Instrumented Measurement of Anteroposterior and Inversion-Eversion Laxity of the Normal Ankle Joint Complex

Kovaleski, John E.; Gurchiek, Larry R.; Heitman, Robert J.; Hollis, J. Marcus; Th, Ackland

doi:10.1177/107110079902001210

Cited by 64 publications

(106 citation statements)

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“…[1][2][3] Valid and reliable measurements of the combined motions within the talocrural and subtalar joints (ankle complex) have been investigated fully and reported using the Hollis Ankle Arthrometer (Blue Bay Research, Inc, Navarre, FL). [3][4][5][6] Consisting of a 6-degrees-of-freedom spatial kinematic linkage, this device is described as a suitable evaluation tool that quantifies the anteroposterior (AP) load displacement and inversion-eversion (I-E) rotational characteristics of the ankle complex. 3,4,7 The Hollis Ankle Arthrometer has been used in a variety of clinical and research settings involving college-aged athletes and participants less than 25 years of age.…”

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“…[3][4][5][6] Consisting of a 6-degrees-of-freedom spatial kinematic linkage, this device is described as a suitable evaluation tool that quantifies the anteroposterior (AP) load displacement and inversion-eversion (I-E) rotational characteristics of the ankle complex. 3,4,7 The Hollis Ankle Arthrometer has been used in a variety of clinical and research settings involving college-aged athletes and participants less than 25 years of age. Researchers have applied this type of arthrometric assessment in studies to biomechanically assess anklecomplex laxity in vivo and in vitro, 3,4,8 identify ankle instability after injury, [9][10][11][12][13] investigate the effects of sex and athletic status on ankle-complex laxity, 14 identify the relationship between ankle and knee ligamentous laxity and generalized joint laxity, 15 investigate the effects of balance training on gait in patients with chronic ankle instability, 13 investigate the effects of limb dominance on ankle laxity, 4 and assess the effectiveness of ankle taping.…”

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confidence: 99%

“…3,4,7 The Hollis Ankle Arthrometer has been used in a variety of clinical and research settings involving college-aged athletes and participants less than 25 years of age. Researchers have applied this type of arthrometric assessment in studies to biomechanically assess anklecomplex laxity in vivo and in vitro, 3,4,8 identify ankle instability after injury, [9][10][11][12][13] investigate the effects of sex and athletic status on ankle-complex laxity, 14 identify the relationship between ankle and knee ligamentous laxity and generalized joint laxity, 15 investigate the effects of balance training on gait in patients with chronic ankle instability, 13 investigate the effects of limb dominance on ankle laxity, 4 and assess the effectiveness of ankle taping. 16 One limitation of using the Hollis Ankle Arthrometer and of using instrumented ankle arthrometry in general is that relatively small sample sizes have been reported and no normative data are available for comparison and reference.…”

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confidence: 99%

“…16 One limitation of using the Hollis Ankle Arthrometer and of using instrumented ankle arthrometry in general is that relatively small sample sizes have been reported and no normative data are available for comparison and reference. [9][10][11][12][13][14] Kovaleski et al 4 investigated total AP displacement and I-E rotation between the dominant and nondominant ankles in a group of 41 male and female participants (age 5 23.8 6 4.4 years). Bilateral ankle comparisons showed no differences in ankle-complex laxity, and they reported mean total AP displacement of 18.47 6 5.1 mm for the dominant ankle and 17.51 6 5.4 mm for the nondominant ankle.…”

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Arthrometric Measurement of Ankle-Complex Motion: Normative Values

Schwarz

Kovaleski

Heitman

et al. 2011

Journal of Athletic Training

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Intervention(s): Each ankle underwent anteroposterior (AP) and inversion-eversion (I-E) loading using an ankle arthrometer.Main Outcome Measure(s): Recorded anterior, posterior, and total AP displacement (millimeters) at 125 N and inversion, eversion, and total I-E rotation (degrees) at 4 Nm.Results: Women had greater ankle-complex motion for all variables except for posterior displacement. Total AP displacement of the ankle complex was 18.79 6 4.1 mm for women and 16.70 6 4.8 mm for men (U 5 3742.5, P , .01). Total I-E rotation of the ankle complex was 42.106 6 9.06 for women and 34.136 6 10.16 for men (U 5 2807, P , .001). All variables were normally distributed except for anterior displacement, inversion rotation, eversion rotation, and total I-E rotation in the women's ankles and eversion rotation in the men's ankles; these variables were skewed positively.Conclusions: Our study increases the available database on ankle-complex motion, and it forms the basis of norm-referenced clinical comparisons and the basis on which quantitative definitions of ankle pathologic conditions can be developed.Key Words: normal distribution, flexibility Key PointsN This study increases the available database on ankle-complex motion and forms the basis of norm-referenced clinical comparisons.N Women had greater ankle range of motion than men, and all of the range-of-motion variables measured were normally distributed except for anterior displacement, inversion rotation, eversion rotation, and total inversion-eversion rotation, which showed a higher incidence toward hypermobility.N Our findings are clinically important because they will assist in the clinical decision-making process, enabling comparisons to be made with individual patient data and enabling quantitative definitions of ankle conditions to be developed.

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Arthrometric Measurement of Ankle-Complex Motion: Normative Values

Schwarz

Kovaleski

Heitman

et al. 2011

Journal of Athletic Training

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“…Different authors recommended stressing the ankle in dorsiflexion, in the neutral position, or in plantarflexion during the stress manoeuvre [6,10,16,17]. The foot position affects ankle stability because the relationship between ligamentous laxity and bony constraints vary with flexion angle during stress testing [7,9,[18][19][20][21]. Our results showed that mobility of the ankle−hindfoot complex varied as foot flexion angle changed.…”

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Analysis of ankle−hindfoot stability in patients with ankle instability and normals

Watanabe

Fujii

Kitaoka

et al. 2011

International Orthopaedics (SICOT)

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Purpose We devised a testing apparatus for in vivo analysis of ankle stability. The purpose of the study was to test the reliability of this apparatus and to determine the stability pattern of the ankle−hindfoot complex in healthy, asymptomatic volunteers and in patients with ankle instability. Methods Ten healthy individuals were studied, and testing was repeated on the same day and different days. Three patients with symptomatic, unstable ankles were also tested on both involved and uninvolved sides. Constant inversion torque was applied, then internal rotation torque, while moving the ankle throughout the range of sagittal motion. Three-dimensional kinematics of the ankle−hindfoot complex were measured by an electromagnetic tracking system. Results Measurements were repeatable, with intraclass correlation coefficients 0.9 or better. Variability was observed among controls, but motion curve patterns were consistent. Motion curve slopes were sensitive in differentiating between unstable and stable ankles. Conclusions Most previous reports are in vitro studies conducted with the ankle in one position, manual stress applied, or joint positions estimated with planar radiographs. Our study indicated that more accurate diagnosis of severity of ankle ligament injuries may be possible.

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