Inertial sensors-based assessment to detect hallmarks of chronic ankle instability during single-leg standing: Is the healthy limb “healthy”?

Deodato, Manuela; Coan, Lorenzo; Buoite Stella, Alex; Ajčević, Miloš; Martini, Miriam; Di Lenarda, Luca; Ratti, Chiara; Accardo, Agostino; Murena, Luigi

doi:10.1016/j.clinbiomech.2023.106036

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Moreover, future studies should examine the balance variable not only on the leg with CAI but also on the contralateral “healthy” leg. This approach is essential due to the “bilateral consequences of unilateral injury” hypothesis, which suggests that unilateral injury could lead to bilateral consequences, resulting in altered postural control on the “healthy” limb due to a general reorganization of the sensorimotor system [ 55 ]. By considering both limbs, researchers can gain a more comprehensive understanding of the effects of injury on balance and motor control.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of External Verbal Feedback on Balance in Athletes with Chronic Ankle Instability

Parlakidis,

Kontopoulos,

Mandalidis

et al. 2024

JFMK

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Chronic ankle instability (CAI) is characterized by muscle weakness and impaired neuromuscular control. This study aimed (a) to assess the impact of external verbal feedback on the dynamic balance of athletes with CAI and (b) to examine the maintenance of dynamic balance ability after the end of the completion of the intervention balance program. Thirty athletes (mean age 21.63 ± 1.53) were randomly divided into three groups: an experimental group with external verbal feedback, 1st control group without external verbal feedback and the 2nd control group without balance training and without feedback. Assessments using a balance board and the ‘Y-balance’ test were conducted before and after the balance training period. Additionally, participants completed the Cumberland Ankle Joint Instability Tool. A retention test of balance ability was administered after the 4-week intervention period. Statistical analysis revealed a significant overall improvement in balance (F(2,36) =5.96, p = 0.006, partial η2 =0.249), including those with no balance training, but no significant differences between the groups. Thus, the external verbal feedback did not show a positive impact on the balance ability between the three different groups. Also, the experimental group with the external verbal feedback demonstrated maintenance of dynamic balance learning ability. Although it appears that balance training has a positive effect on the dynamic balance of individuals with CAI, a non-positive impact of external verbal feedback was found. Also, it appears that external verbal feedback significantly led to sustained retention of balance learning ability. Further research is recommended to validate these findings.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness of External Verbal Feedback on Balance in Athletes with Chronic Ankle Instability

Parlakidis,

Kontopoulos,

Mandalidis

et al. 2024

JFMK

View full text Add to dashboard Cite

show abstract

“…It is important to highlight that this study presents results related to the affected ankle. However, exercises were applied to both CAI groups on both legs due to reports by Hertel and Deodato [ 32 , 33 ] that unilateral CAI also impairs motor control and muscle function on the contralateral side and in the long term, if CAI persists, it may lead to joint-degenerative pathologies, such as osteoarthritis [ 34 ]. Moreover, when surgery is not a preferred management method to treat unilateral CAI, rehabilitation protocols should focus on both sides [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Investigating the Combined Effects of Fascial Distortion Model Manual Therapy and Balance–Strength Training in Individuals with Chronic Ankle Instability

Mohammadi,

Sakhtemani,

Trimmel

et al. 2024

Sports

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Background: The Fascial Distortion Model (FDM) is a relatively new manual therapy approach in the field of musculoskeletal physical therapy, and its potential effectiveness in treating chronic ankle instability (CAI) remains unexplored. Methods: A randomized controlled trial with 23 participants was conducted. Patients were randomly assigned to either the FDM + balance–strength training (BST) group (n = 8), receiving extra FDM sessions weekly in addition to two sessions of BST, or the BST group (n = 7). Healthy controls (n = 8) did not receive any treatment and participated only in pre- and post-test measurements. Objective measurements including Y-Balance Test Lower Quarter (YBT-LQ), Flamingo Balance Test (FBT), Weight-Bearing Lunge Test (WBLT), ankle joint range of motion (ROM), and Cumberland Ankle Instability Tool (CAIT) were recorded at baseline and the end of the intervention. The results demonstrated significant differences between the FDM + BST and BST groups for supination ROM (p = 0.008) and similarly for WBLT (p = 0.041), FBT (p = 0.40), YBT-LQ (p = 0.023), and CAIT score (p = 0.008). Moreover, while both groups demonstrated significant improvement at the post-test compared with their pre-test for plantarflexion and pronation ROM, WBLT, and CAIT score, the FDM + BST group demonstrated significant improvements in supination ROM, FBT, and YBT-LQ. Conclusion: Our study suggests that the addition of FDM concepts to a BST may lead to enhanced improvements in ankle ROM, static and dynamic balance, and self-reported outcomes in individuals with CAI compared to BST.

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“…In addition to its impact on children with CP, incorporating active mediolateral support into the DE-AFO could significantly benefit other populations with ankle control deficits, such as individuals with chronic ankle instability (CAI). CAI is characterized by reduced control of ankle eversion and inversion during single-leg stance [ 53 , 54 ]. The DE-AFO’s advanced capability to detect stance phases allows it to precisely control the activation of its medial and lateral myofibrils, thereby stabilizing the ankle during the mid-stance and terminal stance phases of gait.…”

Section: Discussionmentioning

confidence: 99%

DE-AFO: A Robotic Ankle Foot Orthosis for Children with Cerebral Palsy Powered by Dielectric Elastomer Artificial Muscle

Mohammadi,

Tajdani,

Masaei

et al. 2024

Sensors

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Conventional passive ankle foot orthoses (AFOs) have not seen substantial advances or functional improvements for decades, failing to meet the demands of many stakeholders, especially the pediatric population with neurological disorders. Our objective is to develop the first comfortable and unobtrusive powered AFO for children with cerebral palsy (CP), the DE-AFO. CP is the most diagnosed neuromotor disorder in the pediatric population. The standard of care for ankle control dysfunction associated with CP, however, is an unmechanized, bulky, and uncomfortable L-shaped conventional AFO. These passive orthoses constrain the ankle’s motion and often cause muscle disuse atrophy, skin damage, and adverse neural adaptations. While powered orthoses could enhance natural ankle motion, their reliance on bulky, noisy, and rigid actuators like DC motors limits their acceptability. Our innovation, the DE-AFO, emerged from insights gathered during customer discovery interviews with 185 stakeholders within the AFO ecosystem as part of the NSF I-Corps program. The DE-AFO is a biomimetic robot that employs artificial muscles made from an electro-active polymer called dielectric elastomers (DEs) to assist ankle movements in the sagittal planes. It incorporates a gait phase detection controller to synchronize the artificial muscles with natural gait cycles, mimicking the function of natural ankle muscles. This device is the first of its kind to utilize lightweight, compact, soft, and silent artificial muscles that contract longitudinally, addressing traditional actuated AFOs’ limitations by enhancing the orthosis’s natural feel, comfort, and acceptability. In this paper, we outline our design approach and describe the three main components of the DE-AFO: the artificial muscle technology, the finite state machine (the gait phase detection system), and its mechanical structure. To verify the feasibility of our design, we theoretically calculated if DE-AFO can provide the necessary ankle moment assistance for children with CP—aligning with moments observed in typically developing children. To this end, we calculated the ankle moment deficit in a child with CP when compared with the normative moment of seven typically developing children. Our results demonstrated that the DE-AFO can provide meaningful ankle moment assistance, providing up to 69% and 100% of the required assistive force during the pre-swing phase and swing period of gait, respectively.

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Inertial sensors-based assessment to detect hallmarks of chronic ankle instability during single-leg standing: Is the healthy limb “healthy”?

Cited by 8 publications

References 25 publications

The Effectiveness of External Verbal Feedback on Balance in Athletes with Chronic Ankle Instability

The Effectiveness of External Verbal Feedback on Balance in Athletes with Chronic Ankle Instability

Investigating the Combined Effects of Fascial Distortion Model Manual Therapy and Balance–Strength Training in Individuals with Chronic Ankle Instability

DE-AFO: A Robotic Ankle Foot Orthosis for Children with Cerebral Palsy Powered by Dielectric Elastomer Artificial Muscle

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