Chronic Ankle Sprain Research Articles

Neuromuscular Mechanosensitivity in Subjects with Chronic Ankle Sprain: A Cross-Sectional Study.

Ankle sprain is one of the most common musculoskeletal injuries in sports, at work, and at home. Subjects who suffer from this injury may develop ankle instability. Functional instability has been associated with a high rate of resprain and impaired neuromuscular control in patients with ankle instability. Measurement of neural and muscular mechanosensitivity after ankle sprain injury and establishment of the relationship between these variables. A cross-sectional case-control study was performed with a sample of 58 students from Alcalá de Henares University (21 males and 37 females, mean age ± SD = 21 ± 3.7 years). Subjects were divided into two groups: a case group (N = 29, subjects with unstable ankle) and a control group (N = 29, healthy subjects). The pressure pain threshold (PPT) of the tibialis anterior, peroneus longus, and peroneus brevis muscles and mechanosensitivity of the common peroneus and tibial nerves were evaluated in all subjects through a manual mechanical algometer. Neuromuscular PPTs showed significant differences (P < 0.05) between both groups, such that, compared with the control group, the case group exhibited significantly lower PPT levels. In the case group, a strong positive correlation was observed between neural and muscular homolateral mechanosensitivity in both lower limbs. Participants with chronic ankle instability showed higher neuromuscular mechanosensitivity in muscles and nerves surrounding the ankle joint than healthy subjects. These findings indicate that low PPT values may be associated with symptoms that characterize this disease.

Effects of intradermal needling combined with tuina on ankle sprain sequelae

To compare the clinical efficacy differences between intradermal needling combined with tuina and tuina alone on ankle sprain sequelae. Ninety patients with chronic ankle sprain were randomly divided into an observation group and a control group, 45 cases in each group. The patients in the control group were treated with conventional tuina. The patients in the observation group were treated with conventional tuina, followed by intradermal needling at ashi point (the most painful tendons node), Shenmai (BL 62)/Zhaohai (KI 6), Jiexi (ST 41)/Zhongfeng (LR 4), Qiuxu (GB 40)/Shangqiu (SP 5) for 24 to 48 hours per treatment; acupoint selection was based on the different side of ankle sprain, and 5 acupoints were selected per treatment, including 2 painful points. The treatment was given twice per week, and totally 8 treatments were given within 4 weeks. The follow-up visit was 12 months. The pain of tendon joints was evaluated by visual analogue scale (VAS); the patient number of severity of ankle pain during walking and running as well as the occurrence and frequency of ankle pain during rest in follow-up visit in the two groups were observed; the satisfaction survey was conducted in the observation group. Compared before treatment, VAS of tendon joints, the patient number of severity of ankle pain during walking and running were improved after treatment in the two groups (all P<0.05), and patient number of the severity of ankle pain during running in the observation group was superior to that in the control group (P<0.05). During follow-up visit, compare with the control group, the occurrence and frequency of ankle pain during rest in the observation group was significantly improved (both P<0.05); the satisfaction in the observation group was significant. The intradermal needling combined with tuina could improve the tenderness of tendon joints and pain during walking and running in patients with ankle sprain sequelae; compared with tuina alone, it could reduce the occurrence of ankle pain during rest, which is safe and reliable.

Agility profile in collegiate athletes with chronic ankle sprain: the effect of Athletic and Kinesio taping among both genders

The prevalent of ankle sprain is diagnosed different among both genders in various activities. Taping is generally used as preventive means to protect the ankle joint and enhance the joint to prevent further musculoskeletal damage. Agility drill, as a vital factor for most activities, requires high ankle stability and sufficient range of motion (ROM) during turning, sprinting and cutting. This study aimed to assess the effect of two types of taping (Kinesio taping—KT—and Athletic taping—AT) in six agility tests (Illinois, 505, T test, Hexagon, Compass Drill and 10 m agility Shuttle), which include keeping body balanced, turning, side step cutting and jumping, in comparison with non-taped ankle. Twenty-six university students (13 males, age: 23.9 ± 1.6 years; stature: 1.79 ± 0.05 m; body mass: 75.4 ± 8.7 kg and 13 females, age: 23.7 ± 1.8 years; stature: 1.66 ± 0.06 m; body mass: 59.54 ± 8.2 kg) (mean ± s) performed all six agility tests with and without taped ankle. In ankle Kinesio-taped condition, results portrayed significance differences in 505 (p = 0.2), 10 m Shuttle (p = 0.01), Hexagon (p = 0.00), Compass Drill (0.00) and T (0.03) tests in comparison with non-taped ankle condition in males, and similarly in 505 (p = 0.1), 10 m Shuttle (p = 0.00), Hexagon (p = 0.00), Compass Drill (0.01) and T (0.03) tests among females. After usage of Athletic tape, results showed significance difference in Hexagon (0.00), Compass Drill (0.00) and T (0.01) tests in males and Hexagon (0.00) and Compass Drill (0.00) tests in females. Regardless of costs and ease of use, both Kinesio and Athletic tapes are recommended in instant ankle sprains to return to match for a short time in sports that require stability, jumping and cutting, not linear sprinting, but in sports, which are in need of linear sprinting, Kinesio taping might be an option, because it does not affect joint ROM.

A study on effects of balance and elastic-band exercises for improving symptoms of chronic ankle sprains in leisure sports activity participants

A study on effects of balance and elastic-band exercises for improving symptoms of chronic ankle sprains in leisure sports activity participants

고강도 발목안정화 운동이 발목 염좌 대학생들의 발목 근파워와 자세균형에 미치는 영향

The purpose of this study was to evaluate the effects of a high intensity ankle stability exercise of ankle isokinetic muscle function and posture balance in college students with chronic ankle sprain. The high intensity ankle stability exercise group participated in the exercise program for short-term (12 times) and the effects on isokinetic muscle function(peak torque, total work) and posture balance(weight distribution index, stability index) were evaluated. The high intensity ankle stability exercise group in analyses of ankle muscle functions, as for changes in Peak Torque, significant improvements were shown in right and left Plantar Flexion. With regard to changes in total work, although significant improvements were shown in all variables. Posture balance was improved but no significant difference was seen. To conclude, applying the high intensity ankle stability exercise of short-term period appeared to effectively improve the fundamental ankle muscle function and posture balance in college students of chronic ankle sprain. This research can provide a guideline of the effective verification model of a high intensity ankle stability exercise of short-term period exercise program to college students of chronic ankle sprain.

Effect of Kinesio Tape Versus Athletic Tape on Myoelectric Activity of Ankle Muscles in Patients with Chronic Ankle Sprain

Background: Sprained ankle a common orthopedic injury. The standard treatment for ankle sprains remains nonoperative. Ankle taping was used to protect and prevent ligaments excessive strain. So, the current study aimed at investigating the effect of spa-care Kinesio tape versus standard white athletic tape on myoelectric activities (EMG) of ankle evertors (peroneus longus) and invertors (tibialis anterior) in a chronic ankle sprain. Methods: A convenient sample of 30 patients with a chronic ankle sprain (18 females and 12 males) were included in this study. Their mean age ±SD was 24 ±1.2 years. Their height was 175±4.8 cm among men & 163±5.2 cm for females, and weight was 85±5.2 kg for males & 74±5.5 kg for women. It was a within-group design in which the same participant experienced the two types of taping compared to no taping condition. Root mean square (RMS) was measured while participants were moving the isokinetic dynamometer at an angular velocity of 120°/sec using concentric contraction mode through full ankle range of motion. The EMG (RMS) of evertors and invertors was measured immediately after the three taping ways (no tape, Kinesio tape, and athletic tape) with a one-week interval between each taping. Results: Spa-care Kinesiotape significantly reduced evertors and invertors EMG (RMS) compared with no tape or athletic tape in patients with chronic ankle sprain. Mean± SD of the evertors was 0.7 (±0.1) for no tape and 0.58 (±0.2) for Kinesio tape. The P value was 0.000 for kinesio tape in evertors compared with no tape. Also, mean± SD of the invertors was 0.87 (±0.23) for no tape, and 0.54 (±0.1) for Kinesio tape and the P value was 0.001 for Kinesio tape in invertors compared with no tape. Conclusion: Spa-care Kinesio tape may be useful for reducing EMG activity of ankle muscles in a chronic ankle sprain.

The impact of fatigue on balancing in creating re-injuries in mountaineers with chronic ankle sprain

The impact of fatigue on balancing in creating re-injuries in mountaineers with chronic ankle sprain

Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain

[Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function.

Comparison of dynamic postural stability scores between athletes with and without chronic ankle instability during lateral jump landing.

Many ankle injuries occur while participating in sports that require jumping and landing such as basketball, volleyball and soccer. Most recent studies have investigated dynamic postural stability of patients with chronic ankle instability after landing from a forward jump. The present study aimed to investigate the dynamic postural stability of the athletes who suffer from chronic ankle sprain while landing from a lateral jump. Twelve athletes with self-reported unilateral chronic ankle instability (4 females and 8 males) and 12 matched controls (3 females and 9 males) voluntarily participated in the study. Dynamic postural stability index and its directional indices were measured while performing lateral jump landing test. No differences were found between athletes with and without chronic ankle instability during our landing protocol by means of the dynamic postural stability index and its directional indices. Findings showed that in each group, medial/lateral stability index is significantly higher than anterior/posterior and vertical stability indexes. Findings showed that dynamic postural stability was not significantly different between the two groups. Future studies should examine chronic ankle instability patients with more severe disabilities and expose them to more challenging dynamic balance conditions to further explore postural stability. IIIa.

Validity and reliability of the Foot Function Index (FFI) questionnaire Brazilian-Portuguese version.

PurposeTo evaluate the validity and reliability of the Foot Function Index (FFI) in its Brazilian Portuguese version.MethodsThe validity and reliability of the FFI were tested in 50 volunteers, with plantar fasciitis, metatarsalgia and chronic ankle sprain. The FFI validity process used the Short Form-36 (SF-36) and Foot and Ankle Outcome Score (FAOS) questionnaires. The correlation between FFI, SF-36 and FAOS was done using the Pearson’s linear coefficient. The inter and intra-evaluator reliability was ascertained by means of the intraclass correlation coefficient (ICC) and the internal consistency by means of Cronbach’s alpha coefficient. The scores were used to assess the standard error measurement (SEM), minimal detectable change (MDC) and ceiling floor and effects.ResultsThe validity process showed that there were correlations between FFI and the “pain” and “social aspects” subscales of SF-36 and all subscales of FAOS, except for “other symptoms”. The Brazilian-Portuguese version of FFI showed excellent intra and interevaluator correlations, with an ICC range of 0.99–0.97 and score reliability that was considered highly satisfactory, with Cronbach’s alpha range of 0.80–0.61. The SEMs for inter and intra-evaluator reliability were 1.32 and 1.08, respectively. The MDC was 2.42 (90 % confidence interval). No ceiling and floor effect were detected.ConclusionsThe Brazilian-Portuguese version of the FFI questionnaire was found to be a valid and reliable instrument for foot function evaluation, and can be used both in scientific settings and in clinical practice.

만성 족관절 염좌에 자하거 약침을 병행한 한방 치료로 호전된 2례 보고

Objectives The purpose of this study is to investigate and report the effectiveness of Hominis Placenta pharmacopuncture treatment for chronic ankle sprain. Methods 2 patients are treated at Dept. of Korean Medicine, the Armed Forces Busan Hospital, diagnosed as thinning of anterior talofibular ligament (ATFL), suggestive of partial tear and anterior tibiofibular ligament partial tear. They are treated with Hominis Placenta pharmacopuncture. Each cases are measured and assessed by ankle hindfoot scale (AHS), visual analgue scale (VAS), cumberland ankle instability tool (CAIT) scores. Results 2 patients of chronic disease of ankle sprain have a different kind of diagnoses they have. After treatment of Hominis placenta pharmacopuncture, spontaneous pain is decreased and ankle instability, ankle functions are increased significantly. Conclusions Hominis placenta Pharmacopuncture has a effect on chronic ankle sprain.

The effect of intrinsic foot muscle training on medial longitudinal arch and ankle stability in patients with chronic ankle sprain accompanied by foot pronation

Objective: The purpose of this study was to investigate whether the intrinsic foot muscle training method can improve the medial longitudinal arch in patients with chronic ankle injury and with pronated feet, as well as to investigate for the most effective exercise method for these patients. Design: Randomized controlled trial. Methods: Thirty men and women with pronated feet had participated in this study and were allocated to either the short foot exercise group (SFEG) or the towel curl exercise group (TCEG) randomly. SFEG and TCEG underwent exercises three times a week for 8 weeks, with three sets per day, totalling up to 5 minutes per day. The navicular drop test (NDT) was used in order to assess for changes in the medial longitudinal arch and the Cumberland ankle instability tool (CAIT) was used to assess for ankle instability of the chronic ankle sprain patients. Results: There was a significant increase in CAIT scores in the SFEG (p<0.05) and a significant difference between groups was presented (p<0.05). The NDT scores were significantly decreased in both groups (p<0.05). In the SFEG, the NDT scores were more decreased than in the TCEG (p<0.05). Conclusions: These results suggest that short foot exercises are more effective in providing intrinsic foot muscle training for patients with pronated feet among chronic ankle sprain patients. Furthermore, short foot exercises may be used to provide ankle stability.

Coordination and Symmetry Patterns During the Drop Vertical Jump in People With Chronic Ankle Instability and Lateral Ankle Sprain Copers.

The drop vertical jump (DVJ) task has previously been used to identify movement patterns associated with a number of injury types. However, no current research exists evaluating people with chronic ankle instability (CAI) compared with people coping with lateral ankle sprain (LAS) (referred to as "LAS copers") during this task. The aim of this study was to identify the coping movement and motor control patterns of LAS copers in comparison with individuals with CAI during the DVJ task. This was a case-control study. Seventy individuals were recruited at convenience within 2-weeks of sustaining a first-time acute LAS injury. One year following recruitment, these individuals were stratified into 2 groups: 28 with CAI and 42 LAS copers. They attended the testing laboratory to complete a DVJ task. Three-dimensional kinematic and sagittal-plane kinetic profiles were plotted for the lower extremity joints of both limbs for the drop jump phase (phase 1) and drop landing phase (phase 2) of the DVJ. The rate of impact modulation relative to body weight during both phases of the DVJ also was determined. Compared with LAS copers, participants with CAI displayed significant increases in hip flexion on their "involved" limb during phase 1 of the DVJ (23° vs 18°) and bilaterally during phase 2 (15° vs 10°). These movement patterns coincided with altered moment-of-force patterns at the hip on the "uninvolved" limb. It is unknown whether these movement and motor control patterns preceded or occurred as a result of the initial LAS injury. Participants with CAI displayed hip-centered changes in movement and motor control patterns during a DVJ task compared with LAS copers. The findings of this study may give an indication of the coping mechanism underlying outcome following initial LAS injury.

The Effect of Core Stability Exercises on Dynamic Balance of Athletes with Chronic Ankle Sprain

Introduction: Functional ankle instability is the most common residual and debilitating symptoms of acute ankle sprain leading to lose of training and competition in athletes. The purpose of this randomized controlled trial was to investigate the effect of six weeks core stability training on dynamic postural control in individuals with chronic ankle sprain. Materials and Methods: Thirty people were randomized to the experimental or control group. A pretest-posttest control group design was used to evaluate the intervention. The 6-week intervention (core stability exercises) used for experimental group and conventional physiotherapy for both groups. All subjects were tested before the beginning of the core-stabilization training program (pretest) and immediately after the conclusion of the 6-week program (posttest). Pretesting and posttesting consisted of the star excursion balance test (SEBT) .Analysis of covariance compared outcomes between groups. The paired t test compared results within groups. A significant level of 0.05 was set for all analyses. Results: Results showed significant differences in mean of SEBT (in all directions) in the experimental and control group in post-test (P < 0.05), but improvement of balance in experimental group was greater than control group and this difference was significant (P < 0.05). Conclusion: It can be concluded that core stability training can lead to improve dynamic balance in patients with chronic ankle sprain. Therefore, this type of training is recommended to be considered as a therapeutic option for this population of patients.

Efficacy observation of combining tuina and Chinese herbal fumigation for chronic ankle sprain

Objective To observe the clinical efficacy of combining tuina and Chinese herbal fumigation for chronic ankle sprain.

Locomotive biomechanics in persons with chronic ankle instability and lateral ankle sprain copers.

To compare the locomotive biomechanics of participants with chronic ankle instability (CAI) to those of lateral ankle sprain (LAS) copers. Cross-sectional study. Twenty-eight participants with CAI and 42 LAS copers each performed 5 self-selected paced gait trials. 3-D lower extremity temporal kinematic and kinetic data were collected for these participants from 200ms pre- to 200ms post-heel strike (period 1) and from 200ms pre- to 200ms post-toe off (period 2). The CAI group displayed increased hip flexion bilaterally during period 1 compared to LAS copers. During period 2, CAI participants exhibited reduced hip extension bilaterally, increased knee flexion bilaterally and increased ankle inversion on the 'involved' limb. They also displayed a bilateral decrease in the flexor moment pattern at the knee. Considering that all of the features which distinguished CAI participants from LAS copers were also evident in our previously published research (within 2-weeks following acute first-time LAS); these findings establish a potential link between these features and long-term outcome following first-time LAS. Clinicians must be cognizant of the capacity for these movement and motor control impairments to cascade proximally from the injured joint up the kinetic chain and recognise the value that gait re-training may have in rehabilitation planning to prevent CAI.

Comparison of Ankle Flexibility, Iso-kinetic Strength and Static·Dynamic Balance in High School Judo Player depending on Chronic Ankle Sprain

Comparison of Ankle Flexibility, Iso-kinetic Strength and Static·Dynamic Balance in High School Judo Player depending on Chronic Ankle Sprain

Efficacy of mobilization with movement in treatment of chronic ankle sprain

Efficacy of mobilization with movement in treatment of chronic ankle sprain

Brostrom-Gould Procedure for Lateral Ankle Instability

Acute ankle sprains are most frequently treated conservatively, although some surgeons may advocate acute repairs in certain situations. Surgery is indicated for chronic sprains with persistent ankle instability despite well-designed conservative management. Several anatomic and nonanatomic operative procedures are available. The Brostrom-Gould procedure is a widely-used operative intervention for treatment of chronic lateral ankle sprains. It consists of an anatomic repair or reconstruction of the injured lateral ankle ligament complex (Brostrom procedure), followed by suturing of the inferior extensor retinaculum to periosteum of the distal fibula (Gould modification). This article describes the standard Brostrom-Gould procedure starting with the identification of the anatomic landmarks. The skin incision follows the anterior border of the distal fibula, and careful subcutaneous dissection is carried out to expose the extensor retinaculum and the torn ligaments. This is followed by bone preparation and ligament repair utilizing a box stitch technique while holding the ankle in an appropriate position. Finally, the Gould portion of the procedure is demonstrated.

Musculoskeletal Management of a Patient With a History of Chronic Ankle Sprains: Identifying Rupture of Peroneal Brevis and Peroneal Longus With Diagnostic Ultrasonography

ObjectiveThe purpose of this case report is to describe the use of mobilization and eccentric exercise training for a patient with ankle pain and a history of chronic ankle sprains and discuss the course of diagnostic decision making when the patient did not respond to care. Clinical FeaturesA 48-year-old police officer who had sustained multiple ankle sprains throughout his life presented with pain and restriction in his ability to walk, run, and work. The Global Rating of Change Scale score was −6, the Numeric Pain Rating Scale score was 7/10, and the Lower Extremity Functional Scale score was −33. Palpation of the peroneus longus and brevis muscles and inversion with overpressure reproduced the chief concern (Numeric Pain Rating Scale 7/10). The patient was initially diagnosed with chronic peroneal tendinopathy. Intervention and OutcomeTreatment included lateral translation mobilization of the talocrural joint combined with eccentric exercise using an elastic band for the peroneal muscles. The patient reported improvement in pain and function during the course of intervention but not as rapidly as expected. Therefore, follow-up ultrasonographic imaging and radiography were performed. These studies revealed partial rupture of the peroneal brevis muscle and total rupture of the peroneal longus muscle. ConclusionA patient with long-term concerns of the foot complex with a diagnosis of peroneal tendinopathy showed slight improvement with eccentric exercises combined with manual therapy of the talocrural joint. After a course of treatment but minimal response, a diagnosis of tendon rupture was confirmed with diagnostic ultrasonography. Clinicians should be aware that when injuries do not improve with care, tendon rupture should be considered.