with chronic ankle instability (CAI).

DESIGN

A randomized controlled trial.

SETTING

Laboratory of sports sciences.

PARTICIPANTS

Forty male volunteers were randomly assigned to the experimental group (age 21.2 ± 1.7 years, height 174.5 ± 6.1 cm, and weight 69.6 ± 6.9 kg) or the control group (age 20.9 ± 1.8 years, height 178.2 ± 6.6 cm, and weight 68.8 ± 8.1 kg).

INTERVENTION

Participants in the experimental group performed supervised corrective exercises 3 times per week for 8 weeks. Fatigue was induced with a progressive treadmill protocol before and after the 8-week intervention.

MAIN OUTCOME MEASURES

Outcomes included movement efficiency during 3 squat tasks, static and dynamic postural control, strength of the ankle musculature, joint position sense, and self-reported function with the Foot and Ankle Ability Measure subscales. These outcomes were assessed before and immediately after fatiguing treadmill running both before and after 8-weeks of corrective exercises.

RESULTS

Significant improvements in movement efficiency, sensorimotor function, and self-reported function were noted in the experimental group relative to the control group (P < 0.001), in a nonfatigued state. However, in a fatigued stated, the experimental intervention only improved static postural control (P = 0.016) relative to the control group.

CONCLUSIONS

These findings demonstrate that 8-weeks of corrective exercises were effective at enhancing movement efficiency, sensorimotor function, and self-reported function in collegiate athletes with CAI. However, this intervention program has limited abilities at reducing the effects of fatigue.

Characterizing Lower Extremity Movement Scores Before and After Fatigue in Collegiate Athletes With Chronic Ankle Instability

Sensorimotor function is impaired in chronic ankle instability (CAI) patients. CAI patients have an increased sensitivity to fatigue relative to controls. Few investigations have quantified functional movement scores in CAI patients or the effect of fatigue on such scores. Therefore, we characterized functional movement scores before and after fatigue in 40 collegiate athletes with CAI. Three movement patterns (double-limb squat, double-limb squat with heel lift, and single-limb squat) were completed before and after fatigue and scored using Fusionetics®. All Fusionetics scores were higher (worse) after fatigue. The results demonstrate that functional movement scores were sensitive to fatigue.