Incorporating regenerative medicine into rehabilitation programmes: a potential treatment for ankle sprain

2021 ◽  
Vol 28 (2) ◽  
pp. 1-15
Author(s):  
Quan Fu Gan ◽  
Chai Nien Foo ◽  
Pooi Pooi Leong ◽  
Soon Keng Cheong
Keyword(s):  
Regenerative Medicine ◽  
Ankle Sprain ◽  
Recent Trend ◽  
Holistic Approach ◽  
Ankle Sprains ◽  
Theoretical Concepts ◽  
Ankle Brace ◽  
Operative Complications ◽  
Inflammatory Drugs ◽  
Time Required

Ankle sprain has a great effect on morbidity and complications of chronic diseases. Experts have come to a consensus where ankle sprain can be managed by rest, ice, compression and elevation, non-steroidal anti-inflammatory drugs, immobilisation, functional support such as the use of an ankle brace, exercise, surgery and other therapies that include physiotherapy modalities and acupuncture. However, the time required for healing is still relatively long in addition to post-operative complications. Because of the challenges and setbacks faced by interventions to manage ankle sprains and in view of the recent trend and development in the field of regenerative medicine, this article discusses future treatments focusing on a personalised and holistic approach for ankle sprain management. This narrative review provides a novel idea for incorporating regenerative medicine into conventional therapy as an intervention for ankle sprain based on theoretical concepts and available evidence on regenerative medicine involving ligament injuries.

Non-steroidal anti-inflammatory drugs for treating acute ankle sprains in adults

2013 ◽  
Author(s):  
Michel PJ van den Bekerom ◽  
Arnout Sjer ◽  
Peter AA Struijs ◽  
Leendert Blankevoort ◽  
C N van Dijk ◽  
...  
Keyword(s):  
Ankle Sprains ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Predictive Factors of Recovery after an Acute Lateral Ankle Sprain: A Longitudinal Study

Sports ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 41
Author(s):  
Philippe Terrier ◽  
Sébastien Piotton ◽  
Ilona M. Punt ◽  
Jean-Luc Ziltener ◽  
Lara Allet
Keyword(s):  
Ankle Sprain ◽  
Strength Function ◽  
Selection Procedure ◽  
Ankle Sprains ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Functional Scores ◽  
Logistic Regressions ◽  
Poor Outcomes ◽  
Clinical Measures

A prominent feature of ankle sprains is their variable clinical course. The difficulty of providing a reliable early prognosis may be responsible for the substantial rate of poor outcomes after an ankle sprain. The aim of the present study was to evaluate the prognostic value of objective clinical measures, pain, and functional scores for ankle sprain recovery. Fifty-two participants suffering from lateral ankle sprain were included. Sprain status was assessed four weeks following injury and included evaluations of ankle range of motion, strength, function, and pain. Seven months following injury, a second assessment classified the patients into recovered and non-recovered groups using ankle ability measures. Following a predictor pre-selection procedure, logistic regressions evaluated the association between the four-week predictors and the seven-month recovery status. Twenty-seven participants (52%) fully recovered and 25 did not (48%). The results of the logistic regressions showed that walking pain was negatively associated with the probability of recovering at seven months (odds ratio: 0.71, 95% CI: 0.53–0.95). Pain four weeks after ankle sprain had relevant predictive value for long-term recovery. Special attention should be paid to patients reporting persistent pain while walking four weeks following sprain to reduce the risk of chronicity.

scholarly journals Incidence of Ankle Sprains Among Active-Duty Members of the United States Armed Services From 1998 Through 2006

2010 ◽  
Vol 45 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Kenneth L. Cameron ◽  
Brett D. Owens ◽  
Thomas M. DeBerardino
Keyword(s):  
At Risk ◽  
Incidence Rate ◽  
Ankle Sprain ◽  
Military Service ◽  
Active Duty ◽  
Service Members ◽  
Ankle Sprains ◽  
Injury Patterns ◽  
The Us ◽  
Armed Services

Abstract Context: Ankle sprains have been reported as one of the most common injuries sustained by members of the US Armed Services. However, little is known about the incidence rate and injury patterns associated with ankle sprains in this population. Objective: To examine the incidence of ankle sprains among active-duty members of the US Armed Services from 1998 through 2006. A secondary objective was to describe the sex, age, and service-specific injury patterns in this young, physically active population. Design: Cohort study. Patients or Other Participants: All active-duty service members from the day they enter military service until the day they leave military service and US Army Reserve and National Guard service members during periods of active duty and mobilization. Main Outcome Measure(s): Injury data were extracted from the Defense Medical Epidemiological Database from 1998 through 2006. All data for ankle sprains, coded according to the International Classification of Diseases (9th revision), were included. Cases were limited to those injuries reported as first occurrences. Incidence rates (IRs) were calculated per 1000 person-years by sex, age, and service. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were used to assess the strength of association between the incidence of ankle sprain and the independent variables of sex, age, and service. Results: From 1998 through 2006, 423 581 service members sustained ankle sprains and 12 118 863 person-years at risk to injury were documented in this population. The incidence rate was 34.95 (95% CI  =  34.85, 35.06) per 1000 person-years at risk. Females were 21% more likely (IRR  =  1.21, 95% CI  =  1.21, 1.23) to sustain an ankle sprain than males. Sex-specific IR varied by age and service. Differences in the rate of ankle sprains were also noted by age and service. Conclusions: The incidence of ankle sprains among US service members was 5 times greater than that previously reported in civilian population studies. Sex, age, and branch of military service are important factors related to the incidence of ankle sprains in this population.

scholarly journals POSTERIOR TIBIAL TENDON INJURY - IS MISSED DIAGNOSIS, A POSSIBILITY? SHOULD IT BE SUSPECTED IN ALLANKLE EVERSION SPRAINS? - A CASE REPORT

2020 ◽  
pp. 1-2
Author(s):  
Chavda Sumant ◽  
Garg Chaitanya ◽  
George, Biji Thomas ◽  
Jad Allah, Bader
Keyword(s):  
Physical Examination ◽  
Ankle Sprain ◽  
Weight Bearing ◽  
Ankle Injuries ◽  
Radiographic Evaluation ◽  
Tibialis Posterior ◽  
Posterior Tibial Tendon ◽  
Persistent Symptoms ◽  
Posterior Tibial ◽  
Ankle Brace

Ankle sprains are one of the most common injuries that occur among people of all ages and accounts for 75% of ankle injuries and for 10 to 30 percent of sports-related injuries in young athletes. Inversion sprain is more common than eversion ankle sprain, to result in injury to the lateral ligament complex. Though injury to the posterior tibial tendon is not a very common injury associated with eversion ankle sprain, it often can be overlooked and missed in the initial physical examination. We present a case of a college student who sustained a twisting injury to his left ankle while playing football. After initial history, physical examination and plain radiographic evaluation, a diagnosis of eversion ankle sprain was made by a general practitioner and treated conservatively. Due to persistent symptoms and local signs, subsequent evaluation with an MRI study revealed tibialis posterior (TP) tendon strain with diffuse soft tissue swelling extending up to lower third of the leg and associated Grade I osteochondral injury to the posterolateral aspect of talus. The injury was successfully treated with medial arch support ankle brace, analgesics, guarded weight bearing and physiotherapy with full functional recovery in 12 weeks.

scholarly journals Role of magnetic resonance imaging in ankle sprains

2021 ◽  
Vol 25 (1) ◽  
pp. 438-445
Author(s):  
Nawroz Othman ◽  
Salwa AL-Najjar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Evaluation ◽  
Ankle Sprain ◽  
Soft Tissues ◽  
Ankle Injuries ◽  
Bone Lesions ◽  
Ankle Sprains ◽  
Resonance Imaging ◽  
Imaging Results

Background and objective: Musculoskeletal injuries frequently occur in the ankle in both the athletic and general population. Ankle sprains are among the most frequent types of ankle injuries, which are conventionally diagnosed through clinical examinations. However, magnetic resonance imaging can provide a more precise diagnosis, leading to better injury management and prevention of consequent chronic complications. The present study aimed to examine the significance of magnetic resonance imaging in detecting and assessing changes that occur in ligaments and soft tissues in patients with ankle sprains. Methods: In a prospective study, 50 patients with ankle sprain referred to Rizgary and Erbil Teaching hospitals in Erbil city, Iraqi Kurdistan Region, from March 2018 to April 2019, were included in the study. They underwent clinical evaluation and MRI (GE general electric 1.5 Tesla). Two expert radiologists analyzed the magnetic resonance imaging images, and the results were compared. The collected data were analyzed using SPSS version 23 through descriptive statistics. Results: Most patients (64%) belonged to the age groups of 30-49 years old. Most of them (64%) were males. Most events of ankle sprain (66%) were because of sports and accidents. The clinical evaluation proved 82% of the ankle sprains. Regarding the laterality of the lesions, 60% were spotted in the right ankles and 40% in the left. According to magnetic resonance imaging results, both radiologists diagnosed that the ankle sprains included bone lesions, ligament injury, tendon injury, and effusion. There was an agreement of ≥ 96% between the two radiologists in this regard. The two radiologists were not significantly different in terms of diagnosing the ligament side. As reported by the radiologists based on the magnetic resonance imaging images, the anterior, lateral, and medial tendons were normal in most cases. Conclusion: Magnetic resonance imaging is a vitally important tool that can be utilized reliably and accurately to diagnose and evaluate changes in ligaments and soft tissues in patients with ankle sprains. Keywords: Magnetic resonance imaging (MRI); Ankle sprain; Ligaments; Injuries.

scholarly journals A Perceptual Framework for Conservative Treatment and Rehabilitation of Ankle Sprains: An Evidence-Based Paradigm Shift

2019 ◽  
Vol 54 (6) ◽  
pp. 628-638 ◽  
Author(s):  
Patrick O. McKeon ◽  
Luke Donovan
Keyword(s):  
Skill Acquisition ◽  
Ankle Sprain ◽  
Biopsychosocial Model ◽  
Ankle Instability ◽  
The Body ◽  
Ankle Sprains ◽  
Global Functioning ◽  
Progressive Return ◽  
Coordination Training ◽  
Ankle Support

Lateral ankle sprains are the most common injuries sustained during physical activity. The epidemiologic trends associated with chronic ankle instability (CAI) suggest that current rehabilitation approaches may be inadequate. We sought to synthesize best-practices evidence for the rehabilitation of patients with acute ankle sprains and CAI through the integration of emerging paradigms in perception, the dynamics of skill acquisition, and the biopsychosocial model of function, disability, and health. From the best available evidence, 4 key factors emerged for effective treatment and rehabilitation strategies: pain reduction, external ankle support for up to 1 year, progressive return to motion, and coordination training. We combined these factors into a meta-theoretical framework that centers on the perceptual interdependence of the cellular, local, and global functioning levels by linking insights from the body-self neuromatrix, the dynamics of skill acquisition, and the biopsychosocial model. Based on the best-practice recommendations from systematic reviews, ankle-sprain rehabilitation represents a multidimensional phenomenon governed by perception. The impairments, activity limitations, and participation restrictions associated with CAI may be linked to perceptual-interdependence alterations. Pain and edema reduction, the use of external ankle support for up to 1 year, progressive return to motion, and coordination training foster enhanced perceptual interdependence from cells to society. Using the perceptual-interdependence framework for ankle-sprain rehabilitation, we offer new insights for charting the course of effective strategies for enhancing function, reducing disability, and preventing the long-term sequelae associated with CAI.

Effects of Inversion Perturbation After Step-Down on the Latency of the Peroneus Longus and Peroneus Brevis

2011 ◽  
Vol 27 (4) ◽  
pp. 283-290 ◽  
Author(s):  
Adam C. Knight ◽  
Wendi H. Weimar
Keyword(s):  
Ankle Sprain ◽  
Ankle Sprains ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Peroneus Longus ◽  
Significant Difference ◽  
History Of ◽  
Step Down ◽  
Peroneus Brevis ◽  
High Ankle Sprain

The purpose of this investigation was to determine the effect of different types of ankle sprains on the response latency of the peroneus longus and peroneus brevis to an inversion perturbation, as well as the time to complete the perturbation (time to maximum inversion). To create a forced inversion moment of the ankle, an outer sole with fulcrum was used to cause 25 degrees of inversion at the ankle upon landing from a 27 cm step-down task. Forty participants completed the study: 15 participants had no history of any ankle sprain, 15 participants had a history of a lateral ankle sprain, and 10 participants had a history of a high ankle sprain. There was not a significant difference between the injury groups for the latency measurements or the time to maximum inversion. These findings indicate that a previous lateral ankle sprain or high ankle sprain does not affect the latency of the peroneal muscles or the time to complete the inversion range of motion.

Characteristics of people with recurrent ankle sprains: a systematic review with meta-analysis

2011 ◽  
Vol 45 (8) ◽  
pp. 660-672 ◽  
Author(s):  
Claire E Hiller ◽  
Elizabeth J Nightingale ◽  
Chung-Wei Christine Lin ◽  
Garrett F Coughlan ◽  
Brian Caulfield ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ankle Sprain ◽  
Test Performance ◽  
Postural Sway ◽  
Meta Analysis ◽  
Position Sense ◽  
Joint Position Sense ◽  
Ankle Sprains ◽  
Eyes Closed ◽  
Recurrent Ankle Sprain

ObjectiveTo examine whether people with recurrent ankle sprain, have specific physical and sensorimotor deficits.DesignA systematic review of journal articles in English using electronic databases to September 2009. Included articles compared physical or sensorimotor measures in people with recurrent (≥2) ankle sprains and uninjured controls.Main outcome groupsOutcome measures were grouped into: physical characteristics, strength, postural stability, proprioception, response to perturbation, biomechanics and functional tests. A meta-analysis was undertaken where comparable results within an outcome group were inconsistent.ResultsFifty-five articles met the inclusion criteria. Compared with healthy controls, people with recurrent sprains demonstrated radiographic changes in the talus, changes in foot position during gait and prolonged time to stabilisation after a jump. There were no differences in ankle range of motion or functional test performance. Pooled results showed greater postural sway when standing with eyes closed (SMD=0.9, 95% CI 0.4 to 1.4) or on unstable surfaces (0.5, 0.1 to 1.0) and decreased concentric inversion strength (1.1, 0.2 to 2.1) but no difference in evertor strength, inversion joint position sense or peroneal latency in response to a perturbation.ConclusionThere are specific impairments in people with recurrent ankle sprain but not necessarily in areas commonly investigated.

scholarly journals Motor-Neuron Pool Excitability of the Lower Leg Muscles After Acute Lateral Ankle Sprain

2011 ◽  
Vol 46 (3) ◽  
pp. 263-269 ◽  
Author(s):  
Lindsey W. Klykken ◽  
Brian G. Pietrosimone ◽  
Kyung-Min Kim ◽  
Christopher D. Ingersoll ◽  
Jay Hertel
Keyword(s):  
Motor Neuron ◽  
Ankle Sprain ◽  
Tibialis Anterior ◽  
Ankle Instability ◽  
Ankle Sprains ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Leg Muscles ◽  
Motor Neuron Pool ◽  
Neuron Pool

Context: Neuromuscular deficits in leg muscles that are associated with arthrogenic muscle inhibition have been reported in people with chronic ankle instability, yet whether these neuromuscular alterations are present in individuals with acute sprains is unknown. Objective: To compare the effect of acute lateral ankle sprain on the motor-neuron pool excitability (MNPE) of injured leg muscles with that of uninjured contralateral leg muscles and the leg muscles of healthy controls. Design: Case-control study. Setting: Laboratory. Patients or Other Participants: Ten individuals with acute ankle sprains (6 females, 4 males; age = 19.2 ± 3.8 years, height = 169.4 ± 8.5 cm, mass = 66.3 ±11.6 kg) and 10 healthy individuals (6 females, 4 males; age = 20.6 ± 4.0 years, height = 169.9 ± 10.6 cm, mass = 66.3 ± 10.2 kg) participated. Intervention(s): The independent variables were group (acute ankle sprain, healthy) and limb (injured, uninjured). Separate dependent t tests were used to determine differences in MNPE between legs. Main Outcome Measure(s): The MNPE of the soleus, fibularis longus, and tibialis anterior was measured by the maximal Hoffmann reflex (Hmax) and maximal muscle response (Mmax) and was then normalized using the Hmax:Mmax ratio. Results: The soleus MNPE in the ankle-sprain group was higher in the injured limb (Hmax:Mmax = 0.63; 95% confidence interval [CI], 0.46, 0.80) than in the uninjured limb (Hmax:Mmax = 0.47; 95% CI, 0.08, 0.93) (t6 = 3.62, P = .01). In the acute ankle-sprain group, tibialis anterior MNPE tended to be lower in the injured ankle (Hmax:Mmax = 0.06; 95% CI, 0.01, 0.10) than in the uninjured ankle (Hmax:Mmax = 0.22; 95% CI, 0.09, 0.35), but this finding was not different (t9 = −2.01, P = .07). No differences were detected between injured (0.22; 95% CI, 0.14, 0.29) and uninjured (0.25; 95% CI, 0.12, 0.38) ankles for the fibularis longus in the ankle-sprain group (t9 = −0.739, P = .48). We found no side-to-side differences in any muscle among the healthy group. Conclusions: Facilitated MNPE was present in the involved soleus muscle of patients with acute ankle sprains, but no differences were found in the fibularis longus or tibialis anterior muscles.

Pathogenesis of Pseudophakic Cystoid Macular Oedema

2012 ◽  
Vol 06 (05) ◽  
pp. 290
Author(s):  
Conceição Lobo ◽  
Keyword(s):  
Optical Coherence Tomography ◽  
Cataract Surgery ◽  
Inflammatory Mediators ◽  
Diagnostic Tool ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Blood Retinal Barrier ◽  
Non Invasive ◽  
Operative Complications ◽  
Inflammatory Drugs

Cystoid macular oedema (CMO) is a primary cause of reduced vision after cataract surgery even after uneventful surgery. The incidence of clinical CMO following modern cataract surgery is 1.0-2.0 % but the high number of surgeries performed worldwide makes this entity an important problem. Pre-existing conditions such as diabetes and intra-operative complications increase the risk of developing CMO post-operatively. CMO is caused by an accumulation of intra-retinal fluid in the outer plexiform and inner nuclear layers of the retina, as a result of the breakdown of the blood-retinal barrier. The mechanisms that lead to this condition are not completely understood. However, the principal hypothesis is that the surgical procedure is responsible for the release of inflammatory mediators, such as prostaglandins. Optical coherence tomography is at present an extremely useful non-invasive diagnostic tool. Guidelines for the management CMO should be focused essentially on prevention and are based on the principal pathogenetic mechanisms, including the use of anti-inflammatory drugs.

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