Evaluation of proprioception and postural control at a minimum 1 year follow-up after ankle capsuloligamentous lateralplasty with Brostrom technique

Abstract

Recovery of postural control and proprioception in patients affected by chronic ankle instability (CAI) and operated on capsulo-ligaments reconstructive surgery lacks of objective assessment. The aim of this study was to evaluate long-term post-surgical postural and proprioceptive control through the DPPS device in a cohort of patients operated on ligaments reconstruction through the modified Brostrom procedure at a minimum follow up of 12 months. Eleven patients with post-traumatic lateral CAI, operated of external capsulo-ligamentous complex repair according to Brostrom technique at a minimum follow-up of 1 year were enrolled. Physical examination and American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score. Proprioceptive and postural stability was assessed by DPPS - Delos Postural Proprioceptive System, linked to a computer with a specific software and including a flat table, an electronic unstable proprioceptive board, a Delos Vertical Controller, a monitor and a horizontal bar fitted with an infra-red sensor for hand support. Patients were 5 males and 6 females, mean age of 38.4 ± 12 years. Mean BMI of the patients was 26.8 ± 4.4. Mean follow up was 13.4 ± 2.1. The mean value of (AOFAS) clinical score was 90.3/100. Mean Static Stability Index (SSI) with open eyes was 87.7% (±7.6) in the operated leg and 90.4% (±6.1) in the contra-lateral. SSI with closed eyes was 64.5% (±11.2) in the operated leg and 61.6% (±16.8) in the contra-lateral. Mean Dynamic Stability Index (DSI) without restrictions was 56.2% (±14.6) in the operated leg and 56.8% (±10.6) in the contra-lateral. DSI with restricted upper limbs, had a mean value of 56.3% (±11.4) in the operated leg and 58.1% (±11.9) in the contra-lateral. Re-tensioning capsular-ligamentous surgery of the external compartment for CAI allow to recovery proprioceptive and postural control on the operated side, comparable with data from the contralateral limb and from the healthy population of the same age and sex.

Postural Stability and Proprioception Abnormalities in Patients with Knee Osteoarthritis

“…In the present study an innovative device for postural stability and proprioception assessment, the Delos Proprioceptive System, was used. It demonstrated providing reliable parameters as already reported in the literature [21,29,30]. In particular, the Delos system allows estimating the proprioceptive component of postural stability when standing on single stance with closed eyes.…”

“…Another limitation of the study was the lack of a matched healthy control group assessed comparatively with OA patients, which we tried to overcome comparing data from literature on the device [21]. It was not possible to make further comparisons with previous studies, since participants in other studies using the same device were different from patients with knee OA, as they were affected by other orthopedic conditions [29,30] or were in other age ranges [27].…”

“…The difference between OE and CE trials quantifies the Visual Gain, that is the visual dependence of postural stability. In order to compare data from patients to a reference healthy sample of the same age and sex, data provided by the literature [21] were used, similarly to other previously published papers [29,30].…”

The Effect of Manual Therapy Plus Exercise in Patients with Lateral Ankle Sprains: A Critically Appraised Topic with a Meta-Analysis

“…Some recent studies have highlighted the importance of proprioceptive rehabilitation in the monopodalic stance with the use of unstable electronic platforms for the prevention of ankle injuries in professional basketball players and for reductions in the number of injuries, training sessions and lost games [ 67 ]. The improvement of proprioceptive neuromuscular control and the great exposure of capsules and ligaments to repeated tensile forces increase their capacity to absorb these, perhaps when neuromuscular control is insufficient, further reducing the risk of injury [ 67 , 68 ]. With increases in age, this type of therapeutic proposal is strongly influenced by sight, suggesting that it works with closed eyes [ 69 ].…”

Mobile-Bearing Total Ankle Replacement In Vivo Kinematic Assessment: A Prospective Study Protocol

“…In previous studies, the Delos system has been used to evaluate the effect of visuo-prospective training on the risk of falls [35] as well as to train proprioception in team-sport players. Since DPPS also allows to evaluate single-stance stability, it is of crucial importance for risk assessment and rehabilitation strategies of ankle sprain or other musculoskeletal-related injuries in sports [36,37]. For the purpose of this protocol, the DPPS outcomes will be analyzed to compare the prosthetic and healthy ankle, and pre-and post-surgery.…”