Ankle Instability Is Associated with Balance Impairments

Arnold, Brent L.; Motte, Sarah de la; Linens, Shelley W.; Ross, Scott E.

doi:10.1249/mss.0b013e318192d044

Cited by 239 publications

(186 citation statements)

References 32 publications

(51 reference statements)

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“…These functional deficits may attribute to a longer TTSML in the FAI group. A meta-analysis indicates that individuals with an unstable ankle have balance impairments 8) . Nevertheless, there is no consensus about postural deficit in the individuals with FAI.…”

Section: Time To Stabilizationmentioning

confidence: 99%

“…One of the major problems of FAI is the residual symptoms, such as the sensation of "giving way," chronic pain, and feelings of instability in the ankle 6) . It has reported that a patient with FAI may have functional deficits, such as delayed peroneus reaction time 7) , postural control deficit 8) , and positional sensing error at the ankle joint 9) . Additionally, previous studies suggested that patients with FAI have reduced peroneus longus activity 10,11) , and increased inversion of the ankle joint during a landing [11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

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Postural stability and lower leg muscle activity during a diagonal single-leg landing differs in male collegiate soccer players with and without functional ankle instability

Kunugi

Masunari

Yoshida

et al. 2017

JPFSM

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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.

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Section: Time To Stabilizationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postural stability and lower leg muscle activity during a diagonal single-leg landing differs in male collegiate soccer players with and without functional ankle instability

Kunugi

Masunari

Yoshida

et al. 2017

JPFSM

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show abstract

“…7 Hertel 8,9 first identified the overlapping nature of mechanical and functional instability and later noted that individuals with CAI have a continuum of deficits associated with the use of afferent stimuli, reflexive responses, and efferent motor control. Investigators have identified specific deficits in proprioception, 10,11 peroneal reaction time, 12,13 and postural control 14,15 in individuals with CAI. Alterations in lower extremity kinematics during gait [16][17][18][19] and jump landings 20,21 also are evident in individuals with CAI, whereas strength deficits are controversial.…”

mentioning

confidence: 99%

Lower Extremity Muscle Activation in Patients With or Without Chronic Ankle Instability During Walking

Feger

Donovan

Hart

et al. 2015

Journal of Athletic Training

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Context: Ankle sprains are among the most common musculoskeletal injuries, and many individuals with ankle sprains develop chronic ankle instability (CAI). Individuals with CAI exhibit proprioceptive and postural-control deficits, as well as altered osteokinematics, during gait. Neuromuscular activity is theorized to play a pivotal role in CAI, but deficits during walking are unclear.Objective: To compare motor-recruitment patterns as demonstrated by surface electromyography amplitudes between participants with CAI and healthy control participants during walking.Design: Descriptive laboratory study. Setting: Laboratory.Patients or Other Participants: Fifteen adults with CAI (5 men, 10 women; age ¼ 23 6 4.2 years, height ¼ 173 6 10.8 cm, mass ¼ 72.4 6 14 kg) and 15 matched healthy control adults (5 men, 10 women; age ¼ 22.9 6 3.4 years, height ¼ 173 6 9.4 cm, mass ¼ 70.8 6 18 kg).Intervention(s): Participants walked shod on a treadmill while surface electromyography signals were recorded from the anterior tibialis, peroneus longus, lateral gastrocnemius, rectus femoris, biceps femoris, and gluteus medius muscles.Main Outcome Measure(s): Preinitial contact amplitude, postinitial contact amplitude, time of activation relative to initial contact, and percentage of activation time across the stride cycle were calculated for each muscle.Results: Time of activation for all muscles tested occurred earlier in the CAI group than in the control group. The peroneus longus was activated for a longer duration across the entire stride cycle in the CAI group (36.0% 6 10.3%) than the control group (23.3% 6 22.2%; P ¼ .05). No differences were noted between groups for measures of electromyographic amplitude at either preinitial or postinitial contact (P . .05).Conclusions: We identified differences between the CAI and control groups in the timing of muscle activation relative to heel strike in multiple lower extremity muscles and in the percentage of activation time across the entire stride cycle in the peroneus longus muscle. Individuals with CAI demonstrated neuromuscular-activation strategies throughout the lower extremity that were different from those of healthy control participants. Targeted therapeutic interventions for CAI may need to be focused on restoring normal neuromuscular function during gait.

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“…Diese konzentrieren sich auf Kraftreproduktionsaufgaben der Peronealmuskulatur. Defizite konnten sowohl intraindividuell, also zwischen dem betroffenen und asymptomatischen Gelenk [21,22], als auch im Vergleich zu gesunden Kontrollprobanden [23,24] in jüngerer Vergangenheit mehrfach metaanalytisch zusammengefasst [14,[25][26][27]. Übereinstimmend wurden bei Personen mit funktioneller Sprunggelenkinstabilität Beeinträchtigungen der statischen und dynamischen posturalen Kontrolle nachgewiesen, die berichteten Effektstärken sind als klein bis moderat einzuschätzen (standardisierte Mittelwertdifferenz 0,3-0,6).…”

Section: Propriozeptionunclassified

“…Bislang besteht jedoch kein Konsens bez. der Messverfahren mit dem höchsten diagnostischen Wert zur Identifikation von Defiziten der Haltungskontrolle [25,28,29]. …”

Section: Propriozeptionunclassified

Beeinträchtigungen der sensomotorischen Kontrolle bei funktioneller Sprunggelenkinstabilität

Steib

Pfeifer

2015

Z Orthop Unfall

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!Lateral ankle sprains are among the most common sports injuries, with a prevalence of 25 to 30 % of all injuries. At least one-third of individuals develop long-term complaints and chronic instabilities at the ankle, which in many cases cannot be attributed to mechanical insufficiencies of the joint. This condition is referred to as functional ankle instability (FAI). Impairments of the sensorimotor control system, such as disturbed proprioception and postural control, as well as reduced muscle strength and reflex activity, have been suggested to contribute to the aetiology of FAI. This review summarises the current body of literature regarding sensorimotor control in individuals with FAI. We discuss the results in the context of current neurophysiological models of the development of functional joint instabilities.

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Ankle Instability Is Associated with Balance Impairments

Abstract: FAI is associated with impaired balance. Due to the relatively large effect sizes and simplicity of use of time in balance and foot lifts, we recommend that further research should establish their clinical validity and clinical cutoff scores.

Cited by 239 publications

References 32 publications

Postural stability and lower leg muscle activity during a diagonal single-leg landing differs in male collegiate soccer players with and without functional ankle instability

Postural stability and lower leg muscle activity during a diagonal single-leg landing differs in male collegiate soccer players with and without functional ankle instability

Lower Extremity Muscle Activation in Patients With or Without Chronic Ankle Instability During Walking

Beeinträchtigungen der sensomotorischen Kontrolle bei funktioneller Sprunggelenkinstabilität

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