A three-week intervention emphasized diagonal eccentric contraction on balance and joint position sense and ankle strength in subjects with ankle instability: A randomized controlled trial

2020 ◽  
pp. 1-7
Author(s):  
Du-Jin Park ◽  
Byeong-Jo Kim ◽  
Yong-Hun Kim ◽  
Se-Yeon Park
Keyword(s):  
Ankle Instability ◽  
Dynamic Balance ◽  
Balance Training ◽  
Eccentric Contraction ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Post Intervention ◽  
Total Displacement ◽  
Ankle Strength

BACKGROUND: Problems related to ankle instability, decreased proprioceptive sensation, altered static and dynamic balance abilities are suggested as major representative factors that contribute to the recurrence of ankle sprains. OBJECTIVE: To assess the effect of a three-week intervention (intervention emphasizing diagonal eccentric contraction (IEDEC) and intervention of general exercise (IGE)) on static and dynamic balance abilities, ankle strength and joint position sense at pre- and post-intervention, and at two- and three-week post-intervention. METHODS: Twenty-five participants with ankle instability, including a history of ankle sprain and recurrent episodes of giving way, were enrolled in the study. They were randomly classified into the IEDEC group (n= 12) and the IGE group (n= 13). Dynamic balance was examined using the Y Balance Test, four-way ankle strength was measured, and the static balance was evaluated using the total displacement of the center of pressure (COP). To identify the joint position error, eversion and inversion of the ankle angle were measured. RESULTS: The results revealed significant increases in ankle dynamic stability and strength at two and three weeks post-intervention (p< 0.05). Similarly, the total displacement of the COP differed significantly over time, with a higher COP during the initial measurement than at two and three weeks intervention (p< 0.05) General balance training with IEDEC can improve position sense during ankle inversion (p< 0.05). CONCLUSION: General balance training with IEDEC improved the position sense of the inversion. Combined therapeutic intervention, such as with the manual technique, could be a beneficial approach to maximize the treatment effects.

scholarly journals The effect of the combination of whole body vibration and shoe with an unstable surface in chronic ankle instability treatment: a randomized clinical trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Farideh Shamseddini Sofla ◽  
Mohammad Hadadi ◽  
Iman Rezaei ◽  
Negar Azhdari ◽  
Sobhan Sobhani
Keyword(s):  
Ankle Instability ◽  
Whole Body Vibration ◽  
Position Sense ◽  
Joint Position Sense ◽  
Whole Body ◽  
Joint Position ◽  
Post Intervention ◽  
Unstable Surface ◽  
Hop Test

Abstract Background Chronic ankle instability (CAI) is a common condition following an ankle sprain. This study investigated the effects of whole body vibration (WBV) and shoe with an unstable surface training on balance, functional performance, strength, joint position sense in people with CAI. Method Thirty- four peoples with unilateral CAI were randomly assigned to three groups: WBV group, WBV with shoe with an unstable surface (WBV-S), and no treatment control group (CON). The WBV group received 4 weeks progressive WBV training and the WBV-S group received progressive WBV training with shoe with an unstable surface. Modified star excursion balance test (mSEBT)reach distance, Hop-Test, muscle strength, and joint position sense were measured at baseline and after the 4 weeks; Moreover, the mSEBT and Hop-Test were reassessed again 2 weeks post intervention. Results The result showed a significant group-by-time interaction for anterior and posterolateral directions of mSEBT. The reach distance of these directions at post-intervention and follow-up increased significantly compare to pre-intervention in the WBV and WBV-S groups but not significantly change in the CON group. The Hop test in the WBV-S group was significantly more at post-intervention and follow-up compared to pre-intervention. However, no significant changes were observed in WBV and CON groups. No significant changes were observed for mSEBT posteromedial direction, muscles strength, and joint position sense errors. Conclusion The 4 weeks WBV and WBV-S interventions could improve balance in peoples with CAI. Improvement in Hop test was only observed in the WBV-S group suggesting the added value of combining WBV and shoe with an unstable surface as an effective therapy compared to WBV training alone. The use of WBV and WBV-S were not associated with significant changes in strength and joint position sense variables over a four-week period. Trial registration This work registered in the Iranian Registry of Clinical Trials (IRCT20151118025105N4).

scholarly journals Effects of Plyometric and Balance Training on Neuromuscular Control of Recreational Athletes with Functional Ankle Instability: A Randomized Controlled Laboratory Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5269
Author(s):  
Pi-Yin Huang ◽  
Amornthep Jankaew ◽  
Cheng-Feng Lin
Keyword(s):  
Ankle Instability ◽  
Balance Training ◽  
Absolute Error ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Plyometric Training ◽  
Plantar Flexors ◽  
Drop Landing ◽  
Before And After

Plyometric exercise has been suggested for knee injury prevention in sports participation, but studies on ankle plyometric training are limited. This study aims to investigate the change of joint position sense and neuromuscular activity of the unstable ankle after six-week integrated balance/plyometric training and six-week plyometric training. Thirty recreational athletes with functional ankle instability were allocated into three groups: plyometric group (P) vs. plyometric integrated with balance training group (BP) vs. control group (C). Ankle joint position sense, integrated electromyography (EMG), and balance adjusting time during medial single-leg drop-landing tasks were measured before and after the training period. Following the six-week period, both training groups exhibited a lower absolute error in plantar flexion (P group: pre: 3.79° ± 1.98°, post: 2.20° ± 1.31°, p = 0.016; BP group: pre: 4.10° ± 1.87°, post: 2.94° ± 1.01°, p = 0.045), and the integrated group showed a lower absolute error in inversion angles (pre 2.24° ± 1.44° and post 1.48° ± 0.93°, p = 0.022), and an increased integrated EMG of ankle plantar flexors before landing. The plyometric group exhibited a higher integrated EMG of the tibialis anterior before and after landing (pre: 102.88 ± 20.93, post: 119.29 ± 38.33, p = 0.009 in post-landing) and a shorter adjusting time of the plantar flexor following landing as compared to the pre-training condition (pre: 2.85 ± 1.15 s, post: 1.87 ± 0.97 s, p = 0.006). In conclusion, both programs improved ankle joint position sense and muscle activation of the ankle plantar flexors during single-leg drop landing. The plyometric group showed a reduced adjusting time of the ankle plantar flexor following the impact from drop landing.

Effect of Load, Angle, and Contraction Type on Clinically Assessed Knee Joint Position Sense

2021 ◽  
pp. 1-6
Author(s):  
Adam L. Haggerty ◽  
Janet E. Simon ◽  
Dustin R. Grooms ◽  
Jeffrey A. Russell
Keyword(s):  
Body Position ◽  
Eccentric Contraction ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Active Joint ◽  
Concentric Contraction ◽  
Target Angle ◽  
Significant Difference ◽  
Contraction Type

Context: Proprioception is an individual’s awareness of body position in 3-dimensional space. How proprioceptive acuity changes under varying conditions such as joint position, load, and concentric or eccentric contraction type is not well understood. In addition, a limitation of the variety of techniques to assess proprioception is the lack of clinically feasible methods to capture proprioceptive acuity. The purpose of this study was to implement a readily available instrument, a smartphone, in the clinical evaluation of knee active joint position sense and to determine how joint angle, joint loading, and quadriceps contraction type affect an individual’s active joint position sense. Design: Cross-over study. Methods: Twenty healthy, physically active university participants (10 women and 10 men: 21.4 [2.0] y; 1.73 [0.1] m; 70.9 [14.3] kg) were recruited. Individuals were included if they had no neurological disorder, no prior knee surgery, and no recent knee injury. The participants were given a verbal instruction to locate a target angle and then were tasked with reproducing the target angle without visual or verbal cues. An accelerometer application on a smartphone was used to assess the angle to the nearest tenth of a degree. Three variables, each with 2 levels, were analyzed in this study: load (weighted and unweighted), contraction type (eccentric and concentric), and joint position (20° and 70°). A repeated-measures analysis of variance was conducted to assess the within-subjects factors of load, contraction, and position. Results: A significant difference of 0.50° (0.19°) of greater error with eccentric versus concentric contraction (P = .02) type was identified. In addition, a significant interaction was found for contraction × position, with a mean increase in error of 0.98° (0.33°) at the 20° position when contracting eccentrically (P = .03). Conclusions: Contraction type, specifically eccentric contraction at 20°, showed significantly greater error than concentric contraction. This suggests that, during eccentric contractions of the quadriceps, there may be decreased proprioceptive sensitivity compared with concentric contractions.

Effects of proprioceptive training on the incidence of ankle sprain in athletes: systematic review and meta-analysis

2018 ◽  
Vol 32 (12) ◽  
pp. 1581-1590 ◽  
Author(s):  
Gabriela Souza de Vasconcelos ◽  
Anelize Cini ◽  
Graciele Sbruzzi ◽  
Cláudia Silveira Lima
Keyword(s):  
Postural Sway ◽  
Meta Analysis ◽  
Balance Training ◽  
Neuromuscular Control ◽  
Position Sense ◽  
Joint Position Sense ◽  
Control Group ◽  
Controlled Trials ◽  
Ankle Sprains ◽  
Joint Position

Objective: To investigate how dynamic neuromuscular control, postural sway, joint position sense, and incidence of ankle sprain are influenced by balance training in athletes compared with the control group in randomized clinical trials. Data sources: The search strategy included MEDLINE, Physical Therapy Evidence Database, Cochrane Central Register of Controlled Trials, and Latin American and Caribbean Center on Health Sciences Information. Randomized controlled trials (RCTs) were published by June of 2018. Methods: RCTs that evaluate the effectiveness of proprioception in these outcomes: dynamic neuromuscular control, postural sway, joint position, and the incidence of ankle sprains in athletes aged between 18 and 35 years. Two reviewers independently screened the searched records, extracted the data, and assessed risk of bias. The treatment effect sizes were pooled in a meta-analysis using the RevMan 5.2 software. Internal validity was assessed through topics suggested by Cochrane Collaborations. Results: Of the 12 articles included ( n = 1817), eight were in the meta-analysis ( n = 1722). The balance training reduced the incidence of ankle sprains in 38% compared with the control group ( RR: 0.62; 95% CI: 0.43–0.90). In relation to the dynamic neuromuscular control, the training showed increase in the distance of reach in the anterior (0.62 cm, 95% CI: 0.13–1.11), posterolateral (4.22 cm, 95% CI: 1.76–6.68), and posteromedial (3.65 cm, 95% CI: 1.03–6.26) through the Star Excursion Balance test. Furthermore, training seems to improve postural sway and joint position sense. Conclusion: Balance training reduces the incidence of ankle sprains and increases dynamic neuromuscular control, postural sway, and the joint position sense in athletes.

scholarly journals Ankle Instability Effects on Joint Position Sense When Stepping Across the Active Movement Extent Discrimination Apparatus

2012 ◽  
Vol 47 (6) ◽  
pp. 627-634 ◽  
Author(s):  
Jeremy Witchalls ◽  
Gordon Waddington ◽  
Peter Blanch ◽  
Roger Adams
Keyword(s):  
Clinical Laboratory ◽  
Ankle Instability ◽  
Position Sense ◽  
Joint Position Sense ◽  
Active Movement ◽  
Joint Position ◽  
Repeated Testing ◽  
Functional Ankle Instability ◽  
Angle Variation ◽  
Discrimination Apparatus

Context Individuals with and without functional ankle instability have been tested for deficits in lower limb proprioception with varied results. Objective To determine whether a new protocol for testing participants' joint position sense during stepping is reliable and can detect differences between participants with unstable and stable ankles. Design Descriptive laboratory study. Setting University clinical laboratory. Patients or Other Participants Sample of convenience involving 21 young adult university students and staff. Ankle stability was categorized by score on the Cumberland Ankle Instability Tool; 13 had functional ankle instability, 8 had healthy ankles. Intervention(s) Test-retest of ankle joint position sense when stepping onto and across the Active Movement Extent Discrimination Apparatus twice, separated by an interim test, standing still on the apparatus and moving only 1 ankle into inversion. Main Outcome Measure(s) Difference in scores between groups with stable and unstable ankles and between test repeats. Results Participants with unstable ankles were worse at differentiating between inversion angles underfoot in both testing protocols. On repeated testing with the stepping protocol, performance of the group with unstable ankles was improved (Cohen d = 1.06, P = .006), whereas scores in the stable ankle group did not change in the second test (Cohen d = 0.04, P = .899). Despite this improvement, the unstable group remained worse at differentiating inversion angles on the stepping retest (Cohen d = 0.99, P = .020). Conclusions The deficits on proprioceptive tests shown by individuals with functional ankle instability improved with repeated exposure to the test situation. The learning effect may be the result of systematic exposure to ankle-angle variation that led to movement-specific learning or increased confidence when stepping across the apparatus.

scholarly journals Surgical Reconstruction with the Remnant Ligament Improves Joint Position Sense as well as Functional Ankle Instability: A 1-Year Follow-Up Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kamizato Iwao ◽  
Deie Masataka ◽  
Fukuhara Kohei
Keyword(s):  
Ankle Instability ◽  
Intervention Group ◽  
Position Sense ◽  
Joint Position Sense ◽  
Surgical Reconstruction ◽  
Functional Improvement ◽  
Control Group ◽  
Joint Position ◽  
Functional Ankle Instability ◽  
Significant Difference

Introduction. Chronic functional instability—characterized by repeated ankle inversion sprains and a subjective sensation of instability—is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament.Materials and Methods. We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire.Results and Discussion. There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

Motoneuron Function Does not Change Following Whole-Body Vibration in Individuals With Chronic Ankle Instability

2019 ◽  
Vol 28 (6) ◽  
pp. 614-622 ◽  
Author(s):  
Dana M. Otzel ◽  
Chris J. Hass ◽  
Erik A. Wikstrom ◽  
Mark D. Bishop ◽  
Paul A. Borsa ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Whole Body Vibration ◽  
Position Sense ◽  
Chronic Ankle Instability ◽  
Joint Position Sense ◽  
Whole Body ◽  
Control Group ◽  
Joint Position ◽  
Acute Bout ◽  
Body Vibration

Context: Following a lateral ankle sprain, ∼40% of individuals develop chronic ankle instability (CAI), characterized by recurrent injury and sensations of giving way. Deafferentation due to mechanoreceptor damage postinjury is suggested to contribute to arthrogenic muscle inhibition (AMI). Whole-body vibration (WBV) has the potential to address the neurophysiologic deficits accompanied by CAI and, therefore, possibly prevent reinjury. Objective: To determine if an acute bout of WBV can improve AMI and proprioception in individuals with CAI. Design and Participants: The authors examined if an acute bout of WBV can improve AMI and proprioception in individuals with CAI with a repeated-measures design. A total of 10 young adults with CAI and 10 age-matched healthy controls underwent a control, sham, and WBV condition in randomized order. Setting: Biomechanics laboratory. Intervention: WBV. Main Outcome Measures: Motoneuron pool recruitment was assessed via Hoffmann reflex (H-reflex) in the soleus. Proprioception was evaluated using ankle joint position sense at 15° and 20° of inversion. Both were assessed prior to, immediately following, and 30 minutes after the intervention (pretest, posttest, and 30mPost, respectively). Results: Soleus maximum H-reflex:M-response (H:M) ratios were 25% lower in the CAI group compared with the control group (P = .03). Joint position sense mean constant error did not differ between groups (P = .45). Error at 15° in the CAI (pretest 0.8 [1.6], posttest 2.0 [2.8], 30mPost 2.0 [1.9]) and control group (pretest 0.8 [2.0], posttest 0.6 [2.9], 30mPost 0.5 [2.1]) did not improve post-WBV. Error at 20° did not change post-WBV in the CAI (pretest 1.3 [1.7], posttest 1.0 [2.4], 30mPost 1.5 [2.2]) or control group (pretest −0.3 [3.0], posttest 0.8 [2.1], 30mPost 0.6 [1.8]). Conclusion: AMI is present in the involved limb of individuals with CAI. The acute response following a single bout of WBV did not ameliorate the presence of AMI nor improve proprioception in those with CAI.

Effects of two exercise programmes on joint position sense, dynamic balance and countermovement jump in male amateur football players. A randomised controlled trial

2020 ◽  
Vol 38 (22) ◽  
pp. 2620-2630
Author(s):  
Marcos J. Navarro-Santana ◽  
Iván Asín-Izquierdo ◽  
Guido F. Gómez-Chiguano ◽  
Daniel Albert-Lucena ◽  
Gustavo Plaza-Manzano ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Dynamic Balance ◽  
Controlled Trial ◽  
Position Sense ◽  
Joint Position Sense ◽  
Football Players ◽  
Joint Position ◽  
Countermovement Jump ◽  
Exercise Programmes ◽  
Randomised Controlled
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