Purpose To study validity and reliability of a Japanese version of the Cumberland Ankle Instability Tool and to determine the optimal cutoff score. Methods In this study, the questionnaire was cross-culturally adapted into Japanese. The psychometric properties tested in the Japanese version of the CAIT were measured for criteria validity, internal consistency and test-retest reliability in 111 collegiate soccer athletes. We also established the questionnaire cutoff score for discriminating between individuals with and without CAI. Results There was a significant correlation between the Japanese version of the CAIT and the Karlsson score (r = 0.604, p < 0.001). The questionnaire had a high internal consistency (Cronbach's α = 0.833) and reliability [intraclass correlation coefficient (ICC) = 0.826, 95% confidence interval (CI): 0.732-0.888]. The optimal cutoff score was ≤25, which was consistent with previous reports. Conclusions The Japanese version of the CAIT has been shown to be a valid and reliable questionnaire for determining the presence of CAI. We expect that researchers and clinicians will use the Japanese version of the CAIT in Japan. Implications for Rehabilitation Chronic Ankle Instability (CAI), which not only increases recurrence rate of ankle sprain but also decreases athletic performance, is a residual symptom after ankle sprain. Cumberland Ankle Instability Tool, which has the reliability and validity to assess CAI, will be critically useful in assessment procedure for CAI. It is preferable for clinicians and researchers to use the native language version of the CAIT.

BackgroundThe purpose of this study is to examine the effects of different strike forms, during cutting, on knee joint angle and lower limb muscle activity.MethodsSurface electromyography was used to measure muscle activity in individuals performing cutting manoeuvres involving either rearfoot strikes (RFS) or forefoot strikes (FFS). Three-dimensional motion analysis was used to calculate changes in knee angles, during cutting, and to determine the relationship between muscle activity and knee joint angle. Force plates were synchronized with electromyography measurements to compare muscle activity immediately before and after foot strike.ResultsThe valgus angle tends to be smaller during FFS cutting than during RFS cutting. Just prior to ground contact, biceps femoris, semitendinosus, and lateral head of the gastrocnemius muscle activities were significantly greater during FFS cutting than during RFS cutting; tibialis anterior muscle activity was greater during RFS cutting. Immediately after ground contact, biceps femoris and lateral head of the gastrocnemius muscle activities were significantly greater during FFS cutting than during RFS cutting; tibialis anterior muscle activity was significantly lower during FFS cutting.ConclusionsThe results of the present study suggest that the hamstrings demonstrate greater activity, immediately after foot strike, during FFS cutting than during RFS cutting. Thus, FFS cutting may involve a lower risk of anterior cruciate ligament injury than does RFS cutting.

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Our findings indicate the presence of an association between the CAIT-J score and TTSML, as well as postural stability deficits in collegiate soccer players with FAI during diagonal landings.

The purpose of this study was to investigate postural stability and lower leg muscular activity in male collegiate soccer players with functional ankle instability (FAI), during a diagonal landing. Twenty-two male collegiate soccer players were divided into an FAI group (n = 11) and healthy control group (n = 11). Muscle reaction times for sudden ankle inversion were measured to evaluate neuromuscular control in the peroneus longus (PL), peroneus brevis (PB), tibialis anterior (TA), gastrocnemius lateral head (GL), and gastrocnemius medial head (GM). Time to anteroposterior stabilization (TTSAP), time to mediolateral stabilization (TTSML), and activity of these muscles during a diagonal single-leg landing was measured. Reaction times in the peroneus muscles were delayed in the FAI group, compared to the control group (PL: P < 0.01, PB: P = 0.02). TTSML was increased in the FAI group, compared to the control group (P = 0.02). Muscular activity of PL, PB, and TA were reduced in the FAI group, compared to controls, during a diagonal single-leg landing (PL: P < 0.05, from 87 ms pre-initial contact [pre-IC] to 108 ms post-initial contact [post-IC], PB: P < 0.05, from 180 ms pre-IC to 123 ms post-IC, TA: P < 0.05, from 65 ms to 203 ms post-IC). Male collegiate soccer players with FAI had increased TTSML and reduced muscle activity in PL, PB, and TA during diagonal single-leg landing. It is important for clinicians to assess the postural stability and function of the lower leg muscle activity, during rehabilitation after ankle sprains.

Ankle inversion sprains are the most common football-related injuries. About 74% of patients with residual symptoms such as general ankle instability, the ankle suddenly giving way, or recurrent ankle sprains, may develop chronic ankle instability. Balance training is a common rehabilitation procedure used after an ankle sprain. However, the influence of balance training on the muscle reaction time and muscle chain reaction is still unclear. Accordingly, this study examines how balance training influences muscle reaction time and muscle chain reaction. This controlled laboratory study involved 33 male college football players assessed for existence/non-existence of ankle functional instability (FI). The subjects were then divided into a group of 12 players with FI who underwent balance training (FI group), 12 players without FI who underwent balance training (Con group), and 9 players without FI who did not undergo balance training (NTr group). Muscle reaction times during ankle varus simulation with Trapdoor were measured. The main effect was seen between the peroneus muscle group and anterior tibialis muscle in the Con and NTr groups. In the FI group, no significant main effect on the muscle was seen, but the main effect on intervention period was significant. Balance training reduced the muscle reaction time of the FI group. Results suggest that balance training may improve muscle reaction time. However, the absence of a significant difference between the peroneus muscle group and anterior tibialis muscle in the FI group after balance training indicates that the muscle chain reaction did not recover to the level of an uninjured leg.

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The purpose of this study was to compare angular change and translational motion from the medial longitudinal arch (MLA) and lateral longitudinal arch (LLA) during running between medial tibial stress syndrome (MTSS) and non-MTSS subjects. A total of 10 subjects volunteered, comprising 5 subjects with MTSS and 5 subjects without injury (non-MTSS) as the control group. All subjects performed the test movement that simulated running. Fluoroscopic imaging was used to investigate bone movement during landing in running. Sagittal motion was defined as the angular change and translational motion of the arch. A Mann-Whitney U-test was performed to determine the differences in the measured values between the MTSS and non-MTSS groups. The magnitude of angular change for the MLA and LLA was significantly greater for subjects with MTSS than for control subjects. Translational motion of the MLA and LLA of the MTSS group was also significantly greater than that of the non-MTSS group (all p < 0.05). Soccer players with MTSS have an abnormal structural deformation of foot during support (or stance) phase of running, with a large decrease in both the MLA and LLA. This abnormal motion could be a risk factor for the development of MTSS in these subjects.