|
1
|
Gengatharan D, Wong WSY, Png W, Rikhraj IS, Cher EWL. Concomitant osteochondral lesion of the talus in ankle instability: Utilizing clinical presentation to guide imaging decision. J Foot Ankle Surg 2025; 64:233-237. [PMID: 39486788 DOI: 10.1053/j.jfas.2024.10.011] [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: 07/03/2024] [Revised: 10/14/2024] [Accepted: 10/26/2024] [Indexed: 11/04/2024]
Abstract
Low ankle sprains are a prevalent issue, often involving the anterior talofibular ligament. While there is increased attention placed on ligamentous injuries in ankle sprains, concomitant cartilaginous injuries are frequently overlooked. This article aims to (Park et al., 2021) evaluate the significance of magnetic resonance imaging in anterior talofibular ligament injuries to detect concurrent osteochondral lesions of the talus as well as other associated ligamentous injuries; (Hølmer et al., 1994) determine the importance of clinical presentation and its association with the risk of concomitant osteochondral lesions in anterior talofibular ligament injuries. We conducted a retrospective analysis of 129 patients who underwent anterior talofibular ligament reconstruction, reviewing patient data to assess the incidence of osteochondral lesions of the talus and associated ligamentous injuries. Clinical presentations were then reviewed to identify signs and symptoms associated with the occurrence of osteochondral lesions of the talus. The results indicated that calcaneofibular ligament was most injured in association with anterior talofibular ligament injuries (69.52 %; n = 73). Furthermore. 31.78 % (n = 41) of patients with anterior talofibular ligament injuries had concurrent osteochondral lesion of the talus. Analysis on clinical presentation revealed statistical significance (p < .001) between patients that had ankle joint line tenderness lasting for more than 6 weeks and the occurrence of osteochondral lesions of the talus. This study concludes that magnetic resonance imaging could be beneficial in anterior talofibular ligament injuries with patients exhibiting persistent joint line tenderness to evaluate for osteochondral lesions to ensure a comprehensive pre-operative assessment.
Collapse
Affiliation(s)
- Dhivakaran Gengatharan
- Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore.
| | - Walter Soon Yaw Wong
- Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore
| | - Wenxian Png
- Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore; SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme 20 College Road, Academia Level 4 Singapore 169865, Singapore
| | - Inderjeet Singh Rikhraj
- Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore; SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme 20 College Road, Academia Level 4 Singapore 169865, Singapore
| | - Eric Wei Liang Cher
- Department of Orthopaedic Surgery, Sengkang General Hospital, 110 Sengkang East Way, Singapore 544886, Singapore; SingHealth Duke-NUS Musculoskeletal Sciences Academic Clinical Programme 20 College Road, Academia Level 4 Singapore 169865, Singapore
| |
Collapse
|
|
2
|
Bordalo M, Serner A, Yamashiro E, Al-Musa E, Djadoun MA, Al-Khelaifi K, Schumacher YO, Al-Kuwari AJ, Massey A, D'Hooghe P, Cardinale M. Imaging-detected sports injuries and imaging-guided interventions in athletes during the 2022 FIFA football (soccer) World Cup. Skeletal Radiol 2025; 54:819-828. [PMID: 37715819 PMCID: PMC11845536 DOI: 10.1007/s00256-023-04451-z] [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: 08/02/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE To describe imaging-detected musculoskeletal injuries and image-guided interventional procedures during the 2022 FIFA football (soccer) World Cup. MATERIALS AND METHODS Retrospective analysis of all radiologic examinations performed in a central medical facility for athletes was performed by two board certified musculoskeletal radiologists. Data on muscle, tendon, ligament, cartilage, and bone injuries were collected according to imaging modality and body part. RESULTS A total of 143 radiology examinations in 94 athletes were evaluated at the central medical facility. Magnetic resonance imaging (MRI) was the most utilized modality (67%), followed by radiography (12%), ultrasonography (9%), and computed tomography (4%). Image-guided interventions corresponded to 8% of all radiological examinations. There were 112 injuries described, affecting muscles and tendons (42%), ligaments (25%), cartilage (21%), and bone (12%). Most injured body parts were thigh (27%), foot and ankle (23%), knee (23%), and hip/groin (8%). Most injured players were within the age range of 24-35 years old (71%). CONCLUSION Imaging was utilized in 11% of players who participated in the 2022 FIFA World Cup in Qatar. MRI was the most utilized modality, and acute muscle tears were the most diagnosed type of injury. Diagnostic imaging played an important role in diagnosing sports-related injuries during the 2022 FIFA World Cup.
Collapse
Affiliation(s)
- Marcelo Bordalo
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
| | - Andreas Serner
- Fédération Internationale de Football Association (FIFA), Zurich, Switzerland
| | | | - Emad Al-Musa
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | | | | | | | | | - Andrew Massey
- Fédération Internationale de Football Association (FIFA), Zurich, Switzerland
| | - Pieter D'Hooghe
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Marco Cardinale
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| |
Collapse
|
|
3
|
Takeuchi S, Anan M. Does chronic ankle instability affect side-cutting in female soccer players? Int J Sports Med 2025; 46:217-223. [PMID: 39586997 DOI: 10.1055/a-2487-6036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Abstract
Lateral ankle sprains have a high recurrence rate, often developing into chronic ankle instability (CAI). CAI affects movement strategy during side-cutting maneuvers, with inconsistent results in many studies. This study aimed to clarify the characteristics of movement strategies during side-cutting maneuvers in female soccer players with and without CAI. Thirteen female soccer players with CAI and twelve healthy controls performed 10 successful trials of side-cutting maneuvers in three directions (anterolateral, lateral, and posterolateral) under unanticipated conditions. Compared to the control group, the CAI group displayed an increased stance time in the lateral and posterolateral side-cutting maneuvers (lateral: p=0.021, effect size=0.97, posterolateral: p=0.014, effect size=1.00). In posterolateral side-cutting maneuvers, the CAI group displayed a decreased posterior ground reaction force at 19-30% and 42-54% of the entire stance phase compared with the control group (p=0.001, effect size=1.30-1.42). Female soccer players with CAI may display increased stance time to compensate for self-reported ankle instability and may also exhibit decreased braking and propulsive force when side-cutting to sharper angles. These observations suggest a hypothesis that could help in the assessment of cutting maneuvers under unanticipated conditions after ankle sprains.
Collapse
Affiliation(s)
- Shiki Takeuchi
- Graduate School of Welfare and Health Science, Oita University, Oita, Japan
| | - Masaya Anan
- Faculty of Welfare and Health Science, Oita University, Oita, Japan
| |
Collapse
|
|
4
|
Brougham K, Warren JR, Noe M, Lee BR, Margherio S, Roberson J, Harvey B. Injuries Following COVID-19 Infection in Academy-level Male Youth Soccer Players. J Pediatr Orthop 2025; 45:e248-e253. [PMID: 39494787 DOI: 10.1097/bpo.0000000000002845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2024]
Abstract
BACKGROUND Injury epidemiology data are key to injury prevention strategy development. Most such data surrounding the COVID-19 pandemic compare team injury data during the pandemic to that before the pandemic; few investigate injuries by infection status and even less involve academy-level organizations. We hypothesized that in male youth developmental academy-level soccer players, the rate of injury would be higher following COVID-19 infection than in the uninfected. METHODS Retrospective cohort study involving 141 male youth athletes from a single midwestern US developmental soccer academy during the spring 2022 soccer season. Injury data was gathered prospectively and analyzed retrospectively. Injury rate (incidence per 1000 playing hours), type, location, severity, mechanism, and mode of play were compared between COVID-19-positive and -negative athletes. RESULTS Thirty-four (24.11%) of 141 athletes tested positive for COVID-19. Of those 34, 20 (58.8%) sustained at least 1 injury, totaling 30 injuries. Of the 107 (75.89%) uninfected athletes, 30 (28.04%) sustained at least 1 injury, totaling 37 injuries. COVID-19-positive athletes sustained injuries at higher rates (7.10, 95% CI: 4.79-10.14) than uninfected athletes (2.71, 95% CI: 1.91-3.74), with an infected to uninfected adjusted injury rate ratio of 2.08 (95% CI: 1.20-3.59, P =0.008). COVID-19 positive players were 2.78 times more likely to sustain an injury following their infection than uninfected players (95% CI: 1.14-6.96, P =0.026). There were no significant differences in injury type ( P =0.515), location ( P =0.319), severity ( P =0.679), mechanism ( P =0.225), or mode of play ( P =0.557) between groups. CONCLUSIONS Among academy-level youth soccer athletes, injury rate increased significantly after COVID-19 infection; injury patterns were similar. LEVEL OF EVIDENCE II - Retrospective cohort study.
Collapse
Affiliation(s)
- Kyle Brougham
- Department of Orthopaedic Surgery, University of Missouri-Kansas City
| | - Jonathan R Warren
- Department of Orthopaedic Surgery, University of Missouri-Kansas City
- Department of Orthopaedic Surgery and Sports Medicine, Children's Mercy Kansas City, Kansas City, MO
| | - McKenna Noe
- Department of Orthopaedic Surgery and Sports Medicine, Children's Mercy Kansas City, Kansas City, MO
| | - Brian R Lee
- Department of Orthopaedic Surgery and Sports Medicine, Children's Mercy Kansas City, Kansas City, MO
| | - Shannon Margherio
- Department of Orthopaedic Surgery and Sports Medicine, Children's Mercy Kansas City, Kansas City, MO
| | - James Roberson
- Department of Orthopaedic Surgery and Sports Medicine, Children's Mercy Kansas City, Kansas City, MO
| | - Brian Harvey
- Department of Orthopaedic Surgery and Sports Medicine, Children's Mercy Kansas City, Kansas City, MO
| |
Collapse
|
|
5
|
Flore Z, Hambly K, De Coninck K, Welsch G. Time-loss and recurrence rate of lateral ankle sprains in male professional football players depending on the severity grade: do we trivialise LAS? BMJ Open Sport Exerc Med 2025; 11:e002271. [PMID: 39995611 PMCID: PMC11848657 DOI: 10.1136/bmjsem-2024-002271] [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: 09/10/2024] [Accepted: 01/06/2025] [Indexed: 02/26/2025] Open
Abstract
Objectives Lateral ankle sprains (LAS) are among the most common injuries in professional football (soccer). Despite this, the severity and possible long-term consequences of LAS remain trivialised. This multicentre observational study in German elite football provides insights into time-loss and recurrence rates after LAS. Time-loss and recurrence rates are outcome measures vital for the future evaluation of rehabilitation protocols. Methods 798 male football players representing 34 teams from 13 professional German football clubs participated in this study during the 2021-2022 season, followed by a 12-month follow-up period. Data collection and reporting were carried out in accordance with the UEFA recommendations for the standardised collection of data on football injuries. Time-loss, recurrence rate and standardised severity grades (I-III) after LAS were recorded for professionals, U23, U19 and U17, respectively. Results A total of 187 ankle injuries were reported, with 115 out of the total being analysed. The overall time-loss was 29.89 days, with significant differences between youth elite players and professionals (32.96 vs 15.53 days lost; p<0.001). Professional players demonstrated the shortest time-loss in all LAS injury grades. Time-loss decreased with advancing age (R 2=0.03, F(1, 106)=3.16, p=0.078). Grade I LAS's time-loss differs significantly from grades II and III (p<0.001). A recurrent LAS was recorded in 34 players. The overall LAS recurrence rate was 25.6%. Conclusion This study provides data on time-loss and recurrence, which serve as reference values for future evaluation of rehabilitation concepts after LAS in elite football players.
Collapse
Affiliation(s)
- Zacharias Flore
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
- Hamburger SV Fußball AG, Hamburg, Germany
| | - Karen Hambly
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
| | - Kyra De Coninck
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
| | - Götz Welsch
- UKE-Athleticum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
|
6
|
Bravo-Aguilar M, Abuín-Porras V, Blanco-Morales M, Romero Morales C, Almazán-Polo J, Villafañe JH, Canosa-Carro L. Beyond support: exploring the dynamic and static biomechanical changes induced by preventive ankle taping: a novel cross-sectional study. PeerJ 2025; 13:e18472. [PMID: 39886021 PMCID: PMC11781261 DOI: 10.7717/peerj.18472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 10/15/2024] [Indexed: 02/01/2025] Open
Abstract
Introduction In sports, 80% of all ankle injuries are sprains of the external compartment. Functional bandages are usually used preventively, specially in individuals with a history of lateral ankle injuries. To this day, the actual benefits of such taping remain unknown as important modifications are introduced in the ankle biomechanics. Objective The aim of the present study is to describe the biomechanical processes underlying these effects, such as modification during stance times, balance, contact surface and maximum and average pressures in the rearfoot, forefoot and midfoot, using a sprain preventive taping for the external ankle compartment. Methods An observational, analytic, cross-sectional study was designed. Data from static and dynamic plantar pressures with a pressure platform and balance data assessed with the Y Balance Test (YBT) were analysed in 50 participants (age = 21.00 ± 2.34 years, weight = 71.11 ± 13.12 kg, height = 1.75 ± 00.9 m, BMI = 22.94 ± 2.50 kg/m2, foot size = 41.60 ± 3.00) with and without preventive functional taping for lateral ankle sprain (LAS). Results A statistically significant decrease in YBT was observed in the taped participants toward anterior (p = 0.001) and posterolateral (p = 0.005) motion. On the static measures at the pressure platform, an increase in peak pressure at the midfoot (p = 0.001), a decrease in the maximum pressure in the forefoot (p = 0.003) and a decrease in the contact surface in the rearfoot (p = 0.003) were recorded. Dynamic measures at the pressure platform analysis showed a statistically significant decrease in contact surface at the rearfoot (p = 0.001), an increase in mean pressure in both the midfoot (p = 0.044) and forefoot (p = 0.001) and a significant decrease in velocity in the forefoot (p = 0.003). Conclusions In conclusion, we observed that ankle taping led to increased peak pressures in the midfoot and decreased maximum pressures in the forefoot, indicating a shift in load distribution within the plantar surface. Simultaneously, a significant reduction in the velocity at the forefoot during dynamic tasks suggests that taping may alter natural gait dynamics, potentially affecting movement efficiency and stride characteristics. In addition, the application of ankle taping significantly altered balance, as evidenced by a decrease of YBT scores anterior and posterolateral directions. Prophylactic taping in patients with no prior history of LAS is not recommended.
Collapse
Affiliation(s)
- María Bravo-Aguilar
- Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Vanesa Abuín-Porras
- Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - María Blanco-Morales
- Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Carlos Romero Morales
- Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Jaime Almazán-Polo
- Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Jorge Hugo Villafañe
- Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Lorena Canosa-Carro
- Department of Physiotherapy, Faculty of Medicine, Health and Sports, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| |
Collapse
|
|
7
|
Watabe T, Takabayashi T, Tokunaga Y, Watanabe T, Kubo M. Copers exhibit altered ankle and trunk kinematics compared to the individuals with chronic ankle instability during single-leg landing. Sports Biomech 2024; 23:2785-2797. [PMID: 35435154 DOI: 10.1080/14763141.2022.2058989] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
Copers are individuals who have had a lateral ankle sprain but have no history of recurrent lateral ankle sprain, residual symptoms, or functional disability. Copers have shown no significant difference in lower limb kinematics in landing for proactive conditions compared with a control (CTR) group. However, the copers (CPR) group has shown differences compared to CTR and chronic ankle instability (CAI) groups for dynamic balance conditions, suggesting that the trunk may compensate for foot instability during shock absorption. This study aimed to examine the differences in the kinematics and kinetics among CPR, CAI and CTR groups in reactive and proactive single-leg landing tasks. Participants were physically active adults with CAI (n = 14), CPR (n = 14), and CTR (n = 14), who performed proactive and reactive single-leg landings. The lower limb, trunk kinematics, vertical ground reaction force (vGRF) peak value, and the time to minimum peak vGRF were analysed. It might be conceivable that the CPR group could absorb vGRF efficiently by increasing the trunk flexion angle and increasing the time to reach the minimum peak vGRF regardless of landing condition. The results suggest that evaluating the movements of the entire body, including the ankle and trunk, is essential.
Collapse
Affiliation(s)
- Takaya Watabe
- Section of Rehabilitation, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Tomoya Takabayashi
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Yuta Tokunaga
- Terrabyte Corporation, 3-10-7 Yushima, Bunkyo-ku, Tokyo 113-0034, Japan
| | - Takahiro Watanabe
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Masayoshi Kubo
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| |
Collapse
|
|
8
|
Vermorel PH, Stordeur A, Grange S, Klasan A, Philippot R, Neri T. Oblique or short incisions reduce the risk of saphenous nerve damage during hamstrings harvesting: A model for mapping nerve pathways at the harvest site. J ISAKOS 2024; 9:100358. [PMID: 39489420 DOI: 10.1016/j.jisako.2024.100358] [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: 09/28/2024] [Revised: 10/21/2024] [Accepted: 10/27/2024] [Indexed: 11/05/2024]
Abstract
INTRODUCTION Hamstring autografts are frequently used for ligament reconstruction surgery. Between 12% and 84% of patients report hypoesthesia or dysaesthesia secondary to injury of the saphenous nerve or one of its branches after hamstring harvesting. Type of incision (orientation and length) is subject of much regarding limiting the risk of nerve damage. A cadaveric study was performed to determine which type of incision limits the risk of injury to the saphenous nerve or one of its branches, based on an anatomic model for mapping nerve pathways at the harvest site. METHODS An anatomical study was performed on 20 knees from 12 embalmed bodies. Distance between saphenous nerve branches and 4 points of interest along the tibial crest was measured. Based on these measurements, a digital model of the saphenous nerve and its branches was created. A model of three common types of incision (vertical, horizontal and oblique) was overlaid. Each incision was modeled for three lengths (2, 3, and 4 cm). Percentage of collision between nerve course model and incision model was then calculated to determine the risk of nerve damage for each type of incision. Based on the nerve course model, a 'low-collision-risk' safe zone was identified. RESULTS Nerve damage risk after an oblique incision was significantly lower than for a horizontal or vertical incision, for incision lengths of 3 and 4 cm (p < 0.05). For a specific incision orientation, the length of the incision did not affect the risk of nerve damage. A trapezoidal space close to the tibial crest and distal to the anterior tibial tuberosity appears to reduce risk of nerve damage. CONCLUSION This cadaveric study suggests that during hamstring harvesting, incisions shorter than 2 cm reduce the risk of saphenous nerve's branches injuries. For incisions longer than 2 cm, using an oblique incision may reduce the risk compared to vertical or horizontal incisions. LEVEL OF EVIDENCE Level of evidence not applicable: Laboratory experiments.
Collapse
Affiliation(s)
- Pierre-Henri Vermorel
- Inter-university Laboratory of Human Movement Science, University Lyon - University Jean-Monnet Saint-Étienne, Saint-Étienne, France; Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, Saint-Étienne, EA 7424, France.
| | - Alban Stordeur
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, Saint-Étienne, EA 7424, France
| | - Sylvain Grange
- Department of Radiology, University Hospital Centre of Saint-Étienne, Saint-Étienne, EA 7424, France
| | - Antonio Klasan
- AUVA UKH Steiermark, Graz, Austria; Johannes Kepler University Linz, Austria
| | - Rémi Philippot
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, Saint-Étienne, EA 7424, France
| | - Thomas Neri
- Inter-university Laboratory of Human Movement Science, University Lyon - University Jean-Monnet Saint-Étienne, Saint-Étienne, France; Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, Saint-Étienne, EA 7424, France
| |
Collapse
|
|
9
|
Mineta S, Koyama T, Yamaguchi S, Inagaki H, Sekine Y. Epidemiology of lateral ankle sprain focusing on indirect contact mechanism in male and female soccer players: An 18.5-month cohort study. Injury 2024; 55:111699. [PMID: 38970925 DOI: 10.1016/j.injury.2024.111699] [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: 02/16/2024] [Revised: 06/12/2024] [Accepted: 06/19/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Epidemiological research highlights the need to understand sports injuries for effective prevention. Yet, detailed knowledge about lateral ankle sprain (LAS) in soccer, especially related to indirect contact mechanisms and specific sports movements, remains scarce. This study aimed to determine the prevalence of LAS by examining injury mechanisms, focusing on indirect contact, and analyzing sports-related movements. STUDY DESIGN Prospective study. METHODS In this prospective study, 304 high-school and college soccer players (age: 19.0 ± 2.2 years, height: 168.3 ± 10.6 cm, weight: 64.2 ± 11.1 kg) were monitored for 18.5 months. Attendance and LAS incidents were recorded daily. Injury details, including movement at the time of injury, contact presence, and direction, were collected through interviews conducted on the injury day. LAS were categorized into direct contact, indirect contact, and non-contact mechanisms. Direct contact injuries were due to external forces on the lower leg or foot. Indirect contact injuries resulted from impacts on areas other than the lower leg or foot, and non-contact injuries involved no interaction with the ball or opponent. Incidence rates per 1,000 athlete exposures and 95 % confidence intervals (CIs) were calculated, along with rate ratios (RR) to assess sex differences. RESULTS The study recorded 59 LAS injuries. Indirect injuries were predominant, accounting for 47.5 % (n = 28) of the cases. Men experienced a higher incidence of indirect injuries, with an RR of 2.29 (95 % CI: 1.06-4.96). Outward contact was the most common (77.8 %; n = 21), while inward contact occurred in 22.2 % of the cases (n = 6). CONCLUSION High school and college soccer players primarily sustained injuries through indirect contact mechanisms, with a significant number of injuries occurring during lateral contact. Men were more prone to indirect contact injuries. Furthermore, 47.5 % of LAS incidents involved reactive movements, and injuries frequently occurred during specific sports actions, such as ball interception.
Collapse
Affiliation(s)
- Shinshiro Mineta
- Faculty of Health and Welfare, Fukuyamaheisei University, Hiroshima, Japan.
| | - Takeshi Koyama
- School of Physical Education, Tokai University, Kanagawa, Japan
| | | | - Honoka Inagaki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Yuta Sekine
- Faculty of Humanities and Social Sciences, Teikyo Heisei University, Tokyo, Japan
| |
Collapse
|
|
10
|
Yildiz M. Visualisation of Studies on Knee Injuries in Football: A Bibliometric Analysis. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2024; 38:116-128. [PMID: 39151408 DOI: 10.1055/a-2337-5760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
Football is a popular sport on a global scale, and injuries sustained by football players have become a significant concern for sports physicians and researchers. Among these injuries, knee injuries are a commonly encountered problem in football players with long-term effects. This paper aims to perform a visual mapping and a bibliometric analysis of research on knee injuries in football, examining the current state and research trends. For this purpose, all publications from the Social Sciences Citation Index (SSCI), Science Citation Index Expanded (SCIE), Emerging Sources Citation Index (ESCI), and Arts & Humanities Citation Index (AHCI) within the Web of Science database were analysed. VOSviewer 1.6.18 was utilised for visualising bibliometric data. A total of 2159 publications were included in the study. The analysis covers publication year, authors, citation counts, and distributions among publishing journals. Authors, institutions, and international relationships were investigated, and keyword analysis, bibliometric coupling, and co-citation network analyses were conducted. The findings reveal that the United States and Australia are the countries with the highest number of publications. From 2018, there has been a noticeable increase in the number of publications. Citation and publication counts reached their peak in 2021. Turkey takes the 28th rank in terms of citation and centrality. The keywords "soccer," "football," "knee", and "anterior cruciate ligament" were found to be intensively used with high centrality. In conclusion, visual mapping through bibliometric analysis highlights the magnitude and diversity of research in the field of knee injuries in football. It emphasises the need for further studies in this area for future researchers, shedding light on important research areas. Moreover, it provides insights into the prevention of such injuries in football players and the development of effective treatment strategies by fostering more knowledge and understanding of knee injuries.
Collapse
Affiliation(s)
- Muhammed Yildiz
- Vocational School of Health Services, Artvin Coruh University: Artvin Coruh Universitesi, artvin, TURKEY
| |
Collapse
|
|
11
|
Bsoul N, Ning L, Cai L, Mazmanyan D, Porter D. Evidence-based clinical practice guidelines for the management of acute ankle injuries according to: a PRISMA systematic review and quality appraisal with AGREE II. BMC Musculoskelet Disord 2024; 25:523. [PMID: 38978052 PMCID: PMC11229291 DOI: 10.1186/s12891-024-07655-z] [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: 03/10/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Acute ankle injuries are commonly seen in emergency rooms, with significant social impact and potentially devastating consequences. While several clinical practice guidelines (CPGs) related to ankle injuries have been developed by various organizations, there is a lack of critical appraisal of them. The purpose of this systematic review is to identify and critically appraise evidence-based clinical practice guidelines (EB-CPGs) related to acute ankle injuries in adults. METHOD We conducted searches in the Cochrane Library, MEDLINE, EMBASE databases, WHO, and reviewed 98 worldwide orthopedic association websites up until early 2023. Two authors independently applied the inclusion and exclusion criteria, and each evidence-based clinical practice guideline (EB-CPG) underwent independent critical appraisal of its content by all four authors using the Appraisal of Guidelines for REsearch and Evaluation (AGREE II) instrument. AGREE II scores for each domain were then calculated. RESULTS This review included five evidence-based clinical practice guidelines. The mean scores for all six domains were as follows: Scope and Purpose (87.8%), Stakeholder Involvement (69.2%), Rigour of Development (72.5%), Clarity of Presentation (86.9%), Applicability (45.6%), and Editorial Independence (53.3%). CONCLUSION The number of EB-CPGs related to ankle injuries are limited and the overall quality of the existing evidence-based clinical practice guidelines (EB-CPGs) for ankle injuries is not strong, with three of them being outdated. However, valuable guidance related to Ottawa rules, manual therapy, cryotherapy, functional supports, early ambulation, and rehabilitation has been highlighted. Challenges remain in areas such as monitoring and/or auditing criteria, consideration of the target population's views and preferences, and ensuring editorial independence. Future guidelines should prioritize improvements in these domains to enhance the quality and relevance of ankle injury management. SYSTEMATIC REVIEW Systematic review.
Collapse
Affiliation(s)
- Najeeb Bsoul
- Tsinghua University, Beijing, China
- First Affiliated Hospital of Tsinghua University, Beijing, China
| | - Liang Ning
- Tsinghua University, Beijing, China.
- First Affiliated Hospital of Tsinghua University, Beijing, China.
| | - Leyi Cai
- Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Davit Mazmanyan
- Tsinghua University, Beijing, China
- First Affiliated Hospital of Tsinghua University, Beijing, China
| | - Daniel Porter
- Tsinghua University, Beijing, China
- First Affiliated Hospital of Tsinghua University, Beijing, China
| |
Collapse
|
|
12
|
Elsner A, Klemmer K, Vordemvenne T, Wähnert D. [Treatment of acute ankle distortion in footballers : Are we doing it particularly right or particularly wrong?]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:393-403. [PMID: 38787408 DOI: 10.1007/s00132-024-04506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Despite the high incidence of ankle sprains, the ideal treatment is controversial and a significant percentage of patients who have suffered an ankle sprain never fully recover. Even professional athletes are affected by this post-traumatic complication. There is strong evidence that permanent impairment after an ankle injury is often due to an inadequate rehabilitation and training program and too early return to sport. THERAPY AND REHABILITATION Therefore, athletes should start a criteria-based rehabilitation after ankle sprain and gradually progress through the programmed activities, including e.g. cryotherapy, edema reduction, optimal load management, range of motion exercises to improve ankle dorsiflexion and digital guidance, stretching of the triceps surae with isometric exercises and strengthening of the peroneus muscles, balance and proprioception training, and bracing/taping. The fact that this is professional sport does not exempt it from consistent, stage-appropriate treatment and a cautious increase in load. However, there are a number of measures and tools that can be used in the intensive care of athletes to improve treatment and results.
Collapse
Affiliation(s)
- Andreas Elsner
- DIOOS - Deutsches Institut für Orthopädie, Osteopathie und Sportmedizin, Lipper Hellweg 10, 33604, Bielefeld, Deutschland.
- Orthopädische Gemeinschaftspraxis am Bültmannshof, Bielefeld, Deutschland.
| | - Kira Klemmer
- DIOOS - Deutsches Institut für Orthopädie, Osteopathie und Sportmedizin, Lipper Hellweg 10, 33604, Bielefeld, Deutschland
| | - Thomas Vordemvenne
- Medizinische Fakultät und Universitätsklinikum OWL, Evangelisches Klinikum Bethel, Universitätsklinik für Unfallchirurgie und Orthopädie, Universität Bielefeld, Bielefeld, Deutschland
| | - Dirk Wähnert
- Medizinische Fakultät und Universitätsklinikum OWL, Evangelisches Klinikum Bethel, Universitätsklinik für Unfallchirurgie und Orthopädie, Universität Bielefeld, Bielefeld, Deutschland
| |
Collapse
|
|
13
|
Arulekar RS, Shinde S, Kumbhar VK. Effect of Progressive Balance Control Strategies on Chronic Ankle Instability in Middle-Aged Obese Women. Cureus 2024; 16:e62992. [PMID: 39050340 PMCID: PMC11268981 DOI: 10.7759/cureus.62992] [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: 05/19/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Chronic ankle instability (CAI) is a disease characterized by persistent feelings of instability in the ankle joint and a propensity for recurrent ankle sprains. It is often caused by ligamentous laxity or neuromuscular deficits. Middle-aged obese females represent a demographic subset at increased risk for CAI due to factors such as reduced proprioception and increased loading on the ankle joint. The gaps in the current evidence suggest that more research is needed on middle-aged obese females, who are particularly vulnerable to CAI due to physiological changes associated with poor balance. OBJECTIVES This study aims to determine the effect of progressive balance control strategies on CAI in middle-aged obese women. METHOD In this experimental study, 72 patients with CAI in middle-aged women were selected randomly using a simple random sampling method. Females aged 35-45 with a body mass index (BMI) greater than 27 kg/m2 and a history of ankle sprains greater than one and having residual symptoms. The experimental group (Group B) received progressive balance control strategies, and the conventional group (Group A) received conventional balance exercises. Foot and ankle ability measure (FAAM) scale, push-and-release test (PART), single-leg stance test (SLST), evaluations, and star excursion balance test (SEBT) were used for pre- and posttreatment. RESULTS The experimental group post-intervention for static balance, dynamic balance, and postural control tests showed extremely significant improvement with a p-value of <0.0001. Between groups A and B, the dynamic balance was considered very significant, with a p-value of 0.0001. In the single-leg stance test, Group B's result was significantly greater than that of Group A's (63.4 + 16.1 and 63.4 + 16.1). PART results indicate that Group B is more significant than Group A (0.76 and 0.51, respectively). CONCLUSIONS The study concluded that progressive balance control strategy training is effective in middle-aged obese women with CAI.
Collapse
Affiliation(s)
- Rutuja S Arulekar
- Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Deemed to be University (KIMSDU), Karad, IND
| | - Sandeep Shinde
- Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Deemed to be University (KIMSDU), Karad, IND
| | - Vrushali K Kumbhar
- Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Deemed to be University (KIMSDU), Karad, IND
| |
Collapse
|
|
14
|
Zhang G, Li W, Yao H, Tan R, Li C. A modified "outside-in" Broström-Gould procedure yielding favorable outcomes for the management of chronic lateral ankle instability-a retrospective study with mid-term follow-up. J Orthop Surg (Hong Kong) 2024; 32:10225536241257760. [PMID: 38773724 DOI: 10.1177/10225536241257760] [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] [Indexed: 05/24/2024] Open
Abstract
Purpose: There are various surgical interventions available for the management of Chronic lateral ankle instability (CLAI). The Broström-Gould procedure has gained widespread recognition among foot and ankle specialists for its favorable surgical outcomes. However, with advancements in anatomical understanding and medical technology, further enhancements to the effectiveness of the Gould procedure are warranted. This study introduces a all-inside modified "outside-in" Broström -Gould procedure as an alternative approach for addressing lateral ankle instability. Methods: From August 2020 to October 2022, 40 patients with lateral ankle instability who underwent arthroscopic repair of the modified "outside-in" Broström-Gould procedure were retrospectively analyzed. All patients received standard non-surgical treatment before surgery for more than 6 months without symptom relief. Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) and Karlsson-Peterson score were used to evaluate the postoperative effect. Results: All patients were followed up for (14.62 ± 2.04) months. One year after operation, all patients could walk normally, ankle instability sensation disappeared, varus stress test and anterior drawer test were negative. The VAS , AOFAS and Karlsson-Peterson scores of all patients were significantly better compared with those before operation, and the difference between before and after operation was statistically significant. Conclusions: The modified "outside-in" Broström-Gould procedure can effectively treat CLAI, which can obtain satisfactory results. The procedure is straightforward, the impact is minimal, and the aesthetics are pleasing.
Collapse
Affiliation(s)
- Guolei Zhang
- Department of Hand, Foot and Ankle Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Wenqing Li
- Department of Hand, Foot and Ankle Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Haibo Yao
- Department of Hand, Foot and Ankle Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Rongzhi Tan
- Department of Hand, Foot and Ankle Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Chuyan Li
- Department of Hand, Foot and Ankle Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
|
15
|
Pirri C, Pirri N, Guidolin D, Macchi V, Porzionato A, De Caro R, Stecco C. Ultrasound Imaging in Football Players with Previous Multiple Ankle Sprains: Keeping a Close Eye on Superior Ankle Retinaculum. Bioengineering (Basel) 2024; 11:419. [PMID: 38790287 PMCID: PMC11117889 DOI: 10.3390/bioengineering11050419] [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: 03/11/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
The superior extensor ankle retinaculum (SEAR), a transversely fascial thickening positioned above the tibia-talar joint, serves as a crucial anatomical structure in ankle stability. The purpose of this study was to measure and compare by ultrasound (US) imaging the bilateral thickness and echogenicity of SEAR in football players with previous multiple ankle sprains (group 1) and healthy volunteers (group 2). A cross-sectional study was performed using ultrasound imaging to measure longitudinal and transversal axes using a new protocol in a sample of 50 subjects: 25 football players with previous multiple ankle sprains and 25 healthy subjects. The findings for SEAR thickness revealed statistically significant differences for both axes (p = 0.0011 and p = 0.0032) between the healthy side and the previously sprained side, and with the corresponding side of group 2 (p = 0.003 and p = 0.004). Moreover, in group 1, regarding the ROI echogenicity, a statistically significant difference was found between the sides (p = 0.0378). These findings suggest that the football players with previous ankle sprains showed a thicker and inhomogeneous SEAR on the sprain side, unveiling a remodeling of this structure compared to the other side and to the healthy volunteers. In these athletes, during US examination, one needs to keep "a US eye" on side-to-side SEAR comparisons.
Collapse
Affiliation(s)
- Carmelo Pirri
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (D.G.); (V.M.); (A.P.); (R.D.C.); (C.S.)
| | - Nina Pirri
- Department of Medicine—DIMED, School of Radiology, Radiology Institute, University of Padova, 35121 Padova, Italy;
| | - Diego Guidolin
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (D.G.); (V.M.); (A.P.); (R.D.C.); (C.S.)
| | - Veronica Macchi
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (D.G.); (V.M.); (A.P.); (R.D.C.); (C.S.)
| | - Andrea Porzionato
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (D.G.); (V.M.); (A.P.); (R.D.C.); (C.S.)
| | - Raffaele De Caro
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (D.G.); (V.M.); (A.P.); (R.D.C.); (C.S.)
| | - Carla Stecco
- Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy; (D.G.); (V.M.); (A.P.); (R.D.C.); (C.S.)
| |
Collapse
|
|
16
|
Maria PA, Vuurberg G, Kerkhoffs GMMJ. Exploring influences and risk of bias of studies on return to sport and work after lateral ankle sprain: A systematic review and meta-analysis. World J Meta-Anal 2024; 12:87026. [DOI: 10.13105/wjma.v12.i1.87026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/26/2023] [Accepted: 01/02/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity, with an incidence rate of 15%-20%. The high incidence and prevalence highlights the economic impact of this injury. Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses. Up to 40% of patients who suffer from an ankle sprain develop chronic ankle instability. Chronic instability can lead to prolonged periods of pain, immobility and injury recurrence. Identification of factors that influence return to work (RTW) and return to sports (RTS) after a lateral ankle sprain (LAS) may help seriously reduce healthcare costs.
AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.
METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023. Inclusion criteria were as follows: (1) Injury including LAS or chronic ankle instability; (2) Described any form of treatment; (3) Assessment of RTW or RTS; (4) Studies published in English; and (5) Study designs including randomized controlled clinical trials, clinical trials or cohort studies. Exclusion criteria were: (1) Studies involving children (age < 16 year); or (2) Patients with concomitant ankle injury besides lateral ankle ligament damage. A quality assessment was performed for each of the included studies using established risk of bias tools. Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis. A best evidence synthesis was performed in cases of qualitative outcome analysis. For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.
RESULTS A total of 8904 patients were included in 21 studies, 10 randomized controlled trials, 7 retrospective cohort studies and 4 prospective cohort studies. Fifteen studies were eligible for meta-analysis. The overall RTS rate ranged were 80% and 83% in the all treatments pool and surgical treatments pool, respectively. The pooled mean days to RTS ranged from 23-93 d. The overall RTW rate was 89%. The pooled mean time to RTW ranged from 5.8-8.1 d. For patients with chronic ankle instability, higher preoperative motivation was the sole factor significantly and independently (P = 0.001) associated with the rate of and time to RTS following ligament repair or reconstruction. Higher body mass index was identified as a significant factor (P = 0.04) linked to not resuming sports or returning at a lower level (median 24, range 20-37), compared to those who resumed at the same or higher level (median 23, range 17-38). Patients with a history of psychological illness or brain injury, experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains. The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits. We also observed that 10% of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.
CONCLUSION All treatments yielded comparable results, with each treatment potentially offering unique advantages or benefits. Preoperative motivation may influence rehabilitation after LAS. Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.
Collapse
Affiliation(s)
- Priscilla A Maria
- Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC-Location AMC, Amsterdam 1105 AZ, Netherlands
- Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Amsterdam Collaboration on Health and Safety in Sports, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Academic Center for Evidence-based Sports medicine, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Faculty of Medicine, University of Amsterdam, Amsterdam 1105 AZ, Netherlands
| | - Gwendolyn Vuurberg
- Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC-Location AMC, Amsterdam 1105 AZ, Netherlands
- Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Academic Center for Evidence-based Sports medicine, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Department of Radiology and Nuclear Medicine, Rijnstate Arnhem, Arnhem 6815AD, Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
| | - Gino MMJ Kerkhoffs
- Department of Orthopaedic Surgery and Sports Medicine, Amsterdam UMC-Location AMC, Amsterdam 1105 AZ, Netherlands
- Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Amsterdam Collaboration on Health and Safety in Sports, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Academic Center for Evidence-based Sports medicine, Amsterdam UMC, Amsterdam 1105 AZ, Netherlands
- Faculty of Medicine, University of Amsterdam, Amsterdam, 1105 AZ, Netherlands
| |
Collapse
|
|
17
|
Mao M, Yin Y, Luo D, Liu H, Yu B. Evaluation of dynamic postural control during single-leg landing tasks using initial impact force, landing leg stiffness and time to stabilisation. Sports Biomech 2024; 23:182-195. [PMID: 33594918 DOI: 10.1080/14763141.2020.1833969] [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: 09/13/2018] [Accepted: 10/05/2020] [Indexed: 10/22/2022]
Abstract
Time to stabilisation (TTS) provides limited information to evaluate the dynamic postural control for individuals with functional ankle instability in single-leg landing task. More information is needed to understand TTS and evaluate the dynamic postural control better. The purpose is to develop a method estimating TTS, initial impact force (IIF) and landing leg stiffness (LLS) through fitting ground reaction force (GRF) decay in single leg landing with exponential vibration decay function (EVDF), and investigate effects of landing directions and GRF components on these parameters. Thirty-nine healthy participants were recruited. EVDF was used to fit GRF decays in different single-leg landings. TTS, IIF, and LLS were compared across landing directions and GRF components. The mean regression determinants of fitting GRF decays with EVDF were greater than 0.50. TTS was sensitive to GRF components (P = 0.041 females, P = 0.028 males). IIF was sensitive to GRF components (P = 0.001) for both genders. LLS was sensitive to GRF components (P = 0.023) for males. This method showed a moderate to strong feasibility for reporting GRF decay during landing, and provided movement characteristic information for better understanding of dynamic postural control together with TTS during landing.
Collapse
Affiliation(s)
- Min Mao
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yan Yin
- Department of Physical Education, Beijing University of Post and Telecommunication, Beijing, China
| | - Dongmei Luo
- College of Human Movement Science, Beijing Sport University, Beijing, China
| | - Hui Liu
- College of Human Movement Science, Beijing Sport University, Beijing, China
| | - Bing Yu
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
|
18
|
Watanabe T, Takabayashi T, Kikumoto T, Kikuchi Y, Suzuki S, Hiratsuka S, Kubo M. Differences in abductor hallucis activity during running in individuals with chronic ankle instability and copers. Gait Posture 2024; 108:22-27. [PMID: 37976605 DOI: 10.1016/j.gaitpost.2023.11.005] [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: 05/20/2023] [Revised: 09/26/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Assessment of neuromuscular dysfunction following a lateral ankle sprain during running typically focuses on the activities of the extrinsic foot muscles. Although the interaction between intrinsic and extrinsic foot muscles has been reported, there are no studies on the activities of intrinsic foot muscles in individuals with chronic ankle instability and ankle sprain copers. RESEARCH QUESTION Do copers and individuals with chronic ankle instability (CAI) have different abductor hallucis activity? METHODS This study included 11 controls, 11 copers, and 16 CAI participants. A wireless surface electromyography system was applied to the abductor hallucis, peroneus longus, tibialis anterior, and medial gastrocnemius muscles. Running was performed on a treadmill (speed of 3.5 m/s). The stance phase is divided into four functional phases. The muscle activities during these phases were calculated using the root mean square standardized by the root mean square during static standing with a double-leg stance. RESULTS Abductor hallucis activity was significantly lower during most phases in the coper and control groups than in the CAI group (P < 0.05). There were no differences in the extrinsic foot muscles among the groups (P > 0.05). SIGNIFICANCE Simultaneous investigations of muscle activity in the abductor hallucis and extrinsic foot muscles identified neuromuscular dysfunction after ankle sprains. Increased activity of the abductor hallucis may be associated with recurrent ankle sprains.
Collapse
Affiliation(s)
- Takahiro Watanabe
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| | - Tomoya Takabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Takanori Kikumoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Yudai Kikuchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Shunsuke Suzuki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Shiori Hiratsuka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| | - Masayoshi Kubo
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan
| |
Collapse
|
|
19
|
Flore Z, Hambly K, De Coninck K, Welsch G. [Time-loss and recurrence rates after lateral ankle ligament sprains in male elite football players: summary of a systematic review and meta-analysis]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2023; 37:182-186. [PMID: 37075778 DOI: 10.1055/a-2047-9031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
A literature search was conducted to systematically review and meta-analyse time-loss and recurrence rates of lateral ankle sprains (LAS) in male professional football players. Six electronic databases were screened separately for time-loss and recurrence rates after lateral ankle sprains in elite football players. A total of 13 (recurrence) and 12 (time-loss) studies met the previously defined inclusion criteria. The total sample size of the recurrence studies was 36.201 participants (44.404 overall initial injuries, 7944 initial ankle sprain (AS) injuries, 1193 recurrent AS injuries). 16.442 professional football players (4893 initial AS injuries, 748 recurrent AS injuries) were subsequently meta-analysed. A recurrence rate of 17.11% (95% CI: 13.31-20.92%; df=12; Q=19.53; I2=38.57%) was determined based on the random-effects model. A total of 7736 participants were part of the time-loss studies (35.888 total injuries, 4848 total ankle injuries; 3370 AS injuries). Out of the 7736 participants, 7337 participants met the inclusion criteria with a total of 3346 AS injuries. The average time-loss was 15 days (weighted mean: 15.92, median: 14.95, min: 9.55; max: 52.9). A priori, we determined considerable heterogeneity (CI: 18.15-22.08; df=11; Q=158; I2=93%). There is an average time-loss of 15 days per LAS and a recurrence rate of 17%. LAS is one of the most common types of injury with high recurrence rates in professional football players. The high recurrence rates and long-term consequences show the necessity for research in the field of LAS in elite football. However, heterogeneous data lead to difficulties regarding the aspect of comparability.
Collapse
Affiliation(s)
- Zacharias Flore
- School of Sport and Exercise Sciences, Canterbury, UK, University of Kent at Canterbury: University of Kent, Canterbury, UNITED KINGDOM
- UKE-Athleticum, Hamburg, DE, Universitätsklinikum Hamburg-Eppendorf: Universitatsklinikum Hamburg-Eppendorf, Hamburg, GERMANY
| | - Karen Hambly
- School of Sport and Exercise Sciences, Canterbury, UK, University of Kent at Canterbury: University of Kent, Canterbury, UNITED KINGDOM
| | - Kyra De Coninck
- School of Sport and Exercise Sciences, Canterbury, UK, University of Kent at Canterbury: University of Kent, Canterbury, UNITED KINGDOM
| | - Götz Welsch
- UKE-Athleticum, Hamburg, DE, Universitätsklinikum Hamburg-Eppendorf: Universitatsklinikum Hamburg-Eppendorf, Hamburg, GERMANY
| |
Collapse
|
|
20
|
Jun K, Eo H, Koo WM, Woo S, Lee J, Kim JM, Lee BJ, Nam TW. Long-term changes of standing balance after lateral ankle sprain using Footscan system: A case report. Medicine (Baltimore) 2023; 102:e36058. [PMID: 37986359 PMCID: PMC10659663 DOI: 10.1097/md.0000000000036058] [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: 08/13/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023] Open
Abstract
RATIONALE A lateral ankle sprain (LAS) is a common sports related injury. Ankle instability and balance impairment after injury are common. This case report describes the longitudinal changes in static balance after LAS. PATIENT CONCERNS A 36-year-old man visited our hospital with LAS of the right ankle that occurred during an exercise session. The patient complained of severe pain and swelling of the ankle. The patient was unable to walk a short distance. DIAGNOSES Ultrasound examination showed swelling of the surrounding soft tissues and a partial tear of the right anterior talofibular ligament. In the Doppler scan, vascularity increased around anterior talofibular ligament. No fractures were observed on computed tomography. INTERVENTIONS The patient received analgesics for pain control. The rest, ice, compression, elevation protocol was used. The injured area was protected with a controlled ankle movement walking boot for 2 weeks. Standing balance was measured at 3, 4, 8, 12, and 24 weeks after injury using Footscan. OUTCOME He was able to walk approximately 2 weeks after the injury with reduced pain over time. It was observed that the standing balance improved over time. LESSON In this case, it was objectively confirmed that standing balance was restored naturally after LAS.
Collapse
Affiliation(s)
- Kwangohk Jun
- Department of Physical Medicine and Rehabilitation, Daegu Fatima Hospital, Dong-gu, Daegu, South Korea
| | - Hyoshin Eo
- Department of Physical Medicine and Rehabilitation, Daegu Fatima Hospital, Dong-gu, Daegu, South Korea
| | - Won Mo Koo
- Department of Physical Medicine and Rehabilitation, Daegu Fatima Hospital, Dong-gu, Daegu, South Korea
| | - Seongho Woo
- Department of Physical Medicine and Rehabilitation, Daegu Fatima Hospital, Dong-gu, Daegu, South Korea
| | - Jeeihn Lee
- Department of Physical Medicine and Rehabilitation, Suseong Children’s Hospital, Suseong, Daegu, South Korea
| | - Jong Min Kim
- Department of Physical Medicine and Rehabilitation, Daegu Fatima Hospital, Dong-gu, Daegu, South Korea
| | - Byung Joo Lee
- Department of Physical Medicine and Rehabilitation, Daegu Fatima Hospital, Dong-gu, Daegu, South Korea
| | - Tae-Woo Nam
- Department of Physical Medicine and Rehabilitation, Gyeongbuk Regional Rehabilitation Hospital, Gyeongbuk, South Korea
| |
Collapse
|
|
21
|
Tamura A, Shimura K, Inoue Y. Leg and Joint Stiffness of the Supporting Leg during Side-Foot Kicking in Soccer Players with Chronic Ankle Instability. Sports (Basel) 2023; 11:218. [PMID: 37999435 PMCID: PMC10674260 DOI: 10.3390/sports11110218] [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: 10/01/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Soccer players with chronic ankle instability (CAI) may stabilize their supporting leg by the proximal joint to compensate for the ankle instability during kicking motion. This study aimed to investigate the characteristics of leg and joint stiffness of the supporting leg during side-foot kicking in soccer players with CAI. Twenty-four male collegiate-level soccer players with and without CAI participated in this study. The kinematic and kinetic data were obtained using a three-dimensional motion analysis system. Leg stiffness and joint (hip, knee, and ankle) stiffness in the sagittal and frontal planes were calculated and analyzed. The results clarified that soccer players with CAI (0.106 ± 0.053 Nm/°) had greater knee stiffness in knee adduction during the kicking cycle compared to those without CAI (0.066 ± 0.030 Nm/°; p = 0.046), whereas no characteristic differences were observed in knee stiffness in knee flexion and hip and ankle stiffness (p > 0.05). Knee stiffness is believed to occur to compensate for ankle joint instability in the supporting leg. Therefore, adjusting knee stiffness to accommodate ankle joint instability is crucial for maintaining kicking performance. Based on results of this study, it may be important to consider training and exercises focused on joint coordination to improve knee stiffness in soccer players with CAI.
Collapse
Affiliation(s)
- Akihiro Tamura
- Research Institute for Health and Sport Science, Nippon Sport Science University, Setagaya, Tokyo 158-8508, Japan
| | - Keita Shimura
- School of Health Sciences, Tokyo International University, Kawagoe 350-1197, Saitama, Japan;
| | - Yuri Inoue
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Hyogo, Japan;
| |
Collapse
|
|
22
|
Kim JS, Kim MS, Kim DK, Lee SH. Magnetic Resonance Imaging Characteristics of a Lateral Ligament Injury in Acute Ankle Sprains Among Athletes. Orthop J Sports Med 2023; 11:23259671231207688. [PMID: 37954866 PMCID: PMC10637175 DOI: 10.1177/23259671231207688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 11/14/2023] Open
Abstract
Background It is important to identify the location and pattern of lateral ligament injuries that are related to the development and prognosis of chronic ankle instability in athletes with ankle sprains. Purpose To describe the location and pattern of lateral ligament injuries on magnetic resonance imaging (MRI) in elite-level or amateur athletes with acute ankle sprains and to further assess the risk of associated concomitant injuries. Study Design Cross-sectional study; Level of evidence, 3. Methods The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) of 110 athletes with an ankle lateral ligament injury (mean age, 24.7 years) were evaluated. MRI scans were evaluated for the location and pattern of ATFL and CFL tears such as sleeve avulsions as well as concomitant deltoid ligament injuries, bone contusions, and osteochondral lesions of the talus (OLTs). Results On MRI, 52 (47.3%) athletes had an isolated ATFL tear, 56 (50.9%) athletes had both ATFL and CFL tears, and 2 (1.8%) athletes had an isolated CFL tear. ATFL injuries occurred at the fibula, midsubstance, and talus in approximately equal numbers, whereas the majority of CFL injuries occurred at the calcaneal insertion. Concomitant deltoid ligament injuries were identified in 18 (16.4%) athletes. In addition, concomitant bone contusions and OLTs were identified in 38 (34.5%) and 6 (5.5%) athletes, respectively. Using linear-by-linear analysis, CFL injuries correlated with concomitant deltoid ligament and bone injuries (P = .023 and P = .001, respectively) and a sleeve injury pattern (P = .005). Conclusion After an acute ankle ligament rupture, almost all athletes involved in this study had injured their ATFL, and approximately 50% had a concomitant injury to the CFL. The rate of sleeve-type CFL injuries at the calcaneal insertion was high, and concomitant deltoid ligament injuries and OLTs were associated with this pattern of injury.
Collapse
Affiliation(s)
- Jin Su Kim
- Department of Orthopedic Surgery, Sejong Sports Medicine and Performance Center, Seoul, Republic of Korea
| | - Min Seok Kim
- Department of Orthopedic Surgery, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Do Kyun Kim
- Department of Orthopedic Surgery, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Sung Hyun Lee
- Department of Orthopedic Surgery, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Republic of Korea
- Musculoskeletal and Immune Disease Research Institute, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| |
Collapse
|
|
23
|
Hong CC, Calder J. Ability to return to sports after early lateral ligament repair of the ankle in 147 elite athletes. Knee Surg Sports Traumatol Arthrosc 2023; 31:4519-4525. [PMID: 36480025 DOI: 10.1007/s00167-022-07270-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The literature on elite athletes' ability to return to sports (RTS) after early lateral ligament repair of the ankle remains inadequate. The time needed to RTS after modified Broström repair for acute grade III lateral ligament injuries in a large cohort of elite athletes was evaluated while assessing the impact of other associated injuries. METHODS Prospective data from 147 elite athletes who underwent a primary lateral ligament repair for acute grade III injuries with clinical ankle instability from 2015 to 2019 with a minimum of 2-year follow-up were reviewed. Pertinent details such as characteristics of injury, time taken to RTS, impact of associated injuries on RTS and complications were recorded and analysed. RESULTS The average age was 24.4 years (S.D = 4.9) with 89.1% males. Approximately two-thirds of the elite athletes were football players (66.0%) and 21.1% were rugby players. Isolated lateral ligament complex injuries were sustained by 122 (83%) patients, while 25 (17%) had associated injuries (osteochondral lesions of the talus/deltoid injury/syndesmosis injury). All 147 athletes returned to their preinjury level of sports with a median time of 69 days (range 58-132 days). There was no significant difference found in time to RTS between gender, age, and types of sports. However, there was a statistically significant difference noted in the time taken to RTS earlier in patients with isolated lateral ligament injuries when compared to those with associated injuries (68.6 vs. 82.8 days; p = 0.004). Multiple conditional linear regression yielded three independent predictors of longer time taken to RTS which were associated deltoid injury (7.5 days longer; 95% CI 2.9-12.3; p = 0.002), associated syndesmosis injury (6.7 days longer; 95% CI 0.5-12.8; p = 0.034) and associated OLT (30.3 days longer; 95% CI 25.1-35.5; p = 0.000). CONCLUSION Early surgical repair for acute grade III lateral ligament injuries in elite athletes yielded excellent rate of RTS at 9-10 weeks and a re-injury rate of 2%. Concomitant injuries will delay RTS after surgical intervention. These findings serve as important guide to managing elite athletes following acute rupture of the lateral ligament complex. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Choon Chiet Hong
- Fortius Clinic (FIFA Medical Centre of Excellence), 17 Fitzhardinge Street, London, W1H 6EQ, UK.
- Department of Orthopaedic Surgery, National University Hospital of Singapore, 1E, Kent Ridge Road, Singapore, 119228, Singapore.
| | - James Calder
- Fortius Clinic (FIFA Medical Centre of Excellence), 17 Fitzhardinge Street, London, W1H 6EQ, UK
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| |
Collapse
|
|
24
|
Gurau TV, Gurau G, Musat CL, Voinescu DC, Anghel L, Onose G, Munteanu C, Onu I, Iordan DA. Epidemiology of Injuries in Professional and Amateur Football Men (Part II). J Clin Med 2023; 12:6293. [PMID: 37834937 PMCID: PMC10573283 DOI: 10.3390/jcm12196293] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Background (1): Men's football is a physically demanding contact sport that involves intermittent bouts of sprinting, jogging, walking, jumping and changes of direction. The physical demands of the game vary by level of play (amateur club, sub-elite and open club or international), but injury rates at all levels of the men's football game remain the highest of all sports. Objective: The aim of this study is to conduct a systematic review of data from the epidemiological literature regarding the profile, severity and mechanisms of injuries and the frequency of recurrent injuries in professional and amateur football players. Methods (2): A systematic review, according to PRISMA guidelines, was performed up to June 2023 in the databases of PubMed, Web of Science, Google academic, Google scholar and the Diva portal. Twenty-seven studies that reported data on the type, severity, recurrence and mechanisms of injury in professional and amateur men's football were selected and analyzed. Two reviewers independently audited data and assessed the study quality using the additional and adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): In professional male football players, the mean prevalence of muscle/tendon injuries was 39.78%, followed by joint and ligament injuries-21.13%, contusions-17.86%, and fractures-3.27%, and for amateur football players, the prevalence's were 44.56% (muscle/tendon injuries), 27.62% (joint and ligament injuries), 15.0% (contusions) and 3.05% (fracture), respectively. The frequency of traumatic injuries was higher in amateur football players (76.88%) compared to professional football players (64.16%), the situation being reversed in the case of overuse injuries: 27.62% in professional football players and 21.13% in amateur football players. Most contact injuries were found in professional footballers (50.70%), with non-contact injuries predominating in amateur footballers (54.04%). The analysis of the severity of injuries showed that moderate injuries dominated in the two categories of footballers; the severe injuries in amateur footballers exceeded the severe injuries recorded in professional footballers by 9.60%. Recurrence proportions showed an inverse relationship with the level of play, being higher in amateur footballers (16.66%) compared to professional footballers (15.25%). Conclusions (4): Football-related injuries have a significant impact on professional and amateur football players and their short- and long-term health status. Knowing the frequency of severe diagnoses, such as strains, tears and cramps of the thigh muscles, ankle ligament sprains and hip/groin muscle strain requires the establishment of adequate programs to prevent them, especially in amateur football players, who are more prone to serious injuries.
Collapse
Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania;
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania;
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| |
Collapse
|
|
25
|
Wolf J, Cottom J, Srour J, Rubin L. Arthroscopic Lateral Stabilization. Clin Podiatr Med Surg 2023; 40:495-507. [PMID: 37236686 DOI: 10.1016/j.cpm.2023.03.002] [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] [Indexed: 05/28/2023]
Abstract
The indications and procedures for arthroscopy of the ankle and subtalar joints continues to increase. Lateral ankle instability is a common pathology that may require surgery to repair injured structures of patients nonresponsive to conservative management. Common surgical methods generally include ankle arthroscopy with subsequent open approach to repair/reconstruct the ankle ligament(s). This article discusses two different approaches to repairing lateral ankle instability through an arthroscopic approach. The arthroscopic modified Brostrom procedure creates a strong repair with minimal soft tissue dissection, and is a reliable, minimally invasive approach to lateral ankle stabilization. The arthroscopic double ligament stabilization procedure creates a robust reconstruction of the anterior talofibular and calcaneal fibular ligaments with minimal soft tissue dissection.
Collapse
Affiliation(s)
- Joseph Wolf
- Florida Orthopedic Foot and Ankle Center, 4913 Harroun Road, Suite 1, Sylvania, OH 43560, USA
| | - James Cottom
- Florida Orthopedic Foot and Ankle Center Fellowship, 5741 Bee Ridge Road, Suite 490, Sarasota, Fl 34233, USA
| | - Jonathon Srour
- Virginia Fellowship in Reconstruction, Revision, and Limb Preservation Surgery of the Foot and Ankle, 905 South Willow Avenue, Cookeville, TN 38501, USA
| | - Laurence Rubin
- Virginia Fellowship in Reconstruction, Revision, and Limb Preservation Surgery of the Foot and Ankle, 7016 Lee Park Road, Suite 105, Mechanicsville, VA 23111, USA.
| |
Collapse
|
|
26
|
Jain N, Murray D, Kemp S, Calder J. Republication of "High-Speed Video Analysis of Syndesmosis Injuries in Soccer-Can It Predict Injury Mechanism and Return to Play? A Pilot Study". FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231195048. [PMID: 37578852 PMCID: PMC10422888 DOI: 10.1177/24730114231195048] [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] [Indexed: 08/16/2023] Open
Abstract
Background Ankle syndesmosis injuries in professional soccer may lead to an unpredictable and prolonged recovery. This injury has been investigated in anatomical and radiologic studies but the precise mechanism leading to syndesmosis injury is not well understood and remains debated. The 2 goals of this study were to (1) evaluate the relationship between the mechanism of syndesmosis injury as determined by high-speed video analysis and the injured structures identified by clinical and radiologic examination and to (2) investigate the relationship between mechanism of injury and time of return to play. Methods This pilot study prospectively reviewed high-speed video analysis of 12 professional soccer players who sustained syndesmosis injuries. The mechanism of injury was compared with the clinical and MRI evaluation and the time taken to return to play. Results Higher-grade syndesmosis injuries occurred during ankle external rotation with dorsiflexion. Supination-inversion injuries with a standard lateral ankle sprain (rupture of the anterior talofibular ligament) may extend proximally, causing a lower-grade syndesmosis injury. These may present with signs of a high ankle sprain but have a quicker return to sport than those following a dorsiflexion-external rotation injury (mean 26 days vs 91 days). Conclusions Video analysis confirmed that at least 2 mechanisms may result in injury to the ankle syndesmosis. Those "simple" ankle sprains with signs of syndesmosis injury had a quicker return to play. This new finding may be used by club medical teams during their initial assessment and help predict the expected time away from soccer in players with suspected high ankle sprains. Level of Evidence Level IV, retrospective cohort study.
Collapse
Affiliation(s)
- Neil Jain
- Manchester Institute of Health & Performance, Manchester, UK
| | - David Murray
- Manchester Institute of Health & Performance, Manchester, UK
| | - Steve Kemp
- The Football Association, Burton-upon-Trent, UK
| | - James Calder
- Department of Bioengineering, Imperial College, Fortius Clinic, London, UK
| |
Collapse
|
|
27
|
Hong CC, Calder J. The Burden of the "Simple Ankle Sprains": A Review of the Epidemiology and Long-Term Impact. Foot Ankle Clin 2023; 28:187-200. [PMID: 37137618 DOI: 10.1016/j.fcl.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Lateral ankle sprain (LAS) is not as simple as it was believed to be as it has substantial negative impacts on the active sporting population. The negative impact on physical function, quality of life (QoL) and economic burden is significant with increased risk of reinjury, development of chronic lateral ankle instability and posttraumatic ankle osteoarthritis resulting in functional deficits, decreased QoL and chronic disabilities. Economic burden from a societal perspective demonstrated notably higher indirect costs from productivity loss. Preventative interventions with early surgery for a selective cohort of active sporting population may be considered to mitigate morbidities associated with LAS.
Collapse
Affiliation(s)
- Choon Chiet Hong
- Fortius Clinic (FIFA Medical Centre of Excellence), 17 Fitzhardinge Street, London, W1H 6EQ, UK; Department of Orthopaedic Surgery, National University Hospital of Singapore, 1E, Kent Ridge Road, Singapore 119228, Singapore.
| | - James Calder
- Fortius Clinic (FIFA Medical Centre of Excellence), 17 Fitzhardinge Street, London, W1H 6EQ, UK; Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| |
Collapse
|
|
28
|
Chen L, Xie X, Cao P, Guo Q, Jiang D, Jiao C, Pi Y. Arthroscopic and Open Procedures Result in Similar Calcaneal Tunnels for Anatomical Reconstruction of Lateral Ankle Ligaments. Arthrosc Sports Med Rehabil 2023; 5:e687-e694. [PMID: 37388872 PMCID: PMC10300538 DOI: 10.1016/j.asmr.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 03/29/2023] [Indexed: 07/01/2023] Open
Abstract
Purpose The purpose of this study was to validate the accuracy and reliability of arthroscopic markers of distal insertion of the calcaneofibular ligament (CFL), and to compare the calcaneus bone tunnels of the CFL that were made under arthroscopy and open procedures. Methods Fifty-seven patients who underwent lateral ankle ligament reconstruction procedures were enrolled and divided into open (n = 24) and arthroscopic groups (n = 33). Lateral ankle radiography was performed postoperatively, and the calcaneus bone tunnels referenced to several landmarks, including the subtalar joint, calcaneus superior edge, fibular tip, angulation with fibula axis, cross point of the fibular and tangential line of the fibular obscure tubercle cross point of the tangential lines of the talar posterior edge and deepest point of the subtalar joint, and cross point of the fibular axis and perpendicular line across fibular tip. These results were compared between the two groups. Results No significant intergroup differences were observed between the parameters. When the bone tunnels of the CFL were referenced to the cross point of tangential lines of the talar posterior edge and deepest point of the subtalar joint, and the cross point of the fibular axis and perpendicular line across fibular tip, the coefficient variations were very high, which indicated that the locations of the bone tunnels were scattered over a large area in both groups. Conclusions Arthroscopic and open procedures achieved similar results for calcaneus bone tunnel making of the CFL. However, large variations were observed in both groups. Level of Evidence Level III, retrospective cohort study.
Collapse
Affiliation(s)
- Linxin Chen
- Institute of Sports Medicine, Peking University Third Hospital, Haidian District, Beijing, People’s Republic of China
| | - Xin Xie
- Institute of Sports Medicine, Peking University Third Hospital, Haidian District, Beijing, People’s Republic of China
| | - Peng Cao
- Orthopedics Dept. 1, CangZhou Hospital of Integrated TCM-WM, Cangzhou City, Hebei Province, People’s Republic of China
| | - Qinwei Guo
- Institute of Sports Medicine, Peking University Third Hospital, Haidian District, Beijing, People’s Republic of China
| | - Dong Jiang
- Institute of Sports Medicine, Peking University Third Hospital, Haidian District, Beijing, People’s Republic of China
| | - Chen Jiao
- Institute of Sports Medicine, Peking University Third Hospital, Haidian District, Beijing, People’s Republic of China
| | - Yanbin Pi
- Institute of Sports Medicine, Peking University Third Hospital, Haidian District, Beijing, People’s Republic of China
| |
Collapse
|
|
29
|
Leckie I, Thomas L, Weiler R. Rehabilitation of a lateral ankle reconstruction in a male professional football player - A narrative case report. Phys Ther Sport 2023; 62:32-38. [PMID: 37300971 DOI: 10.1016/j.ptsp.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Lateral ankle sprains involving the ATFL and CFL are common injuries in football with a high recurrence rate. There is a lack of research to guide post-operative rehabilitation of football players following lateral ligament ankle reconstructive surgery. This narrative case report discusses the management of a lateral ligament reconstruction in a male professional football player. METHODS A 25-year-old professional footballer underwent a lateral ankle reconstruction following recurrent lateral ankle sprains leading to an unstable ankle. RESULTS Following 11-weeks of rehabilitation the player was cleared to return to full-contact training. The player competed in his first competitive match 13-weeks post-injury and completed a 6-month full-training block, without episodes of pain or instability. CONCLUSION This case report illustrates the rehabilitation process of a football player following a lateral ankle ligament reconstruction within a timeframe expected in elite sport.
Collapse
Affiliation(s)
| | | | - Richard Weiler
- University Medical Centres, Netherlands; University College London, Instistute Sport, Exercise and Health, Division of Surgery and Interventional Science, United Kingdom; Fortius Clinic London, United Kingdom
| |
Collapse
|
|
30
|
Chen RP, Wang QH, Li MY, Su XF, Wang DY, Liu XH, Li ZL. Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament. World J Clin Cases 2023; 11:3395-3407. [PMID: 37383912 PMCID: PMC10294195 DOI: 10.12998/wjcc.v11.i15.3395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/07/2023] [Accepted: 04/14/2023] [Indexed: 05/25/2023] Open
Abstract
Injury to the anterior talofibular ligament (ATFL) is a common acute injury of the lateral foot ligament. Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients. The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL. The clinical manifestations of acute injury to the ATFL include pain, swelling, and dysfunction. At present, non-surgical treatment is the first choice for acute injury of the ATFL. The standard treatment strategy involves the "peace and love" principle. After initial treatment in the acute phase, personalized rehabilitation training programs can be followed. These may involve proprioception training, muscle training, and functional exercise to restore limb coordination and muscle strength. Static stretching and other techniques to loosen joints, acupuncture, moxibustion massage, and other traditional medical treatments can relieve pain, restore range of motion, and prevent joint stiffness. If the non-surgical treatment is not ideal or fails, surgical treatment is feasible. Currently, arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice. Although open Broström surgery provides good results, the modified arthroscopic Broström surgery has many advantages, such as less trauma, rapid pain relief, rapid postoperative recovery, and fewer complications, and is more popular with patients. In general, when treating acute injury to the ATFL, treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results.
Collapse
Affiliation(s)
- Run-Peng Chen
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Qing-Hua Wang
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Ming-Yue Li
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Xiao-Fang Su
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Dong-Yang Wang
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
- Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Xing-Hui Liu
- Department of Office, Shandong Vheng Data Technology Co., Ltd, Yantai 264003, Shandong Province, China
| | - Zhi-Li Li
- Department of Office, Shandong Vheng Data Technology Co., Ltd, Yantai 264003, Shandong Province, China
| |
Collapse
|
|
31
|
Liu Z, Lu H, Yuan Y, Fu Z, Xu H. Mid-term follow-up evaluation of a new arthroscopic Broström procedure for chronic lateral ankle instability. J Orthop Surg Res 2023; 18:316. [PMID: 37095551 PMCID: PMC10123977 DOI: 10.1186/s13018-023-03789-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/10/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Chronic lateral ankle instability (CLAI) usually progresses from a previous lateral ankle sprain that was not treated properly. Several procedures have been introduced to address these patients, including open or arthroscopic techniques, the most common of which is the Broström procedure. Here, we describe a new outside-in arthroscopic Broström procedure and its results for treating patients with CLAI. METHODS Thirty-nine patients (16 male and 23 female; mean age, 35 years [range, 16-60 years]) with CLAI were treated arthroscopically after failing non-operative management. All patients were symptomatic with a combination of recurrent ankle sprains, "giving way," and avoidance of sports and presented with a positive anterior drawer test upon the physical examination. All patients underwent arthroscopic lateral ligament reconstruction using the new technique. Patient characteristics and pre- and postoperative visual analog scale (VAS), American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale system (AOFAS), and Karlsson scores were recorded. RESULTS The mean AOFAS score increased from 48 (mean 48, range 33-72) preoperatively to 91 (mean 91, range 75-98) at the final follow-up, Karlsson-Peterson and FAAM scores were also significantly improved. Two patients (5.13%) reported superficial peroneal nerve irritation symptoms postoperatively. Three patients (7.69%) complained of mild pain anteroinferior to the lateral ankle. CONCLUSIONS The arthroscopic outside-in Broström procedure with a single suture anchor was a safe, effective, and reproducible technique for CLAI. Ankle stability resumed with a high clinical success rate. The main complication was injury to the superficial peroneal nerve, which crossed the area of repair.
Collapse
Affiliation(s)
- Zhongdi Liu
- National Center for Trauma Medicine, Ministry of Education Key Laboratory of Trauma and Neural Regeneration, Trauma Medicine Center, Peking University People's Hospital, Beijing, China
| | - Hao Lu
- Department of Trauma and Orthopedics, Peking University People's Hospital, No. 11, South XiZhiMen Street, Beijing, 100044, China
| | - Yusong Yuan
- Department of Trauma and Orthopedics, Peking University People's Hospital, No. 11, South XiZhiMen Street, Beijing, 100044, China
| | - Zhongguo Fu
- Department of Trauma and Orthopedics, Peking University People's Hospital, No. 11, South XiZhiMen Street, Beijing, 100044, China
| | - Hailin Xu
- Department of Trauma and Orthopedics, Peking University People's Hospital, No. 11, South XiZhiMen Street, Beijing, 100044, China.
| |
Collapse
|
|
32
|
Kramer Z, Woo Lee Y, Sherrick R. Acute Ankle Sprains. Clin Podiatr Med Surg 2023; 40:117-138. [PMID: 36368838 DOI: 10.1016/j.cpm.2022.07.008] [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
Understanding the types of ankle sprains is essential in determining the most appropriate treatment and preventing substantial missed time from sports. Commonly known and recognized is an acute lateral ankle sprain, however, a differentiation should also be made to understand high (syndesmotic) ankle sprains as the mechanism of injury and recovery periods differ between these two types.
Collapse
Affiliation(s)
- Zachary Kramer
- Scripps Memorial Hospital, 310 Santa Fe Drive #112, Encinitas, CA 92024, USA
| | - Yessika Woo Lee
- Dignity Health, St. Mary's Medical Center, 450 Stanyan Street, San Francisco, CA 94117, USA.
| | - Ryan Sherrick
- Foot & Ankle Surgery, Innovative Medical Solutions Foot & Ankle Institute, 2080 Century Park East, STE 710, Los Angeles, CA 90067, USA
| |
Collapse
|
|
33
|
Individual fascicles of the ankle lateral ligaments and the lateral fibulotalocalcaneal ligament complex can be identified on 3D volumetric MRI. Knee Surg Sports Traumatol Arthrosc 2022; 31:2192-2198. [PMID: 36539639 DOI: 10.1007/s00167-022-07275-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Lateral ligament ankle sprains are common and the anatomy on imaging studies is vital for accurate diagnosis. The lateral fibulotalocalcaneal ligament (LFTCL) complex consists of the inferior fascicle of the anterior talofibular ligament (ATFL) which is connected by arciform fibres with the calcaneofibular ligament (CFL). The superior fascicle of ATFL is an independent structure that should be assessed individually. MRI evaluation of these distinct fascicles and the arciform fibres has not been described. The aim of this study is to identify the anatomical relationship of these components of the LFTCL complex in healthy individuals on MRI. METHODS Thirty ankles from healthy volunteers were imaged using 3D volumetric MRI. The ATFL fascicles and size were evaluated. Presence of arciform fibres connecting the inferior ATFL fascicle and CFL to form the LFTCL complex and anatomical relationship around the lateral ligament complex were assessed. RESULTS Both the superior and inferior ATFL fascicles were observed in 26 (86.7%) ankles. The superior ATFL fascicle was significantly larger in all specimens (39% longer and 80.7% wider). For the specimens with a single fascicle, this was similar in size to the superior fascicle observed in the other 26 specimens. These measurements were not affected by age or gender. Arciform fibres of the LFTCL complex were identified in 22 (84.6%) specimens with two ATFL fascicles and three (75%) ankles with a single ATFL fascicle. Connecting fibres from the ATFL to PTFL were observed in 19 (63.3%) ankles while connections between the CFL and PTFL were identified in 21 (70%) ankles. Five ankles had a perforating artery visualized in the intervening space between the superior and inferior ATFL fascicles (a branch of the lateral tarsal artery of the dorsalis pedis artery). CONCLUSION Two distinct ATFL fascicles may be identified in the majority of ankles on MRI. Isolated injury to the superior fascicle identified on MRI may be useful when diagnosing patients presenting with symptoms of subtle instability without overt ankle laxity on clinical examination. The current study is the first to identify the arciform fibres of the LFTCL complex supporting isolated ATFL repair in the presence of intact LFTCL complex. LEVEL OF EVIDENCE Level III.
Collapse
|
|
34
|
Flore Z, Hambly K, De Coninck K, Welsch G. Time-loss and recurrence of lateral ligament ankle sprains in male elite football: A systematic review and meta-analysis. Scand J Med Sci Sports 2022; 32:1690-1709. [PMID: 35904448 PMCID: PMC9804772 DOI: 10.1111/sms.14217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/07/2022] [Accepted: 07/24/2022] [Indexed: 01/09/2023]
Abstract
A literature search was conducted to systematically review and meta-analyze time-loss and recurrence rate of lateral ankle sprains (LAS) in male professional football players. Six electronic databases (PubMed, Scopus, Web of Science, PEDRO, CINAHL, and Cochrane) were searched independently, separately both for time-loss and recurrence from inception until April 30, 2021. In addition, reference lists were screened manually to find additional literature. Cohort studies, case reports, case-control studies and RCT in English language of male professional football players (aged more than 16 years) for which data on time-loss or recurrence rates of LAS were available were included. A total of 13 (recurrence) and 12 (time-loss) studies met the inclusion criteria. The total sample size of the recurrence studies was 36,201 participants (44,404 overall initial injuries; 7944 initial ankle sprain [AS] injuries, 1193 recurrent AS injuries). 16,442 professional football players (4893 initial AS injuries; 748 recurrent AS injuries) were meta-analyzed. A recurrence rate of 17.11% (95% CI: 13.31-20.92%; df = 12; Q = 19.53; I2 = 38.57%) based on the random-effects model was determined. A total of 7736 participants were part of the time-loss studies (35,888 total injuries; 4848 total ankle injuries; 3370 AS injuries). Out of the 7736 participants, 7337 participants met the inclusion criteria with a total of 3346 AS injuries. The average time-loss was 15 days (weighted mean: 15.92; median: 14.95; min: 9.55; max: 52.9). We determined a priori considerable heterogeneity (CI: 18.15-22.08; df = 11; Q = 158; I2 = 93%), so that the data on time-loss are only presented descriptively. There is an average time-loss of 15 days per LAS and a recurrence rate of 17%. LAS is one of the most common types of injury with higher recurrence rates than ACL injuries (9%-12%) in professional football players. Nevertheless, the focus of research in recent years has been mostly on ACL injuries. However, the high recurrence rates and long-term consequences show the necessity for research in the field of LAS in elite football. Yet, heterogeneous data lead to difficulties concerning the aspect of comparability.
Collapse
Affiliation(s)
- Zacharias Flore
- University of Kent, School of Sport and Exercise SciencesCanterburyUK,Hamburger SV, Fußball AGHamburgGermany,University Medical Center Hamburg‐EppendorfUKE‐AthleticumHamburgGermany
| | - Karen Hambly
- University of Kent, School of Sport and Exercise SciencesCanterburyUK
| | - Kyra De Coninck
- University of Kent, School of Sport and Exercise SciencesCanterburyUK
| | - Götz Welsch
- University Medical Center Hamburg‐EppendorfUKE‐AthleticumHamburgGermany,Department of Trauma and Orthopaedic SurgeryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| |
Collapse
|
|
35
|
Bestwick-Stevenson T, Toone R, Neupert E, Edwards K, Kluzek S. Assessment of Fatigue and Recovery in Sport: Narrative Review. Int J Sports Med 2022; 43:1151-1162. [PMID: 35468639 DOI: 10.1055/a-1834-7177] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Fatigue is a phenomenon associated with decreases in both physical and cognitive performances and increases in injury occurrence. Competitive athletes are required to complete demanding training programs with high workloads to elicit the physiological and musculoskeletal adaptations plus skill acquisition necessary for performance. High workloads, especially sudden rapid increases in training loads, are associated with the occurrence of fatigue. At present, there is limited evidence elucidating the underlying mechanisms associating the fatigue generated by higher workloads and with an increase in injury risk. The multidimensional nature and manifestation of fatigue have led to differing definitions and dichotomies of the term. Consequently, a plethora of physiological, biochemical, psychological and performance markers have been proposed to measure fatigue and recovery. Those include self-reported scales, countermovement jump performance, heart rate variability, and saliva and serum biomarker analyses. The purpose of this review is to provide an overview of fatigue and recovery plus methods of assessments.
Collapse
Affiliation(s)
- Thomas Bestwick-Stevenson
- School of Medicine, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Rebecca Toone
- Mountain Biking, English Institute of Sport, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Emma Neupert
- School of Sport Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom of Great Britain and Northern Ireland
| | - Kimberley Edwards
- School of Medicine, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Stefan Kluzek
- School of Medicine, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
|
36
|
Li P, Wei Z, Zeng Z, Wang L. Acute effect of kinesio tape on postural control in individuals with functional ankle instability following ankle muscle fatigue. Front Physiol 2022; 13:980438. [PMID: 36111154 PMCID: PMC9468612 DOI: 10.3389/fphys.2022.980438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/05/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Kinesio taping (KT) is one of the therapeutic interventions in sports medicine practice. The study aims to assess the acute effect of different KT methods on postural control in individuals with functional ankle instability (FAI) after ankle muscle fatigue. Methods: Twenty-eight participants with FAI were recruited to complete maximum voluntary isometric contraction (MVIC) and proprioception of ankle using isokinetic dynamometer, dynamic postural control using Y-balance test and static postural control using a force platform after a fatigue protocol in four taping conditions: facilitatory KT (FKT), ankle balance taping (ABT), sham taping (ST) and no taping (NT). Results: No significant difference was observed for the data MVIC and proprioception after ankle muscle fatigue amongst the four taping treatments. A significant difference in Y-Balance Test was observed amongst the four taping treatments at posterolateral direction (p < 0.001) and posteromedial direction (p < 0.001), suggesting that KT may significantly improve dynamic postural control following ankle muscle fatigue. For Center of pressure (COP) measurements, the mediolateral COP sway range of NT was significantly larger than that of FKT (p = 0.003) and ST (p < 0.001), suggesting that the placebo effect of KT was inevitable. Conclusion: The effect of KT seems increased dynamic postural control in individuals with FAI after ankle muscle fatigue, and this effect is not strongly related to the taping methods. By preventing fatigue-related impairments of postural control, KT may help reduce the risk of injury in individuals with FAI.
Collapse
|
|
37
|
Choi YG, Park HJ, Kim JN, Kim MS, Park SJ, Hong SW, Kim YH. Association between joint effusions and concomitant structural injuries (tendinitis and structural injury) on MRI in ankle trauma without fracture. Acta Radiol 2022; 63:942-947. [PMID: 34053224 DOI: 10.1177/02841851211021038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The evaluation of correlations among joint effusion, ligament injuries, tenosynovitis and osteochondral lesion of talus (OLT) in the ankle joint is important for developing a treatment plan and predicting prognosis. PURPOSE To evaluate correlations among tibiotalar (anterior) and talocalcaneal (posterior) joint effusion, tenosynovitis of major flexor tendons, ligaments, and OLT in a group of patients with ankle trauma. MATERIAL AND METHODS This retrospective study included 101 patients with ankle trauma who underwent magnetic resonance imaging. Two radiologists assessed the presence and amount of effusion in the tibiotalar and talocalcaneal joints from grade 0 to 2, according to the amount of capsular distension. Concomitant structural injuries were assessed in the tibialis posterior (TP), flexor digitorum longus, flexor hallucis longus, and peroneus tendons, and the anterior talofibular ligament, calcaneofibular ligament, anteroinferior tibiofibular ligament, posteroinferior tibiofibular ligament, and OLT. RESULTS The proportion of anterior and posterior joint effusion according to grade was 67.3% for anterior joint effusion grade 0, 22.8% for grade 1, and 9.9% for grade 2; for posterior joint effusion, grade 0 was 74.2%, grade 1 was 22.8%, and grade 2 was 3.0%. We found statistically significant correlations between posterior joint effusion and tenosynovitis of TP (P < 0.05) and between posterior joint effusion and OLT (P < 0.05). CONCLUSION Posterior joint effusion is correlated with TP injury and OLT; however, tendon injuries have no correlation with other structural injuries of the ankle joint in a general population with ankle trauma.
Collapse
Affiliation(s)
- Yeon Gyu Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Na Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Myung Sub Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Jin Park
- Department of Orthopaedic surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Woo Hong
- Department of Orthopaedic surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Hwan Kim
- Department of Nuclear medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
|
38
|
Tamura A, Shimura K, Inoue Y. Biomechanical Characteristics of the Support Leg During Side-Foot Kicking in Soccer Players With Chronic Ankle Instability. Orthop J Sports Med 2022; 10:23259671221112966. [PMID: 35928176 PMCID: PMC9344159 DOI: 10.1177/23259671221112966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/12/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Chronic ankle instability (CAI) in soccer players can increase the risk of
recurrent ankle varus sprains and damage the articular surface of the ankle
joint, thus increasing the risk of osteoarthritis. It is important to
understand the biomechanical characteristics of the support leg during
kicking in soccer players with CAI. Purpose/Hypothesis: The purpose of this study was to clarify the kinematics of the kicking motion
of soccer players with CAI. It was hypothesized that at the point before
ball contact when the support leg makes flat-foot contact with the ground,
soccer players with CAI will land with ankle inversion in the support leg
during a side-foot kick compared with players without CAI. Study Design: Controlled laboratory study. Methods: The study cohort included 19 male college soccer players (mean age, 20.5 ±
0.9 years) with greater than 8 years of soccer experience who were recruited
from August 2019 to March 2020. Of these athletes, 10 had CAI and 9 had no
CAI in the support leg, as diagnosed according to the Cumberland Ankle
Instability Tool. Kinematic data for the trunk, hip, knee, and foot of the
support leg during a side-foot kick were obtained using a 3-dimensional,
motion-analysis system. The Mann-Whitney U test or Student
t test was selected to identify differences in
variables between the CAI and non-CAI groups. Results: There were no significant differences in physical characteristics between the
CAI and non-CAI groups. At the point when the support leg made flat-foot
contact with the ground, the players with CAI had more eversion of the
hindfoot with respect to the tibia (-28.3° ± 12.1° vs -13.9° ± 14.2°;
P = .03), a more varus alignment of the knee (26.0° ±
10.7° vs 13.7° ± 10.5°; P = .03), and a lower arch height
index (0.210 ± 0.161 vs 0.233 ± 0.214; P = .046) compared
with non-CAI players. Conclusion: Significant differences between players with and without CAI were seen in the
support leg kinematics at flat-foot contact with the ground during the
kicking cycle. Clinical Relevance: The biomechanical alignment of the support leg during a side-foot kick in
players with CAI may reflect a subconscious attempt to avoid inversion of
the foot and further ankle sprains.
Collapse
Affiliation(s)
- Akihiro Tamura
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Chiba, Japan
| | - Keita Shimura
- School of Health Sciences, Tokyo International University, Kawagoe, Saitama, Japan
| | - Yuri Inoue
- Department of Rehabilitation, Nakabayashi Orthopaedic Clinic, Nada, Kobe, Hyogo, Japan
| |
Collapse
|
|
39
|
Kawaguchi K, Taketomi S, Mizutani Y, Inui H, Yamagami R, Kono K, Kage T, Takei S, Fujiwara S, Ogata T, Tanaka S. Dynamic Postural Stability Is Decreased During the Single-Leg Drop Landing Task in Male Collegiate Soccer Players With Chronic Ankle Instability. Orthop J Sports Med 2022; 10:23259671221107343. [PMID: 35912384 PMCID: PMC9326837 DOI: 10.1177/23259671221107343] [Citation(s) in RCA: 4] [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: 03/13/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Chronic ankle instability (CAI) is commonly encountered in soccer players. The feelings of instability and anxiety caused by CAI can lead to poor performance, such as difficulty in sharp change of direction during soccer play. The single-leg drop landing (SLDL) task is often used to evaluate dynamic postural stability. Purpose/Hypothesis: The purpose of this study was to clarify whether dynamic stability measured during SLDL is altered in male collegiate soccer players with CAI. The hypothesis was that athletes with CAI would show poor dynamic postural stability. Study Design: Controlled laboratory study. Methods: A total of 103 male collegiate soccer players were recruited, and their limbs were classified based on the new international CAI criteria. All players performed three 5-second SLDL trials on a force plate. The main outcome measures included time to stabilization of the horizontal ground-reaction force (GRF); peak GRF in the vertical, horizontal, and sagittal directions; and trajectory length of the center of pressure during SLDL. Results: Data from 59 CAI limbs and 147 non-CAI limbs were collected in this study. Time to stabilization of horizontal GRF was significantly longer in the CAI limbs (P < .001), and the peak GRFs in all directions were significantly lower in the CAI limbs (vertical, P < .001; horizontal, P < .001; sagittal, P = .001). Additionally, the trajectory length of the center of pressure was significantly greater in the CAI limbs (P = .004). Conclusion: Soccer players with CAI had decreased dynamic postural stability that led them to land softly when performing the SLDL task. Measurement of dynamic postural stability may be useful in the evaluation of CAI. Clinical Relevance: Our findings may be useful for strategies of daily training or as an evaluation tool.
Collapse
Affiliation(s)
- Kohei Kawaguchi
- The University of Tokyo Sports Science Institute, Tokyo, Japan.,Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Taketomi
- The University of Tokyo Sports Science Institute, Tokyo, Japan.,Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuri Mizutani
- The University of Tokyo Sports Science Institute, Tokyo, Japan
| | - Hiroshi Inui
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryota Yamagami
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenichi Kono
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomofumi Kage
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Seira Takei
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | - Toru Ogata
- Department of Rehabilitation Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
|
40
|
Alterations in Cortical Activation among Soccer Athletes with Chronic Ankle Instability during Drop-Jump Landing: A Preliminary Study. Brain Sci 2022; 12:brainsci12050664. [PMID: 35625050 PMCID: PMC9139920 DOI: 10.3390/brainsci12050664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/03/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Chronic ankle instability (CAI) is a common peripheral joint injury and there is still no consensus on the mechanisms. It is necessary to investigate electrocortical parameters to provide clinical insight into the functional alterations of brain activity after an ankle sprain, which would greatly affect the implementation of rehabilitation plans. The purpose of this study was to assess cortical activation characteristics during drop-jump landing among soccer athletes with CAI. Methods: A total of 24 participants performed the drop-jump landing task on a force platform while wearing a 64-channel EEG system. The differences of power spectral density (PSD) in theta and alpha (alpha-1 and alpha-2) bands were analyzed between two groups (CAI vs. CON) and between two limbs (injured vs. healthy). Results: CAI participants demonstrated significantly higher theta power at the frontal electrode than that in healthy control individuals (F(1,22) = 7.726, p = 0.011, η2p = 0.260). No difference in parietal alpha-1 and alpha-2 power was found between groups (alpha-1: F(1,22) = 0.297, p = 0.591, η2p = 0.013; alpha-2: F(1,22) = 0.118, p = 0.734, η2p = 0.005). No limb differences were presented for any frequency band in selected cortical areas (alpha-1: F(1,22) = 0.149, p = 0.703, η2p = 0.007; alpha-2: F(1,22) = 0.166, p = 0.688, η2p = 0.007; theta: F(1,22) = 2.256, p = 0.147, η2p = 0.093). Conclusions: Theta power at the frontal cortex was higher in soccer athletes with CAI during drop-jump landing. Differences in cortical activation provided evidence for an altered neural mechanism of postural control among soccer athletes with CAI.
Collapse
|
|
41
|
Is Kinesio Taping Effective for Sport Performance and Ankle Function of Athletes with Chronic Ankle Instability (CAI)? A Systematic Review and Meta-Analysis. Medicina (B Aires) 2022; 58:medicina58050620. [PMID: 35630037 PMCID: PMC9146435 DOI: 10.3390/medicina58050620] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. Materials and Methods: This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: (“kinesiology tape” OR “tape” OR “taping” OR “elastic taping” OR “kinesio taping” OR “neuro taping”) AND (unstable OR instability) AND (ankle OR (ankle OR “ankle sprain” OR “injured ankle” OR “ankle injury”)). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. Results: In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. Conclusions: The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI.
Collapse
|
|
42
|
Wagemans J, Bleakley C, Taeymans J, Schurz AP, Kuppens K, Baur H, Vissers D. Exercise-based rehabilitation reduces reinjury following acute lateral ankle sprain: A systematic review update with meta-analysis. PLoS One 2022; 17:e0262023. [PMID: 35134061 PMCID: PMC8824326 DOI: 10.1371/journal.pone.0262023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/15/2021] [Indexed: 12/26/2022] Open
Abstract
Research questions 1) Do exercise-based rehabilitation programs reduce re-injury following acute ankle sprain?; 2) Is rehabilitation effectiveness moderated by the exercise’s therapeutic quality, content and volume? Methods This systematic review with meta-analysis (PROSPERO: CRD42020210858) included randomized controlled trials in which adults who sustained an acute ankle sprain received exercise-based rehabilitation as an intervention. Databases CINAHL, Web of Science, SPORTDiscus, Cochrane Central Register of Controlled Trials, PEDro and Google Scholar were searched for eligible articles (last search: March 2021). ROB II screening tool by Cochrane was used to assess risk of bias and the i-CONTENT tool was used to assess quality of interventions. Both qualitative analysis and quantitative data synthesis were performed. Results Fourteen randomized controlled trials comprising 2182 participants were included. Five studies were judged overall low risk of bias and i-CONTENT assessment showed poor to moderate therapeutic quality of exercise across all included articles. Pooled data found significant reductions in re-injury prevalence at 12 months, in favour of the exercise-based rehabilitation group vs usual care (OR: 0.60; 95%CI: 0.36 to 0.99). Pooled data for re-injury incidence showed not-significant results (MD: 0.027; 95%CI: -2.14 to 2.19). Meta-regression displayed no statistically significant association between training volume and odds of re-injury (r = -0.00086; SD: 0.00057; 95%CI: -0.00197 to 0.00025). Results from patient-reported outcomes and clinical outcomes were inconclusive at 1 month, 3–6 months and 7–12 months of follow up. Conclusion Exercise-based rehabilitation reduces the risk of recurrent ankle sprain compared to usual care, but there is insufficient data to determine the optimal content of exercise-based interventions. Training volume varied considerably across studies but did not affect the odds of sustaining a re-injury. Effects on patient-reported outcomes and clinical outcomes are equivocal. Future research should compare different exercise contents, training volumes and intensities after ankle sprain.
Collapse
Affiliation(s)
- Jente Wagemans
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
- * E-mail: ,
| | - Chris Bleakley
- School of Health Science, Ulster University, Newtownabbey, Northern Ireland
| | - Jan Taeymans
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Kevin Kuppens
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Heiner Baur
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| |
Collapse
|
|
43
|
Negishi T, Nozaki S, Ito K, Seki H, Hosoda K, Nagura T, Imanishi N, Jinzaki M, Ogihara N. Three-Dimensional Innate Mobility of the Human Foot on Coronally-Wedged Surfaces Using a Biplane X-Ray Fluoroscopy. Front Bioeng Biotechnol 2022; 10:800572. [PMID: 35186902 PMCID: PMC8854865 DOI: 10.3389/fbioe.2022.800572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Improving our understanding on how the foot and ankle joints kinematically adapt to coronally wedged surfaces is important for clarifying the pathogenetic mechanism and possible interventions for the treatment and prevention of foot and lower leg injuries. It is also crucial to interpret the basic biomechanics and functions of the human foot that evolved as an adaptation to obligatory bipedal locomotion. Therefore, we investigated the three-dimensional (3D) bone kinematics of human cadaver feet on level (0°, LS), medially wedged (−10°, MWS), and laterally wedged (+10°, LWS) surfaces under axial loading using a biplanar X-ray fluoroscopy system. Five healthy cadaver feet were axially loaded up to 60 kg (588N) and biplanar fluoroscopic images of the foot and ankle were acquired during axial loading. For the 3D visualization and quantification of detailed foot bony movements, a model-based registration method was employed. The results indicated that the human foot was more largely deformed from the natural posture when the foot was placed on the MWS than on the LWS. During the process of human evolution, the human foot may have retained the ability to more flexibly invert as in African apes to better conform to MWS, possibly because this ability was more adaptive even for terrestrial locomotion on uneven terrains. Moreover, the talus and tibia were externally rotated when the foot was placed on the MWS due to the inversion of the calcaneus, and they were internally rotated when the foot was placed on the LWS due to the eversion of the calcaneus, owing to the structurally embedded mobility of the human talocalcaneal joint. Deformation of the foot during axial loading was relatively smaller on the MWS due to restricted eversion of the calcaneus. The present study provided new insights about kinematic adaptation of the human foot to coronally wedged surfaces that is inherently embedded and prescribed in its anatomical structure. Such detailed descriptions may increase our understanding of the pathogenetic mechanism and possible interventions for the treatment and prevention of foot and lower leg injuries, as well as the evolution of the human foot.
Collapse
Affiliation(s)
- Takuo Negishi
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
- *Correspondence: Takuo Negishi, ; Naomichi Ogihara,
| | - Shuhei Nozaki
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Kohta Ito
- Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Hiroyuki Seki
- Department of Orthopedic Surgery, Ogikubo Hospital, Tokyo, Japan
| | - Koh Hosoda
- Graduate School of Engineering Science, Osaka University, Suita, Japan
| | - Takeo Nagura
- Department of Clinical Biomechanics, Keio University School of Medicine, Tokyo, Japan
| | - Nobuaki Imanishi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
- *Correspondence: Takuo Negishi, ; Naomichi Ogihara,
| |
Collapse
|
|
44
|
Watabe T, Takabayashi T, Tokunaga Y, Kubo M. Copers adopt an altered dynamic postural control compared to individuals with chronic ankle instability and controls in unanticipated single-leg landing. Gait Posture 2022; 92:378-382. [PMID: 34923258 DOI: 10.1016/j.gaitpost.2021.12.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 11/02/2021] [Accepted: 12/12/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Several prior studies involving "expected" single-leg landings have not succeeded in establishing a difference between copers and a control group. RESEARCH QUESTION Does expected and unanticipated single-leg landing affect dynamic postural stability in lateral ankle sprain individuals with chronic ankle instability (CAI), copers, and controls? METHODS In this prospective cross-sectional study, physically active adults with CAI (n = 12), copers (n = 12), and controls (n = 12) were included. Participants performed expected single-leg landing by stepping off a 30-cm box. They also performed unanticipated landings including side-step cutting, side-step cutting at 60°, single-leg landing, and forward stepping. The expected and unanticipated conditions of each groups were compared in terms of time to stabilization (TTS) and center of pressure (COP) for the anterior-posterior (AP) and medial-lateral (ML) conditions. To analyze the data, a mixed-model one-way analysis of variance and a Tukey-Kramer post hoc test were performed. RESULTS A significant condition × group interaction was observed in only TTS ML, with the CAI group demonstrating a significantly longer TTS ML than the coper (p < 0.001) and control (p < 0.001) groups during unanticipated trials. In addition, group interaction effects were observed for COP AP and TTS AP. The coper group demonstrated significantly longer COP AP and TTS AP than the control group (p < 0.001). SIGNIFICANCE The CAI group demonstrated a significantly longer TTS ML than the coper and control groups during the unanticipated condition, and the coper group demonstrated significantly longer TTS AP and COP AP than the control group. Thus, longer COP AP and TTS AP sway time in the coper group may be a protection mechanism, allowing greater freedom in the AP plane while quickly controlling ML sway and preventing lateral ankle sprains. These findings can help in the prevention of lateral ankle sprains and assessment of dynamic postural control.
Collapse
Affiliation(s)
- Takaya Watabe
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| | - Tomoya Takabayashi
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| | - Yuta Tokunaga
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| | - Masayoshi Kubo
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, 1398 Shimami-cho, Kita-Ku, Niigata City, Niigata 950-3198, Japan.
| |
Collapse
|
|
45
|
Hip Flexibility and Dynamic Balance Ability in Soccer Players with Functional Ankle Instability. TRAUMA CARE 2021. [DOI: 10.3390/traumacare1030018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The prevention of recurrent ankle sprain and functional ankle instability in soccer players is essential. This study clarified hip joint mobility and dynamic balance ability in soccer players with functional ankle instability. This case–control study included 17 male college soccer players. All participants were assessed using the Cumberland Ankle Instability Tool and were divided into chronic ankle instability (CAI) and non-CAI groups for each of their dominant and nondominant legs. Bilateral passive hip range of motion (ROM) was assessed and the modified Star Excursion Balance Test (mSEBT) was measured for each leg. In the dominant leg, the reach in the posterolateral direction in the CAI group was significantly less than that in the non-CAI group. Hip internal rotation angles in the dominant leg in the CAI group were greater than those in the non-CAI group; however, no significant correlations with the three directions of mSEBT were observed. In the nondominant leg, mSEBT and hip ROMs did not show any significant differences between groups. The dominant leg in soccer players with CAI had poor dynamic balance ability while reaching posterolaterally. However, acquiring hip flexibility may not be necessary to improve the dynamic balance ability. These findings may help develop future research.
Collapse
|
|
46
|
Yang H, Su M, Chen Z, Qu R, Yuan Z, Yuan J, He S, Li Z, Liu C, Xiao Z, Liang H, Ouyang J, Dai J. Anatomic Measurement and Variability Analysis of the Anterior Talofibular Ligament and Calcaneofibular Ligament of the Ankle. Orthop J Sports Med 2021; 9:23259671211047269. [PMID: 34820459 PMCID: PMC8607490 DOI: 10.1177/23259671211047269] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/16/2021] [Indexed: 12/26/2022] Open
Abstract
Background: The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL)
contribute greatly to the overall stability of the ankle joint; however,
ATFL and combined ATFL-CFL sprains are common. Anatomic reconstruction of
the lateral collateral ligament with grafts has been proposed for patients
with poor tissue quality or inadequate local tissue. Anatomic reconstruction
of the lateral ankle ligaments requires a good understanding of their
anatomic location. Purpose: To describe the anatomy of the ATFL and CFL ligaments quantitatively and
qualitatively and explore the relationship of some morphological
parameters. Study Design: Descriptive laboratory study. Methods: A total of 66 adult ankle specimens were analyzed for ATFL band type, origin,
length, width, thickness, and angle between the ATFL and CFL, and 73 adult
ankle specimens were used for measuring the origin of the CFL. The
coefficient of variation was used to describe and compare the respective
variability of angle, length, width, and thickness. The origin of the ATFL
was labeled as point A, and the leading edge of the CFL
intersection with the articular surface of the calcaneus was considered
point B. Results: The ATFL had a variable number of bands. A high degree of variability
(coefficient of variation >0.2) was seen for most morphological
measurements of the ATFL. In addition, the length of distance
AB also varied. The CFL originated at the tip of the
fibula in only 9% of specimens. It was found more commonly at the anterior
border of the lateral malleolus (4.94 ± 1.70 mm from the tip). The angle
between the ATFL and CFL was consistent at 100° to 105º. Conclusion: A fair amount of variability of ATFL length, width, and thickness were found
in our study, with less variability in the ATFL-CFL angle. Most CFLs
attached anterior to the tip of the fibula. Clinical Relevance: Providing relevant anatomic data of ATFL and CFL is important in ensuring
proper surgical treatment of ankle joint injuries.
Collapse
Affiliation(s)
- Han Yang
- The First Clinical Medicine College, Southern Medical University, Guangzhou, China
| | - Minghao Su
- The First Clinical Medicine College, Southern Medical University, Guangzhou, China
| | - Zhimin Chen
- The First Clinical Medicine College, Southern Medical University, Guangzhou, China
| | - Rongmei Qu
- Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Zhirong Yuan
- The First Clinical Medicine College, Southern Medical University, Guangzhou, China
| | - Jiajie Yuan
- The First Clinical Medicine College, Southern Medical University, Guangzhou, China
| | - Shanli He
- Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Zeyu Li
- Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Chang Liu
- Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Zhaoming Xiao
- Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Haibin Liang
- Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Jun Ouyang
- The First Clinical Medicine College, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China.,Investigation performed at the Guangdong Provincial Medical Biomechanical Key Laboratory, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| | - Jingxing Dai
- The First Clinical Medicine College, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China.,Investigation performed at the Guangdong Provincial Medical Biomechanical Key Laboratory, Department of Anatomy, School of Basic Medical Science, Southern Medical University, Guangzhou, China
| |
Collapse
|
|
47
|
Edama M, Takabayashi T, Yokota H, Hirabayashi R, Sekine C, Maruyama S, Syagawa M, Togashi R, Yamada Y, Otani H. Number of fiber bundles in the fetal anterior talofibular ligament. Surg Radiol Anat 2021; 43:2077-2081. [PMID: 34379153 DOI: 10.1007/s00276-021-02816-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE For the anterior talofibular ligament (ATFL), a three-fiber bundle has recently been suggested to be weaker than a single or double fiber bundle in terms of ankle plantarflexion and inversion braking function. However, the studies leading to those results all used elderly specimens. Whether the difference in fiber bundles is a congenital or an acquired morphology is important when considering methods to prevent ATFL damage. The purpose of this study was to classify the number of fiber bundles in the ATFL of fetuses. METHODS This study was conducted using 30 legs from 15 Japanese fetuses (mean weight, 1764.6 ± 616.9 g; mean crown-rump length, 283.5 ± 38.7 mm; 8 males, 7 females. The ATFL was then classified by the number of fiber bundles: Type I, one fiber bundle; Type II, two fiber bundles; and Type III, three fiber bundles. RESULTS Ligament type was Type I in 5 legs (16.7%), Type II in 21 legs (70%), and Type III in 4 legs (13.3%). CONCLUSION The present results suggest that the three fiber bundles of the structure of the ATFL may be an innate structure.
Collapse
Affiliation(s)
- Mutsuaki Edama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan.
| | - Tomoya Takabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Ryo Hirabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Chie Sekine
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Sae Maruyama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Mayuu Syagawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Ryoya Togashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Yuki Yamada
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Shimami-cho 1398, Kita-ku, Niigata, 950-3198, Japan
| | - Hiroki Otani
- Department of Developmental Biology, Faculty of Medicine, Shimane University, Izumo, Japan
| |
Collapse
|
|
48
|
Clark NC, Campbell SD. Preseason weight-bearing ankle dorsiflexion in male professional football players with and without a history of severe ankle injury: A novel analysis in an English Premier League club. Phys Ther Sport 2021; 52:21-29. [PMID: 34365086 DOI: 10.1016/j.ptsp.2021.07.006] [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: 03/20/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Ankle injuries are common in professional football and have profound player/team/club consequences. The weight-bearing lunge-test (WBLT) assesses ankle dorsiflexion range-of-motion in football primary/secondary injury prevention and performance contexts. Data for uninjured and previously ankle-injured players in the English Premier League (EPL) is not available. This study analysed WBLT measurements (cm) within and between uninjured and previously severe ankle-injured players (injured-stiff group, injured-lax group) in one EPL club. DESIGN Cross-sectional. SETTING Preseason. PARTICIPANTS Forty-nine players (age 22.9 ± 4.6 yr; height 181.6 ± 5.2 cm; mass 77.7 ± 7.6 kg). MAIN OUTCOME MEASURES Prevalence (%) of previous unilateral severe ankle injury (USAI). Side-to-side (right/left, dominant/nondominant, injured/uninjured) WBLT comparisons at group-level (t-test [within-group]; Welch's ANOVA [between-group]; effect sizes [within-/between-group]) and individual-level (limb symmetry index [%]; absolute-asymmetry [%]). RESULTS Prevalence of USAI was 38.7%. There were no statistically-significant side-to-side differences for within-/between-group comparisons. Effect sizes: just-below-large (injured-stiff) and extremely-large (injured-lax) for within-group injured-side/uninjured-side comparisons; just-below-medium (injured-lax) to just-above-medium (injured-stiff) for injured-side comparisons to uninjured players. Absolute-asymmetries: uninjured players, 15.4±13.2%; injured-stiff, 21.8±33.6%; injured-lax 20.4±13.6%. CONCLUSIONS Over one-third of players had previous USAI. Effect sizes indicate substantial within-group side-to-side differences and less substantial between-group differences. Across groups, some players had absolute-asymmetries that may elicit concern in ankle primary/secondary injury prevention and performance contexts.
Collapse
Affiliation(s)
- Nicholas C Clark
- School of Sport, Rehabilitation, and Exercise Sciences. University of Essex. Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK.
| | - Stuart D Campbell
- Tottenham Hotspur Football Club. Hotspur Way, Enfield, Middlesex, EN2 9AP, UK.
| |
Collapse
|
|
49
|
Karahan N, Kaya M, Yılmaz B, Kurdal DP, Keskinoz EN, Çiçek EED. Hamstring autograft and anatomical footprint evaluation for anterior talofibular ligament reconstruction: Cadaveric study. J Orthop Surg (Hong Kong) 2021; 28:2309499020974830. [PMID: 33272074 DOI: 10.1177/2309499020974830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The aim of the study was to evaluate whether or not there was any incompatibility between two-strand hamstring tendons taken from the same knee and the ATFL and it was the determination of suitable footprint points in the fibula and talus for anatomical ATFL reconstruction. METHODS 16 fresh frozen cadaver specimens were dissected to gracilis and semitendinosus tendons and the anterior talofibular ligament. The origins, insertions, distances from osseous landmarks of fibular talus of ATFL were determined. The diameters of gracilis, semitendinosus and ATFL were calculated. There was a moderate correlation between body height and the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL (r: 36.5 p: 0.036). There was a weak correlation between body height and the distance between the apex of the lateral talar process and the talus adhesion site of ATFL in a single bundle (r: 28.4 p: 0.002). There was no correlation between the distance from proximal and distal adhesion side of ATFL and body height in the double bundle (p: 0.241). RESULTS There was no significant relationship between ATFL diameter and gracilis, semitendinosus and both hamstring in women. A significant relationship at 80.5% was determined between the ATFL and the gracilis diameter in man. A significant relationship at 92.6% was determined between the ATFL and the semitendinosus diameter in man. CONCLUSION It was determined that there is not compatibility between the gracilis tendons, the semitendinosus tendon and ATFL in women. It should be supported by biomechanical and clinical studies whether this incompatibility has a clinical effect or not.
Collapse
Affiliation(s)
- Nazım Karahan
- Department of Orthopaedics and Traumatology, Corlu State Hospital, Çorlu/Tekirdağ, Turkey
| | - Murat Kaya
- Department of Orthopaedics and Traumatology, Marmara University, Pendik/İstanbul, Turkey
| | - Barış Yılmaz
- Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Research and Training Hospital, Ataşehir/İstanbul, Turkey
| | - Demet Pepele Kurdal
- Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Research and Training Hospital, Ataşehir/İstanbul, Turkey
| | | | - Esma Esin Derin Çiçek
- Deparment of Radiology, Fatih Sultan Mehmet Research and Training Hospital, Ataşehir/İstanbul, Turkey
| |
Collapse
|
|
50
|
Does Acute Exercise Stress Affect Postural Stability and Cognitive Function in Subjects with Chronic Ankle Instability? Brain Sci 2021; 11:brainsci11060788. [PMID: 34203659 PMCID: PMC8232277 DOI: 10.3390/brainsci11060788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/23/2021] [Accepted: 06/08/2021] [Indexed: 12/26/2022] Open
Abstract
Altered postural control in people with chronic ankle instability (CAI) may be attributed to deficits that are associated with neurocognitive function. Acute training is another factor that may negatively affect postural control and increase the risk of ankle sprain. The purpose of this investigation was to determine the effect of acute exercise on postural stability and cognitive function among patients with CAI. Fifteen patients with CAI (aged 21.5 ± 2.0 years) and 15 healthy controls (aged 20.3 ± 1.7 years) completed a single-limb stance postural control test and a battery of computer-based cognitive tests before and after acute exercise. The overall stability index (OSI) was used as a measure of postural stability. The cognitive domains tested were global cognitive score, executive function, attention, visual-spatial perception, information processing, and fine motor control. Subjects in both groups had similar OSI scores, with a trend for reduced stability in the CAI after the exercise protocol (p = 0.053). There were no differences between the groups in all cognitive domains before or after exercise. Following exercise, the domains of overall cognitive score, visual-spatial perception, and information processing speed improved in both groups (p = 0.003, p = 0.033, p = 0.001; respectively). These findings should be considered with caution due to the heterogeneity of the CAI population.
Collapse
|