The improvement of postural control in patients with mechanical ankle instability after lateral ankle ligaments reconstruction

Liu, Hongyun; Zheng, Jicui; Zhang, Jian; Cai, Yong; Hua, Yinghui; Chen, Shiyi

doi:10.1007/s00167-015-3660-2

Cited by 25 publications

(29 citation statements)

References 28 publications

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“…In the present study, time to peak torque for dorsiflexion and eversion was significantly increased in the affected ankles of the MBP group compared with those of normal control groups. after MBP [12], and Konradsen et al demonstrated that delayed muscle reaction time was not related to ligament injury or mechanical instability [39]. Given that the results of the present study were consistent with those of previous studies, we believe that proprioception and neuromuscular training should be considered as a method to improve muscular recruitment time in dorsiflexion and eversion [40,41].…”

Section: Discussionsupporting

confidence: 89%

“…This study had several limitations. First, there is the possibility that visual compensation may directly affect postural stability, as reported by Li et al [12]. However, the control screen was covered to reduce any bias in the postural stability tests in the present study.…”

Section: Discussionmentioning

confidence: 81%

“…A previous study found that deficits of the lateral ankle ligament may decrease postural stability due to increased mechanical instability [7]. In a study by Li et al [12], postural stability was significantly improved at 6 months after MBP. However, in the present study, the postural stability test was performed at 3 months after MBP.…”

Section: Discussionmentioning

confidence: 93%

“…Many studies have reported that insufficient proprioception and neuromuscular control may be the primary cause of ankle instability [6][7][8][9] and may also increase the risk of re-injury [1,10,11]. In particular, postural control [12][13][14] and peroneal muscle reaction time [13,15,16] may be significant factors in the outcomes of CAI. While some authors reported good results using the MBP in most patients [17], many patients still experience subjective instability and persistent pain due to proprioception and neuromuscular control deficits after surgical treatment [18][19][20].…”

mentioning

confidence: 99%

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Proprioception and neuromuscular control after the modified Broström procedure at the timing of a return to sports: A retrospective study

Jh¹,

Hw²,

Wy³

2020

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Background: The modified Broström procedure (MBP) is an initial treatment in symptomatic chronic ankle instability (CAI) patients. However, there was a deficiency of studies regarding the recovery of proprioception and neuromuscular control at the timing of a return to sports after MBP. This study aimed to compare the proprioception and neuromuscular control of both affected and unaffected ankles at the timing of a return to sports after MBP in CAI patients with those of normal controls. Methods: Totally, 75 patients (40 who underwent MBP vs. 35 normal controls) participated. Proprioception and neuromuscular control were measured by postural stability and time to peak torque, respectively. Postural stability tests included static and dynamic balance and the star excursion balance test (SEBT). Static and dynamic balance were tested using a postural stabilometry system, and time to peak torque was measured using an isokinetic device. Results: The dynamic balance test was significantly higher in the affected ankle of the MBP group than in controls (1.5 ± 0.6 vs. 1.1 ± 0.4, p < 0.003). SEBT was significantly lower in the affected ankle of the MBP group compared to controls (anterior: 70.9±16.4 vs. 80.3±11.7, p < 0.006; posterior: 49.2 ± 10.0 vs. 62.2 ± 19.0, p < 0.000; lateral: 49.9 ± 12.7 vs. 57.3 ± 17.7, p < 0.040). Time to peak torque was significantly increased in the affected ankle of the MBP group compared to controls (dorsiflexion: 608.3 ± 139.4 vs.522.9 ± 175.8, p < 0.022; eversion: 689.1 ± 191.6 vs. 593.1 ± 211.2, p < 0.043). Conclusion: Dynamic balance, SEBT, and time to peak torque in CAI patients remained significantly reduced at the timing of a return to sports after MBP. Keywords : Proprioception; Neuromuscular control; Modified Broström procedure; Postural stability; Star excursion balance test

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

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Proprioception and neuromuscular control after the modified Broström procedure at the timing of a return to sports: A retrospective study

Jh¹,

Hw²,

Wy³

2020

Preprint

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“…Current literature suggests that a certain degree of mechanical instability cannot be compensated by functional training but may instead require mechanical stabilization [ 8 , 23 ]. Whether an undetermined severity of mechanical insufficiency inevitably leads to an additional perception of instability, according to the model of Hiller et al [ 24 ], remains unclear in current literature [ 4 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Functional deficits in chronic mechanical ankle instability

Gehring

Mauch³

et al. 2020

J Orthop Surg Res

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Background: The interaction of functional and mechanical deficits in chronic ankle instability remains a major issue in current research. After an index sprain, some patients develop sufficient coping strategies, while others require mechanical support. This study aimed to analyze persisting functional deficits in mechanically unstable ankles requiring operative stabilization. Methods: We retrospectively analyzed the functional testing of 43 patients suffering from chronic, unilateral mechanical ankle instability (MAI) and in which long-term conservative treatment had failed. Manual testing and arthroscopy confirmed mechanical instability. The functional testing included balance test, gait analysis, and concentric-concentric, isokinetic strength measurements and was compared between the non-affected and the MAI ankles. Results: Plantarflexion, supination, and pronation strength was significantly reduced in MAI ankles. A sub-analysis of the strength measurement revealed that in non-MAI ankles, the peak pronation torque was reached earlier during pronation (maximum peak torque angle at 20°vs. 14°of supination, p < 0.001). Furthermore, active range of motion was reduced in dorsiflexion and supination. In balance testing, patients exhibited a significant increased perimeter for the injured ankle (p < 0.02). During gait analysis, we observed an increased external rotation in MAI (8.7 vs. 6.8°, p<0.02). Conclusions: This study assesses functional deficits existent in a well-defined population of patients suffering from chronic MAI. Impairments of postural sway, gait asymmetries, and asymmetric isokinetic strength can be observed despite long-term functional treatment. The finding that pronation strength is particularly reduced with the foot in a close-to-accident position indicates potential muscular dysfunction in MAI. Possibly, these deficits alongside the underlying mechanical instability characterize patients requiring mechanical stabilization.

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