scholarly journals Ultrasound Changes of Peri-Ankle Muscles in Subjects with Unilateral Chronic Ankle Instability

2021 ◽  
Vol 10 (10) ◽  
pp. 673-678
Author(s):  
Khadijeh Kazemi ◽  
Feryal Saadi ◽  
Khodabakhsh Javanshir ◽  
Mohammad Jafar Shaterzadeh Yazdi ◽  
Shahin Goharpey ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Clinical Decision Making ◽  
Ankle Instability ◽  
Treatment Plan ◽  
Chronic Ankle Instability ◽  
Muscle Performance ◽  
Cross Sectional ◽  
Ankle Muscles ◽  
Morphological Criteria ◽  
Significant Difference

BACKGROUND Ankle sprain is a common problem among active people and athletes. About 80 % of the people and 73 % of the athletes, who once had an ankle sprain, have experienced a recurrence of ankle sprain during their work or sport. Chronic ankle instability is described as a repeated ankle sprain, ankle giving way, pain and swelling and functional decline. Due to impaired muscle strength and impaired neuromuscular and postural control, it seems that the morphological criteria of peri-ankle muscles have changed. The study aimed to identify the morphological and muscle performance components of peroneus longus (PL) muscle in subjects with injured and intact sides of the chronic ankle sprain. Furthermore, the difference in ultrasonographic characteristics of PL muscle between genders, and the effect of the dominant limb on PL muscle ultrasonographic characteristics were investigated. METHODS The thickness, width and cross-sectional area (CSA) as morphological components and muscle performance components like fiber length, and pennation angle of PL muscle of the injured were calculated and compared to the intact side of the control in 25 subjects with unilateral chronic ankle instability via ultrasonography. RESULTS The findings of this study indicated a significant difference in the morphological component of PL muscle between both sides with no statistically significant difference in the muscle performance component of PL muscle. CONCLUSIONS Awareness of these changes in the injured side muscle morphology may lead to better clinical decision-making to design the best treatment plan by the physiotherapist. KEY WORDS Ankle Sprain, Chronic Ankle Instability, Ankle Muscle Ultrasonography

scholarly journals Ultrasound measures of intrinsic foot muscle size and motor activation following lateral ankle sprain and chronic ankle instability. A cross-sectional study.

2020 ◽  
Author(s):  
John J Fraser ◽  
Rachel M Koldenhoven ◽  
Jay Hertel
Keyword(s):  
Young Adults ◽  
Ankle Sprain ◽  
Ankle Instability ◽  
Linear Regression Analysis ◽  
Chronic Ankle Instability ◽  
Cross Sectional ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Intrinsic Foot Muscle ◽  
Injury Status

Objectives: To assess the effects of ankle injury status on intrinsic foot muscle (IFM) size at rest and during contraction in young adults with and without a history of lateral ankle sprain (LAS) and chronic ankle instability (CAI). Methods: Foot Posture Index (FPI), Foot Mobility Magnitude (FMM), and ultrasonographic cross-sectional area of the abductor hallucis (AbdH), flexor digitorum brevis (FDB), quadratus plantae (QP), and flexor hallucis brevis (FHB) were assessed at rest, and during non-resisted and resisted contraction in 22 healthy (13 females, BMI: 22.5±3.2, FPI: 4.2±3.9, FMM: 2.5±1.8), 17 LAS (9 females, BMI: 24.1±3.7, FPI: 2.5±3.4, FMM: 2.7±1.7), 21 Copers (13 females, BMI: 23.7±2.9, FPI: 3.6±4.1, FMM: 1.8±1.3), and 20 CAI (15 females, BMI: 25.1±4.5, FPI: 4.4±3.6., FMM: 2.3±1.1). Results: A multiple linear regression analysis assessing group, sex, BMI, FPI, and FMM on resting and contracted IFM size found sex (p<.001), BMI (p=.01), FPI (p=.05), and FMM*FPI interaction (p=.008) accounted for 19% of the variance (p=.002) in resting AbdH measures. Sex (p<.001) and BMI (p=.02) explained 24% of resting FDB measures (p<.001). Having a recent LAS (p=.03) and FMM (p=.02) predicted 11% of non-resisted QP contraction measures (p=.04), with sex (p<.001) explaining 13% of resting QP measures (p=.02). Both sex (p=.01) and FMM (p=.03) predicted 16% of resting FDB measures (p=.01). There were no other statistically significant findings. Conclusions: IFM resting ultrasound measures were primarily determined by sex, BMI, and foot phenotype and not injury status. The clinical utility of these IFM ultrasonographic assessments in young adults with LAS and CAI may be limited.

scholarly journals Comparison of the Psychological Profile of Ankle Sprain Between Coper and Chronic Ankle Instability Individuals: Cross-sectional Study

2021 ◽  
Author(s):  
Shima Babakhanian ◽  
Mohammad Hani Mansori ◽  
Mohammad Karimizadeh Ardakani ◽  
Homa Naderifar
Keyword(s):  
Goal Setting ◽  
Sports Injuries ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Mental Practice ◽  
Self Report ◽  
Mental Skills ◽  
Cross Sectional ◽  
Self Confidence ◽  
Significant Difference

Abstract Background: The aim of this study was to compare the psychological parameters in Coper individuals and people with chronic ankle instability (CAI).Methods: This study was a cross-sectional and comparative study. Sixty elite athletes, from multiple athletic disciplines, who have suffered from lateral ankle sprains at least once in the last two years, were selected as research subjects and were divided into two groups: Copers (n = 30) and CAI (n = 30). Classification of CAI, and coper groups were done by AJFAT, CAIT and FAAM self-report questionnaires. Athletes' psychological characteristics were measured using the Ottawa Mental Skills Assessment Tool (OMSAT-3). Multivariate analysis of variance (MANOVA) and independent t-test were used to evaluate the differences between groups at a significance level of 0.05. Results: The results showed there was a significant difference between the two groups in Goal setting, Self-confidence, Commitment, Relaxation, Fear control and Coping with stress, Focusing, Refocusing, and Mental practice (P <0.05). And Coper athletes scored higher than ankle instability athletes. But there were no significant differences between the two groups in the following parameters: Inactivation, Imagery, and Competition planning skills (P <0.05).Conclusion: The findings showed that athletes with CAI scored lower than Coper athletes on psychological exams. Given the importance of prioritizing the mental components of goal setting, imagery, relaxation, activation, and self-confidence, the design of the competition should be a priority for rehabilitation. Therefore, coaches and sports experts are recommended to focus and improve mental skills in athletes who suffer from sports injuries, to reduce the occurrence of repetitive sports injuries.

The Effects of a Semi-Rigid Brace or Taping on Talocrural and Subtalar Kinematics in Chronic Ankle Instability

2014 ◽  
Vol 7 (6) ◽  
pp. 471-477 ◽  
Author(s):  
Takumi Kobayashi ◽  
Masayuki Saka ◽  
Eiichi Suzuki ◽  
Naohito Yamazaki ◽  
Makoto Suzukawa ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Ankle Instability ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Case Series ◽  
Chronic Ankle Instability ◽  
Cross Sectional ◽  
Anterior Translation ◽  
Computed Tomography Images ◽  
Significant Difference

Background. A semi-rigid brace or taping is often used to prevent giving-ways in the joint with chronic ankle instability (CAI). However, it remains unknown whether the application of a semi-rigid brace or taping modifies abnormal kinematics in CAI joints. The objective of this study was to determine if the application of a semi-rigid brace or taping of the ankle normalizes abnormal weight-bearing kinematics in CAI joints during ankle internal rotation in plantar flexion. Methods. A total of 14 male patients with unilateral CAI (mean age 21.1 ± 2.5 years) were enrolled. Three-dimensional bone models created from the computed tomography images were matched to the fluoroscopic images to compute the 6 degrees-of-freedom talocrural, subtalar, and ankle joint complex (AJC) kinematics for the healthy and contralateral CAI joints, as well as for CAI joints with a brace or taping. Selected outcome measures were talocrural anterior translation, talocrural internal rotation, and subtalar internal rotation. Results. There was no significant difference in talocrural anterior translation and internal rotation induced by applying either a semi-rigid brace or taping ( P > .05). For subtalar internal rotation, there was a tendency toward restoration of normal kinematics in CAI joints after applying a semi-rigid brace or taping. However, the difference was not significant ( P > .05). Discussion. Application of a semi-rigid brace or taping had limited effects on the CAI joint during weight-bearing ankle internal rotation in plantar flexion. Further studies using a variety of testing conditions should be conducted in the future. Levels of Evidence: Therapeutic, Level IV: Cross-Sectional Case Series

scholarly journals Lack of Medical Treatment From a Medical Professional After an Ankle Sprain

2019 ◽  
Vol 54 (6) ◽  
pp. 671-675 ◽  
Author(s):  
Tricia Hubbard-Turner
Keyword(s):  
Medical Treatment ◽  
Ankle Sprain ◽  
Ankle Instability ◽  
Cross Sectional Study ◽  
Chronic Ankle Instability ◽  
Medical Professional ◽  
Medical Attention ◽  
Ankle Sprains ◽  
Cross Sectional ◽  
Initial Management

Context Despite the prevalence of ankle sprains and the potential for developing chronic ankle instability and ankle osteoarthritis, ankle sprains are often perceived as an innocuous injury. Objective To understand the initial management and treatment sought by patients after a lateral ankle sprain (LAS) and to identify any differences in subjective function and self-reported injury. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants A total of 175 participants with chronic ankle instability (73 men, 102 women; age = 20.9 ± 3.4 years, height = 173.5 ± 13.2 cm, mass = 81.4 ± 24.6 kg) were involved in the study. Main Outcome Measure(s) Participants were administered a questionnaire regarding their initial LAS. All participants also completed the Foot and Ankle Ability Measure (FAAM). The primary questions of interest were (1) Did the participants seek treatment from a medical professional for their initial LAS? (2) Did the participants perform rehabilitation? (3) Was the initial LAS immobilized? and (4) Did the participants use crutches? The other variables measured were scores on the FAAM and the FAAM Sports subscale, total number of ankle sprains, and incidents of giving way. Results Sixty-four percent of participants did not seek medical treatment after their LAS. Those who did not seek medical treatment scored worse on the FAAM (81.21% ± 3.1% versus 89.23% ± 2.8%, P = .03) and the FAAM Sports subscale (72.34% ± 5.3% versus 81.26% ± 3.1%, P = .001). Those not seeking treatment also reported more ankle sprains since the initial injury (4.7 ± 2.4 versus 1.9 ± 0.90, P = .02) and more incidents of giving way each month (3.8 ± 1.9 versus 1.1 ± 0.87, P = .04). Conclusions It is not surprising that those who did not seek medical treatment for their LASs had worse subjective function, more ankle sprains, and more incidents of the ankle giving way. The public needs to be educated on the significance of ankle sprains and the need for medical attention to provide appropriate management. However, we also need to continue to evaluate initial management and rehabilitation to ensure that those who seek treatment receive the best care in order to reduce reinjury rates.

Ultrasound Measures of Intrinsic Foot Muscle Size and Activation Following Lateral Ankle Sprain and Chronic Ankle Instability

2021 ◽  
pp. 1-11
Author(s):  
John J. Fraser ◽  
Rachel Koldenhoven ◽  
Jay Hertel
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Muscle Size ◽  
Abductor Hallucis ◽  
Cross Sectional ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Flexor Digitorum Brevis ◽  
Flexor Digitorum

Context: Tibial nerve impairment and reduced plantarflexion, hallux flexion, and lesser toe flexion strength have been observed in individuals with recent lateral ankle sprain (LAS) and chronic ankle instability (CAI). Diminished plantar intrinsic foot muscles (IFMs) size and contraction are a likely consequence. Objectives: To assess the effects of ankle injury on IFM size at rest and during contraction in young adults with and without LAS and CAI. Setting: Laboratory. Design: Cross-sectional. Patients: A total of 22 healthy (13 females; age = 19.6 [0.9], body mass index [BMI] = 22.5 [3.2]), 17 LAS (9 females; age =21.8 [4.1], BMI = 24.1 [3.7]), 21 Copers (13 females; age = 20.8 [2.9], BMI = 23.7 [2.9]), and 20 CAI (15 females; age = 20.9 [4.7], BMI = 25.1 [4.5]). Main Outcome Measures: Foot Posture Index (FPI), Foot Mobility Magnitude (FMM), and ultrasonographic cross-sectional area of the abductor hallucis, flexor digitorum brevis, quadratus plantae, and flexor hallucis brevis were assessed at rest, and during nonresisted and resisted contraction. Results: Multiple linear regression analyses assessing group, sex, BMI, FPI, and FMM on resting and contracted IFM size found sex (B = 0.45; P < .001), BMI (B = 0.05; P = .01), FPI (B = 0.07; P = .05), and FMM × FPI interaction (B = −0.04; P = .008) accounted for 19% of the variance (P = .002) in resting abductor hallucis measures. Sex (B = 0.42, P < .001) and BMI (B = 0.03, P = .02) explained 24% of resting flexor digitorum brevis measures (P < .001). Having a recent LAS (B = 0.06, P = .03) and FMM (B = 0.04, P = .02) predicted 11% of nonresisted quadratus plantae contraction measures (P = .04), with sex (P < .001) explaining 13% of resting quadratus plantae measures (B = 0.24, P = .02). Both sex (B = 0.35, P = .01) and FMM (B = 0.15, P = .03) predicted 16% of resting flexor hallucis brevis measures (P = .01). There were no other statistically significant findings. Conclusions: IFM resting ultrasound measures were primarily determined by sex, BMI, and foot phenotype and not injury status. Routine ultrasound imaging of the IFM following LAS and CAI cannot be recommended at this time but may be considered if neuromotor impairment is suspected.

Injury-Related Fear in Individuals With and Without Chronic Ankle Instability: A Systematic Review

2021 ◽  
pp. 1-10
Author(s):  
Ashley M.B. Suttmiller ◽  
Ryan S. McCann
Keyword(s):  
Systematic Review ◽  
Ankle Sprain ◽  
Methodological Quality ◽  
Ankle Instability ◽  
Evidence Synthesis ◽  
Chronic Ankle Instability ◽  
Fear Avoidance ◽  
Physically Active ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

Context: Injury-related fear has recently been recognized to exist in ankle sprain populations. It is unclear, however, if injury-related fear levels differ between those who develop chronic ankle instability (CAI) and those who do not and the best tools for assessing these differences. Objective: The purpose of this study was to conduct a comprehensive systematic review investigating differences in injury-related fear between individuals with and without CAI. Evidence Acquisition: Relevant studies from CINAHL Plus with full text, PubMed, and SPORTDiscus through November 2020 were included. All studies used the Tampa Scale of Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, or Athlete Fear Avoidance Questionnaire as either a descriptor or a main outcome and provided comparison data between a CAI group and ankle sprain copers (COP) or controls (CON). The authors independently assessed methodological quality using the modified Downs and Black Quality Index. Studies were then grouped by between-group comparisons including CAI and CON, CAI and COP, and COP and CON. The authors calculated Hedge g effect sizes and 95% confidence intervals to examine group differences. Evidence Synthesis: A total of 11 studies were included in this review. In total, 8 studies provided data for the CAI and CON comparison, 7 for CAI and COP comparisons, and 4 for COP and CON comparisons. Methodological quality scores ranged from 60.0% to 86.7%, with 2 high-, and 9 moderate-quality studies. Overall, the evidence suggests that physically active individuals with CAI report higher levels of injury-related fear when compared with both COP and CON. Although limited, ankle sprain COP do not seem to differ from CON. Conclusion: Available evidence emphasizes the importance of injury-related fear in individuals who develop chronicity after ankle sprain injury. The Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia are useful for the identification of injury-related fear in individuals after sustaining an ankle sprain and should be used to inform rehabilitation strategies and to monitor efficacy in fear reduction.

Comparison of the effect of foot orthoses on Star Excursion Balance Test performance in patients with chronic ankle instability

2018 ◽  
Vol 43 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Faezeh Abbasi ◽  
Mahmood bahramizadeh ◽  
Mohammad Hadadi
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Textured Surface ◽  
Foot Orthoses ◽  
Textured Surfaces ◽  
Balance Test ◽  
Star Excursion Balance Test ◽  
Foot Orthosis

Background: Chronic ankle instability as a prevalent consequence of ankle sprain causes various impairments such as balance and postural control deficits. Foot orthoses are one of the common interventions for rehabilitation of patients with chronic ankle instability. Objectives: To investigate the effect of custom-molded foot orthoses with textured surfaces on dynamic balance of chronic ankle instability patients and to compare their effects with other types of foot orthoses. Study design: This is a repeated measure design. Methods: A total of 30 participants were recruited based on the guideline introduced by the International Ankle Consortium. The effect of prefabricated, custom-molded, and custom-molded with textured surface foot orthoses was evaluated on dynamic balance by the Star Excursion Balance Test. Normalized reach distances in anteromedial, medial, and posteromedial directions of the test were computed to be used for statistical analysis. Results: The foot orthoses increased reach distances compared to the no-orthosis conditions in all three directions. The custom-molded with textured surface foot orthosis has significant differences compared with prefabricated foot orthosis ( p = 0.001) in all measured directions and with custom-molded foot orthosis ( p < 0.01) in medial and posteromedial directions. Conclusion: Foot orthoses improve reach distances in patients with chronic ankle instability. Custom-molded with textured surface foot orthosis has a more pronounced effect compared with other foot orthoses. Clinical relevance The custom-molded foot orthosis with textured surface could be an effective device to improve dynamic balance in chronic ankle instability (CAI) patients. It may be considered as an efficient intervention to reduce ankle sprain recurrence in these individuals, although further research should be conducted.

Standardized Synoptic Cancer Pathology Reports — So What and Who Cares?: A Population-Based Satisfaction Survey of 970 Pathologists, Surgeons, and Oncologists

2013 ◽  
Vol 137 (11) ◽  
pp. 1599-1602 ◽  
Author(s):  
Sara Lankshear ◽  
John Srigley ◽  
Thomas McGowan ◽  
Marta Yurcan ◽  
Carol Sawka
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Physician Satisfaction ◽  
Cross Sectional ◽  
Cancer Pathology ◽  
Report Turnaround Time ◽  
Significant Difference ◽  
Pathology Reporting ◽  
The Impact

Context.—Cancer Care Ontario implemented synoptic pathology reporting across Ontario, impacting the practice of pathologists, surgeons, and medical and radiation oncologists. The benefits of standardized synoptic pathology reporting include enhanced completeness and improved consistency in comparison with narrative reports, with reported challenges including increased workload and report turnaround time. Objective.—To determine the impact of synoptic pathology reporting on physician satisfaction specific to practice and process. Design.—A descriptive, cross-sectional design was utilized involving 970 clinicians across 27 hospitals. An 11-item survey was developed to obtain information regarding timeliness, completeness, clarity, and usability. Open-ended questions were also employed to obtain qualitative comments. Results.—A 51% response rate was obtained, with descriptive statistics reporting that physicians perceive synoptic reports as significantly better than narrative reports. Correlation analysis revealed a moderately strong, positive relationship between respondents' perceptions of overall satisfaction with the level of information provided and perceptions of completeness for clinical decision making (r = 0.750, P &lt; .001) and ease of finding information for clinical decision making (r = 0.663, P &lt; .001). Dependent t tests showed a statistically significant difference in the satisfaction scores of pathologists and oncologists (t169 = 3.044, P = .003). Qualitative comments revealed technology-related issues as the most frequently cited factor impacting timeliness of report completion. Conclusion.—This study provides evidence of strong physician satisfaction with synoptic cancer pathology reporting as a clinical decision support tool in the diagnosis, prognosis, and treatment of cancer patients.

Effects of Textured Balance Board Training in Adolescent Ballet Dancers With Ankle Pathology

2019 ◽  
Vol 28 (6) ◽  
pp. 584-592 ◽  
Author(s):  
Nili Steinberg ◽  
Roger Adams ◽  
Oren Tirosh ◽  
Janet Karin ◽  
Gordon Waddington
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Textured Surface ◽  
Ballet Dancers ◽  
Discrimination Ability ◽  
Board Training ◽  
Ankle Proprioception ◽  
Balance Board ◽  
Group 1

Context:Ankle sprains are common among adolescent ballet dancers and may be attributed to inadequate ankle proprioception. Thus, a short period of training utilizing proprioceptive activities requires evaluation.Objective:To assess training conducted for 3 or 6 weeks on a textured-surface balance board using ankle proprioception scores for ballet dancers with and without chronic ankle instability, and with and without previous ankle sprain (PAS).Design:Intervention study.Setting:The Australian Ballet School.Participants:Forty-two ballet dancers, aged 14–18 years.Interventions:Dancers randomized into 2 groups: group 1 undertook 1 minute of balance board training daily for 3 weeks; group 2 undertook the same training for 6 weeks.Main Outcome Measures:Preintervention, Cumberland Ankle Instability Tool questionnaire data were collected, and PAS during the last 2 years was reported. Active ankle inversion movement discrimination ability was tested immediately pre and post intervention and at 3 and 4 weeks.Results:Ankle discrimination acuity scores improved over time for both groups, with a performance decline associated with the early cessation of training for group 1 (P = .04). While dancers with PAS had significantly worse scores at the first test, before balance board training began (P < .01), no significant differences in scores at any test occasion were found between dancers with and without chronic ankle instability. A significantly faster rate of improvement in ankle discrimination ability score over the 4 test occasions was found for dancers with PAS (P = .002).Conclusions:Three weeks of textured balance board training improved the ankle discrimination ability of ballet dancers regardless of their reported level of chronic ankle instability and at a faster rate for dancers with PAS. Previous ankle sprain was associated with a lower level of ankle discrimination ability; however, following 3 weeks of balance board training, previously injured dancers had significantly improved their ankle discrimination acuity scores.

scholarly journals Influence of Foot Progression Angle on Center of Pressure During Stair Ascending in Subjects With Chronic Ankle Instability

2021 ◽  
Vol 15 ◽  
pp. 350-354
Author(s):  
Jung-Hyun Ban ◽  
Tae-Ho Kim
Keyword(s):  
Center Of Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Foot Progression Angle ◽  
Significant Difference ◽  
The Stability ◽  
Neutral Posture ◽  
Criteria For Selection ◽  
Anterior Posterior ◽  
Selection Of

The purpose of this study was to identify changes in the center of pressure during stair ascending in subjects with chronic ankle instability while different angles of foot are applied. The subjects of this study were 20 male and female adults with chronic ankle instability were selected from among the employees of D Hospital in Daegu Metropolitan City. The criteria for selection of subjects with chronic ankle instability were those who felt wobbling in the ankle joint and scored not higher than 24 points in a test using the Cumberland Ankle Instability Tool (CAIT). The subjects carried out stair ascending in neutral, toe-in and toe-out postures, respectively, and changes in the center of pressure (COP) were compared and analyzed. The results of this study, no statistically significant difference appeared in the comparison between the toe-in posture and neutral posture or between the neutral posture and the toe-out posture but medial/lateral movements of the center of pressure showed significant differences between the toe-in and toe-out postures. In addition, the total travel range and the moving range of the center of pressure, the average velocity, and the anterior/posterior movements of the center of pressure showed no statistically significant difference among all three postures. As a result, it could be seen that when adults with chronic ankle instability climb the stairs, the toe-in posture reduce the medial/lateral movements of the center of pressure thereby increasing the stability of the ankle and effectively preventing re-injuries.

Sign in / Sign up

Export Citation Format

Share Document