Identifying Range-of-Motion Deficits and Talocrural Joint Laxity After an Acute Lateral Ankle Sprain

Abstract

Context Approximately 72% of patients with an ankle sprain report residual symptoms 6 to 18 months later. Although 44% of patients return to activity in less than 24 hours after experiencing a sprain, residual symptoms should be evaluated in the long term to determine if deficits exist. These residual symptoms may be due to the quality of ligament tissue and motion after injury. Objective To compare mechanical laxity of the talocrural joint and dorsiflexion range of motion (DFROM) over time (24 to 72 hours, 2 to 4 weeks, and 6 months) after an acute lateral ankle sprain (LAS). Design Cross-sectional study. Setting Athletic training research laboratory. Patients or Other Participants A total of 108 volunteers were recruited. Fifty-five participants had an acute LAS and 53 participants were control individuals without a history of LAS. Main Outcome Measure(s) Mechanical laxity (talofibular interval and anterior talofibular ligament length) was measured in inversion (INV) and via the anterior drawer test. The weight-bearing lunge test was conducted and DFROM was measured. The data were analyzed using repeated-measures analysis of variance, independent-samples t tests, and 1-way analysis of variance. Results Of the 55 LASs, 21 (38%) were grade I, 27 (49%) were grade II, and 7 (13%) were grade III. Increases were noted in DFROM over time, between 24 and 72 hours, at 2 to 4 weeks, and at 6 months (P < .05). The DFROM was less in participants with grade III than grade I LASs (P = .004) at 24 to 72 hours; INV length was greater at 24 to 72 hours than at 2 to 4 weeks (P = .023) and at 6 months (P = .035) than at 24 to 72 hours. The anterior drawer length (P = .001) and INV talofibular interval (P = .004) were greater in the LAS group than in the control group at 6 months. Conclusions Differences in range of motion and laxity were evident among grades at various time points and may indicate different clinical responses after an LAS.

Construction and Validation of a Risk Prediction Nomogram Model for Different Sites of Ankle Pain in Patients with Chronic Ankle Instability Using the OpenSim Environment

“…This is caused by the disruption of the structure of the anterior talo bular ligament due to grade II or III ankle sprains, which could lead to the formation of scar tissue during the ligament-remodelling phase. The scar tissue in the damaged ligament is less mobile than the intact ligament, and may lead to anterior movement of the talus, which reduces the range of motion (ROM) during ankle dorsi exion 25 . However, studies have consistently shown that the ankle dorsi exion ROM during running should be at least 20°~30°2 5 .…”

Reliability and validity of ultrasonographic automated length measurement system for assessing talofibular anterior instability in acute lateral ankle sprain

“…The sample size was calculated by an a priori power analysis using the G*Power (version 3.1). Based on an α of 0.05, a power of 0.80, and an effect size of 0.46 and with respect to the results of a previous sonography study 6 , size analysis indicated that a total sample size of 39 would be required to demonstrate a significant difference in the paired t test. 2.…”

“…There is no evidence indicating which type of conservative treatment is more effective for patients with acute LAS 5 . Although the severity of LAS is determined by the magnitude of the ligament rupture and the level of the ankle joint mechanical instability, limit evidence is available that quantifies the degree of the ankle joint mechanical instability for patients with acute LAS 6 . This poses a problem in understanding the severity of LAS, which is central to the clinician’s decision-making process regarding specific rehabilitation protocols and the time needed to return to play 6 .…”

“…Although the severity of LAS is determined by the magnitude of the ligament rupture and the level of the ankle joint mechanical instability, limit evidence is available that quantifies the degree of the ankle joint mechanical instability for patients with acute LAS 6 . This poses a problem in understanding the severity of LAS, which is central to the clinician’s decision-making process regarding specific rehabilitation protocols and the time needed to return to play 6 . Quantifying the degree of ankle joint mechanical instability in patients with acute LAS could be crucial to the development of a functional diagnosis and enhanced rehabilitation protocols.…”

“…to return to play 6 . Quantifying the degree of ankle joint mechanical instability in patients with acute LAS could be crucial to the development of a functional diagnosis and enhanced rehabilitation protocols.…”