BackgroundAnkle arthrometers are available to objectively assess ankle joint laxity and range-of-motion, and have been useful in the research environment. This study is unique in that our institution has access to two of the same ankle arthrometers, which enabled us to efficiently study both the reliability and validity of the derived joint laxity measurements.ObjectiveTo estabilish the reliability and validity of instrumented ankle arthrometer measurements from two identical ankle arthrometers.DesignA crossover study design where both examiners tested each subject with one arthrometer the first session and the other arthrometer the second session.SettingAthletic training research laboratory.ParticipantsNineteen participants (6 male, 13 female, age = 21.4 ± 3.3 years, height = 168.0 ± 8.8 cm, body mass = 66.4 ± 12.0 kg) with no history of ankle injuries.InterventionsAnkle arthrometry measurements were performed on two separate occasions, separated by at least seven days. Two identical ankle arthrometers (Blue Bay Research Inc., Milton, FL) were used by two different examiners. Both examiners tested each participant with one arthrometer in the first session and with the other arthrometer in the second session. Anterior displacement (mm) and inversion/eversion rotation (deg) were assessed utilising both ankles. Measurements were analysed using LabVIEW software (National Instruments, Austin, TX). Examiners were blinded to the results of their own measurements to reduce bias.Main outcome measurementsDependent variables included anterior displacement and inversion/eversion rotation. The independent variables were arthrometer and examiner. Reliability and validity were determined using interclass correlation coefficients (ICC).ResultsICC’s for inter-rater reliability (left) and intra-rater reliability (right) are provided in the table below. The highest inter-rater reliability was 0.97 (left inversion). The lowest inter-rater reliability was 0.80 (left anterior displacement). Intra-rater reliability values varied from 0.25 (left anterior) to 0.92 (right inversion).ConclusionsThis study confirms previous reports supporting the reliability of ankle arthrometry measurements. However, inconsistencies in the ICC values, especially those for anterior displacement, question the validity of the measurements derived from the two identical arthrometers.
BackgroundStrength training interventions have long been a cornerstone of ankle injury rehabilitation, with greater emphasis on the eccentric (ECC) muscle actions necessary for coordinated ankle movements. Deficits in strength between involved and uninvolved ankles typically exist following an acute ankle sprain; while these same deficits have also been implicated as a contributing factor to the development and persistence of chronic ankle instability (CAI).ObjectiveTo compare ECC isokinetic ankle strength measures between athletes with and without CAI after a history of unilateral ankle sprain.DesignCross-sectional.SettingAthletic training research laboratory.ParticipantsA total of 135 male and female student-athletes participating in the high risk sports of football, basketball, lacrosse, soccer, field hockey, and volleyball with histories of unilateral ankle sprain.InterventionsThe independent variables were group classification (CAI, stable) and limb (involved, uninvolved). Subjects completed the Cumberland Ankle Instability Tool (CAIT) to define group classification with subjects scoring <25 being classified as CAI and those scoring >25 being classified as stable.Main outcome measurementsECC isokinetic peak torque (PT) values were collected using a KinCom isokinetic dynamometer during plantar flexion (PF), dorsiflexion (DF), inversion (INV), and eversion (EV) and movements at both 30˚/s and 120˚/s. 2 × 2 ANOVAs were used to compare group (CAI, stable) and limb (involved, uninvolved) for each dependent variable.ResultsA significant main effect was present for ECC INV at 30˚/s (p = 0.033). The uninvolved side (26.9 ± 10.9 Nm) was stronger than the involved side (25.3 ± 9.6 Nm). A trend towards significance existed for the ECC PF, with the uninvolved side appearing to be stronger at 30˚/s (229.9 ± 74.5 Nm, p = 0.095) and 120˚/s (218.4 ± 7 9.8 Nm, p = 0.106) than the involved limb (30˚/s = 223.8 ± 82.4 Nm; 120˚/s = 207.3 ± 82.0 Nm). A similar trend was observed when examining ECC INV values at 120˚/s (p = 0.100) and ECC DF at 120˚/s (p = 0.098). Interestingly, there were no significant differences between any of the group comparisons.ConclusionsECC ankle strength does not differentiate whether an athlete has CAI, but the musculature on the involved ankle appears to be weak compared to the opposite uninvolved limb. Our results add to the growing evidence suggesting that neuromuscular deficits other than strength are likely producing the chronic signs and symptoms associated with CAI.
BackgroundWhile ankle taping is a preferred method of external prophylactic support, its mechanical efficiency significantly declines during exercise. The Under Armour® Highlight cleat is marketed on the premise that it is lightweight and wraps your foot and ankle in a “second skin” for added support without the need for additional ankle taping.ObjectiveTo determine if differences in ankle joint laxity and postural control exist between football players wearing the Under Armour® Highlight cleat as compared to a low or mid-top cleat with ankle tape.DesignA crossover study.SettingAthletic training room and football practice field sideline.ParticipantsTwenty-one male intercollegiate football players (age = 19.6 ± 0.9 years, height = 187.4 ± 6.7 cm, body mass 98.9 ± 13.3 kg). All participants were free from any lower extremity injuries at the time of the study.InterventionsAnkle laxity was assessed using an instrumented ankle arthrometer (Blue Bay Research Inc., Milton, FL), while balance testing was performed on the Tekscan MobileMat™ BESS (Tekscan, South Boston, MA). The two treatments included Under Armour® Highlight cleats (session 1); while in the other session (session 2) participants wore an Under Armour® low/mid-cut cleat with ankle tape on the non-dominant ankle only.Main outcome measurementsThe independent variable was cleat type (Highlight vs low/mid with ankle tape). Dependent variables included anterior displacement (mm), inversion/eversion rotation (deg), and single-leg and tandem stance BESS error scores. Double-leg firm and foam surface stances were not analysed.ResultsA linear mixed-effects regression model was used for analysis. The mid/low-cut cleat with tape condition had significantly higher inversion/eversion rotation post-exercise when compared to the Highlight cleat (b = 4.05, df = 22.12, t = 3.866, p = 0.001). No other significant differences were derived with the other dependent variables.ConclusionsThe results of this study provide some evidence that the Under Armour® Highlight cleat restricts inversion/eversion rotation following a training session better than the taped low/mid-cut cleat. Further study is warranted to determine if this high-top style of football cleat can reduce the incidence of ankle sprains and how it might compare to spat taping.
Study DesignResearch report- retrospective cohort.ObjectivesTo determine if differences in Y-Balance Test (YBT) scores exist between those that have sustained an ankle sprain (AS) and those that have not (C).BackgroundAnkle sprains are one of the most common injuries occurring in an athletic population. Many factors may contribute to the occurrence of an ankle sprain, including poor movement strategies and deficits in dynamic postural control.Methods and MeasuresThirty-six (30 male, 6 female) university student-athletes (age=18.4±0.7 years., height=178.2±6.8 cm, mass=88.6±20.8 kg); with AS (n=18) and C (n=18) participated. Single-limb reach distance was tested using the YBT in three reach directions; anterior (ANT), posteromedial (PM), and posterolateral (PL). Differences between limbs in each direction (ANTdiff, PMdiff, PLdiff) and the composite scores (COMPdiff), relative to limb length, were calculated. Our independent variable was group (AS vs. C) and the dependent variables included ANTdiff, PMdiff, PLdiff, and COMPdiff. Separate independent T-test analyses were performed to determine differences between means.ResultsThere was a significant difference in COMPdiff between AS (3.67%±2.51%) and C (2.35%±1.11%, p=0.05, t=3.57) and a moderate effect size (Cohen’s d=0.68). There were no significant differences in ANTdiff, PMdiff, or PLdiff.ConclusionsThe difference in percentages between the two groups demonstrates the asymmetry present between the limbs. We can conclude that student-athletes with larger asymmetries in composite YBT scores may have sensorimotor impairments prior to an ankle sprain, leading to a difference in dynamic balance between their limbs. Unequal dynamic balance during activity may lead to the potential of further injury. This finding has a meaningful impact to clinicians that may implement this easy-to-use tool to determine the potential of developing a subsequent ankle sprain.
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