Abstract
BackgroundAnkle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI.MethodsThe athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: [1] Cumberland Ankle Instability Tool (CAIT) scores, [2] Star Excursion Balance Test (SEBT) reach distances, [3] ankle joint plantar flexion during drop landing and drop vertical jumping, and [4] ground reaction forces (GRFs) during walking.ResultsCAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention.ConclusionsThe 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.
Highlights
The human ankle joint is one of the most frequently injured joints in the human body, with lateral ligament sprains being the most common type of ankle injury [1]
Observed effects include enhanced strength [9], heightened joint position sense [7,8] and improved postural stability [6,7]. In two of these studies ankle joint function as measured by the Functional Ankle Disability Index (FADI) improved following completion of the rehabilitation protocol, which is indicative of improved function and decreased disability [6,7]
In addition to measures of ankle joint kinematics during jump landing we investigated the effects of the intervention on other important aspects of ankle joint function, such as walking kinetics, postural stability as well as self-reported ankle joint function as measured by the Cumberland Ankle Instability Tool (CAIT)
Summary
The human ankle joint is one of the most frequently injured joints in the human body, with lateral ligament sprains being the most common type of ankle injury [1]. Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI
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