Risk Of Ankle Injury Research Articles

Injury prevention programs that include balance training exercises reduce ankle injury rates among soccer players: a systematic review.

What is the effect of injury prevention programs that include balance training exercises on the incidence of ankle injuries among soccer players? Systematic review of randomised trials with meta-analysis. Soccer players of any age, sex or competition level. The experimental intervention was an injury prevention program that included balance training exercises. The control intervention was the soccer team's usual warm-up program. Exposure-based ankle injury rates. Nine articles met the inclusion criteria. The pooled results of injury prevention programs that included balance training exercises among 4,959 soccer players showed a 36% reduction in ankle injury per 1,000 hours of exposure compared to the control group with an injury risk ratio (IRR) of 0.64 (95% CI 0.54 to 0.77). The pooled results of the Fédération Internationale de Football Association (FIFA) injury prevention programs caused a 37% reduction in ankle injury (IRR 0.63, 95% CI 0.48 to 0.84) and balance-training exercises alone cause a 42% reduction in ankle injury (IRR 0.58, 95% CI 0.41 to 0.84). This meta-analysis demonstrates that balance exercises alone or as part of an injury prevention program decrease the risk of ankle injuries. PROSPERO CRD42017054450.

Correlation between Spinal Instability and Ankle Injuries in Amateur Marathon Runners

Background: Marathon running is becoming more popular among middle-aged people who have no prior running experience. Improper or incomplete knowledge increases the risk of injuries in amateur runners. Individuals with spinal instability experience alteration in balance control while walking as well as running which in turn results in asymmetrical bodyweight distribution throughout the lower extremity. This changes the pattern of running leading to injuries of hips, knees, and ankle. Methods: The objective of the study was to correlate spinal instability with ankle injuries in amateur marathon runners. In this study, both male and female amateur marathon runners between the age group of 20 and 45 years with normal body mass index (BMI) were chosen and individuals with the previous surgery as well as degenerative diseases of spine and ankle fractures were ruled out. Spinal instability tests were carried out on amateur marathon runners with symptoms of instability. Subjects were asked questions related to ankle injuries. Outcome measures used were Oswestry Disability Index (ODI) and tests for spinal instability. Results: About 57% of participants were tested positive for the passive lumbar extension test and 42% of participants were tested positive for the prone instability test. There was the presence of ankle pain (68%), ankle swelling (24%), heel pain (60%), blisters (42%), ankle sprain (28%), and strain (26%) in selected participants. There were 68% runners with minimal disability and 32% runners with moderate disability. Conclusion: Amateur marathon runners with spinal instability had the presence of ankle injuries like ankle pain, ankle swelling, heel pain, blisters, ankle sprain, and strain. Based on the test performed and interpretation of the ODI and after correlating spinal instability with ankle injuries, we concluded that spinal instability increases the risk of ankle injuries in amateur marathon runners.

Analysis of landing performance and ankle injury in elite British artistic gymnastics using a modified drop land task: A longitudinal observational study

ObjectivesTo determine whether differences in landing force and asymmetry of landing force exist between gymnasts at the time of data collection versus those that subsequently experienced an ankle injury 12-months later. Study designProspective longitudinal observational design with baseline measures and 12 month follow up. SettingBritish Gymnastics National Training Centre. ParticipantsThirty-two asymptomatic elite level gymnasts from three artistic gymnastic squads (n = 15 senior female, n = 10 junior female and n = 7 senior male). Main outcome measuresA modified drop land task was used to quantify measures of landing performance. Peak Vertical Ground Reaction Force (PVGRF) was used to measure landing force. The level of inter-limb asymmetry of landing force was calculated using the Limb Symmetry index (LSI). Other measures included injury incidence and percentage coefficient of variation (% CV). ResultsThere was no statistical difference for landing force (p = 0.481) and asymmetry of landing force (p = 0.698) when comparing injured and non-injured gymnasts. Most participants (69%) demonstrated inter-limb asymmetry of landing forces. ConclusionsOur findings observed inter-limb asymmetry of landing force in injured gymnasts, although uninjured gymnasts also exhibited asymmetry of landing force. Both magnitude of landing force and inter-limb asymmetries of landing force failed to identify the risk of ankle injury.

Impact of Physiotherapy with Unstable Platforms for the Prevention of Ankle Injuries and Improving Balance in Male Volleyball Players

Background. Ankle sprain is the most common sports injury. Conducting physiotherapy with unstable platforms efficiently decreases risk of ankle injuries and increases static and dynamic balance parameters.
 Aim. To estimate the effect of physiotherapy on balance of volleyball players and the prevention of ankle injuries.
 Methods. The study involved 10 male volleyball players, who were randomly divided into two groups: intervention (physiotherapy with unstable platforms) and control (no physiotherapy applied). Flamingo test and modified star excursion balance test were used before and after intervention. Duration of intervention – 4 weeks.
 Results. After 4 weeks of physiotherapy with unstable platforms static balance increased in intervention group subjects by 66.7% (p < 0,05); however, there were no changes in the control group. Post intervention examination showed statistically significant increase in Y balance test results in different directions, while the control group did not show any change.
 Conclusion. After a physiotherapy program with unstable platforms, static balance as well as dynamic balance increased. A 4-week physiotherapy program with unstable platforms significantly decreased the risk of ankle injuries in male volleyball players.
 Keywords: balance, ankle injury prevention, volleyball.

Immediate effects of vibration biofeedback on ankle kinematics in people with chronic ankle instability

BackgroundPeople with chronic ankle instability are more inverted during initial contact and loading response which may increase the risk of subsequent ankle injuries. Vibration feedback gait retraining causes medial center of pressure shifts but its impact on ankle kinematics remains unknown. The purpose of this study was to understand kinematic ankle changes in people with chronic ankle instability following vibration feedback gait retraining. MethodsNineteen participants with chronic ankle instability walked with vibration feedback for 10 min on a treadmill and for one mile in the real-world. A vibration stimulus occurred at the lower leg when pressure under the 5th metatarsal exceeded a threshold. Three-dimensional kinematics of the ankle were recorded in the lab before and after training. Paired t-tests compared baseline and posttest ankle, hindfoot, and forefoot positions during initial contact and loading response for the lab and real-world conditions. FindingsAfter lab training the ankle (mean difference:-1.68 ± 1.62°, effect size:0.95) and forefoot (mean difference:-1.68 ± 1.67°, effect size:0.92) were more abducted. After real-world training, the ankle (mean difference:-1.19 ± 2.12°, effect size:0.54) and forefoot (mean difference:-1.87 ± 3.00°, effect size:0.63) were more everted. Similarly the ankle (mean difference:-2.37 ± 4.79°, effect size:0.46) and forefoot (mean difference:-2.78 ± 4.91°, effect size:0.51) were more abducted after real-world training. InterpretationVibration feedback decreases inversion and adduction during loading response. However, RW compared to lab training may have more beneficial frontal plane changes for people with chronic ankle instability.

Profesyonel futbolcularda alt ekstremite kas kuvveti asimetrisi, denge ve ayak bileği yaralanma riski arasındaki ilişkinin incelenmesi

Amaç: Bu çalışmada profesyonel futbolcularda alt ekstremite kas kuvvet asimetrisi, dinamik denge ve ayak bileği yaralanma riski arasındaki ilişkinin incelenmesi amaçlandı. Yöntem: Çalışmaya 20 profesyonel erkek futbolcu dahil edildi. Bilateral dinamik dengeyi değerlendirmek için Y denge testi kullanıldı. Alt ekstremiteye ait bilateral kalça fleksör, kalça ekstansör, kalça abduktör, kalça adduktör, diz fleksör, diz ekstansör, ayak bileği dorsifleksör, ayak bileği plantar fleksör, ayak bileği evertör ve ayak bileği invertör kas gruplarının maksimal izometrik kontraksiyonu değerlendirmek için Groinbar sistemi kullanıldı. Bulgular: Çalışmaya dahil edilen oyuncuların yaş ortalaması 27,80±5,80 yıl ve vücut kütle indeksi ortalaması 24,04 ± 1,55 kg/m² olarak bulundu. Her iki ayak bileği dorsifleksör ve plantarfleksör kas grupları arasındaki oran ile denge testinde anteriorposterior bilateral fark arasında istatistiksel açıdan anlamlı sonuç elde edildi (Sol: p=0,012, rho=-0,552, Sağ: p=0, rho=- 0,727). Anterior-posterior denge farkının yaralanma riski açısından değerlendirildiğinde; kalça abduktör ve adduktör kas grupları arasındaki oran ile ayak bileği yaralanma riski açısından anlamlı korelasyon bulundu (Sol: p=0,026, rho=-0,498, Sağ: p=0,006, rho=-0,595). Sonuç: Profesyonel futbolcularda alt ekstremiteye ait plantarfleksör/dorsifleksör ve adduktör/abduktör kas gruplarının izometrik kuvvet oranının ve bilateral plantar fleksör kuvvet asimetrisinin dinamik denge ve ayak bileği yaralanma riskiyle ilişkili olduğu bulundu.

Postural Control and Functional Ankle Stability in Professional and Amateur Skateboarders.

Basic maneuvers in skateboarding, such as the ollie, put the player at high risk for ankle injuries because of the position of the feet required to perform the maneuvers. This study investigated ankle stability and reaction time for the tibialis anterior, fibularis longus, and fibularis brevis in professional and amateur skateboarders. In total, 16 professional and 16 amateur skateboarders were recruited as participants and underwent range of motion assessments, balance testing, and muscle reaction time measurements. The results revealed that professional skateboarders had a significantly smaller inversion angle compared to amateur players, which suggested better joint control and hence greater safety in the former. Balance testing results indicated better balance in professional skateboarders, and healthy skateboarders had better balance than did injured professional and amateur skateboarders. No significant difference in muscle reaction time was observed between amateur and professional skateboarders.

In Silico Finite Element Analysis of the Foot Ankle Complex Biomechanics: A Literature Review.

Computational approaches, especially finite element analysis (FEA), have been rapidly growing in both academia and industry during the last few decades. FEA serves as a powerful and efficient approach for simulating real-life experiments, including industrial product development, machine design, and biomedical research, particularly in biomechanics and biomaterials. Accordingly, FEA has been a "go-to" high biofidelic software tool to simulate and quantify the biomechanics of the foot-ankle complex, as well as to predict the risk of foot and ankle injuries, which are one of the most common musculoskeletal injuries among physically active individuals. This paper provides a review of the in silico FEA of the foot-ankle complex. First, a brief history of computational modeling methods and finite element (FE) simulations for foot-ankle models is introduced. Second, a general approach to build an FE foot and ankle model is presented, including a detailed procedure to accurately construct, calibrate, verify, and validate an FE model in its appropriate simulation environment. Third, current applications, as well as future improvements of the foot and ankle FE models, especially in the biomedical field, are discussed. Finally, a conclusion is made on the efficiency and development of FEA as a computational approach in investigating the biomechanics of the foot-ankle complex. Overall, this review integrates insightful information for biomedical engineers, medical professionals, and researchers to conduct more accurate research on the foot-ankle FE models in the future.

Incidence and prediction of ankle injury risk: a prospective cohort study on 91 contemporary preprofessional dancers

ObjectivesThis study examines the incidence of ankle injuries and identifies ankle injury risk among contemporary preprofessional dancers.MethodsA total of 91 first-year contemporary preprofessional dancers were prospectively followed during one academic...

EFFECTS OF WEARING AN ANKLE BRACE ON GROUND REACTION FORCES DURING JUMPS IN BASKETBALL GAME SIMULATION

ABSTRACT Introduction: The use of ankle braces reduces the risk of ankle injuries in basketball players. However, the mechanisms of injury protection provided by the ankle braces in the basketball game are still unknown. Objectives: To analyze the effects of wearing a lace-up ankle brace, and to conduct an exercise protocol that simulated the intensity of the basketball game on ground reaction force (GRF) during basketball-specific vertical jumps. Methods: Eleven male younger basketball players aged under 18 completed 48 vertical jumps, with and without ankle braces, during an exercise protocol composed of four 10-minute periods, simulating the activity profile and intensity of the basketball game as well as the typical intervals between periods. Mediolateral (variables: the greatest medial and lateral peaks) and vertical (variables: vertical peak, impulse peak, impulse at 50 ms of landing, loading rate and jump height) GRF were measured during takeoff and landing for all the jumps performed in the exercise protocol. Results: The use of the ankle brace reduced mediolateral GRF in all periods of the exercise protocol during takeoff and landing ( P < 0.05), without affecting the vertical GRF ( P > 0.05). Mediolateral and vertical GRF (takeoff mediolateral vertical peaks, landing mediolateral peaks, landing impulse peak, takeoff and landing loading rate) increased significantly during four subsequent 10-minute periods ( P < 0.05). However, for mediolateral GRF, the increase overtime was higher without braces. Conclusions: The use of the ankle brace reduced the mediolateral GRF on the lower limb, while there was a progressive increase in the external load applied to the body during the vertical jumps in the subsequent periods of the exercise protocol performed at the same intensity of the basketball game. Level of evidence I; Randomized clinical trial .

Plantar pressure analysis: Identifying risk of foot and ankle injury in soccer players

Plantar pressure analysis: Identifying risk of foot and ankle injury in soccer players

Health View to Decrease Negative Effect of High Heels Wearing: A Systemic Review.

Effective recommendations about how to decrease adverse effects of high heels (HH) need to be provided, since wearing HH is inevitable for most women in their daily life, regardless of their negative impacts on the foot morphology. The main purpose of this systematic review was to summarize studies which have provided specific information about how to effectively offset the negative effects of wearing HH, in the case of women, by means of examining heel height, insole, and heel base support (HBS). Some evidence indicate the following: (i) the range of appropriate heel height for HH shoes is 3.76 cm to 4.47 cm; (ii) compared to small HBS, the larger ones effectively increase gait stability, reduce risk of ankle injury, and improve comfort rating during HH walking; and (iii) the use of a total contact insert (TCI) significantly decreases plantar pressure and the impact on the foot, resulting in higher perceived comfort. It must be noted that these results are based on short-term research; therefore, any conclusions with regard to effects in the long term should be taken with a grain of salt. Nevertheless, future studies should be aimed at combining numerical and experimental methods, in order to provide personal recommendations for HH shoes by considering heel height and HBS size, based on the individual characters (weight, height, and age).

Association between lower extremity muscle strength and acute ankle injury in youth team-sports athletes

ObjectivesTo investigate lower extremity muscle strength as risk factor for an acute ankle injury in youth athletes. DesignCohort study. SettingBasketball and floorball clubs. Participants188 youth (≤21) male and 174 female athletes. Main outcome measures1RM leg press, maximal concentric isokinetic quadriceps and hamstrings as well as maximal isometric hip abductor strength were measured and athletes were followed for an acute ankle injury up to three years. Cox regression models were used in statistical analyses. ResultsIn males, greater 1RM leg press and maximal quadriceps strength increased the risk of any type of acute ankle injury (Hazard ratio [HR] for 1 SD increase, 1.63 [95% CI, 1.12–2.39] and 1.43 [95% CI, 1.01–2.01], respectively). In females, greater 1RM leg press and difference between legs in hip abduction strength increased the risk of acute non-contact ankle injury (HR for 1 SD increase, 1.44 [95% CI, 1.03–2.02] and 1.44 [95% CI, 1.03–2.00], respectively). However, ROC curve analyses showed AUC:s of 0.57–0.64 indicating “fail” to “poor” combined sensitivity and specifity of these tests. ConclusionGreater strength in both sexes along with asymmetry in hip abductor strength in females increased the risk of acute ankle injury.

Risk Factors for Lower Limb Injury in Female Team Field and Court Sports: A Systematic Review, Meta-analysis, and Best Evidence Synthesis.

Identifying risk factors for lower limb injury is an important step in developing injury risk reduction training and testing for player monitoring. Female athletes are distinct from male athletes, warranting separate investigation into risk factors. To systematically review the literature and synthesise the evidence for intrinsic risk factors for lower limb injury in female team field and court sports. Five online databases were searched from inception to April 2020. To be eligible for inclusion, studies were required to be a prospective study presenting intrinsic risk factors for lower limb injury in female team field or court sport athletes. Risk of bias was assessed using the Quality of Prognosis Studies tool. Sixty-nine studies, capturing 2902 lower limb injuries in 14,492 female athletes, and analysing 80 distinct factors met the inclusion criteria. Risk factors for any lower limb injury included greater body mass (standardised mean difference [SMD] = 0.24, 95% confidence interval [95% CI] 0.18-0.29), greater body mass index (BMI) (SMD = 0.22, 95% CI 0.05-040), older age (SMD = 0.20, 95% CI 0.09-0.31), greater star excursion balance test (SEBT) anterior reach distance (SMD = 0.18, 95% CI 0.12-0.24), and smaller single-leg hop distance (SMD = - 0.09, 95% CI - 0.12 to - 0.06). Lower knee injury and osteoarthritis outcome score (KOOS) increased the risk of knee injury. Anterior cruciate ligament (ACL) injury risk factors included prior ACL injury (odds ratio [OR] = 3.94, 95% CI 2.07-7.50), greater double-leg postural sway (SMD = 0.58, 95% CI 0.02-1.15), and greater body mass (SMD = 0.25, 95% CI 0.12-0.39). Ankle injury risk factors included smaller SEBT anterior reach distance (SMD = - 0.13, 95% CI - 0.14 to - 0.13), greater single-leg hop distance asymmetry (OR = 3.67, 95% CI 1.42-9.45), and slower agility course time (OR = 0.20, 95% CI 0.05-0.88). Remaining factors were not associated with injury or had conflicting evidence. Prior injury, older age, greater body mass, and greater BMI are risk factors for lower limb injury in female athletes. Limited evidence showed an association between KOOS, SEBT anterior reach, single-leg hop distance and asymmetry, double-leg postural sway, agility, and lower limb injury. CRD42020171973.

Sex Differences in Human Ankle Stiffness During Standing Balance.

The purpose of this study is to quantify sex differences in 2-dimensional (2D) ankle stiffness during upright standing balance and investigate the mechanisms for the differences. A dual-axis robotic platform, capable of perturbing the ankle and measuring the corresponding ankle torques in both the sagittal and frontal planes, was used to reliably quantify the 2D ankle stiffness while healthy young human subjects perform a range of standing balance tasks, specifically, ankle muscle co-contraction tasks, weight-bearing tasks, and ankle torque generation tasks. In all task conditions and in both planes of ankle motion, ankle stiffness in males was consistently greater than that in females. Among all 26 experimental conditions, all but 2 conditions in the frontal plane showed statistically significant sex differences. Further investigation on the normalized ankle stiffness, scaled by weight times height, suggests that while sex differences in ankle stiffness in the sagittal plane could be explained by sex differences in anthropometric factors as well as neuromuscular factors, the differences in the frontal plane are mostly explained by anthropometric factors. This study also demonstrates that the sex differences in the sagittal plane were significantly higher as compared to those in the frontal plane. The results in this study will provide a foundation for not only characterizing sex differences in ankle stiffness during locomotion, but also investigating sex differences in lower body stability and risk of ankle injury.

Response profile of fibular repositioning tape on ankle osteokinematics, arthrokinematics, perceived stability and confidence in chronic ankle instability

BackgroundPreliminary evidence suggests that fibular repositioning tape reduces risk of recurrent ankle injuries, but the underlying mechanism has not been investigated. ObjectiveTo investigate the effects of fibular repositioning tape on ankle osteokinematics, arthrokinematics and perceived stability and confidence in individuals with chronic ankle instability immediately post-tape and following exercise. DesignCross-sectional repeated measures study. MethodPassive ankle plantarflexion-inversion range of motion, weight-bearing dorsiflexion range of motion, anteroposterior translation, inversion-eversion tilt, and perceived ankle stability and confidence during hopping were assessed before and immediately after the application of fibular repositioning tape and after 15 min of exercise in 14 individuals with chronic ankle instability. ResultsAnkle plantarflexion-inversion range of motion, inversion-eversion tilt and anteroposterior translation were reduced immediately after the application of tape compared to pre-tape (p < 0.01). After exercise, total inversion-eversion tilt was significantly lower than pre-tape (p = 0.01), but there were no differences for any of the other mechanical outcomes. Dorsiflexion range of motion did not differ between conditions (p > 0.11). Perceived ankle stability, ankle and task confidence were greater immediately post-tape and post-exercise compared to pre-tape (p < 0.01). ConclusionsFibular repositioning tape was associated with a restriction of ankle total inversion-eversion tilt and improved perceived ankle stability and confidence both immediately after application of tape and after participating in exercise. This data provides grounds for exploring mechanical and psychological mechanisms underpinning any clinical efficacy of fibular repositioning tape.

Females Sustain more Ankle Injuries than Males in Youth Football.

This prospective study evaluated the incidence and pattern of acute injuries in youth (9- to 14-year- old) football players. Ten football clubs [n=730 players (567 males, 163 females)] participated in the 20-week follow-up study (January-June 2015). Data was collected by sending a standardized weekly SMS to players' parents/guardians with follow-up interviews for injured players. During the study period, 278 players (38%) sustained 410 acute injuries. The overall injury incidence for males and females was 6.47 (95% CI, 5.84-7.09) injuries per 1000 h of football exposure. Most injuries (40%) caused minimal absence from sports. Eighty-four percent of the injuries affected the lower extremities, with the ankle (30%), knee (17%), and thigh (16%) being the most commonly injured body sites. Females had significantly higher ankle injury rate (IRR) 1.85 (95% CI, 1.18-2.91, p=0.007) and non-contact ankle injury rate IRR 2.78 (95% CI, 1.91-4.02, p<0.001) than males. In conclusion, our results showed that the acute injury incidence among youth football is moderately high, and females are at higher risk for ankle injuries. Injury prevention programs aimed at preventing ankle injuries should be considered in the future.

Identification of Ankle Injury Risk Factors in Professional Soccer Players Through a Preseason Functional Assessment.

Background:Etiologically, the risk of an ankle injury depends on extrinsic and intrinsic factors, such as muscle strength asymmetry, decreased flexibility, and decreased proprioception, as well as patient age and history of injuries.Purpose/Hypothesis:The purpose of this study was to identify risk factors present in the preseason assessment that may predispose professional soccer players to ankle injuries. We hypothesized that analysis of these parameters could relate the incidence of injuries to the deficits found during the preseason period, enabling the identification of risk factors to predict the occurrence of injuries.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 89 professional soccer athletes were evaluated in the preseason period; the evaluation included athlete history and anthropometric data collection, an isokinetic ankle evaluation, and functional tests: the Dorsiflexion Lunge Test and Y-Balance Test (YBT). The athletes were monitored during the competitive period, and the incidence of injuries was surveyed. The association of quantitative variables and injury outcomes was analyzed using the Student t test for independent samples, with P < .05. For the association of categorical variables and injury outcomes, the chi-square test was performed, with P < .05.Results:A higher incidence of ankle injuries was associated with lower YBT scores in the dominant (P = .04) and nondominant (P = .01) limbs. A higher body mass index was also associated with a higher injury occurrence (P = .01).Conclusion:Functional tests, such as the YBT, are indicated tools for assessing the physical capacities and possible risks of ankle sprains, as they can evaluate the ankle functional capacity in a complex way, identifying athletes more prone to ankle injuries. Athletes’ body mass index should also be taken into account to prevent such injuries.

Ten-year nationwide review of netball ankle and knee injuries in New Zealand

ObjectivesTo review netball ankle and knee injuries between 2008 and 2017. DesignAudit of insurance injury claims. MethodsData were divided into 5 equal year groups (2008/9, 2010/11, 2012/13, 2014/15, 2016/17), and 3 age groups (10 to 14 years, 15 to 19 years, 20 to 24 years old). Raw injury counts and injury rates per 1000 affiliated players were reported. Changes in injury rates over the 10-year period and differences between age groups were expressed as Incident rate ratios (IRRs). A Shewhart control chart was created to identify monthly injury patterns. Results10-14-year-olds showed the biggest increase in injury counts (ankle 84% increase and knee 133% increase). 20-24-year-olds had the highest mean injury rate over the ten-years (ankle = 77.8, knee = 71.6 injuries/1000 players). 10-14-year-olds had the biggest increase in risk of injury between 2008/09 to 2016/17, (ankle IRR = 2.0; knee IRR = 2.5), 15-19-year-olds (ankle IRR = 1.4; knee IRR = 1.5), 20-24 year olds (ankle IRR = 0.5; knee IRR = 1.9). The older two groups had a significantly higher mean risk of ankle and knee injury (IRR = 1.9 to 2.2; p < 0.001). Higher than expected yearly injury incidence was repeatedly seen in 10-19-year-olds. ConclusionAnkle and Knee injuries have increased with the biggest increase in 10-19-year-olds. Injuries in 20-24-year-olds still represent the highest cost and continue at a higher rate than in younger players. Spikes in injury are likely associated with intense periods of trialling and tournament play.

Biofidelity of THOR 5th Percentile Female ATD in Ankle Eversion and Inversion

&lt;div class="section abstract"&gt;&lt;div class="htmlview paragraph"&gt;Females have higher frequency and risk of foot and ankle injuries in motor vehicle collisions than similar-sized males. Therefore, lower extremity biofidelity and accurate injury prediction of female ATDs is critical. This paper aims to compare the THOR 5th percentile female (THOR-05F) anthropomorphic test device (ATD) response with male and female PMHS data of various sizes under ankle inversion and eversion. The THOR-05F lower extremity was subjected to dynamic inversion and eversion ankle loading with a constant 2000N axial force applied through the tibia. Twelve THOR-05F tests (3 inversion and 3 eversion on both, left and right legs) were performed with boundary conditions consistent with previous post-mortem human subject (PMHS) lower extremity tests. The biofidelity of THOR-05F ankle stiffness was evaluated via comparison of measured and equal-stress equal-velocity scaled data (using mass-based scale factors) from previous PMHS datasets with mid-size males, small females and larger females. THOR-05F ankle moment-angle response falls within the range of previous mid-sized male and larger female PMHS test data for eversion, when scaled to a small female. However, when compared to PMHS response measured on small female subjects, the THOR-05F response was less stiff in both inversion and eversion. The THOR-05F moments were 65% and 90% less stiff in eversion and inversion respectively, when compared to the average of the measured small female PMHS dataset at 25&lt;sup&gt;°&lt;/sup&gt; ankle rotation. Because ATD stiffness differs from measured PMHS ankle stiffness, care should be taken when applying PMHS-based injury risk functions (IRF) to the THOR-05F ankle.&lt;/div&gt;&lt;/div&gt;