Is balance impaired by recurrent sprained ankle?

Abstract

Objective-To evaluate uninjured and recurrent sprained ankles during single leg standing, both with and without visual input, and the contribution ofrelated proprioceptive feedback in this event.Methods-A force measuring system was used for monitoring reaction forces in the anteroposterior and mediolateral directions during single leg standing. Differences between selected variables obtained in the uninjured and sprained ankles were analysed using two way analysis ofvariance. Results-Foot-ground Two different theories have been suggested to explain recurrent ankle sprains.'01 The first is the functional instability theory, which assumes that the afferent nerve fibres in the capsule, ligaments, and muscles subserve reflexes that help to stabilise the ankle. The second is the mechanical instability theory, which assumes that instability is due to a loss of integrity in the supporting ligaments of the ankle complex. The result is a pathological anterior drawer sign.' However, no consistent relation has been found between functional and mechanical instability. Assuming that ankle stability depends on intact peripheral afferent proprioceptive input,812 the reaction time of the peroneal muscles to a sudden inversion tilt in recurrently sprained and in normal ankles was measured. The results indicated that the reaction time of these muscles in the injured ankle was significantly slower. These findings were disputed by others"3 who conducted a similar measurement procedure and found an almost equal reaction time in both peroneal muscles.The ability to maintain balance during standing on a single leg or both legs depends on the integrity of the visual, vestibular, and nervous systems. In the presence of an intact vestibular system, standing with eyes closed depends mostly on the normal function of the various proprioceptive receptors.4 14 An inversion ankle sprain that results in injury to the proprioreceptors of capsule and ligaments may impair standing balance on the affected limb, especially when eyes are closed.8"'.4Several research methods are used to assess ankle proprioception during upright standing. All subjects, with right lower limb dominance, reported a past history of at least three inversion injuries to one ankle only, which required protected weightbearing and immobilisation. A manual evaluation for anteroposterior stability of each ankle was performed. In all eight affected ankles, the anterior drawer sign was positive, as shown by the greater forward excursion of the injured compared to the uninjured foot. Four suffered right ankle sprains; four left ankle recurrent sprains. The sprains were never accompanied by a fracture of the ankle osseous elements. During the four months before testing, all subjects were fully weightbearing, pain-free, and the functional use of the ankle was unimpaired. EQUIPMENTPostural sway was evaluated by means of a force measuring system, which consisted of a force plate (Kistler Z-4305, Winterthur, Switzerland). The foot-ground reaction forces in the anteroposterior ...

Assessment of Postural Stability in Young, Physically Active Men With the History of Ankle Sprain

“…2). The result is in conformity with the results obtained by de Vries who showed no statistically significant differences in the mean sway velocity and root mean square (RMS) of a CoP shift in relation to mean CoP (RMS-CoP) between the patients diagnos ed with acute joint sprain, the patients with chronic ankle instability and the group of healthy individuals [43]. Similarly, Baier and Hopf, based on the results of the one leg standing trial on the stabilographic platform with the eyes open, did not find any statistically significant differences in postural stability, manifested by sway velocity parameter values between 22 patients with the history of ankle sprain and the control group comprising 22 healthy individuals [44].…”

“…2). Wy nik ten jest zgod ny z wy ni ka mi uzy ska ny mi przez de Vrie sa, któ ry wy ka zał brak staty stycz nie istot nych ró żnic w śred niej szyb ko ści wychwiań oraz w śred niej kwa dra to wej (RMS) prze sunię cia CoP wzglę dem śred nie go CoP (RMS -CoP) po mię dzy oso ba mi ze skrę ce niem sta wu sko ko wo -gole nio we go w fa zie ostrej, oso ba mi z prze wle kłą niesta bil no ścią sta wu sko ko wo -go le nio we go oraz gru pą zdro wych osób [43]. Po dob nie Ba ier i Hopf, na podsta wie wy ni ków pró by sta nia jed no nóż na plat for mie sta bi lo me trycz nej z ocza mi otwar ty mi, nie wy ka za li sta ty stycz nie istot nych ró żnic w sta bil no ści po stu ralnej w pa ra me trach szyb ko ści wy chwiań po mię dzy 22 pa cjen ta mi po ura zach skręt nych sta wu sko ko wo -gole nio we go a gru pą kon tro l ną skła da ją ca się z 22 zdro wych osób [44].…”

Possible Factors Related to Functional Ankle Instability

“…The contradictory findings regarding FAI causal factors showed in past studies 15,17,18,20,25,39 may, in part, be explained by the variability in ankle deficits found in the present study. For example, studies that failed to demonstrate strength deficits in individuals with FAI 17 might have had in their experimental population only a few individuals with weakness, hence, not enough to reach significance.…”

“…It also pres- 15 reported no significant differences in postural sway between the affected and unaffected sides in subjects with unilateral recurrent sprains. These contradictory findings might be explained by the ability of some subjects with FAI to compensate for their possible afferent or efferent deficits.…”

“…The healthy subjects had no histories of severe ankle, knee, or hip injuries, neurological diseases, or any other bilateral pathology that would impair their motor performance. also been reported for other possible deficits such as mechanical instability, 20 balance control impairments, 15 and delayed of the fibularis (peroneals) muscles reaction time. 5,34 Various authors have also found different combinations of deficits in individuals with FAI.…”