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Chen L, Hu Q, Gao H, Tang D. The Clinical Effect of Electroacupuncture Combined with Surround Needling in the Treatment of Acute Lateral Ankle Sprain Based on Musculoskeletal Ultrasound Imaging Technology: A Protocol for a Single-Centre, Randomized, Controlled Trial. J Pain Res 2025; 18:2467-2478. [PMID: 40391277 PMCID: PMC12087604 DOI: 10.2147/jpr.s517109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2025] [Accepted: 05/08/2025] [Indexed: 05/21/2025] Open
Abstract
Objective To verify the efficacy of electroacupuncture (EA) combined with surround needling on acute lateral ankle sprain (ALAS) based on musculoskeletal ultrasound (MSKUS) imaging technology. Methods and Analysis Sixty-six ALAS patients will be randomly divided into EA combined with surround needling group, sham EA group and ice combined with brake rest group in a 1:1:1 ratio by using a random number table. The Kofoed scores, MSKUS quantitative measurement and circumference of ankle joint will be compared to evaluate the differences in efficacy caused by the three treatment methods as stated. Data for the assessment will be collected at baseline, three-week treatment, and two-month follow-up in three groups of ALAS patients. Trial Registration ChiCTR-2300078874.
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Affiliation(s)
- Liao Chen
- The Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Qimiao Hu
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Hong Gao
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Ding Tang
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, People’s Republic of China
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Feng SM, Luo X, Maffulli N, van Dijk CN, Oliva F, Fehske K, Plaass C, Karius T, Saxena A, Gao SH, Zhao HM, Zhao JJ, Ma C. Clinical practice guidelines for rehabilitation following surgical management of chronic lateral ankle instability: enhancing recovery based on available evidence. Br Med Bull 2025; 154:ldaf002. [PMID: 40350696 DOI: 10.1093/bmb/ldaf002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2025] [Revised: 02/18/2025] [Accepted: 03/21/2025] [Indexed: 05/14/2025]
Abstract
BACKGROUND Rehabilitation is a crucial component of comprehensive disease management and functional recovery. Despite advancements in surgical techniques for chronic lateral ankle instability (CLAI), there is still a lack of standardized, evidence-based rehabilitation protocols. SOURCE OF DATA After nine clinical questions were proposed by the guidance steering group, an independent search strategy was conducted for all clinical questions, encompassing the PubMed, MEDLINE, Web of Science, EMBASE, and Cochrane databases. AREAS OF AGREEMENT Rehabilitation is crucial to optimize surgical outcomes and patient recovery. An appropriate and well-structured rehabilitation plan can optimize a safe return to sports and daily activities. AREAS OF CONTROVERSY Rehabilitation for surgical management of CLAI poses significant challenges, especially in the areas of preoperative preparation, control of postoperative swelling and pain, early-stage rehabilitation, advanced rehabilitation, and return to exercise. GROWING POINTS Given the lack of established guidelines for rehabilitation following surgical management of CLAI, this clinical practice guideline presents nine key recommendations aimed at addressing the existing controversies in this area. For CLAI patients undergoing surgery, preoperative rehabilitation should include exercise and education, followed by postoperative focus on pain and swelling management. Early rehabilitation emphasizes nonweight-bearing functional training, with gradual progression to weight-bearing exercises, dynamic balance, and strength training over the first 18 weeks. Regular follow-up visits are essential to monitor recovery and promote functional restoration. AREAS TIMELY FOR DEVELOPING RESEARCH In patients undergoing surgery for CLAI, there is a pressing need for comparative studies to assess the necessity of immobilization and to determine the optimal selection of braces.
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Affiliation(s)
- Shi-Ming Feng
- Sports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, No. 199 Jiefang south Road, Quanshan District, Xuzhou, Jiangsu 221009, P.R. China
| | - Xin Luo
- Sports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, No. 199 Jiefang south Road, Quanshan District, Xuzhou, Jiangsu 221009, P.R. China
| | - Nicola Maffulli
- Department of Orthopaedic, University La Sapienza, Faculty of Medicine and Psychology, Via di Grottarossa, 00189, Rome, Italy
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Thornburrow Drive, Stoke-on-Trent ST4 7QB, United Kingdom
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, United Kingdom
| | - C Niek van Dijk
- Department of Orthopedic Surgery, University of Amsterdam, Meibergdreef 9, Amsterdam, 1081 HV, the Netherlands
- Ankle Unit, FIFA Medical Centre of Excellence Ripoll-DePrado Sport Clinic, C. de Almagro, 34, Chamberí, Madrid 28010, Spain
- Ankle Unit, FIFA Medical Centre of Excellence Clínica do Dragão Porto, Estádio Dragão Entrada Nascente, Porto 4350-415, Portugal
- Casa di Cura, San Rossore, Viale delle Cascine, 152/f, Pisa 56122, Italy
| | - Francesco Oliva
- Department of Sports Traumatology, Universita' Telematica San Raffaele, Via di Val Cannuta, 247, Roma 00166, Italy
| | - Kai Fehske
- Department of Trauma Surgery, University Hospital Wuerzburg, Josef-Schneider-Straße 2, Wuerzburg 97080, Germany
- Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Waldstraße 73, Bonn 53177, Germany
| | - Christian Plaass
- Department for Foot and Ankle Surgery, DIAKOVERE Annastift, Orthopedic Clinic of the Hannover Medical School, Anna-von-Borries Strasse 1-7, Hannover 30625, Germany
| | - Thomas Karius
- Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Waldstraße 73, Bonn 53177, Germany
| | - Amol Saxena
- Department of Sports Medicine, Sutter-PAMF, 795 El Camino Real, Palo Alto, CA 94301, United States
| | - Shun-Hong Gao
- Orthopaedic Department, The Second Hospital of Tangshan, No. 21, North Jianshe Road, Lubei District, Tangshan, Hebei 063000, P.R. China
| | - Hong-Mou Zhao
- Foot and Ankle Surgery Center, Honghui hospital of Xi'an Jiaotong University, No. 555, Youyi East Road, Nanshaomen, Beilin District, Xi'an, Shanxi 710054, P.R. China
| | - Jia-Ju Zhao
- Department of Hand and Foot, The Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Gusu District, Suzhou, Jiangsu 215004, P.R. China
| | - Chao Ma
- Sports Medicine Department, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, No. 199 Jiefang south Road, Quanshan District, Xuzhou, Jiangsu 221009, P.R. China
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Hoveidaei AH, Moradi AR, Nakhostin-Ansari A, Mousavi Nasab MM, Taghavi SP, Eghdami S, Forogh B, Bagherzadeh Cham M, Murdock CJ. Risk Factors of Ankle Sprain in Soccer Players: A Systematic Review and Meta-Analysis. Sports (Basel) 2025; 13:105. [PMID: 40278731 PMCID: PMC12031617 DOI: 10.3390/sports13040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 01/23/2025] [Accepted: 02/12/2025] [Indexed: 04/26/2025] Open
Abstract
BACKGROUND Soccer is associated with substantial injury risk, with reported between 13 to 35 injuries per 1000 player-hours of competitive play. Notably, approximately 77% of soccer-related ankle injuries are attributed to ankle sprain injuries (ASIs). ASI can lead to chronic ankle instability, obesity, and post-traumatic osteoarthritis. This study focuses on identifying factors such as gender, age, body mass index (BMI), and a history of ASIs, which contribute to the development of ASI in soccer players. METHODS A systematic literature search was conducted in October 2023 across databases, including PubMed, Web of Science, Scopus, Cochrane Library, and ProQuest, without applying any filters. Keywords included ankle, ankle joint, sprain, risk factors, etc. Data extraction was performed on the included studies, with findings standardized and analyzed using Stata Statistical Software: Release 17 to determine a weighted treatment effect. RESULTS Our systematic review included 26 studies. The meta-analysis revealed that a history of ankle sprain is the most significant risk factor for future ASIs. BMI emerged as a risk factor in three out of seven studies, while age and height were significant in one out of six studies each. Gender and weight were not found to significantly affect ASI occurrence. Other factors identified but not subjected to a meta-analysis due to methodological heterogeneity or insufficient studies included playing surface, joint laxity, muscle weakness, match congestion, strength asymmetries, ground reaction forces, balance maintenance, skill level, and playing position. CONCLUSIONS This research contributes valuable insights into the prevention of ASIs in soccer, highlighting the importance of previous ankle sprains and playing surface quality. These findings assist sports professionals in developing optimal conditions and strategies for effective ankle sprain prevention.
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Affiliation(s)
- Amir Human Hoveidaei
- International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA;
| | - Amir Reza Moradi
- School of Medicine, Tehran University of Medical Sciences, Tehran 1416634793, Iran;
| | - Amin Nakhostin-Ansari
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran 1416634793, Iran; (A.N.-A.); (S.E.); (M.B.C.)
| | | | - Seyed Pouya Taghavi
- Student Research Committee, Kashan University of Medical Sciences, Kashan 8715981151, Iran;
| | - Shayan Eghdami
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran 1416634793, Iran; (A.N.-A.); (S.E.); (M.B.C.)
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran 1416634793, Iran; (A.N.-A.); (S.E.); (M.B.C.)
| | - Masumeh Bagherzadeh Cham
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran 1416634793, Iran; (A.N.-A.); (S.E.); (M.B.C.)
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Utku B, Bähr G, Knoke H, Mai P, Paganini F, Hipper M, Braun L, Denis Y, Helwig J, Willwacher S. The effect of fresh and used ankle taping on lower limb biomechanics in sports specific movements. J Sci Med Sport 2024; 27:772-778. [PMID: 39030083 DOI: 10.1016/j.jsams.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/26/2024] [Accepted: 07/01/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVES We aimed to investigate the effects of ankle taping on lower extremity biomechanics related to injury development and how these effects change after sports-specific use. DESIGN Randomized, repeated measures design with three conditions: Barefoot, tape applied fresh, and tape after sports-specific use (between-subject factor: sex). METHODS Twenty-five healthy participants (ten female) performed sports-specific movements, including running, drop jumping, and 180° change of direction, under the three conditions. Kinetic and kinematic data were collected using 3D motion capturing and force platforms. RESULTS Tape applied fresh and tape after sports-specific use significantly reduced peak ankle inversion. Biomechanical risk factors for anterior cruciate ligament or running overuse injuries were either unchanged or decreased with tape applied fresh, except for the peak loading rate of the resultant ground reaction force, which increased between 4% and 18% between movement types. After 15 minutes of sports-specific use of the tape, the alterations induced by tape applied fresh remained for some biomechanical risk factors while they became closer to barefoot again for others, indicating a differential response to prolonged use of taping for different biomechanical variables. CONCLUSIONS Ankle taping protects the ankle joint by reducing biomechanical risk factors associated with ankle sprains, and most biomechanical risk factors for anterior cruciate ligament or running overuse injuries are not increased. Further research is needed to explore the duration of protective effects, variations across sports, and its impact on patients with chronic ankle instability, contributing to a more comprehensive understanding of ankle taping's influence on lower extremity biomechanics.
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Affiliation(s)
- Burkay Utku
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany. https://twitter.com/burkayutku
| | - Gloria Bähr
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
| | - Hannah Knoke
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
| | - Patrick Mai
- Department of Physical Performance, Norwegian School of Sport Sciences, Norway
| | - Francesca Paganini
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
| | - Markus Hipper
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
| | - Luca Braun
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
| | - Yannick Denis
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
| | - Janina Helwig
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
| | - Steffen Willwacher
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Germany
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Golmohammadi Qadikolai M, Sanjari MA, Mohsenifar H, Boozari S. Effect of non-elastic taping on vertical stiffness of healthy athletes during a basketball jump shot. J Bodyw Mov Ther 2024; 38:562-566. [PMID: 38763609 DOI: 10.1016/j.jbmt.2024.03.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 03/09/2024] [Accepted: 03/19/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Basketball is a high-risk team sport for lower extremity injuries, with ankle sprains being the most common injury. Non-elastic tape is widely used in injury prevention and quick return to play after ankle sprains, but its impact on stiffness, particularly global stiffness, has not been thoroughly investigated. OBJECTIVES The aim of this study was to investigate the effects of non-elastic ankle taping on vertical stiffness, among basketball players during the jump shot tasks; and to assess the reliability of accelerometers to evaluate vertical stiffness. DESIGN Single group, repeated measures study. PARTICIPANTS Thirty healthy semi-professional basketball players (15 males and 15 females) participated in the study. INTERVENTIONS Vertical stiffness was compared among three conditions: 1) without taping, 2) while the non-elastic tape was applied to their ankles, and 3) after running while taped. Vertical stiffness was calculated from acceleration data using a mass-spring model. RESULTS The result of a one-way repeated measures ANOVA showed that vertical stiffness was not significantly different between the three conditions (P = 0.162). Within-day and between-day reliability for average measurements were found to be high or very high. CONCLUSION The findings showed that the vertical stiffness is unaffected by non-elastic taping. Therefore, while non-elastic tape can limit ankle range of motion, it may not have an impact on vertical stiffness, a global parameter which reflects the musculoskeletal performance. On the other hand, the high reliability of the stiffness variable supports the use of an accelerometer as a small portable instrument for outdoor sports measurements.
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Affiliation(s)
- Maryam Golmohammadi Qadikolai
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sanjari
- Biomechanics Laboratory, Rehabilitation Research Center and Department of Basic Rehabilitation Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Holakoo Mohsenifar
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Boozari
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Yona T, Kamel N, Cohen-Eick G, Ovadia I, Fischer A. One-dimension statistical parametric mapping in lower limb biomechanical analysis: A systematic scoping review. Gait Posture 2024; 109:133-146. [PMID: 38306782 DOI: 10.1016/j.gaitpost.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/26/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Biomechanics significantly impacts sports performance and injury prevention. Traditional methods like discrete point analysis simplify continuous kinetic and kinematic data, while one-dimensional Statistical Parametric Mapping (spm1d) evaluates entire movement curves. Nevertheless, spm1d's application in sports and injury research is limited. As no systematic review exists, we conducted a scoping systematic review, synthesizing the current applications of spm1d across various populations, activities, and injuries. This review concludes by identifying gaps in the literature and suggesting areas for future research. RESEARCH QUESTION What research exists using spm1d in sports biomechanics, focusing on the lower limbs, in what populations, and what are the current research gaps? METHODS We searched PubMed, Embase, Web of Science, and ProQuest databases for the following search string: "(((knee) OR (hip)) OR (ankle)) OR (foot) OR (feet) AND (statistical parametric mapping)". English peer-reviewed studies assessing lower limb kinetics or kinematics in different sports or sports-related injuries were included. Reviews, meta-analyses, conference abstracts, and grey literature were excluded. RESULTS Our search yielded 165 papers published since 2012. Among these, 112 examined healthy individuals (67 %), and 53 focused on injured populations (33 %). Running (n = 45), cutting (n = 25), and jumping/landing (n = 18) were the most common activities. The predominant injuries were anterior cruciate ligament rupture (n = 21), chronic ankle instability (n = 18), and hip-related pain (n = 9). The main research gaps included the unbalanced populations, underrepresentation of common sports and sport-related injuries, gender inequality, a lack of studies in non-laboratory settings, a lack of studies on varied sports gear, and a lack of reporting standardization. SIGNIFICANCE This review spotlights crucial gaps in spm1d research within sports biomechanics. Key issues include a lack of studies beyond laboratory settings, underrepresentation of various sports and injuries, and gender disparities in research populations. Addressing these gaps can significantly enhance the application of spm1d in sports performance, injury analysis, and rehabilitation.
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Affiliation(s)
- Tomer Yona
- Department of Biomedical Engineering, Technion, Israel Institute of Technology, Haifa, Israel
| | - Netanel Kamel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Galya Cohen-Eick
- Department of Biomedical Engineering, Technion, Israel Institute of Technology, Haifa, Israel
| | - Inbar Ovadia
- Department of Mechanical Engineering, Technion, Israel Institute of Technology, Haifa, Israel
| | - Arielle Fischer
- Department of Biomedical Engineering, Technion, Israel Institute of Technology, Haifa, Israel.
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Mohaddis M, Maqsood SA, Ago E, Singh S, Naim Z, Prasad S. Enhancing Functional Rehabilitation Through Orthotic Interventions for Foot and Ankle Conditions: A Narrative Review. Cureus 2023; 15:e49103. [PMID: 38024022 PMCID: PMC10659571 DOI: 10.7759/cureus.49103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 12/01/2023] Open
Abstract
Non-surgical, conservative approaches to foot and ankle conditions are of important consideration. Orthotics play a significant role in treating these conditions, preventing progression, and alleviating pressure on affected areas, thereby promoting normal gait. This article aims to assess the utility and effectiveness of various orthotic treatments in different clinical scenarios. We reviewed 27 peer-reviewed articles using electronic databases, employing keywords such as "orthoses," "orthotic treatment," "arthritis," "neuropathy," and "foot and ankle trauma." Studies conducted in recent decades have explored the effectiveness of orthoses in various conditions, including connective tissue disorders, tendon and ligament injuries, foot arthritis, neuropathic and inflammatory wounds, and sports-related recurrent injuries. Orthotic management has proven effective across diverse foot and ankle conditions. Integrating orthotic treatment with systemic approaches benefits patients with foot and ankle disorders. We believe this review can be utilised by clinicians in the management of foot and ankle disorders.
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Affiliation(s)
- Momin Mohaddis
- Trauma and Orthopaedics, Warrington and Halton Hospitals NHS Trust, Liverpool, GBR
| | - Saad A Maqsood
- Trauma and Orthopaedics, Warrington and Halton Hospitals NHS Trust, Liverpool, GBR
| | - Emmanuel Ago
- Trauma and Orthopaedics, Warrington and Halton Hospitals NHS Trust, Liverpool, GBR
| | - Sushmit Singh
- Trauma and Orthopaedics, Warrington and Halton Hospitals NHS Trust, Liverpool, GBR
| | - Zahra Naim
- General Practice, Shadan Institute of Medical Sciences, Hyderabad, IND
| | - Seema Prasad
- Trauma and Orthopaedics, Warrington and Halton Hospitals NHS Trust, Liverpool, GBR
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Sahin GK, Gulen M, Acehan S, Satar DA, Erfen T, Satar S. Comparison of intravenous ibuprofen and tenoxicam efficiency in ankle injury: a randomized, double-blind study. Ir J Med Sci 2023; 192:1737-1743. [PMID: 36100795 DOI: 10.1007/s11845-022-03159-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND AIM Pain after soft tissue injuries in and around the ankle is a troublesome process in terms of patient comfort and mobilization. The aim of this study was to compare the analgesic efficacy of intravenous ibuprofen and intravenous tenoxicam in patients with acute musculoskeletal pain due to ankle injury. METHODS We conducted a prospective, double-blind, randomized controlled study in a tertiary hospital. The patients were divided into two groups as those administered IV 400 mg ibuprofen and IV 20 mg tenoxicam. After the treatment of the patients, visual analog scale (VAS) scores were recorded at 15, 30, 60, and 120 min. VAS scores were compared with the effectiveness of drugs, their side effects, and the need for rescue drugs. RESULTS One hundred and twenty-four patients were included in the study. There were 62 patients in the tenoxicam group and 62 patients in the ibuprofen group. When VAS scores were compared, it was found that the VAS scores of the ibuprofen group were statistically significantly lower (p < 0.001). When the ΔVAS scores were compared, it was observed that the ΔVAS scores of the ibuprofen group were statistically significantly higher from 30 min (p < 0.001). There was a statistically significant difference in favor of ibuprofen between the two drug groups in terms of the need for rescue analgesics (p < 0.001). Conclusıon. The analgesic efficacy of intravenous ibuprofen and tenoxicam is equal after an ankle injury. However, after 30 min of drug administration, ibuprofen provides more effective analgesia than tenoxicam.
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Affiliation(s)
- Gonca Koksaldi Sahin
- Emergency Medicine Clinic, Health Sciences University, Adana City Training and Research Hospital, Mithat Ozhan Avenue, 01370, Yuregir, Adana, Turkey
| | - Muge Gulen
- Emergency Medicine Clinic, Health Sciences University, Adana City Training and Research Hospital, Mithat Ozhan Avenue, 01370, Yuregir, Adana, Turkey
| | - Selen Acehan
- Emergency Medicine Clinic, Health Sciences University, Adana City Training and Research Hospital, Mithat Ozhan Avenue, 01370, Yuregir, Adana, Turkey
| | - Deniz Aka Satar
- Assisted Reproduction Unit, Andrology Laboratory, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Tahsin Erfen
- Department of Emergency Medicine, Anamur State Hospital, Mersin, Turkey
| | - Salim Satar
- Emergency Medicine Clinic, Health Sciences University, Adana City Training and Research Hospital, Mithat Ozhan Avenue, 01370, Yuregir, Adana, Turkey.
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9
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Rowe PL, Hinman RS, Bryant AL, Paterson KL. Health-seeking behaviors, management practices, and return to play decisions after an ankle sprain in netball: An international cross-sectional survey of 1592 non-elite netballers. J Sci Med Sport 2023; 26:415-420. [PMID: 37400287 DOI: 10.1016/j.jsams.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES Evaluate if non-elite netballers sought health care, treatments received, and return-to-play decisions after an ankle sprain, including intercountry differences. DESIGN Cross-sectional survey. METHODS Non-elite netballers aged >14 years were recruited from Australia, United Kingdom, and New Zealand. Participants completed an online survey regarding their last ankle sprain and were queried regarding health care sought, health professionals consulted, treatments received, time missed, and return-to-play clearance. Data were described using number (proportion) for the overall cohort and countries. Between-country differences in health care use were compared using chi-square tests. Descriptive statistics were presented for management practices. RESULTS We received 1592 responses from Australian (n = 846), United Kingdom (n = 454), and New Zealand (n = 292) netballers. Three in five (n = 951, 60 %) sought health care. Of those, most consulted a physiotherapist (n = 728, 76 %), received strengthening exercises (n = 771, 81 %), balance exercises (N = 665, 70 %) and taping (n = 636, 67 %). Few received return-to-play clearance (n = 362, 23 %). Comparing countries, fewer United Kingdom netballers sought health care than Australian and New Zealand netballers (Australia: 60 % vs United Kingdom: 53 % vs New Zealand: 68 %, p < 0.001), consulted a physiotherapist (Australia: 79 %, United Kingdom: 63 %, New Zealand: 87 %), received strengthening (Australia: 84 %, United Kingdom: 73 %, New Zealand: 84 %) or balance exercises (Australia: 71 %, United Kingdom: 60 %, New Zealand: 80 %) or taping (Australia: 74 %, United Kingdom: 39 %, New Zealand: 82 %). More Australian netballers returned to play within 1-7 days (Australia: 25 %, United Kingdom: 15 %, New Zealand: 21 %) and fewer United Kingdom netballers received return-to-play clearance (Australia: 28 %, United Kingdom: 10 %, New Zealand: 28 %). CONCLUSIONS Health-seeking behaviours are adopted by some, but not all netballers after an ankle sprain. For those who sought care, most consulted a physiotherapist and were prescribed exercise-based interventions and external ankle support, but few received return-to-play clearance. Comparing countries, United Kingdom netballers had lower health-seeking behaviours and received less best-practice management than Australian and New Zealand netballers.
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Affiliation(s)
- Patrick L Rowe
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia. https://twitter.com/patrickrowe94
| | - Rana S Hinman
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia. https://twitter.com/HinmanRana
| | - Adam L Bryant
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
| | - Kade L Paterson
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
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Tummala SV, Morikawa L, Brinkman JC, Crijns TJ, Vij N, Gill V, Kile TA, Patel K, Chhabra A. Characterization of Ankle Injuries and Associated Risk Factors in the National Basketball Association: Minutes Per Game and Usage Rate Associated With Time Loss. Orthop J Sports Med 2023; 11:23259671231184459. [PMID: 37529529 PMCID: PMC10387785 DOI: 10.1177/23259671231184459] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/13/2023] [Indexed: 08/03/2023] Open
Abstract
Background Ankle injuries are more common in the National Basketball Association (NBA) compared with other professional sports. Purpose/Hypothesis The purpose of this study was to report the incidence and associated risk factors of ankle injuries in NBA athletes. It was hypothesized that factors associated with an increased physiologic burden, such as minutes per game (MPG), usage rate, and associated lower extremity injury, would be associated with increased ankle injury risk and time loss. Study Design Descriptive epidemiology study. Methods Ankle injury data from the 2015-2016 through 2020-2021 NBA seasons were evaluated. The truncated 2019-2020 season due to the COVID-19 pandemic was omitted. The primary outcome was the incidence of ankle injuries, reported per 1000 game-exposures (GEs). Secondary analysis was performed to identify risk factors for ankle injuries through bivariate analysis and multivariable logistic regression of player demographic characteristics, performance statistics, injury characteristics, and previous lower extremity injuries. Factors influencing the time loss after injury were assessed via a negative binomial regression analysis. Results A total of 554 ankle injuries (4.06 injuries per 1000 GEs) were sustained by NBA players over 5 NBA seasons, with sprain/strain the most common injury type (3.71 injuries per 1000 GEs). The majority of ankle injury events (55%) resulted in 2 to 10 game absences. The likelihood of sustaining an ankle injury was significantly associated with a greater number of games played (P = .029) and previous injury to the hip, hamstring, or quadriceps (P = .004). Increased length of absence due to ankle injury was associated with greater height (P = .019), MPG (P < .001), usage rate (P = .025), points per game (P = .011), and a prior history of foot (P = .003), ankle (P < .001), and knee injuries (P < .001). Conclusion The incidence of ankle injuries was 4.06 per 1000 GEs in professional basketball players. Games played and prior history of hip, hamstring, or quadriceps injuries were found to be risk factors for ankle injuries. Factors associated with physiologic burden such as MPG and usage rate were associated with an increased time loss after injury.
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Affiliation(s)
| | | | | | - Tom J. Crijns
- Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Neeraj Vij
- Phoenix Children’s Hospital, Phoenix, Arizona, USA
| | - Vikram Gill
- Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Todd A. Kile
- Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Karan Patel
- Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | - Anikar Chhabra
- Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, USA
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11
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Abstract
Despite the high frequency of ankle sprains, the ideal management is controversial, and a significant percentage of patients sustaining an ankle sprain never fully recover. There is strong evidence that residual disability of ankle joint injury is often caused by an inadequate rehabilitation and training program and early return to sports. Therefore, the athlete should start their criteria-based rehabilitation and gradually progress through the programmed activities, including cryotherapy, edema relief, optimal weight-bearing management, range of motion exercises for ankle dorsiflexion improvement, triceps surae stretching, isometric exercises and peroneus muscles strengthening, balance and proprioception training, and bracing/taping.
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Affiliation(s)
- Theodorakys Marín Fermín
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar.
| | - Ayyoub A Al-Dolaymi
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar
| | - Pieter D'Hooghe
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar
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12
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Wang F, Guan Y, Bamber Z, Cao X, Qi Q, Niu W, Chen B. Preventive interventions for lateral ankle sprains: A systematic review and meta-analysis. Clin Rehabil 2023; 37:585-602. [PMID: 36630892 DOI: 10.1177/02692155221137640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the effect of preventive interventions for lateral ankle sprain in the general population. DATA SOURCES A search of PubMed, EMBASE, Cochrane CENTRAL, Medline, CINAHL, and ClinicalTrials.gov was conducted up to August 2022. REVIEW METHODS Randomized controlled trials and prospective cohort studies that evaluated any interventions for preventing lateral ankle sprain were included. Two reviewers independently conducted the search, screening, and data extraction. The methodological quality of each study was assessed using the revised Cochrane risk-of-bias tool for randomized trials or using the Cochrane Risk Of Bias In Non-Randomized Studies tool for prospective cohort studies. RESULTS Seventeen studies met the inclusion criteria. Proprioceptive training exhibited better effects on preventing future lateral ankle sprain compared with the control group (risk ratio = 0.59, p < 0.001), and a stronger preventive effect was observed in participants with a history of lateral ankle sprain in the subgroup analysis (risk ratio = 0.49, p = 0.02). Compared with no bracing, ankle bracing had no significant better effect in preventing lateral ankle sprain (risk ratio = 0.43, p = 0.05). Proprioceptive training and ankle bracing had similar preventive effects (risk ratio = 0.98, p = 0.97). Limited evidence hindered the synthesis of data on pain, swelling, costs, and time loss. CONCLUSION Proprioceptive training is recommended for preventing lateral ankle sprain, especially for people with a history of lateral ankle sprain. Bracing seems to have an ambiguous preventive effect and requires more further investigation.
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Affiliation(s)
- Fanjia Wang
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Yonghao Guan
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zoe Bamber
- Division of Orthopaedics, Trauma and Sports Medicine, Faculty of Medicine and Health Sciences, School of Medicine, 6123University of Nottingham, Nottingham, UK
| | - Xianxin Cao
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Qi Qi
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Wenxin Niu
- Department of Rehabilitation Sciences, 481875Tongji University School of Medicine, Shanghai, China
| | - Bin Chen
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
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13
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Willwacher S, Bruder A, Robbin J, Kruppa J, Mai P. A Multidimensional Assessment of a Novel Adaptive Versus Traditional Passive Ankle Sprain Protection Systems. Am J Sports Med 2023; 51:715-722. [PMID: 36734465 PMCID: PMC9983046 DOI: 10.1177/03635465221146294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Ankle braces aim to reduce lateral ankle sprains. Next to protection, factors influencing user compliance, such as sports performance, motion restriction, and users' perceptions, are relevant for user compliance and thus injury prevention. Novel adaptive protection systems claim to change their mechanical behavior based on the intensity of motion (eg, the inversion velocity), unlike traditional passive concepts of ankle bracing. PURPOSE To compare the performance of a novel adaptive brace with 2 passive ankle braces while considering protection, sports performance, freedom of motion, and subjective perception. STUDY DESIGN Controlled laboratory study. METHODS The authors analyzed 1 adaptive and 2 passive (one lace-up and one rigid brace) ankle braces, worn in a low-cut, indoor sports shoe, which was also the no-brace reference condition. We performed material testing using an artificial ankle joint system at high and low inversion velocities. Further, 20 male, young, healthy team sports athletes were analyzed using 3-dimensional motion analysis in sports-related movements to address protection, sports performance, and active range of motion dimensions. Participants rated subjective comfort, stability, and restriction experienced when using the products. RESULTS Subjective stability rating was not different between the adaptive and passive systems. The rigid brace was superior in restricting peak inversion during the biomechanical testing compared with the passive braces. However, in the material test, the adaptive brace increased its stiffness by approximately 400% during the fast compared with the slow inversion velocities, demonstrating its adaptive behavior and similar stiffness values to passive braces. We identified minor differences in sports performance tasks. The adaptive brace improved active ankle range of motion and subjective comfort and restriction ratings. CONCLUSION The adaptive brace offered similar protective effects in high-velocity inversion situations to those of the passive braces while improving range of motion, comfort, and restriction rating during noninjurious motions. CLINICAL RELEVANCE Protection systems are only effective when used. Compared with traditional passive ankle brace technologies, the novel adaptive brace might increase user compliance by improving comfort and freedom of movement while offering similar protection in injurious situations.
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Affiliation(s)
- Steffen Willwacher
- Department of Mechanical and Process
Engineering, Offenburg University of Applied Sciences, Offenburg, Germany,Steffen Willwacher, Prof., Department of Mechanical and Process
Engineering, Offenburg University of Applied Sciences, Badstr. 24, 77652
Offenburg, Germany ()
(Twitter handle: @S_Willwacher)
| | - Anna Bruder
- Department of Mechanical and Process
Engineering, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Johanna Robbin
- Department of Mechanical and Process
Engineering, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Jakob Kruppa
- Department of Mechanical and Process
Engineering, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Patrick Mai
- Department of Mechanical and Process
Engineering, Offenburg University of Applied Sciences, Offenburg, Germany,Institute of Biomechanics and
Orthopaedics, German Sport University Cologne, Cologne, Germany
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14
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Vähi I, Rips L, Varblane A, Pääsuke M. Musculoskeletal Injury Risk in a Military Cadet Population Participating in an Injury-Prevention Program. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:356. [PMID: 36837558 PMCID: PMC9961050 DOI: 10.3390/medicina59020356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Background and Objectives: Musculoskeletal injuries are a major health hazard among military personnel. Previous research has proposed several exercise-based strategies for prevention. The purpose of this study was to investigate the effect of an exercise-based injury-prevention program on the incidence of musculoskeletal injury, motor performance and psychosocial status. Materials and Methods: Thirty-six Estonian Military Academy cadets were randomly assigned into either an intervention or control group. The intervention group followed a neuromuscular exercise-based injury-prevention warm-up program, three times per week for 6 months. The control group continued with the usual warm-up. The main outcome measure was injury incidence during the study period. Additionally, evaluation of isokinetic lower-extremity strength, postural sway, physical fitness and psychosocial status was included pre- and post-intervention. Results: During the 6-month study period, the musculoskeletal injury incidence was 43% in the intervention group and 54% in the control group (RR = 0.8; 95% CI = 0.41 to 1.99). The noted 20% risk reduction was not statistically significant (p = 0.59). Furthermore, there were no statistically significant differences between the intervention and control group in motor performance or psychosocial status measures. Conclusions: In conclusion, no effect of the exercise-based injury-prevention program on injury risk, motor performance or psychosocial status could be detected.
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Affiliation(s)
- Ivar Vähi
- Estonian Military Academy, War and Disaster Medicine Centre, Riia 12, 51010 Tartu, Estonia
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Ujula 4, 51008 Tartu, Estonia
| | - Leho Rips
- Estonian Military Academy, War and Disaster Medicine Centre, Riia 12, 51010 Tartu, Estonia
- Sports Medicine and Rehabilitation Clinic, Tartu University Hospital, Puusepa 1a, 50406 Tartu, Estonia
- Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, L. Puusepa 8, 50406 Tartu, Estonia
| | - Ahti Varblane
- Estonian Military Academy, War and Disaster Medicine Centre, Riia 12, 51010 Tartu, Estonia
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Ujula 4, 51008 Tartu, Estonia
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15
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The Effects of Motor Imagery on Pain in Lower Limb Sports Injuries: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10122545. [PMID: 36554069 PMCID: PMC9778028 DOI: 10.3390/healthcare10122545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
This review evaluated the efficacy of Motor Imagery intervention in athletes with lower limb sports injuries that could affect their pain levels during rehabilitation. We carried out a thorough research of the scientific literature for RCT studies in athletes with lower limb musculoskeletal sports injuries including search terms Motor Imagery AND pain, Motor Imagery AND sport injuries, Motor Imagery AND lower limb. We searched 3 major databases, PubMed, Scopus, and ScienceDirect, with the search period ranging from their inception until May 2022. We assessed the quality of the studies using the PEDro Scale and the data was recorded and extracted with the use of Mendeley software. The search criteria resulted in a pool of 10.107 possible articles. Upon completion of the selection procedure, only 3 RCT studies met the inclusion criteria with a total of 60 injured athletes (n = 18 with ankle sprain and n = 42 with ACL injuries). The meta-analysis showed no statistically significant positive effects of MI intervention on pain intensity after lower limb sports injuries (n = 60; MD = -1.57; 95% CI: -3.60 to 0.46; I2 = 50%; p = 0.13). The limited number of studies could justify the statistically insignificant effect of MI, but although the methodological quality of the studies was moderate to high, the heterogeneity of them was also relatively high. More RCT's are required to explore the effect of MI on pain in athletes with lower limb injuries in order to address psychophysiological processes during rehabilitation.
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16
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Thompson F, Rongen F, Cowburn I, Till K. The Impacts of Sports Schools on Holistic Athlete Development: A Mixed Methods Systematic Review. Sports Med 2022; 52:1879-1917. [PMID: 35260992 PMCID: PMC9325842 DOI: 10.1007/s40279-022-01664-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND To understand the multiple and wide-ranging impacts of intensified youth sport, the need for a holistic approach to athlete development has recently been advocated. Sports schools are an increasingly popular operationalisation of intensified youth sport, aiming to offer an optimal environment for holistic development by combining sport and education. Yet, no study has systematically explored the impacts associated with sports schools. OBJECTIVES The aims of this mixed method systematic review were to (1) determine the characteristics and features of sports schools; (2) identify the methods used to evaluate sports school impacts, and (3) evaluate the positive and negative holistic athlete development impacts associated with sports school programme involvement. METHODS Adhering to PRISMA guidelines, eight electronic databases were searched until the final return in February 2021. Forty-six articles satisfied the inclusion criteria, were analysed thematically, and synthesised using a narrative approach. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. RESULTS Findings indicated (1) sports school student-athletes receive considerable support in terms of academic and athletic services, more intensified training and competition schedules with high-level training partners, but regularly miss school; (2) multiple methods have been used to evaluate student-athlete impacts, making comparison across studies and developing consensus on the impacts of sports schools difficult; and (3) there are a multitude of immediate, short- and long-term positive and negative impacts associated with the academic/vocational, athletic/physical, psychosocial and psychological development of sports school student-athletes. CONCLUSIONS This study is the first to systematically review the research literature to understand the impacts associated with sports schools in terms of holistic athlete development. Practitioners should be aware that they can promote (positive) and negate (negative) health impacts through the design of an appropriate learning environment that simultaneously balances multiple training, academic, psychosocial and psychological factors that can be challenging for youth athletes. We recommend that practitioners aim to design and implement monitoring and evaluation tools that assess the holistic development of student-athletes within their sports schools to ensure they are promoting all-round and healthy youth athlete development.
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Affiliation(s)
- Ffion Thompson
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
- Queen Ethelburga's College, Thorpe Underwood, York, UK.
- Carnegie School of Sport, Leeds Beckett University, Room G07, Cavendish Hall, Headingley Campus, Leeds, LS6 3QS, UK.
| | - Fieke Rongen
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Ian Cowburn
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Kevin Till
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
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17
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Beck JJ, Carpenter CM, West N, Sabatino MJ, Ellis HB. Treatment Variability and Complications Associated With Pediatric Lateral Ankle Injuries: A POSNA Quality, Safety, and Value Initiative Survey. Orthop J Sports Med 2022; 10:23259671221100223. [PMID: 35668871 PMCID: PMC9163735 DOI: 10.1177/23259671221100223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/17/2022] [Indexed: 12/26/2022] Open
Abstract
Background Isolated pediatric lateral ankle injuries, including ankle sprain (AS) and nondisplaced Salter-Harris type 1 (SH-1) distal fibular fracture, are common orthopaedic sports-related injuries. Variability in treatment is suspected among pediatric orthopaedic surgeons. Complications from medical treatment or lack thereof have not been reported in this population. Purpose The purpose of this study was to investigate treatment variability and associated complications after pediatric AS and SH-1 via a survey of members of the Pediatric Orthopaedic Society of North American (POSNA). Study Design Cross-sectional study. Level of evidence, 5. Methods A voluntary, anonymous survey was distributed to POSNA membership (approximately 1400 members) via email. Survey questions, specific to both grade 1 or 2 AS and nondisplaced or minimally displaced SH-1 injuries in skeletally immature patients, focused on initial evaluation, immobilization, return to sports, and complications. We analyzed variability both in treatment between AS and SH-1 injury and in respondent characteristics. For statistical analysis, chi-square or Fisher exact test was used for categorical variables, and analysis of variance was used for continuous variables. Results The survey response rate was 16.4% (229/1400). Of the respondents, 27.7% used examination only to distinguish between AS and SH-1, whereas 18.7% performed serial radiography to aid with diagnosis. A controlled ankle motion boot or walking boot was the most common immobilization technique for both AS (46.3%) and SH-1 (55.6%); the second most common technique was bracing in AS (33.5%) and casting in SH-1 (34.7%). Approximately one-third of all respondents recommended either outpatient or home physical therapy for AS, whereas only 11.4% recommended physical therapy for SH-1 (P < .01). Results showed that 81.2% of respondents reported no complications for SH-1 treatment and 87.8% reported no complications for AS treatment. Cast complications were reported by 9.6% for SH-1 and 5.2% for AS. Rare SH-1 complications included distal fibular growth arrest, infection, nonunion, late fracture displacement, and recurrent fracture. Conclusion Significant variability was found in primary treatment of pediatric AS and SH-1 injuries. Rare complications from injury, treatment, and neglected treatment after SH-1 and AS were reported.
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Affiliation(s)
- Jennifer J. Beck
- Orthopaedic Institute for Children, Los Angeles, California, USA
| | | | - Nicole West
- Orthopaedic Institute for Children, Los Angeles, California, USA
| | | | - Henry B. Ellis
- Scottish Rite for Children, Dallas, Texas, USA
- University of Texas Southwestern, Dallas, Texas, USA
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18
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The effect of ankle supports on lower limb biomechanics during functional tasks: a systematic review with meta-analysis. J Sci Med Sport 2022; 25:615-630. [DOI: 10.1016/j.jsams.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 11/18/2022]
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19
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Owoeye OBA, Whittaker JL, Toomey CM, Räisänen AM, Jaremko JL, Carlesso LC, Manske SL, Emery CA. Health-Related Outcomes 3-15 Years Following Ankle Sprain Injury in Youth Sport: What Does the Future Hold? Foot Ankle Int 2022; 43:21-31. [PMID: 34353138 DOI: 10.1177/10711007211033543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND This study examined the association between youth sport-related ankle sprain injury and health-related outcomes, 3-15 years postinjury. METHODS A historical cohort study in which uninjured controls were cluster-matched with injured cases. The primary outcome was self-reported Foot and Ankle Outcome Score (FAOS). Secondary outcomes included measures of adiposity, validated questionnaires for physical activity, athletic identity, fear of pain, and tests of strength, balance, and function. RESULTS We recruited 86 participants (median age of 23 years; 77% female); 50 with a time-loss ankle sprain, median of 8 years postinjury, and 36 uninjured controls cluster-matched by sex and sport. Based on mixed effects multivariable regression models, previously injured participants demonstrated poorer outcomes than controls on all 5 FAOS subscales regardless of sex and time since injury, with the largest differences observed in symptoms (-20.9, 99% CI: -29.5 to -12.3) and ankle-related quality of life (-25.3, 99% CI: -34.7 to -15.9) subscales. Injured participants also had poorer unipedal dynamic balance (-1.9, 99% CI: 3.5 to -0.2) and greater fear of pain (7.2, 99% CI: 0.9-13.4) compared with controls. No statistically significant differences were found for other secondary outcomes. CONCLUSION At 3-15 years following time-loss ankle sprain injury in youth sport, previously injured participants had more pain and symptoms, poorer self-reported function, ankle-related quality of life, reduced sport participation, balance, and greater fear of pain than controls. This underlines the need to promote the primary prevention of ankle sprains and secondary prevention of potential health consequences, including posttraumatic osteoarthritis. LEVEL OF EVIDENCE Level III, historical cohort study.
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Affiliation(s)
- Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St Louis, MO, USA.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jackie L Whittaker
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Clodagh M Toomey
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Republic of Ireland
| | - Anu M Räisänen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Department of Physical Therapy Education, College of Health Sciences, Western University of Health Sciences, Lebanon, OR, USA
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa C Carlesso
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sarah L Manske
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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20
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Stephenson SD, Kocan JW, Vinod AV, Kluczynski MA, Bisson LJ. A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies. Orthop J Sports Med 2021; 9:23259671211035776. [PMID: 34734094 PMCID: PMC8558815 DOI: 10.1177/23259671211035776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/03/2021] [Indexed: 12/26/2022] Open
Abstract
Background A large volume of systematic reviews and meta-analyses has been published on the effectiveness of sports injury prevention programs. Purpose To provide a qualitative summary of published systematic reviews and meta-analyses that have examined the effectiveness of sports injury prevention programs on reducing musculoskeletal injuries. Study Design Systematic review; Level of evidence, 4. Methods We searched the PubMed, CINAHL, EMBASE, and the Cochrane databases for systematic reviews and meta-analyses that evaluated the effectiveness of sports injury prevention programs. We excluded published abstracts, narrative reviews, articles not published in English, commentaries, studies that described sports injury prevention strategies but did not assess their effectiveness, studies that did not assess musculoskeletal injuries, and studies that did not assess sports-related injuries. The most relevant results were extracted and summarized. Levels of evidence were determined per the Oxford Centre for Evidence-Based Medicine, and methodological quality was assessed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, revised version). Results A total of 507 articles were retrieved, and 129 were included. Articles pertaining to all injuries were divided into 9 topics: sports and exercise in general (n = 20), soccer (n = 13), ice hockey (n = 1), dance (n = 1), volleyball (n = 1), basketball (n = 1), tackle collision sports (n = 1), climbing (n = 1), and youth athletes (n = 4). Articles on injuries by anatomic site were divided into 11 topics: general knee (n = 8), anterior cruciate ligament (n = 34), ankle (n = 14), hamstring (n = 11), lower extremity (n = 10), foot (n = 6), groin (n = 2), shoulder (n = 1), wrist (n = 2), and elbow (n = 1). Of the 129 studies, 45.7% were ranked as evidence level 1, and 55.0% were evidence level 2. Based on the AMSTAR-2, 58.9% of the reviews reported a priori review methods, 96.1% performed a comprehensive literature search, 47.3% thoroughly described excluded articles, 79.1% assessed risk of bias for individual studies, 48.8% reported a valid method for statistical combination of data (ie, meta-analysis), 45.0% examined the effect of risk of bias on pooled study results, and 19.4% examined the risk for publication bias. Conclusion This comprehensive review provides sports medicine providers with a single source of the most up-to-date publications in the literature on sports injury prevention.
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Affiliation(s)
- Samuel D Stephenson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Joseph W Kocan
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Amrit V Vinod
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Melissa A Kluczynski
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Leslie J Bisson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
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21
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Eberbach H, Gehring D, Lange T, Ovsepyan S, Gollhofer A, Schmal H, Wenning M. Efficacy of a semirigid ankle brace in reducing mechanical ankle instability evaluated by 3D stress-MRI. J Orthop Surg Res 2021; 16:620. [PMID: 34663386 PMCID: PMC8522107 DOI: 10.1186/s13018-021-02750-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/24/2021] [Indexed: 12/26/2022] Open
Abstract
Background Novel imaging technologies like 3D stress-MRI of the ankle allow a quantification of the mechanical instability contributing to chronic ankle instability. In the present study, we have tested the efficacy of a semirigid ankle brace on joint congruency in a plantarflexion/supination position with and without load. Methods In this controlled observational study of n = 25 patients suffering from mechanical ankle instability, a custom-built ankle arthrometer implementing a novel 3D-stress MRI technique was used to evaluate the stabilizing effect of an ankle brace. Three parameters of joint congruency (i.e., 3D cartilage contact area fibulotalar, tibiotalar horizontal and tibiotalar vertical) were measured. The loss of cartilage contact area from neutral position to a position combined of 40° of plantarflexion and 30° of supination without and with axial load of 200 N was calculated. A semirigid ankle brace was applied in plantarflexion/supination to evaluate its effect on joint congruence. Furthermore, the perceived stability of the brace during a hopping task was analyzed using visual analogue scale (VAS). Results The application of a semirigid brace led to an increase in cartilage contact area (CCA) when the foot was placed in plantarflexion and supination. This effect was visible for all three compartments of the upper ankle joint (P < 0.001; η2 = 0.54). The effect of axial loading did not result in significant differences. The subjective stability provided by the brace (VAS 7.6/10) did not correlate to the magnitude of the improvement of the overall joint congruency. Conclusions The stabilizing effect of the semirigid ankle brace can be verified using 3D stress-MRI. Providing better joint congruency with an ankle brace may reduce peak loads at certain areas of the talus, which possibly cause osteochondral or degenerative lesions. However, the perceived stability provided by the brace does not seem to reflect into the mechanical effect of the brace. Trial registration The study protocol was prospectively registered at the German Clinical Trials Register (#DRKS00016356).
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Affiliation(s)
- Helge Eberbach
- Department of Orthopedic and Trauma Surgery, University Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Dominic Gehring
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
| | - Thomas Lange
- Center for Diagnostic and Therapeutic Radiology, Medical Physics, University Medical Center, Faculty of Medicine, University of Freiburg, Kilianstrasse 5, 79106, Freiburg, Germany
| | - Spartak Ovsepyan
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
| | - Hagen Schmal
- Department of Orthopedic and Trauma Surgery, University Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.,Department of Orthopaedic Surgery, Odense University Hospital, J.B. Winslows Vej 4, 5000, Odense, Denmark
| | - Markus Wenning
- Department of Orthopedic and Trauma Surgery, University Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.,Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
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22
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Esposito F, Barni L, Manzi F, Braccio P, Latella L, Corvi A, Freddolini M. Does ankle Kinesio Taping® application improve static and dynamic balance in healthy trained semi-professional soccer male players? A single blinded randomized placebo controlled crossover study. Sci Sports 2021. [DOI: 10.1016/j.scispo.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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23
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Bamber ZA, Wheeler PC, Swain ID, Fong DT. Effect of 8-week treadmill running with peroneal muscle functional electrical stimulation on laterally deviated centre of plantar pressure position and star excursion balance test performance. J Rehabil Assist Technol Eng 2021; 8:20556683211021526. [PMID: 34434562 PMCID: PMC8381417 DOI: 10.1177/20556683211021526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 05/13/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Ankle sprain is a common injury that can have long-term sequelae resulting in pain, swelling and a reduction of physical activity participation. Previous research has shown a laterally deviated centre of pressure (COP) during running gait increases the risk of lateral ankle sprain. As a method of altering COP, electrical stimulation has been considered. Method A group of 14 healthy males were randomly allocated to case control groups which were single blinded. The intervention involved an 8-week training programme of functional electrical stimulation to the peroneal muscles during treadmill running, with a sham control group. Outcomes were COP position and star excursion balance test. Statistical analysis was through SPSS using a combination of MANOVA, T-tests and Wilcoxon signed rank. Results There was a significant difference in the results post intervention at max pressure for intervention M = 0.7(±0.7) and control M = -6.0 (±4.6) conditions; t(6) = -2.9, p < 0.05. Conclusion It has been demonstrated that FES can alter COP during max pressure in running gait after an 8-week training programme, although carry over effect appears limited and further testing is required.
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Affiliation(s)
- Zoe A Bamber
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Division of Orthopaedics, Trauma and Sports Medicine, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Patrick C Wheeler
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Department of Sport and Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ian D Swain
- The Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK
| | - Daniel Tp Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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24
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Dickerson LC, Queen RM. Foot Posture and Plantar Loading With Ankle Bracing. J Athl Train 2021; 56:461-472. [PMID: 34000019 DOI: 10.4085/1062-6050-164-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk. Ankle bracing is commonly used in sport to prevent these injuries, but no researchers have examined the effects of ankle bracing on plantar loading. OBJECTIVE To evaluate the effects of ankle braces on plantar loading during athletic tasks. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 36 participants (11 men, 25 women; age = 23.1 ± 2.5 years, height = 1.72 ± 0.09 m, mass = 66.3 ± 14.7 kg) were recruited for this study. INTERVENTION(S) Participants completed walking, running, and cutting tasks in 3 bracing conditions: no brace, lace-up ankle-support brace, and semirigid brace. MAIN OUTCOME MEASURE(S) We analyzed the plantar-loading variables of contact area, maximum force, and force-time integral for 2 midfoot and 3 forefoot regions and assessed the displacement of the center of pressure. A 3 × 3 mixed-model repeated-measures analysis of variance was used to determine the effects of brace and foot type (α = .05). RESULTS Foot type affected force measures in the middle (P range = .003-.047) and the medial side of the foot (P range = .004-.04) in all tasks. Brace type affected contact area in the medial midfoot during walking (P = .005) and cutting (P = .01) tasks, maximum force in the medial and lateral midfoot during all tasks (P < .001), and force-time integral in the medial midfoot during all tasks (P < .001). Portions of the center-of-pressure displacement were affected by brace wear in both the medial-lateral and anterior-posterior directions (P range = .001-.049). CONCLUSIONS Ankle braces can be worn to redistribute plantar loading. Additional research should be done to evaluate their effectiveness in injury prevention.
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Affiliation(s)
- Laura C Dickerson
- Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg
| | - Robin M Queen
- Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg
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25
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Stotz A, John C, Gmachowski J, Rahlf AL, Hamacher D, Hollander K, Zech A. Effects of elastic ankle support on running ankle kinematics in individuals with chronic ankle instability and healthy controls. Gait Posture 2021; 87:149-155. [PMID: 33933933 DOI: 10.1016/j.gaitpost.2021.04.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 04/12/2021] [Accepted: 04/21/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with chronic ankle instability (CAI) have an increased risk for recurrent injuries. The preventive effects of external ankle supports are not fully understood. This study aimed to examine the effect of elastic ankle support on running ankle kinematics. METHODS 3D running gait analysis of individuals with and without CAI was conducted at three-minute-running trials at 2.78 m/s with and without elastic ankle support in a randomised order. Ankle kinematics and intra-individual standard deviations (variability) were calculated at each percent of the running gait cycle. Group and ankle support effects were calculated using statistical parameter mapping. RESULTS Twenty-seven individuals were analysed (CAI: n = 14, controls: n = 13). When wearing ankle support, CAI individuals showed significantly decreased plantarflexion angles at 43-47 % (p = 0.033) and 49-51 % (p = 0.043) of the running gait cycle compared to normal running. In healthy controls, no differences in ankle angles between both conditions were found. Comparisons between CAI individuals and healthy controls showed statistically significant differences in the plantar-/dorsiflexion angles at 38-41 % (p = 0.044) with ankle support and at 34-46 % (p = 0.004) without ankle support. Significant ankle angle variability differences were found for ankle in-/eversion between CAI individuals and healthy controls (p = 0.041) at 32-33 % of the running gait cycle. CONCLUSIONS Elastic ankle support reduces the range of sagittal plane running ankle kinematics of CAI individuals but not of healthy controls. Further research is needed to evaluate the association between ankle support effects and the risk for recurrent ankle sprains.
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Affiliation(s)
- Andreas Stotz
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany.
| | - Cornelius John
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
| | - Julian Gmachowski
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
| | - Anna Lina Rahlf
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
| | - Daniel Hamacher
- Methods and Statistics in Sports, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany; Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, 1575 Cambridge St., Cambridge, MA, 02138, USA
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749, Jena, Germany
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Fuerst P, Gollhofer A, Wenning M, Gehring D. People with chronic ankle instability benefit from brace application in highly dynamic change of direction movements. J Foot Ankle Res 2021; 14:13. [PMID: 33596976 PMCID: PMC7890883 DOI: 10.1186/s13047-021-00452-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/26/2021] [Indexed: 12/26/2022] Open
Abstract
Background The application of ankle braces is an effective method for the prevention of recurrent ankle sprains. It has been proposed that the reduction of injury rates is based on the mechanical stiffness of the brace and on beneficial effects on proprioception and neuromuscular activation. Yet, how the neuromuscular system responds to the application of various types of ankle braces during highly dynamic injury-relevant movements is not well understood. Enhanced stability of the ankle joint seems especially important for people with chronic ankle instability. We therefore aimed to analyse the effects of a soft and a semi-rigid ankle brace on the execution of highly dynamic 180° turning movements in participants with and without chronic ankle instability. Methods Fifteen participants with functional ankle instability, 15 participants with functional and mechanical ankle instability and 15 healthy controls performed 180° turning movements in reaction to light signals in a cross-sectional descriptive laboratory study. Ankle joint kinematics and kinetics as well as neuromuscular activation of muscles surrounding the ankle joint were determined. Two-way repeated measures analyses of variance and post-hoc t-tests were calculated. Results Maximum ankle inversion angles and velocities were significantly reduced with the semi-rigid brace in comparison to the conditions without a brace and with the soft brace (p ≤ 0.006, d ≥ 0.303). Effect sizes of these reductions were larger in participants with chronic ankle instability than in healthy controls. Furthermore, peroneal activation levels decreased significantly with the semi-rigid brace in the 100 ms before and after ground contact. No statistically significant brace by group effects were found. Conclusions Based on these findings, we argue that people with ankle instability in particular seem to benefit from a semi-rigid ankle brace, which allows them to keep ankle inversion angles in a range that is comparable to values of healthy people. Lower ankle inversion angles and velocities with a semi-rigid brace may explain reduced injury incidences with brace application. The lack of effect of the soft brace indicates that the primary mechanism behind the reduction of inversion angles and velocities is the mechanical resistance of the brace in the frontal plane.
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Affiliation(s)
- Patrick Fuerst
- Department of Sport Science, University of Freiburg, Sandfangweg 4, 79102, Freiburg i. Br, Germany.
| | - Albert Gollhofer
- Department of Sport Science, University of Freiburg, Sandfangweg 4, 79102, Freiburg i. Br, Germany
| | - Markus Wenning
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Dominic Gehring
- Department of Sport Science, University of Freiburg, Sandfangweg 4, 79102, Freiburg i. Br, Germany
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Halabchi F, Hassabi M. Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World J Orthop 2020; 11:534-558. [PMID: 33362991 PMCID: PMC7745493 DOI: 10.5312/wjo.v11.i12.534] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/04/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023] Open
Abstract
Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40% of all sports-related injuries. It is especially common in basketball, American football, and soccer. The majority of sprains affect the lateral ligaments, particularly the anterior talofibular ligament. Despite its high prevalence, a high proportion of patients experience persistent residual symptoms and injury recurrence. A detailed history and proper physical examination are diagnostic cornerstones. Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules. Several interventions have been recommended in the management of acute ankle sprains including rest, ice, compression, and elevation, analgesic and anti-inflammatory medications, bracing and immobilization, early weight-bearing and walking aids, foot orthoses, manual therapy, exercise therapy, electrophysical modalities and surgery (only in selected refractory cases). Among these interventions, exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process. An exercise program should be comprehensive and progressive including the range of motion, stretching, strengthening, neuromuscular, proprioceptive, and sport-specific exercises. Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables, manual tests for stability, and functional performance testing. There are some common myths and mistakes in the management of ankle sprains, which all clinicians should be aware of and avoid. These include excessive imaging, unwarranted non-weight-bearing, unjustified immobilization, delay in functional movements, and inadequate rehabilitation. The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.
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Affiliation(s)
- Farzin Halabchi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Mohammad Hassabi
- Department of Sports and Exercise Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19979-64151, Iran
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28
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The Effect of Ankle Brace Use on a 3-Step Volleyball Spike Jump Height. Arthrosc Sports Med Rehabil 2020; 2:e461-e467. [PMID: 33134981 PMCID: PMC7588605 DOI: 10.1016/j.asmr.2020.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/28/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose The purpose of this study was to determine whether ankle brace use in university-level varsity volleyball athletes affected their 3-step spike jump height and whether certain types of ankle braces have a greater effect on jump height. Methods Nine male university-level varsity volleyball athletes participated in a repeated-measures design study in which each athlete performed three 3-step volleyball spike jumps in 3 ankle brace conditions (soft, rigid, and no brace). Vertical jump height was measured by the Vertec device and video motion analysis at a university biomechanics research laboratory. Results Vertical jump heights were significantly lower in both brace conditions (soft, 2.3 cm, standard deviation [SD] 1.2 cm, P < .001; rigid, 1.7 cm, SD 0.9 cm, P < .003) compared with the no-brace condition, and no differences in vertical jump height were observed between the brace conditions (0.6 cm, SD 0.3, P = .3). There was a negative correlation between body fat percentage and vertical jump height (r = –0.075, P = .02). The Vertec device reliably measured vertical jump in all 3 conditions. The no-brace vertical ground reaction forces during the loading phase were significantly greater than brace conditions. Ankle range of motion was greatest in the no-brace condition. Conclusions Results from this study suggests that high-performance athletes wearing ankle braces experience a significant decrease in vertical jump height independent of the type of ankle brace worn. Clinical Relevance Sports physicians and health care providers caring for high-level athletes should counsel athletes on the trade-offs of wearing protective equipment in sport, as potential decreases in sports performance can lead to increased injury prevention. Level of Evidence III.
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29
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Zhang C, Ji X, Xue Y, Hu G. Statistical ankle-shape and pressure analysis for design of elastic tubular bandage. Proc Inst Mech Eng H 2020; 235:148-156. [PMID: 33070763 DOI: 10.1177/0954411920965286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ankles can benefit from the elastic tube bandage (ETB) by providing the ankle joint with compression, but partial high- or low-pressure leads to body discomfort. The aim of this paper is to propose a method for analyzing the ankle shape with the fabric compression which is basis on the comfortable pressure on human body. First, a standard model of ankle is established from the scanned data of 306 samples, and the mapping of the fabric shape curves on ankle were constructed by the U-direction convex curves of the model. The positions or areas of maximum and minimum pressure are then marked by extracting the curvatures of the fabric shape curves. According to the Laplace's Law, the sizes of ETBs can be calculated given that the value of comfortable pressure on human body is the maximum one. The data of calculation is approximate to the relevant previous studies which has the same parameters of ETBs. Nine groups of the ankle shapes from the database are discussed, each group has a proportional coefficient to the standard model, and the result shows that six sizes of ETBs with comfort pressure match for the nine groups. These can be applied to the comfort design, and the method proposed can boost size customization of ETBs, as well as will inspire the research on other elastic compression garments.
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Affiliation(s)
- Chunqiang Zhang
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an, China
| | - Xiaomin Ji
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an, China
| | - Yanmin Xue
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an, China
| | - Gang Hu
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xi'an, China
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Cupler ZA, Alrwaily M, Polakowski E, Mathers KS, Schneider MJ. Taping for conditions of the musculoskeletal system: an evidence map review. Chiropr Man Therap 2020; 28:52. [PMID: 32928244 PMCID: PMC7491123 DOI: 10.1186/s12998-020-00337-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background Taping is a common treatment modality used by many rehabilitation providers. Several types of tapes and taping methods are used in the treatment of musculoskeletal dysfunction and pain. Purpose To summarize and map the evidence related to taping methods used for various joints and conditions of the musculoskeletal system, and to provide clinicians and researchers with a user-friendly reference with organized evidence tables. Data sources The PEDro, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register for Controlled Trials, PubMed, and PROSPERO databases were searched from inception through October 31, 2019. Study selection Eligible studies were selected by two independent reviewers and included either systematic reviews (SRs) or randomized controlled trials (RCTs) and included a musculoskeletal complaint using a clinical outcome measure. Data extraction Data was extracted by two investigators independently. Risk of bias and quality were assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) for SRs or the Physiotherapy Evidence Database (PEDro) scale for RCTs. The protocol was registered with PROSPERO (CRD42019122857). Data synthesis Twenty-five musculoskeletal conditions were summarized from forty-one SRs and 127 RCTs. There were 6 SRs and 49 RCTs for spinal conditions. Kinesio tape was the most common type of tape considered. Four evidence tables representing the synthesized SRs and RCTs were produced and organized by body region per condition. Limitations Inclusion of only English language studies. Also, the heterogeneous nature of the included studies prevented a meta-analysis. Conclusions There is mixed quality evidence of effectiveness for the different types of taping methods for different body regions and conditions. All of the SRs and RCTs found during our search of the taping literature have been organized into a series of appendices. A synthesis of the results have been placed in evidence tables that may serve as a useful guide to clinicians and researchers.
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Affiliation(s)
- Zachary A Cupler
- Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, 353 N. Duffy Road, Butler, Pennsylvania, USA.
| | - Muhammad Alrwaily
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, West Virginia, USA.,Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Emily Polakowski
- Private Practice, Independence Physical Therapy, Mystic, Connecticut, USA
| | - Kevin S Mathers
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Michael J Schneider
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Lai JHC, Ling SKK, Cacho P, Mok SW, Yung PSH. The effects of shoe collar height on ankle sprain mechanics in athletes: A review of literature. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720950325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Our aim was to conduct a review to summarize the existing information regarding the effects of shoe collar height in altering ankle sprain mechanics in athletes. Methods: A systematic literature search of PubMed, Embase, MEDLINE, and SPORTDiscus was conducted in September 2019. Results: There were 10 studies published from 1993 to 2019 that were included. Most studies showed high-top shoes limited ankle sprain kinematics and increased resistance to inversion moment in static but not dynamic testing. High-top shoes were associated with delayed pre-landing ankle evertor muscle activation and smaller electromyography amplitudes. Conclusions: There is currently weak evidence to support that high-top shoes can limit ankle sprain kinematics in dynamic testing. Further studies with more consistent study interventions and outcome variables are needed to definitively establish the effects of shoe collar height on ankle sprain mechanics in athletes. The Translational Potential of this Article: Multiple studies on the effects of shoe collar height and ankle sprain mechanics have been performed but there is a lack of consistency in terms of study design, intervention, and outcome measures. A formal systematic review and meta-analysis were not applicable due to the heterogeneity of studies, and mixed results from these studies can be confusing to interpret, making further research on this topic difficult as a result of lack of future direction. We summarized the existing literature on this topic to provide a clearer picture and guide future research on this controversial matter.
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Affiliation(s)
- Jojo Hoi-Ching Lai
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - Samuel KK Ling
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - Patrick Cacho
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - SW Mok
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - Patrick SH Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
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Is an Elastic Ankle Support Effective in Improving Jump Landing Performance, and Static and Dynamic Balance in Young Adults With and Without Chronic Ankle Instability? J Sport Rehabil 2020; 29:789-794. [PMID: 31629338 DOI: 10.1123/jsr.2019-0147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/23/2019] [Accepted: 06/09/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT In some patients, ankle sprains lead to chronic symptoms like pain or muscular weakness called chronic ankle instability (CAI). External ankle supports have shown to be effective in preventing sprains and reducing recurrence, but the underlying mechanisms are unclear. As sensorimotor variables are associated with injury incidence, an influence of external ankle support on landing performance and balance seems plausible. OBJECTIVE To analyze the effects of an elastic ankle support on jump landing performance and static and dynamic balance in patients with CAI and healthy controls. DESIGN Crossover study. SETTING Functional tests in a laboratory setting. PATIENTS OR OTHER PARTICIPANTS Twenty healthy students and 20 patients with CAI were included for study participation based on their scores in ankle stability and function questionnaires. INTERVENTION Healthy and CAI participants performed each test with and without an elastic ankle support. MAIN OUTCOME MEASURES (1) Jump landing performance was measured with the Landing Error Scoring System, (2) static balance was assessed with the Balance Error Scoring System, and (3) dynamic balance was assessed using the Y Balance Test. Linear mixed models were used to analyze the effects of the elastic ankle support on sensorimotor parameters. RESULTS Healthy controls performed significantly better in the Landing Error Scoring System (P = .01) and Y Balance Test anterior direction (P = .01). No significant effects of elastic ankle support on Landing Error Scoring System, Balance Error Scoring System, or Y Balance Test performance were observed in the CAI or control group. There were no significant group-by-ankle support interactions. CONCLUSIONS In the current study, the acute use of elastic ankle support was ineffective for enhancing jump landing performance, and static and dynamic balance. Further research is needed to identify the underlying mechanisms of the preventive effects of elastic ankle support.
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Abstract
Purpose of Review The purpose of this review is to describe the current evidence on the most common sports-related ankle injuries. Joint anatomy, epidemiology, clinical findings, diagnostic approach, and treatment are presented with a specific focus on the available evidence towards return to play. Recent Findings Recent findings show that ankle sprain is the most common injury in the world of sports. Bony fractures, cartilage defects, and syndesmotic lesions are frequently seen in association with the more severe type of ankle sprains. Summary In summary, the majority of the athletes’ ankle sprains are managed conservatively with excellent outcomes and full return to their pre-injury level of play. However, it is essential to differentiate the single ligament sprain from a more complex injury to the ankle joint. The evidence-based treatment and rehabilitation programmes are associated with a better prognosis and a faster time to return to sport participation.
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Affiliation(s)
- P D'Hooghe
- Department of Orthopaedic Surgery, Aspetar Sports Medicine and Orthopedic Surgery Hospital, Sports City Street 1, Aspire Zone, P.O. Box: 29222, Doha, Qatar.
| | - F Cruz
- Department of Orthopaedic Surgery, Aspetar Sports Medicine and Orthopedic Surgery Hospital, Sports City Street 1, Aspire Zone, P.O. Box: 29222, Doha, Qatar
| | - K Alkhelaifi
- Department of Orthopaedic Surgery, Aspetar Sports Medicine and Orthopedic Surgery Hospital, Sports City Street 1, Aspire Zone, P.O. Box: 29222, Doha, Qatar
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Ihmels WD, Seymore KD, Brown TN. Effect of Sex and Ankle Brace Design on Knee Biomechanics During a Single-Leg Cut. Am J Sports Med 2020; 48:1496-1504. [PMID: 32223652 DOI: 10.1177/0363546520911048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Despite success at preventing ankle sprain, prophylactics that restrict ankle plantarflexion motion may produce deleterious knee biomechanics and increase injury risk. PURPOSE To determine if ankle prophylactics that restrict plantar- and dorsiflexion motion produce changes in knee biomechanics during a single-leg cut and whether those changes differ between sexes. STUDY DESIGN Controlled laboratory study. METHODS A total of 17 male and 17 female participants performed a single-leg cut with 4 conditions: Ankle Roll Guard (ARG), lace-up brace, nonelastic tape, and an unbraced control. Peak stance knee flexion, abduction, and internal rotation joint angle and moment; total knee reaction moment (TKM) and its components (sagittal, frontal, and transverse); and ankle plantarflexion and inversion range of motion (ROM) and peak stance joint moments were tested with a repeated measures analysis of variance to determine the main effect and interaction of condition and sex. RESULTS Brace and tape restricted plantarflexion ROM as compared with ARG and control (all P < .001). With the brace, women had increased peak knee abduction angle versus ARG (P = .012) and control (P = .009), and men had decreased peak knee internal rotation moment as compared with ARG (P = .032), control (P = .006), and tape (P = .003). Although the restrictive tape decreased inversion ROM when compared with ARG (P = .004) and brace (P = .017), it did not change knee biomechanics. Neither brace nor tape produced significant changes in TKM or components, yet sagittal TKM increased with ARG versus control (P = .016). Women exhibited less ankle inversion ROM (P = .003) and moment (P = .049) than men, while men exhibited significantly greater frontal TKM (P = .022) and knee internal rotation moment with the ARG (P = .029), control (P = .007), and tape (P = .016). CONCLUSION Prophylactics that restrict ankle plantarflexion motion may elicit knee biomechanical changes during a single-leg cut, but these changes may depend on prophylactic design and user's sex and may increase women's injury risk. CLINICAL RELEVANCE Sex-specific ankle prophylactic designs may be warranted to reduce knee injury during sports.
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Affiliation(s)
- Wyatt D Ihmels
- Department of Kinesiology, Boise State University, Boise, Idaho, USA
| | - Kayla D Seymore
- Department of Kinesiology, Boise State University, Boise, Idaho, USA
| | - Tyler N Brown
- Department of Kinesiology, Boise State University, Boise, Idaho, USA
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Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses. Sports Med 2019; 48:2775-2784. [PMID: 30298478 DOI: 10.1007/s40279-018-0993-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Ankle bracing has been verified as being effective for secondary prevention of ankle injuries. However, new studies have recently been published that are not included in previous meta-analyses. Furthermore, the effects of bracing for primary prevention of ankle injuries are still unclear. OBJECTIVE The objective of this article was to systematically review the literature about the effectiveness of ankle bracing on primary and secondary prevention of acute ankle injuries in athletes. METHODS We searched PubMed, EMBASE, SPORTDiscus, CINAHL, and PEDro databases for eligible articles until July 2018. Randomized controlled trials that studied ankle bracing vs. no intervention for athletes were included. Risk of bias was assessed with the Cochrane Risk of Bias tool. Meta-analyses were conducted to study the effect of ankle bracing for primary and secondary prevention of ankle injuries. The Grading of Recommendation Assessment, Development, and Evaluation method was used to determine the quality of evidence. RESULTS We included six randomized controlled trials. Significant risk ratios of 0.53 (95% confidence interval 0.32-0.88) and 0.37 (95% confidence interval 0.24-0.58) were found in favor of ankle bracing vs. no ankle bracing for primary (low quality of evidence, I2 = 77%) and secondary prevention (moderate quality of evidence, I2 = 0%) of acute ankle injuries. Numbers needed to treat were 26 and 12 for the primary and secondary prevention of acute ankle injuries. CONCLUSIONS Ankle bracing is effective for primary and secondary prevention of acute ankle injuries among athletes. However, conclusions in regard to primary prevention should be drawn cautiously because of the low quality of evidence and significant heterogeneity.
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Review of Musculoskeletal Injury Prevention in Female Soccer Athletes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00230-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Ankle sprains are common injuries involving the lateral ankle ligaments and affect athletes of all levels. Most patients heal uneventfully, but those with symptoms persisting past 3 months should be evaluated for chronic ankle instability and its associated conditions as well as for the presence of varus malalignment. Chronic ankle instability is initially treated nonoperatively, with surgical management reserved for those who have failed to improve after 3 to 6 months of bracing and functional rehabilitation. Anatomic repair using a modification of the Broström procedure is the preferred technique for initial surgery. Anatomic reconstruction with tendon graft should be considered when repair is not possible, as it maintains physiological joint kinematics. Nonanatomic reconstructions are seldom indicated. Arthroscopic repair or reconstruction of the lateral ankle ligaments is a promising new technique with results similar to those of open surgery.
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Affiliation(s)
| | | | - Yu Deng
- Department of Foot and Ankle Surgery, Wuhan University, Hubei, China
| | - L. Daniel Latt
- Department of Orthopaedic Surgery, University of Arizona, Tucson
- San Antonio Military Medical Center, TX
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Abstract
CONTEXT Given the frequency of ankle sprains, especially in the athletic population, prevention is a primary task of athletic trainers and other sports health care professionals. OBJECTIVE To discuss the current evidence as it relates to prophylactic programs for the prevention of ankle sprains and to provide critical interpretation of the evidence supporting and refuting the implementation of preventive programs. CONCLUSIONS External prophylactic supports and preventive exercise programs are effective for reducing the risk of ankle sprains in both uninjured and previously injured populations. Ankle bracing appears to offer the best outcomes in terms of cost and risk reduction. However, there remains a paucity of well-designed, prospective randomized controlled trials relevant to the primary prevention of lateral ankle sprains, especially across a range of sport settings.
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Ohta K, Kimura T. Effects of sudden unexpected mechanical perturbation training aimed at the primary prevention of inversion ankle sprain on reactiveness of ankle movement and cortical activity in normal young adults. J Phys Ther Sci 2019; 31:242-249. [PMID: 30936639 PMCID: PMC6428645 DOI: 10.1589/jpts.31.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 12/17/2018] [Indexed: 12/26/2022] Open
Abstract
[Purpose] To determine the effects of sudden unexpected mechanical perturbation training
aimed at the primary prevention of inversion ankle sprain on the reactiveness of ankle
eversion movement and cortical activity. [Participants and Methods] Sixty healthy
participants were randomly allocated equally into 1) the sudden unexpected mechanical
perturbation training group, 2) self-paced training group, or 3) control group. The first
two groups performed each course of training 3 days per week for 4 weeks. During
pre-training and post-training, the latency to peak amplitude on the surface
electromyography of the peroneus longus and the time to reposition the plate back to its
initial position under the right foot after sudden unexpected mechanical perturbation were
measured. Functional near-infrared spectroscopy was used to measure the changes in the
concentration of oxygenated hemoglobin. [Results] The latency to peak amplitude was
significantly shorter in group 1 than in group 2; time to reposition the plate was the
shortest among the 3 groups during post-training. The changes in the concentration of
oxygenated hemoglobin were significantly increased in the supplementary motor and
pre-motor areas during post-training than during pre-training in group 1. [Conclusion]
Sudden unexpected mechanical perturbation training may facilitate the primary prevention
of inversion ankle sprain via the positive effects on the reactiveness of ankle eversion
movement and cortical activity.
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Affiliation(s)
- Kaori Ohta
- Graduate School of Medicine, Shinshu University: 3-1-1 Asahi, Matsumoto City, Nagano 390-8621, Japan.,Omachi Municipal General Hospital, Japan
| | - Teiji Kimura
- School of Health Sciences, Faculty of Medicine, Shinshu University, Japan
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40
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Ankle taping and bracing does not change static and dynamic balance in volleyball players. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-018-0490-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Participation in sport and recreation has important positive implications for public health across the lifespan; however, the burden of sport-related musculoskeletal injury is significant, with the greatest risk being in youth and young adults. Moving upstream to primary prevention of injury is a public health priority that will have significant implications for reducing the long-term consequences of musculoskeletal injury including early post-traumatic osteoarthritis. The primary targets for the prevention of musculoskeletal injury in sport include neuromuscular training (NMT), rule modification, and equipment recommendations. Currently, there is significant high-quality evidence to support the widespread use of NMT warm up programs in team and youth sport, with an expected significant impact of reducing the risk of musculoskeletal injury by over 35%. Policy disallowing body checking in youth ice hockey has led to a >50% reduction in injuries, and rules limiting contact practice in youth American football has significant potential for injury prevention. There is evidence to support the use of bracing and taping in elite sport to reduce the risk of recurrent ankle sprain injury but not for use to prevent the primary injury, and wrist guards are protective of sprain injuries in snowboarding. Future research examining the maintenance of NMT programs across real-world sport and school settings, optimization of adherence, additional benefit of workload modification, and evaluation of rule changes in other sports is needed.
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Affiliation(s)
- Carolyn A Emery
- Chair Sport Injury Prevention Research Centre, Faculty of Kinesiology, Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, 2500 University Dr. NW, Calgary, Alberta, T2N1N4, Canada.
| | - Kati Pasanen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, Alberta, T2N1N4, Canada.
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Gill LE, Klingele KE. Management of foot and ankle injuries in pediatric and adolescent athletes: a narrative review. Orthop Res Rev 2019; 10:19-30. [PMID: 30774457 PMCID: PMC6209353 DOI: 10.2147/orr.s129990] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In this review, we focus on the treatment of injuries to the foot and ankle in the adolescent athlete. While many injuries in the adolescent foot and ankle are similar to or overlap with their counterparts in the adult population, the anatomy of the adolescent ankle, especially the presence of growth plates, results in different injury patterns in many cases and calls for specific management approaches. We discuss the unique anatomy of the pediatric patient as well as the diagnostic evaluation and treatment of common injuries in the young athlete.
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Affiliation(s)
- Laura E Gill
- Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, USA, .,Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA,
| | - Kevin E Klingele
- Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, USA, .,Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA,
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Abstract
Youth have very high participation and injury rates across sport and recreational activities, including in adventure and extreme sports. Sport and recreation is the leading cause of injury in youth and may lead to lower levels of physical activity, higher adiposity, and long-term consequences such as overweight/obesity, post-traumatic osteoarthritis, and post-concussion syndrome which can adversely affect future health. Injuries are predictable and preventable in youth sport, including adventure and extreme sport. However, injury prevention strategies can have a significant impact in reducing the number and severity of injuries in many sports. This article provides an evidence-informed overview on what is known about injury prevention strategies which have been evaluated in youth adventure and extreme sports. Recommendations to contribute to effective and sustainable injury prevention in youth adventure and extreme sports have been summarized.
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Affiliation(s)
- Carolyn A Emery
- a Sport Injury Prevention Research Centre, Faculty of Kinesiology and Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine , University of Calgary , Calgary , Canada
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Souza HH, Pacheco I, Gehrke LC, Freitas GPD, Loureiro-Chaves RF, Pacheco AM. EVALUATION OF THE EFFECT OF ELASTIC BANDAGE ON THE ANKLE BASKETBALL PLAYERS WITH AND WITHOUT CHRONIC INSTABILITY. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182406173600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Basketball is a sport that requires good motor coordination as well as intense and multidirectional movements. Chronic ankle instability affects about 40% of patients who have sustained a sprain injury. In order to minimize the effects of this dysfunction, functional elastic tape has been widely used due to its mechanical properties, having some positive effects on athletes’ functional performance. Objective: To evaluate the effect of elastic tapes on the ankles of basketball players with and without chronic instability. Method: Thirteen athletes from a varsity basketball team of both sexes, aged between 18 and 30 years (23.2 ± 3.2 years), who had been playing the sport for at least one year and trained at least twice a week. The subjects were assessed using the anterior drawer test for the presence or absence of chronic ankle instability and in three different situations: placebo, elastic tape and control, and the order of use of the implements was randomly determined, using the Star Excursion Balance Test (SEBT) to assess the ankle stability of these athletes. Results: Among the eight directions proposed in the SEBT, there was statistical significance in the difference in three directions for the placebo method in comparison to elastic taping and control. There was no statistical significance in the difference in four directions between the assessments, and there was no statistical significance in the difference in all directions between the control and elastic tapes. Conclusion: It can be inferred from the study that elastic taping does not have positive effects on joint stability in athletes with and without chronic instability, taking into account their functionality. Levef of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.
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Affiliation(s)
| | - Ivan Pacheco
- Grêmio Náutico União, Brazil; Federação Gaúcha de Futebol, Brazil
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Theodorakos I, Rueterbories J, Lund ME, Eils E, Andersen MS, De Zee M, Kersting UG. Effects of a semi-rigid ankle brace on ankle joint loading during landing on inclined surfaces. Int Biomech 2018. [PMCID: PMC7857457 DOI: 10.1080/23335432.2018.1481767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Ankle bracing is commonly used to prevent ankle sprain occurrences. The present study investigated the effects of a semi-rigid ankle brace on the ankle joint complex during landing on inclined surfaces. Seventeen recreational athletes performed a single leg landing task onto three different surface alignments (everted, neutral, inverted), with and without the brace. Ground reaction forces (GRF), kinematics, and brace pressure were recorded. Six two-way repeated measures MANOVA tested for differences in GRF, talocrural and subtalar kinematics and kinetics. Participants landed with a significantly less plantar flexed (P < 0.001) and more everted (P = 0.001) foot during the braced condition. Although no differences were observed for the joint moments, an increased subtalar compression force (P = 0.009) was observed with the brace. Landing on the inverted surface resulted in significantly higher peak magnitudes of the vertical and the mediolateral GRF and the talocrural inversion moment compared to landing on the neutral surface. Ankle bracing altered ankle kinematics by restricting the ROM of the ankle joint complex. This study confirmed that landing on inverted surfaces may increase the risk for lateral ankle ligaments injuries. The significantly higher subtalar compression force during the brace condition might contribute to overuse injuries.
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Affiliation(s)
- Ilias Theodorakos
- Sport Sciences, Dept. of Health Science and Technology, Aalborg University , Denmark
| | - Jan Rueterbories
- Sport Sciences, Dept. of Health Science and Technology, Aalborg University , Denmark
| | - Morten E. Lund
- Dept. of Mechanical and Manufacturing Engineering, Aalborg University , Denmark
| | - Eric Eils
- Institute of Sport and Exercise Sciences, Westfälische Wilhelms-Universität Münster , Germany
| | - Michael S. Andersen
- Dept. of Mechanical and Manufacturing Engineering, Aalborg University , Denmark
| | - Mark De Zee
- Sport Sciences, Dept. of Health Science and Technology, Aalborg University , Denmark
| | - Uwe G. Kersting
- Sport Sciences, Dept. of Health Science and Technology, Aalborg University , Denmark
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THE EFFECT OF BRACING AND BALANCE TRAINING ON ANKLE SPRAIN INCIDENCE AMONG ATHLETES: A SYSTEMATIC REVIEW WITH META-ANALYSIS. Int J Sports Phys Ther 2018. [PMID: 30038824 DOI: 10.26603/ijspt20180379] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Ankle sprains are common musculoskeletal injuries in the athletic population that have been addressed with prevention strategies that include bracing and balance training. Many authors have examined ankle sprain incidence after bracing or balance training in athletes at different levels of competition and in various sports. No systematic review has analyzed the results of both interventions. Purpose The purpose of this review was to compare the effect of balance training and bracing in reducing the incidence and relative risk of ankle sprains in competitive athletes, with or without prior injury, across different sports. Design Systematic review, with meta-analysis. Methods A literature search of four databases was conducted for randomized control trials that reported ankle sprain incidence published from 2005 through 2016. Included articles studied high school, college, or professional level athletes with or without a history of a prior sprain, who received bracing or balance training as an intervention compared to a non-intervention control group. Methodological study quality was assessed by two reviewers using the PEDro scale, with scores ≥5 considered moderate quality. Group incidence and relative risk were determined to assess the preventative effect of bracing or balance training compared to control. Results From 1832 total citations, 71 full-text articles were reviewed, and eight articles were included in the study. Methodological quality of the available evidence contained in the systematic review was moderate. Five studied the effect of balance training, two studied the effect of bracing, and one studied the effect of bracing and balance training compared to the control condition. In all eight studies, athletes in the control condition did not receive any intervention. Athletes who wore braces had fewer ankle sprains (p=0.0037) and reduced their risk of sprains by 64% (RR=0.36) compared to controls, based on analysis of 3,581 subjects. Athletes performing balance training had fewer ankle sprains (p=0.0057) and reduced their risk by 46% (RR=0.54) compared to controls, based on analysis of 3,577 subjects. Conclusion The findings of the current systematic review and meta-analysis support the use of bracing and balance training to reduce the incidence and relative risk of ankle sprains in athletic populations. Clinicians can utilize this information to educate their patients on wearing a brace or performing balance training exercises to decrease the risk of an ankle sprain. Level of evidence Level 1a.
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Abstract
Context:It has been reported that there is a high rate of Achilles tendon injury among kendo athletes. For protection and to support the area, kendo athletes habitually use taping during practice or games.Objective:To investigate the effect of various taping techniques on injury prevention and functional performance in kendo athletes.Design:Case-control study.Setting:Laboratory.Participants:15 University Kendo Team athletes with at least 2 y kendo experience.Main Outcome Measures:Athletes completed 5 stepping backwards and striking cycles under 4 taping conditions: no taping, athletic taping of ankle joint (AT-Ankle), athletic taping of Achilles tendon (AT-Achilles), and Kinesio-Tex taping of Achilles tendon (KT-Achilles). Jump distance, lower limb angular motion, left foot-ground contact time, Achilles tendon force (ATF), and soleus and medial gastrocnemius muscle activities were measured.Results:Lowest peak ATF was found in AT-Achilles during heel-down phase, with statistically significant difference from KT-Achilles peak force. Significant decline of soleus muscle electromyography amplitude was also found when compared to no taping during heel-down phase and other conditions during pushing phase. Conversely, KT-Achilles showed significant decrease in foot-ground contact time compared with no taping and greater ankle range of motion than in AT-Ankle.Conclusion:To protect the Achilles tendon, AT-Achilles taping is recommended since it tends to decrease ATF. Conversely, to enhance athlete performance, we recommend KT-Achilles taping to speed up kendo striking motion. However, the Achilles tendon must withstand greatest forces concurrently. This finding implies that AT-Achilles taping can protect the injured Achilles tendon and KT-Achilles taping can enhance performance on the kendo striking motion.
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Willeford K, Stanek JM, McLoda TA. Collegiate Football Players' Ankle Range of Motion and Dynamic Balance in Braced and Self-Adherent-Taped Conditions. J Athl Train 2018; 53:66-71. [PMID: 29314872 DOI: 10.4085/1062-6050-486-16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Ankle sprains are one of the most common injuries in the physically active population. Previous researchers have shown that supporting the ankle with taping or bracing is effective in preventing ankle sprains. However, no authors have compared the effects of self-adherent tape and lace-up ankle braces on ankle range of motion (ROM) and dynamic balance in collegiate football players. OBJECTIVE To examine the effectiveness of self-adherent tape and lace-up ankle braces in reducing ankle ROM and improving dynamic balance before and after a typical collegiate football practice. DESIGN Crossover study. SETTING Collegiate athletic training room. PATIENTS OR OTHER PARTICIPANTS Twenty-nine National Collegiate Athletic Association Division I football athletes (age = 19.2 ± 1.14 years, height = 187.52 ± 20.54 cm, mass = 106.44 ± 20.54 kg). INTERVENTION(S) Each participant wore each prophylactic ankle support during a single practice, self-adherent tape on 1 leg and lace-up ankle brace on the other. Range of motion and dynamic balance were assessed 3 times for each leg throughout the testing session (baseline, prepractice, postpractice). MAIN OUTCOME MEASURE(S) Ankle ROM for inversion, eversion, dorsiflexion, and plantar flexion were measured at baseline, immediately after donning the brace or tape, and immediately after a collegiate practice. The Y-Balance Test was used to assess dynamic balance at these same time points. RESULTS Both interventions were effective in reducing ROM in all directions compared with baseline; however, dynamic balance did not differ between the tape and brace conditions. CONCLUSIONS Both the self-adherent tape and lace-up ankle brace provided equal ROM restriction before and after exercise, with no change in dynamic balance.
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Affiliation(s)
| | - Justin M Stanek
- Kinesiology and Recreation, Illinois State University, Normal
| | - Todd A McLoda
- Applied Science and Technology, Illinois State University, Normal
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Jahjah A, Seidenspinner D, Schüttler K, Klasan A, Heyse TJ, Malcherczyk D, El-Zayat BF. The effect of ankle tape on joint position sense after local muscle fatigue: a randomized controlled trial. BMC Musculoskelet Disord 2018; 19:8. [PMID: 29316902 PMCID: PMC5759174 DOI: 10.1186/s12891-017-1909-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 12/13/2017] [Indexed: 11/29/2022] Open
Abstract
Background Ankle tape is widely used by athletes to prevent ankle sprain. Although there is growing evidence that ankle tape improve joint position sense, but yet it is not clear even if tape improve joint position sense after muscle fatigue, because fatigue impair joint position sense and raise the risk of ankle sprain. The aim of this study is to examine the effect of ankle tape on joint position sense after local muscle fatigue. Method This trial is a randomized controlled trial. 34 healthy subjects participated in this trial. Subjects were randomized distributed into two groups: with tape and without tape. Active and passive absolute error and variable error mean values for two target positions of the ankle joint (15° inversions and inversion minus 5°) before and after fatigue protocol consisted of 30 consecutive maximal concentric/concentric contractions of the ankle evertors and invertors. In this trail joint position sense for all subjects was assessed using The Biodex System isokinetic dynamometer 3, this system is used also for fatigue protocol. Results For the variable error (VE), significant mean effect was found for active joint position sense in 15° of inversion after muscle fatigue (P < 0, 05). It was a significant decrease in the work in the last third of inversion detected (P < 0, 05). There was no significant main effect found for fatigue index of eversion. Conclusion Ankle tape can improve joint position sense at the fatigue session when joint position sense becomes worse. As a result, ankle tape may be useful to prevent ankle sprain during playing sports. We suggest athletes and individuals at risk of ankle sprain to apply taping before high-load activity. Trial registration The study was retrospectively registered on the ISRCTN registry with study ID ISRCTN30042335 on 12th December 2017.
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Affiliation(s)
- Akram Jahjah
- Center of Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35033, Marburg, Germany
| | - Dietmar Seidenspinner
- Center of Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35033, Marburg, Germany
| | - Karl Schüttler
- Center of Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35033, Marburg, Germany
| | - Antonio Klasan
- Center of Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35033, Marburg, Germany
| | - Thomas J Heyse
- Center of Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35033, Marburg, Germany
| | - Dominik Malcherczyk
- Center of Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35033, Marburg, Germany
| | - Bilal Farouk El-Zayat
- Center of Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35033, Marburg, Germany.
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Wardle SL, Greeves JP. Mitigating the risk of musculoskeletal injury: A systematic review of the most effective injury prevention strategies for military personnel. J Sci Med Sport 2017; 20 Suppl 4:S3-S10. [PMID: 29103913 DOI: 10.1016/j.jsams.2017.09.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 09/11/2017] [Accepted: 09/19/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To update the current injury prevention strategy evidence base for making recommendations to prevent physical training-related musculoskeletal injury. DESIGN We conducted a systematic review to update the evidence base on injury prevention strategies for military personnel. METHODS Literature was systematically searched and extracted from five databases, and reported according to PRISMA guidelines. Sixty one articles meeting the inclusion criteria and published during the period 2008-2015 were selected for systematic review. RESULTS The retrieved articles were broadly categorised into six injury prevention strategies; (1) conditioning, (2) footwear modifications, (3) bracing, (4) physical activity volume, (5) physical fitness, and (6) leadership/supervision/awareness. The majority of retrieved articles (n=37 (of 61) evaluated or systematically reviewed a conditioning intervention of some nature. However, the most well-supported strategies were related to reducing physical activity volume and improving leadership/supervision/awareness of injuries and injury prevention efforts. CONCLUSIONS Several injury prevention strategies effectively reduce musculoskeletal injury rates in both sexes, and many show promise for utility with military personnel. However, further evaluation, ideally with prospective randomised trials, is required to establish the most effective injury prevention strategies, and to understand any sex-specific differences in the response to these strategies.
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Affiliation(s)
- Sophie L Wardle
- Division of Applied Human Physiology, Army Personnel Research Capability, Army Headquarters, Andover, UK.
| | - Julie P Greeves
- Division of Applied Human Physiology, Army Personnel Research Capability, Army Headquarters, Andover, UK
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