Ankle Strength Deficits in a Cohort of College Athletes With Chronic Ankle Instability

Wisthoff, Bethany; Matheny, Shannon; Struminger, Aaron; Gustavsen, Geoffrey; Glutting, Joseph J.; Swanik, C. Buz; Kaminski, Thomas W.

doi:10.1123/jsr.2018-0092

Cited by 13 publications

(10 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Comparable to our data, several studies have provided evidence that concentric pronation and supination strength are impaired in CAI [10][11][12]. The novel finding in this study was that the joint angle in which the maximum pronation strength can be produced is significantly different between the two ankles (MAI 14°vs.…”

Section: Discussionsupporting

confidence: 50%

“…Furthermore, a recent systematic review found that impairments of peroneal reaction time and pronation strength strongly contribute to perceived ankle instability in a chronic population [10]. Also, strength deficits resulting from ankle injuries have been described especially in plantarflexion and pronation strength, while dorsiflexion and supination strength seems to remain rather unaffected [11,12]. It is thought that spinal and cortical pathways may lead to an inhibition of neuromuscular activity and thus contribute to these persisting deficiencies in CAI patients [13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Functional deficits in chronic mechanical ankle instability

Gehring

Mauch³

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background: The interaction of functional and mechanical deficits in chronic ankle instability remains a major issue in current research. After an index sprain, some patients develop sufficient coping strategies, while others require mechanical support. This study aimed to analyze persisting functional deficits in mechanically unstable ankles requiring operative stabilization. Methods: We retrospectively analyzed the functional testing of 43 patients suffering from chronic, unilateral mechanical ankle instability (MAI) and in which long-term conservative treatment had failed. Manual testing and arthroscopy confirmed mechanical instability. The functional testing included balance test, gait analysis, and concentric-concentric, isokinetic strength measurements and was compared between the non-affected and the MAI ankles. Results: Plantarflexion, supination, and pronation strength was significantly reduced in MAI ankles. A sub-analysis of the strength measurement revealed that in non-MAI ankles, the peak pronation torque was reached earlier during pronation (maximum peak torque angle at 20°vs. 14°of supination, p < 0.001). Furthermore, active range of motion was reduced in dorsiflexion and supination. In balance testing, patients exhibited a significant increased perimeter for the injured ankle (p < 0.02). During gait analysis, we observed an increased external rotation in MAI (8.7 vs. 6.8°, p<0.02). Conclusions: This study assesses functional deficits existent in a well-defined population of patients suffering from chronic MAI. Impairments of postural sway, gait asymmetries, and asymmetric isokinetic strength can be observed despite long-term functional treatment. The finding that pronation strength is particularly reduced with the foot in a close-to-accident position indicates potential muscular dysfunction in MAI. Possibly, these deficits alongside the underlying mechanical instability characterize patients requiring mechanical stabilization.

show abstract

Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Functional deficits in chronic mechanical ankle instability

Gehring

Mauch³

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…Specifically, participants with CAI had significantly reduced plantarflexion and dorsiflexion ROM, inversion and eversion strength, and muscular endurance as assessed in two different single leg heel raise tests. These findings are consistent with previous research, whereby deficits in a variety of measures of ankle function have been observed in individuals with CAI ( Gribble et al, 2014 ; Silva et al, 2013 ; Wisthoff et al, 2019 ).…”

Section: Discussionsupporting

confidence: 93%

Ability of functional performance assessments to discriminate athletes with and without chronic ankle instability : a case-control study

Jamsandekar

Patel

Prabhakar

et al. 2022

PeerJ

View full text Add to dashboard Cite

Background The decline in motor function associated with chronic ankle instability (CAI) can be assessed using Functional Performance tests. Ankle muscular strength, endurance and range of motion (ROM) has been assessed in previous studies but functional activities such as sprinting and change of direction are less well studied in athletes with CAI. Hence the aim of this study was to determine how sprint, change of direction, ankle isometric strength, endurance and ROM measures may be associated with discriminate athletes with and without CAI. Methods One hundred and six participants (CAI: n = 53 or no CAI: n = 53) provided informed consent to participate in this study. Participants performed three functional performance tests, (30-m sprint test, Modified Illinois change of direction test (MICODT)) and change of direction test. Range of motion for dorsiflexion was measured using weight bearing lunge test and inversion, eversion and plantarflexion using Saunders® digital inclinometer. Strength was assessed using Baseline® hand-held dynamometer for plantarflexors, dorsiflexors, invertors and evertors. Muscular endurance was assessed by single heel raise test and Modified single heel raise test. Between-group comparisons utilised Student’s t-test and Mann-Whitney U-tests, with a number of unique variable and multivariable binomial logistic regression performed to determine which performance measures may discriminate participants with CAI. Results The CAI participants performed significantly worse in the three functional performance tests as well as multiple measures of ankle ROM, isometric strength and muscular endurance (p < 0.008). While several measures of ROM (plantarflexion and dorsiflexion), strength (inversion and eversion) and both muscular endurance tests were significantly associated with CAI in the univariable analysis, the strongest association was the functional performance tests, especially MICDOT time (odds ratio (95% CI): 0.06 [0.02–0.17], sensitivity 94.3%, specificity 88.7%). Multivariable regression analyses indicated that performance across the functional performance tests were more strongly associated with CAI than any ankle ROM, muscular strength or endurance test. Further, the inclusion of the best ankle range of motion, strength or muscular endurance tests did not significantly improve upon the association of the MICDOT with CAI. Conclusions Chronic ankle instability in athletic populations appears to be highly associated with declines in functional performance and to a somewhat lesser extent, ankle range of motion, strength and muscle endurance measures. This may suggest that optimal rehabilitation for athletes with CAI may require a greater focus on improving sprinting speed and change of direction ability in the mid to latter stages of rehabilitation, with regular assessments of these functional performance tests necessary to guide the progression and overload of this training.

show abstract

“…6,7 An association with functional instability scores for CAI has also been reported. 8 Structural changes at the ligament and bone level due to childhood LAS may be associated with progression to CAI secondary to LAS.…”

Section: Introductionmentioning

confidence: 99%

Lateral Ankle Sprains and Their Association with Physical Function in Young Soccer Players

Murata

Kumai

Hirose

2021

OAJSM

View full text Add to dashboard Cite

Purpose: Lateral ankle sprain (LAS) in childhood can result in lateral malleolus avulsion fractures; additionally, bone nonunion may occur. Physical maturity relates to the development of bone morphology and physical functionality. It is unknown how changes in physical functionality attributable to physical maturity affect young soccer players with abnormal lateral malleolus (ALM) morphology. Hence, the present study aimed to investigate the bone morphology of the lateral malleolus in young soccer players and to examine its relationship with physical functionality at different maturity levels. Subjects and Methods: Two hundred and ninety young soccer players aged 6-15 years were included. The presence of ALM was assessed using ultrasonography. The subjects were allocated to three groups based on physical maturity (Pre-, Mid-, and Post-peak height velocity age [PHVA]). The prevalence of ALM and the relationship between ALM and physical maturity were examined for body composition, foot pressure distribution, foot alignment, ankle mobility, and single-leg balance. Results: The prevalence of ALM was 17.6%. For physical maturity, the post-PHVA group showed a decrease in ankle dorsiflexion and eversion and an increase in one-leg hop distance compared to the Pre-PHVA group (P < 0.05). In the ALM group, the center of pressure during heel raising was distributed laterally in the Post-PHVA (P < 0.01), and the weightbearing dorsiflexion angle was decreased in the Mid-and Post-PHVA (P < 0.05). Conclusion:In the Post-PHVA young soccer players, decreased ankle dorsiflexion and eversion and increased one-leg hop distance were observed. The ALM group exhibited lateral loading during heel raising in the Post-PHVA group and decreased weight-bearing ankle dorsiflexion angle in the Mid-and Post-PHVA groups. The findings indicate the importance of secondary prevention of LAS and ultrasonography. Prospective studies of LAS in young athletes are required in the future.

show abstract

Ankle Strength Deficits in a Cohort of College Athletes With Chronic Ankle Instability

Abstract: Collegiate athletes who present with mechanical laxity on a previously injured ankle exhibit PF and EV strength deficits between ankles.

Cited by 13 publications

References 39 publications

Functional deficits in chronic mechanical ankle instability

Functional deficits in chronic mechanical ankle instability

Ability of functional performance assessments to discriminate athletes with and without chronic ankle instability : a case-control study

Lateral Ankle Sprains and Their Association with Physical Function in Young Soccer Players

Contact Info

Product

Resources

About