Relationship between Kinesiophobia and Ankle Joint Position Sense and Postural Control in Individuals with Chronic Ankle Instability-A Cross-Sectional Study.

Ravi Shankar Reddy,Mastour Saeed Alshahrani

doi:10.3390/ijerph19052792

Abstract

Functional ankle instability (FAI) is a condition that causes mechanical alterations to the ankle joint and leads to disability. Fear of movement can significantly influence physical factors, and understanding their relationship is crucial in assessing and managing individuals with FAI. The present study aimed to (1) assess the impact of kinesiophobia on ankle joint position sense (JPS) and postural control and (2) evaluate if kinesiophobia can predict JPS and postural control in FAI individuals. This cross-sectional study included 55 FAI individuals. The Tampa Scale of Kinesiophobia (TSK) score was used to measure kinesiophobia. The ankle JPS was evaluated using a digital inclinometer. The individuals were asked to actively reposition to the target position of 10° and 15° of dorsiflexion and plantarflexion. The reposition accuracy is measured in degrees. The static postural control was evaluated in unilateral stance using a stabilometric force platform, including assessments for the ellipse area, anterior to posterior sway, and medial to lateral sway in mm2. Kinesiophobia showed a significant positive correlation (moderate) with the ankle JPS errors in dorsiflexion (10°: r = 0.51, p < 0.001; at 15°: = r = 0.52, p < 0.001) and plantarflexion (10°: r = 0.35, p = 0.009; at 15°: = r = 0.37, p = 0.005). Kinesiophobia also showed significant positive (moderate) correlation with postural control variables (ellipse area: r = 0.44, p = 0.001; Anterior–Posterior sway: r = 0.32, p = 0.015; Medial–Lateral sway: r = 0.60, p < 0.001). Kinesiophobia significantly predicted ankle JPS (p < 0.05) and postural control (p < 0.05). Increased fear of movement is associated with increased ankle JPS errors and postural sway in FAI individuals. Therefore, assessment of these factors is critical in FAI individuals.

Highlights

This study aimed to assess the relationship between kinesiophobia, joint position sense (JPS), and postural control and evaluate if kinesiophobia can predict JPS and postural control in individuals with Functional ankle instability (FAI)
Lentz et al [32] conducted a cross-sectional study with 85 patients with foot and ankle pathology to determine if kinesiophobia can impact foot and ankle mobility—factors such as decreased range of motion (ROM), age, and chronicity of ankle symptoms correlated with fear of movement
This study shows that kinesiophobia is significantly correlated to ankle JPS and postural control

Summary

Introduction

The mechanical sciences view the human body as a sophisticated biomechanical system with kinematics and dynamics [1,2]. The key joints, which include the knee, shoulder, elbow, wrist, hip, ankle, cervical vertebrae, and lumbar vertebrae, are selflubricating and practically frictionless, able to tolerate stress, torsion, and compression while still performing smooth and accurate movements [1,3]. The ankle joint is a congruent synovial joint with a single oblique axis that transfers weight to the proximal joints and allows smooth movements during functional activities [4]. Lateral ankle sprain is the most prevalent lower extremity musculoskeletal injury in physically active individuals [5]. An estimated 3 million individuals with ankle sprains receive standard care in a hospital emergency department [6]. Individuals with ankle sprains tend to have recurrences, and around 40% of people develop chronic symptoms such as pain, swelling, and instability leading to functional disability [7]. Previous studies have demonstrated that a majority of individuals with a repeated ankle sprain and persistent symptoms had functional ankle instability [8]

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