Effect of Kinesio Taping on Ankle Joint Kinematics During Landing on Stable and Unstable Surfaces in Ankle Sprain and Health Persons

Background and Aims: Landing is a typical sports motion that can create impact force 2-12 times of body weight, and finally, it’s one of the main reasons for non-contact injuries in ankle ligaments. Specialized. The usual effects of Kinesio tape include increasing proprioception, health direction of joints, reducing pain, and raising pressure on nervous tissue. The study aimed to investigate the effect of Kinesio taping on ankle joint kinematics during landing on stiff and soft surfaces in ankle sprain and healthy persons. Methods: The method of the present study was quasi-experimental with a two-group design in control groups (without ankle sprain) and experimental (with an ankle sprain). A total of 30 male students of the Shahid Bahonar University of Kerman were purposefully and accessibly selected and divided into two groups with (15 students) and without ankle sprains (15 students). Then, they performed both landing operations on stable and unstable surfaces, with and without Kinesio tape. Maximum dorsi and plantar flexion, supination, pronation and maximum ankle angular velocity parameters were recorded by a three-dimensional motion analysis system. Statistical analysis was performed using independent t-test and repeated measures analysis of variance at the significant level of 0.05. Results: There was no significant reduction in plantar flexion of the ankle in healthy and twisted individuals while landing on stable and unstable surfaces with and without Kinesio tape (P≤0.07), but there was a significant reduction in the dorsiflexion in both groups(P≤0.001). On the other hand, there was no significant decrease in pronation (P≤0.66), but there was a significant decrease in foot supination (P≤0.001). Conclusion: Generally, Kinesio tape in recovery ankle movement is offered to persons for ankle sprain. Thus recommendation landing exercises fare with more flexion angle and less knee joint valgus and more dorsiflexion angle at ankle joint and preferable on the unstable surfaces.

Three-dimensional analysis of anterior talofibular ligament strain patterns during cadaveric ankle motion using a miniaturized ligament performance probe

Background Measuring the strain patterns of ligaments at various joint positions informs our understanding of their function. However, few studies have examined the biomechanical properties of ankle ligaments; further, the tensile properties of each ligament, during motion, have not been described. This limitation exists because current biomechanical sensors are too big to insert within the ankle. The present study aimed to validate a novel miniaturized ligament performance probe (MLPP) system for measuring the strain patterns of the anterior talofibular ligament (ATFL) during ankle motion. Methods Six fresh-frozen, through-the-knee, lower extremity, cadaveric specimens were used to conduct this study. An MLPP system, comprising a commercially available strain gauge (force probe), amplifier unit, display unit, and logger, was sutured into the midsubstance of the ATFL fibers. To measure tensile forces, a round, metal disk (a “clock”, 150 mm in diameter) was affixed to the plantar aspect of each foot. With a 1.2-Nm load applied to the ankle and subtalar joint complex, the ankle was manually moved from 15° dorsiflexion to 30° plantar flexion. The clock was rotated in 30° increments to measure the ATFL strain detected at each endpoint by the miniature force probe. Individual strain data were aligned with the neutral (0) position value; the maximum value was 100. Results Throughout the motion required to shift from 15° dorsiflexion to 30° plantar flexion, the ATFL tensed near 20° (plantar flexion), and the strain increased as the plantar flexion angle increased. The ATFL was maximally tensioned at the 2 and 3 o’clock (inversion) positions (96.0 ± 5.8 and 96.3 ± 5.7) and declined sharply towards the 7 o’clock position (12.4 ± 16.8). Within the elastic range of the ATFL (the range within which it can return to its original shape and length), the tensile force was proportional to the strain, in all specimens. Conclusion The MLPP system is capable of measuring ATFL strain patterns; thus, this system may be used to effectively determine the relationship between limb position and ATFL ankle ligament strain patterns.

Strain patterns in normal anterior talofibular and calcaneofibular ligaments and after anatomical reconstruction using gracilis tendon grafts: A cadaver study

BackgroundInversion sprains of the lateral ankle ligaments often result in symptomatic lateral ankle instability, and some patients need lateral reconstruction surgeries to reduce pain, improve function, and prevent subsequent injuries. Although anatomically reconstructed ligaments should behave in a biomechanically normal manner, previous studies have not measured the strain patterns of the anterior talofibular (ATFL) and calcaneofibular ligaments (CFL) after anatomical reconstruction. This study aimed to measure the strain patterns of normal and reconstructed ATFL and CFLs using a miniaturization ligament performance probe (MLPP) system.MethodsThe MLPP was sutured into the ligamentous bands of the ATFLs and CTLs of three fresh-frozen, lower extremity, cadaveric specimens. Each ankle was manually moved from 15° dorsiflexion to 30° plantar flexion, and a 1.2-N m force was applied to the ankle and subtalar joint complex.ResultsThe normal and reconstructed ATFLs exhibited maximal strain (100) during supination in three-dimensional motion. Although the normal ATFLs were not strained during pronation, the reconstructed ATFLs demonstrated relative strain values of 16–36. During axial motion, the normal ATFLs began to gradually tense at 0° plantarflexion, with the strain increasing, as the plantarflexion angle increased, to a maximal value (100) at 30° plantarflexion; the reconstructed ATFLs showed similar strain patterns. The normal CFLs exhibited maximum strain (100) during plantarflexion-abduction and relative strain measurements of 30–52 during dorsiflexion in three-dimensional motion. The reconstructed CFLs exhibited the most strain during dorsiflexion-adduction and demonstrated relative strain measurements of 29–62 during plantarflexion-abduction. During axial motion, the normal CFLs began to gradually tense at 20° plantarflexion and 5° dorsiflexion.ConclusionOur results showed that the strain patterns of reconstructed ATFLs and CFLs are not exactly the same as those in the normal ligaments.

A New Landmark for Positioning the Anatomical Insertions of Lateral Ankle Ligaments under Arthroscopy: A Preliminary Study

Background: Several landmarks are used to ascertain the insertions of lateral ankle ligaments, however, few could be discerned under arthroscopy. The objective of this study was to assess the feasibility and reliability of labeling the anterior process of fibular cartilage surface (FCAP) under arthroscopy, and to compare the distances from the new or conventional landmark to the ligament insertion.Methods: Twenty paired ankles from ten Chinese cadavers were included. A senior and a junior surgeon randomly performed the arthroscopic FCAP marking procedures for the paired ankles of a single cadaver using a Kirchner wire. The distance and direction from the anatomical FCAP' to the marked FCAP were recorded after open dissection. Reliability analysis were calculated using the intraclass correlation coefficient (ICC) and independent sample t test. Moreover, the distance from the upper landmarks (anterior fibular tubercle or FCAP) to the anterior talofibular ligament (ATFL) insertion center (distance “a” or “c”), and from the ATFL to calcaneofibular ligament (CFL) footprint center was measured at the anterolateral side (distance “b”) and lateral groove (distance “d”), respectively.Results: The FCAP was located 1.23±0.29 (range, 0.77–1.67) mm) and 1.52±0.41 (range, 0.92–2.03) mm from the anatomical FCAP' in the senior and junior surgeons’ operations, respectively, which showed no significant difference between the two groups (t=-1.773, P=0.093). And the calculated ICC was 0.767 (P=0.003). The average distance “a” was 19.03±1.47 (range, 16.29–21.3) mm, significantly longer than distance “c”, 15.98±0.97 (range, 14.48–18.02) mm (t=-7.72, P<0.001). However, the distance “b” (7.43±0.54 mm; range, 6.47–8.47) and distance “d” (7.78±0.67 mm; range, 6.42–9.03) showed no statistical difference (t=1.8, P=0.08).Conclusions: The FCAP may be a useful landmark that can be utilized to ascertain anatomical insertions of lateral ankle ligaments under arthroscopy. The measured distances from the landmark to the ligament footprint center could provide spatial information that assist in endoscopic anatomical repair or reconstruction.

Three-dimensional analysis of anterior talofibular ligament strain patterns during cadaveric ankle motion using a miniaturized ligament performance probe

BackgroundMeasuring the strain patterns of ligaments at various joint positions informs our understanding of their function. However, few studies have examined the biomechanical properties of ankle ligaments; further, the tensile properties of each ligament, during motion, have not been described. This limitation exists because current biomechanical sensors are too big to insert within the ankle. The present study aimed to validate a novel miniaturized ligament performance probe (MLPP) system for measuring the strain patterns of the anterior talofibular ligament (ATFL) during ankle motion.MethodsSix fresh-frozen, through-the-knee, lower extremity, cadaveric specimens were used to conduct this study. An MLPP system, comprising a commercially available strain gauge (force probe), amplifier unit, display unit, and logger, was sutured into the midsubstance of the ATFL fibers. To measure tensile forces, a round, metal disk (a “clock”, 150 mm in diameter) was affixed to the plantar aspect of each foot. With a 1.2-Nm load applied to the ankle and subtalar joint complex, the ankle was manually moved from 15° dorsiflexion to 30° plantar flexion. The clock was rotated in 30° increments to measure the ATFL strain detected at each endpoint by the miniature force probe. Individual strain data were aligned with the neutral (0) position value; the maximum value was 100.ResultsThroughout the motion required to shift from 15° dorsiflexion to 30° plantar flexion, the ATFL tensed near 20° (plantar flexion), and the strain increased as the plantar flexion angle increased. The ATFL was maximally tensioned at the 2 and 3 o’clock (inversion) positions (96.0 ± 5.8 and 96.3 ± 5.7) and declined sharply towards the 7 o’clock position (12.4 ± 16.8). Within the elastic range of the ATFL (the range within which it can return to its original shape and length), the tensile force was proportional to the strain, in all specimens.ConclusionThe MLPP system is capable of measuring ATFL strain patterns; thus, this system may be used to effectively determine the relationship between limb position and ATFL ankle ligament strain patterns.

Ultrasound shear wave elastography of the anterior talofibular and calcaneofibular ligaments in healthy subjects

Aim of study: Most sprained lateral ankle ligaments heal uneventfully, but in some cases the ligament’s elastic function is not restored, leading to chronic ankle instability. Ultrasound shear wave elastography can be used to quantify the elasticity of musculoskeletal soft tissues; it may serve as a test of ankle ligament function during healing to potentially help differentiate normal from ineffective healing. The purpose of this study was to determine baseline shear wave velocity values for the lateral ankle ligaments in healthy male subjects, and to assess inter-observer reliability. Material and methods: Forty-six ankles in 23 healthy male subjects aged 20–40 years underwent shear wave elastography of the lateral ankle ligaments performed by two musculoskeletal radiologists. Each ligament was evaluated three times with the ankle relaxed by both examiners, and under stress by a single examiner. Mean shear wave velocity values were compared for each ligament by each examiner. Inter-observer agreement was evaluated. Results: The mean shear wave velocity at rest for the anterior talofibular ligament was 2.09 ± 0.3 (range 1.41–3.17); and for the calcaneofibular ligament 1.99 ± 0.36 (range 1.29–2.88). Good inter-observer agreement was found for the anterior talofibular ligament and calcaneofibular ligament shear wave velocity measurements with the ankle in resting position. There was a significant difference in mean shear wave velocities between rest and stressed conditions for both anterior talofibular ligament (2.09 m/s vs 3.21 m/s; p <0.001) and calcaneofibular ligament (1.99 m/s vs 3.42 m/s; p <0.0001). Conclusion: Shear wave elastography shows promise as a reproducible method to quantify ankle ligament stiffness. This study reveals that shear waves velocities of the normal lateral ankle ligaments increased with applied stress compared to the resting state.