Risk Factors For Ankle Sprains Research Articles

Dorsiflexion Range Of Motion Deficits Alter Joint Muscle Activation Patterns During Walking In Chronic Ankle Instability

Decreased dorsiflexion range of motion (DFROM) has been identified as a risk factor for ankle sprains. Patients with chronic ankle instability (CAI) demonstrate reduced DFROM during functional tasks. However, variation in DFROM exists within a CAI population. It remains unclear whether varied DFROM affects muscle activation during walking. PURPOSE: To examine the effects of varied DFROM on tibialis anterior (TA), peroneus brevis (PB), peroneus longus (PL), and gluteus maximus (Gmax) activation during walking within the CAI population. METHODS: 100 CAI subjects were classified into 3 subgroups based on DFROM, measured by the weight-bearing lunge test: a Hypo (14 M, 10F; ≤ 39°; 35 ± 2.5°, 23 ± 2 yrs, 176 ± 13 cm, 80 ± 13 kg), Normal (25 M, 32F; 40-50°; 46 ± 2.6°, 21 ± 2 yrs, 174 ± 7 cm, 72 ± 14 kg), and Hyper DFROM group (11 M, 8F; ≥ 51°; 54 ± 3°, 22 ± 2 yrs, 175 ± 11 cm, 74 ± 14 kg). Subjects performed 5 walking trials at a preferred speed while muscle activation were collected using wireless surface electrodes (2000 Hz). Functional liner models were used to detect between-group differences. If 95% confidence intervals did not cross zero, differences were significant. RESULTS: Figure 1 shows Hypo DFROM group showed increased muscle activation of the TA and Gmax during early stance phase, as well as increased muscle activation of the PL and PB during the late stance phase compared to Normal and/or Hyper DFROM groups. CONCLUSION: While CAI patients with Normal and Hyper DFROM show similar muscle activation patterns during walking, CAI patients with Hypo DFROM appear to demonstrate increased muscle activation during walking. These muscle activation patterns may elicit perceived, protective neuromuscular control in an attempt to prevent injuries due to ankle instability. Differences in muscle activation may compensate for limited arthrokinematics at the ankle joint. However, prospective studies are needed to determine whether these patterns would reduce injury risk and performance deficits.

Hip Abductor Muscle Fatigue Induces Different Strategies During Disrupted Postural Control.

BackgroundAnkle sprain is one of the most common injuries in sport, and hip abductor muscle weakness has recently been reported as a predisposing factor. Currently, the influence of hip abductor muscle fatigue on ankle joint control has not been elucidated during an ankle disturbed balance exercise. This study aimed to determine the influence of hip abductor muscle fatigue on ankle joint control during a disturbed balance task, and to consider inter-individual variability in the kinematic and neuromuscular reorganizations implemented.MethodsTwenty-six healthy subjects (13 males; 13 females) performed a unipedal postural balance task with eyes closed before and after a fatiguing exercise (up to a 50% decrease in strength) of the hip abductor muscles. Subjects completed balance task while equipped with an ankle destabilization device that allows inversion/eversion movements. Electromyographic (EMG) activity of the gastrocnemius lateralis (GastL), peroneus longus (PL) and brevis, tibialis anterior, and gluteus medius were recorded during task. Kinematics (e.g., frontal foot angulation) of the ankle complex were determined using inertial measurement units.ResultsIn the overall group, no significant time, sex or interaction effect was observed for kinematic and EMG variables. However, when considering individual responses to hip fatigue, 14 subjects decreased the standard deviation of frontal angulation (−30%) suggesting enhancement of ankle joint control, while 12 subjects increased it (+46%). Normalized EMG for PL and GastL muscles changed with fatigue for both these groups. However, variations were significantly different between groups (p = 0.027 for PL and p = 0.006 for GastL). Indeed, the contribution of ankle muscles increased for the enhanced-stability group while no change for the impaired-stability group.ConclusionThese results highlight that subject adopt different neuromuscular and kinematic ankle strategies to control ankle destabilization in response to hip abductor muscle fatigue. Frontal foot angulation variability seemed to be a valuable marker to detect the type of strategy employed. The strategy adopted by the impaired-stability group might have important implications when analyzing risk factors for ankle sprains. Further studies should consider individual responses to fatigue, to understand which factor could predispose athletes to use of one or other strategy.

Risk Factors Causing Ankle Sprain among undergraduate female students

High heeled shoes align the foot in planter flexion, modifying the relative orientation of the skeletal structures of ankle, metatarsal, and metatarsophalangeal joints, and alter the insertion angles of the foot and gliding joint muscles, therefore increasing the risk factor for ankle sprain. Objective: Study conducted to determine Risk Factors Causing Ankle Sprain among undergraduate female students. Methods: Cross-Sectional study was conducted among 500 female students (Between ages 18-26 years) at Sargodha Medical College and completed in 06 months (June 2019-December 2019). Non-probability convenient sampling technique was used to collect data and then entered to SPSS-25 for further statistical analysis. Result: Among 500 participants, Age 19.65±1.416 years. Mean height (m) 1.61±0.073, mean weight (kg) 57.37±10.4, Mean BMI was 22.02±3.6. Female experience ankle sprain (54%), not experienced ankle sprain (46%) Significant association found between Ankle Sprain and body mass index (BMI) as the P value was 0.014 which was <0.05. Female wearing high heel have 1.082 times greater chance of developing ankle sprain (OR 1.082). Female wearing high heel for long duration (4-6 hrs.) have 1.271 times greater chance of developing ankle sprain (OR 1.271), female wearing high heel (3-4 inches) have 1.072 times greater chance of developing ankle sprain (OR 1.072), female using Pencil heel have 1.281 times greater chance of developing ankle sprain (OR 1.281). Conclusion: Significant association found between Ankle Sprain and body mass index (BMI). Female wearing, high heel for long duration (4-6 hrs.), high heel (3-4 inches height), using Pencil heel have greater chance of developing ankle sprain.

Risk Factors Causing Ankle Sprain among undergraduate female students

High heeled shoes align the foot in planter flexion, modifying the relative orientation of the skeletal structures of ankle, metatarsal, and metatarsophalangeal joints, and alter the insertion angles of the foot and gliding joint muscles, therefore increasing the risk factor for ankle sprain. Objective: Study conducted to determine Risk Factors Causing Ankle Sprain among undergraduate female students. Methods: Cross-Sectional study was conducted among 500 female students (Between ages 18-26 years) at Sargodha Medical College and completed in 06 months (June 2019-December 2019). Non-probability convenient sampling technique was used to collect data and then entered to SPSS-25 for further statistical analysis. Result: Among 500 participants, Age 19.65±1.416 years. Mean height (m) 1.61±0.073, mean weight (kg) 57.37±10.4, Mean BMI was 22.02±3.6. Female experience ankle sprain (54%), not experienced ankle sprain (46%) Significant association found between Ankle Sprain and body mass index (BMI) as the P value was 0.014 which was <0.05. Female wearing high heel have 1.082 times greater chance of developing ankle sprain (OR 1.082). Female wearing high heel for long duration (4-6 hrs.) have 1.271 times greater chance of developing ankle sprain (OR 1.271), female wearing high heel (3-4 inches) have 1.072 times greater chance of developing ankle sprain (OR 1.072), female using Pencil heel have 1.281 times greater chance of developing ankle sprain (OR 1.281). Conclusion: Significant association found between Ankle Sprain and body mass index (BMI). Female wearing, high heel for long duration (4-6 hrs.), high heel (3-4 inches height), using Pencil heel have greater chance of developing ankle sprain.

Quadriceps strength asymmetry as predictor of ankle sprain in male volleyball players.

Ankle sprain is the most common acute time-loss injury in volleyball and occurs mainly during landing from a jump. Therefore, we have evaluated the role of quadriceps strength and countermovement jump height on ankle sprain occurrence, as these intrinsic modifiable risk factors were not yet evaluated. We have also hypothesized that presence of quadriceps strength asymmetry could be a possible risk factor for ankle sprains in male volleyball players. This was a prospective cohort study. Male volleyball players (N.=99) from Slovenian national league participated in the study. Before the start of the season, all participants completed a preseason questionnaire and underwent evaluation of vertical jump performance and bilateral isokinetic strength of the quadriceps (Q) and hamstrings (H). During the subsequent season the players reported acute time loss injuries because of ankle sprain through a weekly questionnaire. We have registered 19 ankle sprains during the season. Overall ankle sprain incidence was 0.41±0.24 per 1000 h. Previous ankle sprain (Odds Ratio: 0.86; 95% CI: 0.25-2.89, P=0.802) and jump height (1.05; 95% CI: 0.94-1.19, P=0.393) were not significant risk factors, while Q strength asymmetry was a significant predictor of an ankle sprain (Odds Ratio: 0.956; 95% CI: 0.919-0.995, P=0.026). Compared with the uninjured players, the injured players had higher right concentric Q strength, higher Q strength asymmetry, and lower concentric right H-Q strength ratio (all P<0.03). Our results suggest that excessive concentric strength of the right Q, which leads to low H-Q strength ratio, and high bilateral Q strength asymmetry in favor of the right side, could be associated with increased risk of ankle sprains in male volleyball.

Incidence and risk factors for poor ankle functional recovery, and the development and progression of posttraumatic ankle osteoarthritis after significant ankle ligament injury (SALI): the SALI cohort study protocol

BackgroundAnkle sprains are one of the most common musculoskeletal injuries, accounting for up to 5% of all Emergency Department visits in the United Kingdom. Ankle injury may be associated with future ankle osteoarthritis. Up to 70% of ankle osteoarthritis cases may be associated with previous ankle injury. There is limited research regarding the association between ankle sprain and ankle osteoarthritis development. The current study aims to phenotype those who suffer significant ankle ligament injuries, identify potential risk factors for ankle injuries and subsequent poor recovery, examine why individuals may develop osteoarthritis, and what factors influence this chance.MethodsIn this multicentre cohort study participants were recruited from nine Emergency Departments and two Urgent Care Centres in the United Kingdom. Participants (aged 18–70 years old) were defined as those who had suffered an isolated acute ankle sprain, which was Ottawa Ankle Rules positive, but negative for a significant ankle fracture on x-ray. Age and sex matched controls were also recruited. The controls were individuals who had not suffered a significant ankle injury, including ankle pain, function affected for more than 7 days, or the ankle caused them to report to an Emergency Department. Data is collected through a series of seven questionnaires (at baseline, 3 months, 1 year, 3 years, 5 years, 10 years, and 15 years later). The questionnaires include four sections (demographic questions; index injury, and injury history questions; functional assessment questions; and quality of life questions) and are designed to collect detailed information about the individual, their injury, potential risk factors for ankle sprains and ankle osteoarthritis, plus their medical history and any medication consumed.DiscussionThe Significant Ankle Ligament Injury (SALI) study aims to add to the limited knowledge regarding which factors can predict ankle sprains, complaints, and osteoarthritis. This is important because despite ankle sprains being regarded as a benign injury that resolves quickly, residual symptoms are not uncommon months and years after the injury.

Correlation of Foot Wears with MSK Disorders in Ankle Joints Among Females

AIM: This paper is a report of study conducted to explain the factors that causes ankle sprain by wearing high heels among students of Sargodha medical college and university of Sargodha. BACKGROUND: High heeled shoes have been worn for several centuries and despite numerous cautions against their use, they remain extremely popular. Wearing high heeled shoes is thought to increase the individual’s likelihood of experiencing a lateral ankle sprain. The 19 th century saw the first warnings that wearing high heels footwear could lead to trips and falls. Previous investigations have shown that high heeled shoes align the foot in planter flexion, modifying the relative orientation of the skeletal structures of ankle, midtarsal, and metatarsophalangeal joints, and alter the insertion angles of the foot and gliding joint muscles, therefore increasing the risk factor for ankle sprain. METHODS: observational non-experimental study was conducted via a questionnaire which was distributed among 500 female students of SMC (Sargodha medical college) and university of Sargodha. These female students fall in age group between18-26. RESULT: The result of our study concluded that the types of heel and height of heel are the most significant factors that cause ankle sprain. The ankle sprain caused by wearing pencil heels and by use of <3 inch heels are greatest. Keywords: Pencil heel, height of heel, Ankle sprain, SMC, Female student. DOI: 10.7176/JHMN/80-09 Publication date: September 30 th 2020

Prevalence and Risk Factors of Ankle Sprain Among Male Soccer Players in Tabuk, Saudi Arabia: A Cross-Sectional Study

Background: Ankle sprains are common among soccer players, and their risk factors are well documented in the literature. In Saudi Arabia, some healthcare and sport-related characteristics provide the necessity for investigating the prevalence and risk factors of ankle sprain in that region as well. Objective: To analyze the prevalence of lower limb injuries and risk factors of ankle sprains among male soccer players in Tabuk, Saudi Arabia. Methods: A cross-sectional study among 400 male soccer players from different sports clubs in Tabuk, Saudi Arabia was conducted. A self-structured questionnaire was used to collect data related to ankle sprains. Chi-square, Fisher’s exact tests, and unpaired t-tests were used to test the association between variables. Univariate logistic regression analysis was used to identify the risk factors. Results: Ankle sprains were the most prevalent, reported by 63.8%. Previous ankle injury, lack of stretching, lack of warm-up, and not wearing bracing were identified as significant risk factors. A total of 47.9% of players preferred to go to the hospital for treatment, 15.8% selected physical therapy, while 56% had no prior education regarding injury prevention. Conclusion: Ankle sprain is the most prevalent lower limb injury. Risk factors include previous ankle injuries, lack of stretching, lack of warm-up, and not wearing bracing. Players have little knowledge of physical therapy measures and lack of injury prevention education. Our findings suggest that increasing the awareness of injuries and proper physical therapy measures might assist in preventing recurrence of ankle sprains among male soccer players.

Determining the relationship between physical status and musculoskeletal injuries in children: a cohort study.

Background: In Japan, in 2016, the School Health and Safety Act was revised and examination of extremities in addition to scoliosis became mandatory. Musculoskeletal examinations were subsequently started using a mark sheet-type questionnaire. In the present study, we aimed to analyze the relationship between physical findings and musculoskeletal problems and propose a preventive strategy for musculoskeletal injuries.Methods: In 2017, a total of 4,073 elementary and middle school students underwent direct musculoskeletal examination. In a direct examination, the following elements were included: torticollis; scoliosis; stiffness of the shoulder, elbow, hip, knee, and ankle; flexion and extension in standing position; flat foot; hallux valgus; and alignment of the upper and lower extremities. Of the 4,073 students who underwent direct examination in early 2017, only 3,754 were able to complete the mark sheet-type questionnaires in early 2018. A prospective longitudinal analysis of the data gathered was performed.Results: A total of 396 (11%) students had injuries. The ankle sprain/non-ankle sprain group comprised 119 (3%)/3,635 (97%) students, while the fracture/non-fracture group comprised 105 (2.8%)/3,650 (97.2%) students, respectively. Comparing the sprain group with the non-sprain group, ankle stiffness significantly correlated with ankle sprain in the univariable and multivariable analyses. Injuries occurred more frequently among boys, older students, students with stiff bodies, and students who were involved in sports activities of longer duration.Conclusion: Ankle stiffness was assumed to be a risk factor for ankle sprain. Stretching of the ankle might be effective for preventing ankle sprain. However, further interventional studies are needed to confirm this finding.

COMPARISON OF RISK FACTORS FOR ANKLE SPRAINS IN KARATE PLAYERS WITH OR WITHOUT ANKLE SPRAINS

15Nov 2019 COMPARISON OF RISK FACTORS FOR ANKLE SPRAINS IN KARATE PLAYERS WITH OR WITHOUT ANKLE SPRAINS Aditi Dand , Manasi Desai and Sukhada Prabhu B.P.Th, D.Y. Patil University, School of Physiotherapy, Nerul, Navi Mumbai, Maharashtra M.P.Th in Neurosciences, Department of Neuro - physiotherapy, Assistant Professor, D. Y. Patil University, School of Physiotherapy, Nerul, Navi Mumbai, Maharashtra M.P.Th in Cardio Vascular and Respiratory Physiotherapy, Department of Kinesiotherapeutics, Assistant Professor, D. Y. Patil University, School of Physiotherapy, Nerul, Navi Mumbai, Maharashtra

Immediate Effects of Joint Mobilization Techniques on Clinical Measures in Individuals with CAI

Objective: Epidemiological research shows that 47 to 73% of athletes suffer from recurrent ankle sprains. Joint mobilization techniques (JMT) implemented in correcting may be beneficial in the management of ankle injuries. The purpose of this study is to examine the immediate JM on ankle complex as clinical measures in individuals with chronic ankle instability (CAI) through intervention. Method: Thirteen subjects with CAI (8 males and 5 females) participated in this study. Each subject tried total four alignments (Navicular drop test: NDT, Standing rearfoot angle: SRA, Tibia torsion: TT, and dorsiflexion range of motion: DFROM). The participants were performed the 10 meter shuttle run after JMT for post-task. Finally, it was tried to compare between pre-post tasks after shuttle run. Results: SRA and DFROM after intervention showed significant differences. SRA (p=.026), and DFROM (p=.034). Conclusion: We concluded that the JMT has resulted in improvement in SRA, DFROM. Increased DFROM and varus shapes of foot would be closed kinetic chain, indicating that reduce the risk factors of ankle sprain. Future study needs to be conducted in order to measure the effects of prolonged intervention of JMT.

Postural stability deficit could predict ankle sprains: a systematic review.

To perform a systematic review aimed to determine (1) if the postural stability deficit represents a risk factor for ankle sprains; (2) the most effective postural stability evaluation to predict ankle sprains and (3) eventual confounding factors that could influence postural stability and ankle sprain risk. A systematic electronic search was performed in MEDLINE, EMBASE and CINAHL using the search terms (balance) OR (postural stability) matched with (lower limb) OR (ankle) OR (foot) and (sprain) OR (injury) on October 2 2017. All prospective studies that evaluated postural stability as risk factor for ankle sprains were included. The PRISMA Checklist guided the reporting and data abstraction. Methodological quality of all included papers was carefully assessed. Fifteen studies were included, evaluating 2860 individuals. Various assessment tools or instruments were used to assess postural stability. The injury incidence ranged from 10 to 34%. Postural stability deficit was recognized as risk factor for ankle sprain (OR = 1.22-10.2) in 9 cases [3 out of 3 with Star Excursion Balance Test (SEBT)]. Among the six studies that measured the center-of-gravity sway, five were able to detect worse postural stability in athletes that sustained an ankle sprain. In nine cases, the measurement of postural stability did not show any statistical relationship with ankle sprains (four out of five with examiner evaluation). In the studies that excluded patients with history of ankle sprain, postural stability was reported to be a significant risk factor in five out of six studies. The ultimate role of postural stability as risk factor for ankle sprains was not defined, due to the high heterogeneity of results, patient's populations, sports and methods of postural stability evaluation. Regarding assessment instruments, measurement of center-of-gravity sway could detect athletes at risk, however, standardized tools and protocols are needed to confirm this finding. The SEBT could be considered a promising tool that needs further investigation in wider samples. History of ankle sprains is an important confounding factor, since it was itself a source of postural stability impairment and a risk factor for ankle sprains. These information could guide clinicians in developing screening programs and design further prospective cohort studies comparing different evaluation tools. I (systematic review of prospective prognostic studies).

The Risk Factors for Ankle Sprain in Cadets at a Male Military School in Iran: A Retrospective Case-control Study

The Risk Factors for Ankle Sprain in Cadets at a Male Military School in Iran: A Retrospective Case-control Study

Incidence and Cost of Ankle Sprains in United States Emergency Departments.

Background:Ankle sprains represent a common injury in emergency departments, but little is known about common complications, procedures, and charges associated with ankle sprains in emergency departments.Hypothesis:There will be a higher incidence of ankle sprains among younger populations (≤25 years old) and in female patients. Complications and procedures will differ between ankle sprain types. Lateral ankle sprains will have lower health care charges relative to medial and high ankle sprains.Study Design:Descriptive epidemiological study.Level of Evidence:Level 3.Methods:A cross-sectional study of the 2010 Nationwide Emergency Department Sample was conducted. Outcomes such as charges, complications, and procedures were compared using propensity score matching between lateral and medial as well as lateral and high ankle sprains.Results:The sample contained 225,114 ankle sprains. Female patients sustained more lateral ankle sprains (57%). After propensity score adjustment, lateral sprains incurred greater charges than medial ankle sprains (median [interquartile range], $1008 [$702-$1408] vs $914 [$741-$1108]; P < 0.01). Among complications, pain in the limb (1.92% vs 0.52%, P = 0.03), sprain of the foot (2.96% vs 0.70%, P < 0.01), and abrasion of the hip/leg (1.57% vs 0.35%, P = 0.03) were more common in lateral than medial ankle sprain events. Among procedures, medial ankle sprains were more likely to include diagnostic radiology (97.91% vs 83.62%, P < 0.01) and less likely to include medications than lateral ankle sprains (0.87% vs 2.79%, P < 0.01). Hospitalizations were more common following high ankle sprains than lateral ankle sprains (24 [6.06%] vs 1 [0.25%], P < 0.01).Conclusion:Ankle sprain emergency department visits account for significant health care charges in the United States. Age- and sex-related differences persist among the types of ankle sprains.Clinical Relevance:The health care charges associated with ankle sprains indicate the need for additional preventive measures. There are age- and sex-related differences in the prevalence of ankle sprains that suggest these demographics may be risk factors for ankle sprains.

The identification of risk factors for ankle sprains sustained during netball participation

ObjectivesAnkle sprains account for a large percentage of injuries sustained in netball. The identification of risk factors for ankle sprain is the preliminary action required to inform future prevention strategies. DesignProspective study. ParticipantsNinety-four netball players from club and inter-district teams. MethodsPreseason data were collected for; vertical jump height, perceived ankle instability, sprain history, arthrometry inversion-eversion angles, star excursion balance test reach distances, the number of foot lifts during unilateral stance and demi-pointe balance test results. Participants were followed for the duration of one netball season and ankle sprains were recorded. ResultsEleven sprains were recorded for eleven players using a time-loss definition of injury. Ankle sprains occurred at an incidence rate of 1.74/1000 h of netball exposure. One risk factor was identified to increase the odds of sustaining an ankle sprain during netball participation – a reach distance in the posterior-medial direction of the star excursion balance test of less than or equal to 77.5% of leg length (OR = 4.04, 95% CI = 1.00–16.35). ConclusionsThe identified risk factor can be easily measured and should be considered for preseason injury risk profiling of netball players. Netball players may benefit from training programs aimed at improving single leg balance.

The Prevalence of Selected Intrinsic Risk Factors for Ankle Sprain Among Elite Football and Basketball Players.

BackgroundLateral ankle sprains (LAS) are among the most common sports- related injuries and the reinjury rate is very high.ObjectivesThis study aimed to evaluate the prevalence of some intrinsic risk factors among professional football and basketball players with or without history of acute or recurrent ankle sprain.Patients and MethodsOne hundred and six professional football and basketball players who were referred for pre-participation examinations were recruited in this study. Prepared checklist was completed for each participant. Athletes were asked for any history of previous ankle sprain and the severity (based of self-description of signs and symptoms by the athlete), level and number of injuries in the last two years. All players were assessed for measures of foot posture index- 6, foot length and width, Beighton generalized joint laxity score, anterior drawer and talar tilt tests, star excursion and single leg balance tests and goniometric assessment of ankle plantarflexion, ankle dorsiflexion and first metatarsophalangeal dorsiflexion.ResultsForty eight basketball players (45.3%) and 58 football players (54.7%) with mean (SD) age of 19.8 (4.5) years participated. About 58.5% and 14.2% of athletes had a history of ankle sprain and recurrent sprain in at least one extremity, respectively. Sprains were more prevalent in basketball players and in dominant leg. There was no significant difference in assessed risk factors between athletes with and without history of ankle sprain, except for positive single leg balance test which was more prevalent in athletes with history of ankle sprain and also for positive talar tilt test and decreased ankle plantarflexion range of motion in acute and recurrent injury of left ankle.ConclusionsSome intrinsic risk factors including lateral ankle ligaments laxity, balance and ankle plantarflexion seem to be related to acute or recurrent LAS in athletes. Further research is needed to reveal the role of different arthrokinematics following lateral ankle sprain.

A new jump-landing protocol identifies differences in healthy, coper, and unstable ankles in collegiate athletes

Ankle sprains are the most common injury in sport. With stability being an important risk factor for ankle sprains, a jump-landing protocol that can elicit differences in time-to-stabilisation (TTS) is necessary. The objective of this study was to develop a jump-landing protocol that could identify differences in TTS among healthy, ‘coper’, and unstable ankles of high-level athletes. 61 Division I collegiate athletes (32 females, 29 males; age: 19.9 ± 1.2 years; height: 176.6 ± 9.5 cm; mass: 74.3 ± 10.8 kg) participated in a jump-landing protocol that utilised sporting movements with preparatory steps and a vertical propulsion of the body in two multi-directional jumps. Utilising the landing on a force plate, ground reaction forces were used to quantify TTS. TTS of the unstable group (1.58 ± 0.62s) was significantly longer than the healthy (1.19 ± 0.37s; p = 0.050) and ‘coper’ (1.13 ± 0.49s; p = 0.019) groups in the forward hops. In addition, TTS of the lateral hops in the unstable group (1.55 ± 0.63s) was also significantly longer than the healthy (1.14 ± 0.37s; p = 0.026) and ‘coper’ (1.15 ± 0.39s; p = 0.028) groups. This new jump-landing protocol was able to elicit differences in TTS in high-level athletes that were not found using previous protocols. This new jump-landing protocol could be an effective tool to identify injury risk for high-level athletes.

Paper 113: The Medial Longitudinal Arch as a Possible Risk Factor For Ankle Sprains

Paper 113: The Medial Longitudinal Arch as a Possible Risk Factor For Ankle Sprains

The Epidemiology of Ankle Sprain During Hiking in Uniformed Groups

Purpose To determine the prevalence of ankle sprain during hiking training in uniformed groups and identify the risk factors of ankle sprain and the risk factors associated with residual problems after ankle sprain. Methods A retrospective cross-sectional study involved 590 members of a uniformed group from secondary schools and their leaders by means of a self-administered anonymous questionnaire. Results The prevalence of ankle sprain was 9.15%. Most of them were lateral sprains (70.4%) and occurred in scree ground (51.9%) and downhill slope (50.0%). Subjects who are “older” aged, are overweight, are leaders in uniformed groups, have a past history of ankle sprain or problem, have a long-term lower limb injury, wear inadequate sized or tight shoes, and use hiking poles, have significant risks. The prevalence of having residual problems after ankle sprains was 48.14%, and the most common one was residual ankle pain (25.0%). Conclusion Uniformed group leaders and members should be aware of the risk factors of ankle sprain during hiking training in the countryside. They should also be aware of the importance of proper treatment and rehabilitation to prevent residual ankle problem. Level of Evidence Level II prognostic study.

The Epidemiology of Ankle Sprains in the United States

Ankle sprain has been studied in athletic cohorts, but little is known of its epidemiology in the general population. A longitudinal, prospective epidemiological database was used to determine the incidence and demographic risk factors for ankle sprains presenting to emergency departments in the United States. It was our hypothesis that ankle sprain is influenced by sex, race, age, and involvement in athletics. The National Electronic Injury Surveillance System (NEISS) was queried for all ankle sprain injuries presenting to emergency departments between 2002 and 2006. Incidence rate ratios were then calculated with respect to age, sex, and race. During the study period, an estimated 3,140,132 ankle sprains occurred among an at-risk population of 1,461,379,599 person-years for an incidence rate of 2.15 per 1000 person-years in the United States. The peak incidence of ankle sprain occurred between fifteen and nineteen years of age (7.2 per 1000 person-years). Males, compared with females, did not demonstrate an overall increased incidence rate ratio for ankle sprain (incidence rate ratio, 1.04; 95% confidence interval, 1.00 to 1.09). However, males between fifteen and twenty-four years old had a substantially higher incidence of ankle sprain than their female counterparts (incidence rate ratio, 1.53; 95% confidence interval, 1.41 to 1.66), whereas females over thirty years old had a higher incidence compared with their male counterparts (incidence rate ratio, 2.03; 95% confidence interval, 1.65 to 2.65). Compared with the Hispanic race, the black and white races were associated with substantially higher rates of ankle sprain (incidence rate ratio, 3.55 [95% confidence interval, 1.01 to 6.09] and 2.49 [95% confidence interval, 1.01 to 3.97], respectively). Nearly half of all ankle sprains (49.3%) occurred during athletic activity, with basketball (41.1%), football (9.3%), and soccer (7.9%) being associated with the highest percentage of ankle sprains during athletics. An age of ten to nineteen years old is associated with higher rates of ankle sprain. Males between fifteen and twenty-four years old have higher rates of ankle sprain than their female counterparts, whereas females over thirty years old have higher rates than their male counterparts. Half of all ankle sprains occur during athletic activity.