THE DIFFERENCE OF THE BALANCE ABILITIY BETWEEN THE FUNCTIONAL ANKLE INSTABILITY AND HEALTHY SUBJECTS

Ankle inversion sprains are one of the most common injuries occurring in sports activities. Repeated ankle sprains may lead to chronic ankle instability. In order to prevent the occurrence of ankle instability, it is necessary to understand the difference in the physiological characteristics of the subjects who have chronic ankle instability and those who do not. However, there is little known about the differences between the two. It has been reported that there are two types of ankle instability: mechanical ankle instability (MAI) and functional ankle instability (FAI) which is the disability to which patients refer when they say that their foot tends to “giving way”. In this study, we have attempted to uncover the difference in the center of pressure (COP) and muscle activities during a single leg standing between FAI subjects and healthy subjects with or without an ankle brace

Mechanical ankle instability: relationship with active joint position sense

Current research defines chronic ankle instability (CAl) as the combination of mechanical ankle instability (MAl) and functional ankle instability (FAI). Previous research has found individuals with CAl and FAI to have deficits in proprioception, more specifically joint position sense (JPS). The purpose of this study was to examine the relationship between MAl and active JPS. Twelve participants (5 male, 7 female) were selected for this study based upon their subjective ankle instability as assessed by a score on the Cumberland Ankle Instability Tool (CAIT) and objective ankle instability as assessed by measurements taken using a portable ankle arthrometer. Eligible participant\u27s absolute error in JPS was assessed as a non-weight bearing, active-to-active joint replication, and measured with a Biodex System 3 dynamometer. The absolute error of each joint angle replication was averaged after a reliability analysis. Statistical analysis had planned on using a 2x2 and a 2x3 factorial ANOVA. The research question could not be assessed in the frontal and the sagittal plane. The pilot study showed that there was a population of individuals with unilateral MAl exclusive of functional ankle instability (FAI) --Document

Multi-segment foot landing kinematics in subjects with chronic ankle instability

Background Chronic ankle instability has been associated with altered joint kinematics at the ankle, knee and hip. However, no studies have investigated possible kinematic deviations at more distal segments of the foot. The purpose of this study was to evaluate if subjects with ankle instability and copers show altered foot and ankle kinematics and altered kinetics during a landing task when compared to controls. Methods Ninety-six subjects (38 subjects with chronic ankle instability, 28 copers and 30 controls) performed a vertical drop and side jump task. Foot kinematics were obtained using the Ghent Foot Model and a single-segment foot model. Group differences were evaluated using statistical parametric mapping and analysis of variance. Results Subjects with ankle instability had a more inverted midfoot position in relation to the rearfoot when compared to controls during the side jump. They also had a greater midfoot inversion/eversion range of motion than copers during the vertical drop. Copers exhibited less plantar flexion/dorsiflexion range of motion in the lateral and medial forefoot. Furthermore, the ankle instability and coper group exhibited less ankle plantar flexion at touchdown. Additionally, the ankle instability group demonstrated a decreased plantar flexion/dorsiflexion range of motion at the ankle compared to the control group. Analysis of ground reaction forces showed a higher vertical peak and loading rate during the vertical drop in subjects with ankle instability. Interpretation Subjects with chronic ankle instability displayed an altered, stiffer kinematic landing strategy and related alterations in landing kinetics, which might predispose them for episodes of giving way and actual ankle sprains

Bilateral compensatory postural adjustments to a unilateral perturbation in subjects with chronic ankle instability

To evaluate the magnitude of bilateral compensatory postural adjustments in response to a unilateral sudden inversion perturbation in subjects with chronic ankle instability. Methods: 24 athletes with chronic ankle instability (14 with functional ankle instability, 10 with mechanical ankle instability) and twenty controls participated in this study. The bilateral electromyography of ankle muscles was collected during a unilateral sudden ankle inversion to assess the magnitude of subcortical and voluntary compensatory postural adjustments in both the perturbed and the contralateral limb (support limb). In the support position, compared to the control group, the group with functional ankle instability presented decreased compensatory postural adjustments of the tibialis anterior in both the injured and the uninjured limbs in the support position and of the soleus in the uninjured limb. In the side of the perturbation, participants with functional ankle instability presented decreased soleus compensatory postural adjustments in the uninjured limb when compared to the control group. Increased values of soleus and peroneal brevis compensatory postural adjustments were observed in the group with mechanical instability when compared to the control group and to the group with functional ankle instability. Subjects with functional ankle instability present bilateral impairment of compensatory postural adjustments of the tibialis anterior in a support position and of the soleus of the uninjured limb regardless of the position. Subjects with mechanical instability present bilateral increase of these adjustments in the peroneal brevis regardless of the position and in the soleus muscle in the side of the perturbation.info:eu-repo/semantics/publishedVersio

Clinical Recommendations for Functional Ankle Instability Based Upon Best Practice Guidelines

Functional Ankle Instability is often the result of multiple previous lateral ankle sprains. Usually more than two lateral ankle sprains on the same ankle puts that ankle into a category of Functional Ankle Instability. The reoccurring lateral ankle sprains lead to Functional Ankle Instability, which is stated as being a feeling of instability, repeated episodes of giving way, weakness during physical activity, and self-reported disability (Hall, Docherty, Simon, Kingma, Klossner, 2015). Patients describe Functional Ankle Instability by saying that their ankle “gives way,” or that there is “weakness with function” (Hall, 2015). There are several questionnaires that allow for patients Functional Ankle Instability to be ranked. These questionnaires include the Functional Ankle Disability Index and the Cumberland. The exact number of people affected by Functional Ankle Instability is unknown, but multiple sources estimate that about half of people who have experienced a lateral ankle sprain go on to suffer from Functional Ankle Instability. This large number of patients creates an increase to insurance costs, as well as the utilization of resources within the clinic. Understanding the best treatment protocols for Functional Ankle Instability leads to the best outcomes for patients, which in turn helps ease the burden from both a clinical and a administrative aspect. Utilizing the most efficient treatment interventions leads to an increase in patient outcomes, which in turn leads to a decrease in the number of overall patient visits. Decreasing the number of overall visits lowers the amount of out of pocket costs for the patient

Cross-cultural adaptation, reliability, and validation of the Korean version of the identification functional ankle instability (IdFAI)

Purpose: To cross-culturally adapt the Identification Functional Ankle Instability for use with Korean-speaking participants. Methods: The English version of the IdFAI was cross-culturally adapted into Korean based on the guidelines. The psychometric properties in the Korean version of the IdFAI were measured for test-retest reliability, internal consistency, criterion-related validity, discriminative validity, and measurement error 181 native Korean-speakers. Results: Intra-class correlation coefficients (ICC2,1) between the English and Korean versions of the IdFAI for test–retest reliability was 0.98 (standard error of measurement = 1.41). The Cronbach’s alpha coefficient was 0.89 for the Korean versions of IdFAI. The Korean versions of the IdFAI had a strong correlation with the SF-36 (rs = −0.69, p \u3c .001) and the Korean version of the Cumberland Ankle Instability Tool (rs = −0.65, p \u3c .001). The cutoff score of \u3e10 was the optimal cutoff score to distinguish between the group memberships. The minimally detectable change of the Korean versions of the IdFAI score was 3.91. Conclusion: The Korean versions of the IdFAI have shown to be an excellent, reliable, and valid instrument. The Korean versions of the IdFAI can be utilized to assess the presence of Chronic Ankle Instability by researchers and clinicians working among Korean-speaking populations. Implications for rehabilitation The high recurrence rate of sprains may result into Chronic Ankle Instability (CAI). The Identification of Functional Ankle Instability Tool (IdFAI) has been validated and recommended to identify patients with Chronic Ankle Instability (CAI). The Korean version of the Identification of Functional Ankle Instability Tool (IdFAI) may be also recommend to researchers and clinicians for assessing the presence of Chronic Ankle Instability (CAI) in Korean-speaking population

Influence of balance surface on ankle stabilizing muscle activity in subjects with chronic ankle instability

Objective: To evaluate the effect of surface type on muscle activity of ankle stabilizing muscles in subjects with chronic ankle instability. Design: Case controlled, repeated measures study design. Subjects: 28 subjects with chronic ankle instability and 28 healthy controls. Methods: Subjects performed a barefooted single legged stance on uni-axial and multidirectional unstable surfaces. Muscle activity of the mm. peroneus longus/brevis, tibialis anterior, gastrocnemius medialis was registered using surface electromyography. Mixed model analysis was used to explore differences in muscle activity between subjects with chronic ankle instability and controls, and the effect of surface type on muscle activity levels within subjects with chronic ankle instability. Results: No differences were found between subjects with chronic ankle instability and healthy controls. Within subjects with chronic ankle instability, balancing along a frontal axis and on the BOSU evoked overall highest muscle activity level and the firm surface the least. Balancing on the firm surface showed the lowest tibialis anterior/peroneus longus ratio, followed by balancing along a frontal axis and on the Airex pad. Conclusions: Clinicians can use these findings to improve the focus of their balance training program by gradually progressing in difficulty level based on muscle activation levels taking cocontraction ratio’s into account

Arthroscopic anterior talofibular ligament repair for lateral instability of the ankle

UNLABELLED: Although several arthroscopic procedures for lateral ligament instability of the ankle have been reported recently, it is difficult to augment the reconstruction by arthroscopically tightening the inferior extensor retinaculum. There is also concern that when using the inferior extensor retinaculum, this is not strictly an anatomical repair since its calcaneal attachment is different to that of the calcaneofibular ligament. If a ligament repair is completed firmly, it is unnecessary to add argumentation with inferior extensor retinaculum. The authors describe a simplified technique, repair of the lateral ligament alone using a lasso-loop stitch, which avoids additionally tighten the inferior extensor retinaculum. In this paper, it is described an arthroscopic anterior talofibular ligament repair using lasso-loop stitch alone for lateral instability of the ankle that is likely safe for patients and minimal invasive. LEVEL OF EVIDENCE: Therapeutic study, Level V

Cross-cultural adaptation and measurement properties of the Portuguese version of the Ankle Instability Instrument

Chronic ankle instability is one of the most common clinical conditions in the general population, especially in adult athletes. The cross-cultural adaptation of self-reported questionnaires that identify and classify this condition contribute to criteria standardization in research but also in rehabilitation. Aim of Study. To validate the Ankle Instability Instrument to the Portuguese population and to investigate its psychometric properties. Material and Methods. Linguistic and semantic equivalence of the original version of the Ankle Instability Instrument to the Portuguese population was firstly performed. The Portuguese version of the Ankle Instability Instrument was then applied to 81 higher education adult students, with (n = 59) and without history of ankle sprain (n = 22). Participants were evaluated two times with an interval of one week to assess the psychometric properties of the Portuguese version of the Ankle Instability Instrument. Results. In the reliability of binary responses based on the test retest, the tetrachoric correlation coefficient ranged from 0.99 to 1.00. In addition, the Kuder–Richardson coefficient was 0.79 suggesting good internal consistency. Conclusions. Test-retest showed an almost perfect match in all answers between the two moments, which seem to be related to sample characteristics. The internal consistency value was similar to the one obtained in the original version. The Portuguese version of the Ankle Instability Instrument is highly reliable and can be used in clinical practice.info:eu-repo/semantics/publishedVersio

Full gait cycle analysis of lower limb and trunk kinematics and muscle activations during walking in participants with and without ankle instability

This document is the Accepted Manuscript version of the following article: Lynsey Northeast, Charlotte N. Gautrey, Lindsay Bottoms, Gerwyn Hughes, Andrew C. S. Mitchell, and Andrew Greenhalgh, ‘Full gait cycle analysis of lower limb and trunk kinematics and muscle activations during walking in participants with and without ankle instability’, Gait & Posture, Vol. 64: 114-118, July 2018. Under embargo until 7 June 2019. The final, definitive version is available online at doi: https://doi.org/10.1016/j.gaitpost.2018.06.001Background Chronic ankle instability (CAI) has previously been linked to altered lower limb kinematics and muscle activation characteristics during walking, though little research has been performed analysing the full time-series across the stance and swing phases of gait. Research Question The aim of this study was to compare trunk and lower limb kinematics and muscle activity between those with chronic ankle instability and healthy controls. Methods Kinematics and muscle activity were measured in 18 (14 males, 4 females) healthy controls (age 22.4 ± 3.6 years, height 177.8 ± 7.6 cm, mass 70.4 ± 11.9 kg, UK shoe size 8.4 ± 1.6), and 18 (13 males, 5 females) participants with chronic ankle instability (age 22.0 ± 2.7 years, height 176.8 ± 7.9 cm, mass 74.1 ± 9.6 kg, UK shoe size 8.1 ± 1.9) during barefoot walking trials, using a combined Helen Hayes and Oxford foot model. Surface electromyography (sEMG) was recorded for the tibialis anterior and gluteus medius. Full curve statistical parametric mapping was performed using independent and paired-samples T-tests. Results No significant differences were observed in kinematic or sEMG variables between or within groups for the duration of the swing phase of gait. A significantly increased forefoot-tibia inversion was seen in the CAI affected limb when compared to the CAI unaffected limb at 4–16% stance (p = 0.039). No other significant differences were observed. Significance There appears to be no differences in muscle activation and movement between CAI and healthy control groups. However, participants with CAI exhibited increased inversion patterns during the stance phase of gait in their affected limb compared to their unaffected limb. This may predispose those with CAI to episodes of giving way and further ankle sprains.Peer reviewedFinal Accepted Versio