Weight-Bearing Dorsiflexion Range of Motion and Landing Biomechanics in Individuals With Chronic Ankle Instability

Abstract

Context: People with chronic ankle instability (CAI) exhibit less weight-bearing dorsiflexion range of motion (ROM) and less knee flexion during landing than people with stable ankles. Examining the relationship between dorsiflexion ROM and landing biomechanics may identify a modifiable factor associated with altered kinematics and kinetics during landing tasks.Objective: To examine the relationship between weightbearing dorsiflexion ROM and single-legged landing biomechanics in persons with CAI.Design: Cross-sectional study. Setting: Laboratory.Patients or Other Participants: Fifteen physically active persons with CAI (5 men, 10 women; age ¼ 21.9 6 2.1 years, height ¼ 168.7 6 9.0 cm, mass ¼ 69.4 6 13.3 kg) participated.Intervention(s): Participants performed dorsiflexion ROM and single-legged landings from a 40-cm height. Sagittal-plane kinematics of the lower extremity and ground reaction forces (GRFs) were captured during landing.Main Outcome Measure(s): Static dorsiflexion was measured using the weight-bearing-lunge test. Kinematics of the ankle, knee, and hip were observed at initial contact, maximum angle, and sagittal displacement. Sagittal displacements of the ankle, knee, and hip were summed to examine overall sagittal displacement. Kinetic variables were maximum posterior and vertical GRFs normalized to body weight. We used Pearson product moment correlations to evaluate the relationships between dorsiflexion ROM and landing biomechanics. Correlations (r) were interpreted as weak (0.00-0.40), moderate (0.41-0.69), or strong (0.70-1.00). The coefficient of determination (r 2 ) was used to determine the amount of explained variance among variables.Results: Static dorsiflexion ROM was moderately correlated with maximum dorsiflexion (r ¼ 0. Key Words: ankle sprain, drop landing, neuromuscular control, kinematics, kinetics Key PointsDuring a single-legged landing, persons with chronic ankle instability demonstrated moderate to strong relationships between dorsiflexion range of motion (ROM) and sagittal-plane kinematics at the knee and hip and vertical ground reaction forces. Persons with less dorsiflexion ROM exhibited a less flexed landing strategy that attenuated ground reaction forces less efficiently. Identifying dorsiflexion deficits may enable clinicians to implement interventions to increase ROM and potentially modify the landing biomechanics that persons with chronic ankle instability exhibit.

Altered movement strategies during jump landing/cutting in patients with chronic ankle instability

“…A prospective study revealed that limited dorsiflexion range of motion (ROM) has been identified as a strong risk factor for LAS . It is believed that static arthrokinematic restriction could limit dorsiflexion during functional tasks, resulting in a decreased ability to absorb GRF effectively via eccentrically controlled plantarflexors . We believe that observed increases in vertical and posterior GRF could be due to decreased dorsiflexion angle during mid‐landing (Figure ).…”

Comparison of hand grip strength and upper limb pressure pain threshold between older adults with or without non-specific shoulder pain

“…Correlations were interpreted as weak (0.00–0.40), moderate (0.41–0.69), or strong (0.70–1.00) (Hoch et al, 2015). …”

Therapeutic interventions for improving self-reported function in patients with chronic ankle instability: a systematic review

“…Specifically, researchers have suggested that both mechanical and sensorimotor insufficiencies may be present in those with CAI 5. Identified mechanical insufficiencies include arthrokinematic restrictions,20 21 ligamentous laxity22–24 and joint degeneration,25 whereas sensorimotor deficiencies such as diminished static26–28 and dynamic postural control,29–31 loss of strength32 33 and altered spinal reflex excitability34–36 have also been found in patients with CAI. This has led to the development of several therapeutic interventions such as balance training,37–39 resistive training,40 41 joint mobilisation42 43 and multimodal rehabilitations44 45 programmes that have all led to the improvements in the mechanical and sensorimotor insufficiencies previously mentioned.…”