Proprioception and neuromuscular control at return to sport after ankle surgery with the modified Brostr\xf6m procedure

Jin Hyuck Lee,Hae Woon Jung,Woo Young Jang

doi:10.1038/s41598-021-04567-z

Abstract

The modified Broström procedure (MBP) is an initial treatment for symptomatic chronic ankle instability (CAI) patients. This study aimed to compare the proprioception and neuromuscular control ability of both affected and unaffected ankles at the time of return to sports after MBP for patients with scores of normal controls. 75 individuals (40 who underwent MBP, 35 normal controls) participated. The dynamic balance test scores were significantly higher in the affected ankle of the patients than in the controls (1.5 ± 0.6° vs. 1.1 ± 0.4°, p < 0.003). The time to peak torque for dorsiflexion (60.8 ± 13.9 ms vs. 52.2 ± 17.5 ms, p < 0.022) and eversion (68.9 ± 19.1 ms vs. 59.3 ± 21.1 ms, p < 0.043) was significantly delayed in the affected ankle of the patients than in the controls. The dynamic balance test and time to peak torque in CAI patients remained significantly reduced at the time of return-to-sport after MBP. Clinicians and therapists should be aware of potential deficits in proprioception and neuromuscular control when determining the timing of return to sports after MBP.

Highlights

The modified Broström procedure (MBP) is an initial treatment for symptomatic chronic ankle instability (CAI) patients
Lateral ankle ligament injuries, including those of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL), can cause mechanical ankle instability (MAI), whereas proprioception and neuromuscular deficits can lead to functional ankle instability (FAI)
There were no significant differences in age, height, and weight between the 40 patients who underwent MBP and the 35 normal controls

Summary

Introduction

The modified Broström procedure (MBP) is an initial treatment for symptomatic chronic ankle instability (CAI) patients. This study aimed to compare the proprioception and neuromuscular control ability of both affected and unaffected ankles at the time of return to sports after MBP for patients with scores of normal controls. Most patients with CAI can recover to their pre-injury activity levels with conservative treatment, but some clinicians argue that surgical intervention is required in 10–30% of patients in whom conservative treatment is u nsuccessful[2,8,9] For these reasons, the modified Broström procedure (MBP) is typically the initial treatment in symptomatic CAI patients in whom recovery was not attained with conservative t reatment[10]. This study aimed to compare the proprioception and neuromuscular control of both affected and unaffected ankles in CAI patients at 3 months after a MBP with scores for normal controls. We hypothesized that patients’ proprioception and neuromuscular control scores at 3 months after MBP would recover to the same level as that of normal controls

Objectives

Results

Conclusion