Chronic ankle instability (CAI) is characterized by impaired ankle joint position sense (JPS) and compromised balance. Despite previous studies investigating the correlation between ankle JPS and balance in individuals with CAI, the potential mediating effect of pain in this relationship remains unclear. Understanding the role of pain as a mediator between ankle JPS and balance could provide valuable insights into the complex interplay among these variables in individuals with CAI. Therefore, further research is needed to elucidate the mediating effect of pain and its implications in assessing and managing ankle JPS and balance deficits in individuals with CAI. This cross-sectional study aimed to investigate the mediating role of pain in the association between ankle JPS and balance in individuals with unilateral CAI. Methods: Fifty-five individuals diagnosed with CAI participated in this study. Ankle JPS was assessed using a digital inclinometer, whereas the balance was measured using a computerized dynamic posturography device. Results: Participants with CAI showed impaired ankle JPS in the affected leg compared to that in the asymptomatic leg (p < 0.001). Ankle JPS errors were greater in both dorsiflexion and plantarflexion directions in the CAI. Balance was compromised in the CAI leg (p < 0.001). Moderate correlations (p < 0.001, r = 0.31 to 0.48) were found between the balance variables. Pain significantly mediated the ankle JPS-balance relationship in the CAI (p < 0.05, Sobel test). The findings suggest that individuals with CAI exhibit impaired ankle JPS and compromised balance. Pain plays a mediating role in the association between ankle JPS and balance in individuals with CAI. These results highlight the importance of considering pain as a potential mediator when assessing and treating balance issues in individuals with CAI. Healthcare professionals should incorporate assessments of ankle JPS and pain into the management of interventions that address these factors and improve balance and functional ability.
SUMMARY: Osteoarthritis (OA) caused by ageing joints or as a secondary complication of diabetes is a common health problem. We sought to develop an animal model of OA induced by a combination of the chondrocyte glycolytic inhibitor mono-iodoacetate (MIA) and streptozotocin (STZ), the agent that induces diabetes mellitus. We then hypothesized that the extent of damages to the knee joint induced by this model can be greater than OA induced by either MIA or STZ. Rats were either injected with MIA (model 1) or STZ (model 2) or both agents (model 3). After 8 weeks, harvested tissues from the knee joint of these groups were examined using scanning and transmission electron microscopy. In addition, blood samples were assayed for tumor necrosis factor alpha (TNF-α) and interleukin -6 (IL-6) that are known to be modulated in OA and diabetes. Compared to control group, substantial damages to the articular cartilage of the knee joint were observed in the three models with the severest in model 3. In addition, rats in model 3 showed significant (P<0.0001) increase in TNF-α and IL-6 compared to model 1 and 2. Thus, we have developed a new model of knee OA in rats that mimics a type of OA that is common among elderly people who have both, "ageing" joints and diabetes.
Subacromial Impingement Syndrome (SAIS) is a common shoulder condition characterized by pain and functional impairment. Proprioception, the sense of joint position and movement, is crucial in maintaining joint stability and coordinating movements. The relationship between shoulder proprioception, pain intensity, and functional disability in individuals with SAIS remains unclear, with conflicting findings in the literature. This cross-sectional study aimed to evaluate shoulder proprioception, examine its correlation with pain intensity and functional disability, and contribute to our understanding of the clinical implications of proprioceptive deficits in individuals with SAIS. Forty-two individuals were diagnosed with SAIS, and an equal number of asymptomatic controls were recruited. Shoulder proprioception was assessed using a digital inclinometer, measuring joint position sense at various angles of flexion and rotation. Pain intensity was measured using the Visual Analog Scale (VAS), and functional disability was assessed using the Shoulder Pain and Disability Index (SPADI). Results: Individuals with SAIS exhibited significantly higher joint position error (JPE) values compared to asymptomatic controls in all measured angles of flexion and rotation (p < 0.001). Strong positive correlations were observed between JPE and pain intensity (r = 0.61 to 0.71, p < 0.01) and disability (r = 0.56 to 0.68, p < 0.01). These findings suggest impaired shoulder proprioception is associated with higher pain intensity and functional disability in SAIS. This study provides evidence of impaired shoulder proprioception in individuals with SAIS and its correlation with pain intensity and functional disability. The results highlight the clinical relevance of proprioceptive deficits in SAIS and emphasize the importance of incorporating proprioceptive assessment and targeted rehabilitation interventions into managing this condition. Future research should focus on longitudinal studies with larger and more diverse samples to further understand the underlying mechanisms and evaluate the effectiveness of proprioceptive interventions in improving outcomes for individuals with SAIS.
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