History Of Lower Limb Injury Research Articles

Y balance test has no correlation with the Stability Index of the Biodex Balance System

Study designA cross-sectional study design. BackgroundThe Stability Index of the Biodex Balance System (SI-BBS) and Y Balance Test (YBT) has been used in studies assessing postural stability but no studies have verified the association of the YBT with the SI-BBS. ObjectiveTo analyze the association of the Y Balance Test (YBT) with the Stability Index of the Biodex Balance System (SI-BBS) to evaluate postural stability. MethodsForty participants who engaged in recreational physical activities, 12 of whom had a history of injury to the lower limbs. Was used the SI-BBS and the anterior, posterolateral, posteromedial, and composite measures of the YBT. The order of execution of the tests and of the lower limbs evaluated was randomized and blind tested by two evaluators. ResultsPearson's correlation coefficient was used to check the strength of the relationship between the distances achieved on the YBT and the SI-BBS. The YBT showed excellent reliability in the anterior, posteromedial, and posterolateral directions. However, the YBT showed no statistically significant correlation with any variables in the SI-BBS, indicating poor validity between YBT and SI-BBS assessments of postural stability in people with and without history of lower limb injuries. ConclusionsThe results of this study showed the YBT is not correlated with the SI-BBS as an assessment of postural stability. This finding has implications for researchers and clinicians using YBT results as the only measure of postural stability.

Transtibial Versus Anteromedial Portal Technique in Single-Bundle Anterior Cruciate Ligament Reconstruction

Background: In anterior cruciate ligament (ACL) reconstruction, the transtibial (TT) technique often creates a nonanatomically placed femoral tunnel, which is a frequent cause of surgical failure and postsurgical knee instability. Several studies reported that drilling the femoral tunnel through an anteromedial portal (AMP) yields a more anatomic tunnel position compared with the TT technique. Purpose: To compare the effectiveness of these two surgical techniques in restoring the intact knee joint kinematics during a physiological loading situation. Study Design: Controlled laboratory study. Methods: Twenty-four patients (TT, n = 12; AMP, n = 12; sex, weight, and height matched, and half with dominant leg involved) who underwent unilateral single-bundle ACL reconstruction by the same surgeon were recruited. Twenty healthy patients with no history of lower limb injuries were recruited as the control group. Tibiofemoral joint motion in 6 degrees of freedom (3 translations and 3 rotations) was determined during level walking by using a least mean square–based optimization algorithm. A redundant marker set was used to improve the accuracy of the motion analysis. Knee joint kinematics as well as spatiotemporal parameters were compared between these two techniques. Results: The AMP technique restored the anterior-posterior translation of the knee joint, while the TT technique resulted in significantly greater (TT, 22.2 mm vs controls, 13.2 mm; P < .01) anterior femoral translations than in the healthy controls during the swing phase. Excessive femoral external (tibial internal) rotation (3.8°; P < .05) was found at midstance in the knees that were reconstructed using the TT technique; using the AMP technique, the external rotation offset was greatly reduced during the stance phase. However, knees repaired using the AMP technique were significantly less extended (5°; P < .05) compared with the knees of the controls during the late stance phase. Neither surgical technique restored the superior-inferior femoral translation to the intact level during the swing phase. Conclusion: The AMP technique better restores the anterior-posterior translation during the swing phase and femoral external rotation at midstance than the TT technique does. However, the AMP technique is also correlated with an extension loss during the late stance phase. Clinical Relevance: The AMP femoral tunnel drilling technique can improve overall knee joint stability, but the increased difficulty with full extension may need to be considered.

Exergaming and Static Postural Control in Individuals With a History of Lower Limb Injury

Therapeutic exercise programs that incorporate real-time feedback have been reported to enhance outcomes in patients with lower extremity joint injuries. The Wii Fit has been purported to improve balance, strength, flexibility, and fitness. To determine the effects of Wii Fit rehabilitation on postural control and self-reported function in patients with a history of lower limb injury. Single-blinded, randomized controlled trial. Laboratory. Twenty-eight physically active participants with a history of lower limb injuries were randomly assigned to 1 of 3 groups (9 Wii Fit, 10 traditional, 9 control). Intervention groups performed supervised rehabilitation 3 d/wk for a total of 12 sessions. Time to boundary (TTB) and the Star Excursion Balance Test (SEBT) were conducted at baseline, 2 weeks, and 4 weeks. Self-reported function was measured at baseline and 4-week follow-up. Between-groups differences were compared using repeated-measures multivariate analysis of variance. With the eyes open, both intervention groups improved (P < .05) in the mean and the SD of the TTB anterior-posterior minima. In the eyes-closed condition, a time main effect (P < .05) for absolute TTB medial-lateral minima was observed. A time main effect was also noted in the posteromedial and posterolateral reach directions of the SEBT. When the scores for each group were pooled, improvement (P < .05) in self-reported function was demonstrated at 4-week follow-up. Rehabilitation using the Wii Fit and traditional exercises improved static postural control in patients with a history of lower extremity injury.

The effect of prophylactic knee bracing on performance: balance, proprioception, coordination, and muscular power

Prophylactic knee braces are largely used in the prevention of ligament injuries, but their effectiveness on performance are still controversial. The aim of this study was to determine which brace was the most effective on functional performance. Twenty-four healthy subjects (14 men and 10 women), between the age of 18 and 22 with no prior history of lower limb injury and brace use, voluntarily participated in this study. Five different prophylactic knee braces were used. The test protocol consisted of dynamic balance, jumping performance, proprioception, coordination, and maximal force. Balance was assessed by the Y balance test; jumping performance was assessed by vertical jump and one-leg hop tests; maximal force, proprioception, and coordination were assessed by using functional squat testing. Proprioceptive test was performed by using the functional squat system machine that the participants were instructed to keep the crosshair on the line, even after the visual aid had disappeared. The subjects without a brace and with the brace by using 5 different braces (DonJoy-USA) were evaluated by five different therapists. Hinged "H" buttress for the support of the knee brace was found to be more effective than the others in terms of balance. Drytex economy hinged knee brace had the best result in terms of proprioception and maximal force. There were no significant differences in vertical jump and one-leg hop tests (n.s.). In conclusion, the hinged "H" buttress for support of the knee brace and Drytex economy hinged knee brace produced the best results on the performance parameters. The other three braces demonstrated more variable and less optimal results. Prophylactic knee braces can be used for both healthy subjects and athletes to enhance proprioception, coordination, maximal force, and balance, but it is important to choose the best proper brace to the individuals according to their fitness level. (Economic and decision analysis-developing an economic or decision model), Level II.

Sensory changes associated with severe ankle sprain

An intact afferent nervous system is important in providing the feedback necessary for effective motor control. Joint injury may influence afferent feedback and, if the lower limb is involved, lead to a decrease in stability. Accordingly, the association between severe ankle sprain and local sensory deficit was examined. Measurements of vibration perception, two point discrimination and balance in one legged standing were made in subjects who had sustained a previous severe unilateral ankle sprain and in subjects with no history of lower limb injury. Comparisons between the two groups showed that subjects with previous severe ankle sprain had sensory deficits in all measured variables between the injured and non-injured sides. Such differences between sides was not apparent in the non-injured group. This study highlights that local sensory deficits are associated with severe ankle sprain.

Risk Factors for Injury during Basic Military Training

A retrospective case-control study into the risk factors for injury during basic military training was conducted at the Recruit Training Unit, Royal Australian Air Force Base Edinburgh, South Australia. Case subjects were recruits suffering a musculoskeletal injury during the course, severe enough to result in backcoursing (being delayed and joining a later course) and usually requiring the loss of 5 days of training. Control subjects were 629 recruits selected randomly from recruits who were not case subjects from the same period of Jan 1, 1985 to Dec 31, 1990. Two hundred thirty-eight cases were identified (2.7% of the recruit population), of which 123 were overuse-type injuries and 115 acute-type injuries. Most injuries occurred in the first 2 weeks of training. Bivariate and logistic regression analysis of possible risk factors for injury was conducted, both for all case subjects and for the subgroup of case subjects with overuse injuries. Statistically significant associations were identified for female gender, body mass index > 26.9, winter training, a history of lower limb injury, and the presence of a lower limb deformity. All these associations were stronger for overuse injury, and preenlistment physical activity was also significantly associated with overuse injury. No significant association was found for height, weight, age, smoking, or gender makeup of courses. Most striking was a large rise in overuse injury incidence in women over the period of study, from 0.2% in 1985 to 8.8% in 1990. Reasons for this increase may include "social pathogenesis."