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Liu Y, Li H, Yang Z, Xiao Y. Correlation between upper limb proprioception and stroke effect of table tennis players. Sci Rep 2025; 15:13655. [PMID: 40254652 PMCID: PMC12010000 DOI: 10.1038/s41598-025-98648-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 04/14/2025] [Indexed: 04/22/2025] Open
Abstract
This study aims to evaluate the upper limb proprioception of table tennis players and investigate the correlation between upper limb proprioception and the stroke effect. A cross-sectional design was employed in this study and 106 right-handed table tennis players were recruited from China Table Tennis College. All participants attended the upper limb proprioception test (joint position sense test and force sense test) and stroke effect test. The force sense had a significant correlation with the ball speed, rotation speed, and placement (all p < 0.05). The accuracy of the elbow joint flexion at 30° and 60° was significantly correlated with the placement and rotation speed (p < 0.05). The accuracy of the elbow joint extension at 30° and 60° was significantly correlated with the ball speed and rotation speed (p < 0.05). The accuracy of the elbow joint flexion and extension at 60° was higher than that at 30°, respectively. There were significant differences in the upper limb proprioception and stroke effect between different skill levels of table tennis players. The results indicate that: (1) Athletes with superior force sense can better regulate stroke power, thereby enhancing stroke effect; (2) The accuracy of the elbow joint position sense is a critical factor in improving ball rotation speed and placement; (3) The higher usage frequency of 60° elbow flexion and extension movements helps to increase the neural adaptation to these movements, thereby enhancing the elbow joint position sense at 60°; (4) Apart from the disparity in skill levels, the more precise control of the nervous system over muscle and joint movements may also contribute to better stroke effect of table tennis players.
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Affiliation(s)
- Yifan Liu
- China Table Tennis College, Shanghai University of Sport, Qingyuan Ring Road 650, Shanghai, China
| | - Han Li
- China Table Tennis College, Shanghai University of Sport, Qingyuan Ring Road 650, Shanghai, China
| | - Zengrui Yang
- China Table Tennis College, Shanghai University of Sport, Qingyuan Ring Road 650, Shanghai, China
| | - Yi Xiao
- China Table Tennis College, Shanghai University of Sport, Qingyuan Ring Road 650, Shanghai, China.
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Kamin K, Mäder M, Marx C, Rammelt S. [Injuries to the lateral ankle ligaments]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2025; 128:47-58. [PMID: 39656242 DOI: 10.1007/s00113-024-01503-4] [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: 10/24/2024] [Indexed: 01/16/2025]
Abstract
Acute sprains and ruptures of the lateral ankle ligaments are the most common injuries of the ankle joint. They are often related to sporting activity and predominantly affect individuals under 40 years old. Lateral ligament injuries occur due to supination trauma. The anterior talofibular ligament is most commonly affected often in combination with the calcaneofibular ligament. In contrast, ruptures of all three lateral ankle ligaments (luxatio pedis supinatoria) or complete ruptures of the medial and lateral ligaments (luxatio pedis cum talo) are extremely rare. The clinical diagnostics have a high sensitivity and specificity and X-ray images are used to exclude fractures and other accompanying injuries. In cases of acute injuries conservative treatment in an orthosis for 5-6 weeks to prevent supination is the method of choice. Surgical treatment is reserved for exceptional indications. For both operative and conservative forms of treatment the functional treatment with initial movement exercises in a semi-rigid orthosis and the following proprioceptive training are crucial for the success of treatment and show superior results compared to immobilization in a surgical cast.
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Affiliation(s)
- Konrad Kamin
- UniversitätsCentrum für Orthopädie und Unfall- und Plastische Chirurgie, Am Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - Marcel Mäder
- UniversitätsCentrum für Orthopädie und Unfall- und Plastische Chirurgie, Am Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - Christine Marx
- UniversitätsCentrum für Orthopädie und Unfall- und Plastische Chirurgie, Am Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - Stefan Rammelt
- UniversitätsCentrum für Orthopädie und Unfall- und Plastische Chirurgie, Am Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
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Antohe BA, Panaet EA. The Effects of Proprioceptive Exercises on Postural Control in Handball Players with Chronic Ankle Instability-A Non-Randomized Control Trial. Sports (Basel) 2024; 12:304. [PMID: 39590906 PMCID: PMC11598724 DOI: 10.3390/sports12110304] [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: 09/19/2024] [Revised: 10/21/2024] [Accepted: 11/05/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND This paper aims to investigate the impact of proprioceptive exercises on postural control in handball players with chronic ankle instability. METHODS The research participants (n = 22) were divided into two groups: the experimental group (n = 11) and the control group (n = 11). Chronic ankle instability was diagnosed using the Identification of Functional Ankle Instability (IdFAI) questionnaire, while postural control was evaluated with the Iso-Shift stabilometric platform. The intervention consisted of a 15-week proprioceptive exercise program, with sessions performed three times a week. The rehabilitation protocol was conducted at the start of each training session, immediately following the warm-up. RESULTS The data were analyzed using the Wilcoxon and Mann-Whitney U tests. Both groups improved their score on the Identification of Functional Ankle Instability (IdFAI) questionnaire (IdFAI_CG, p < 0.011; IdFAI_EG, p < 0.003) and reduced the number of ankle sprains (NS_EG, p < 0.008). Also, the experimental group had better results for the following tests: ellipse area with open eyes on the left leg (EA_I-OE_L, p < 0.009), ellipse area with closed eyes on the left leg (EA_I-CE_L, p < 0.033), anteroposterior deviation with open eyes on the left leg (APD_I-OE_L, p < 0.023), and the initial and final number of ankle sprains (NS_I, p < 0.01; NS_F, p < 0.024). CONCLUSIONS Athletes who suffer from chronic joint instability are more likely to experience severe postural deviations than those who do not have this condition. Proprioceptive exercises had a positive impact on postural control in both groups, but the experimental group showed a greater improvement.
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Affiliation(s)
| | - Elena-Adelina Panaet
- Faculty of Movement, Sports and Health Sciences, “Vasile Alecsandri” University of Bacau, Bacau 600115, Romania;
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Yılmaz O, Soylu Y, Erkmen N, Kaplan T, Batalik L. Effects of proprioceptive training on sports performance: a systematic review. BMC Sports Sci Med Rehabil 2024; 16:149. [PMID: 38965588 PMCID: PMC11225257 DOI: 10.1186/s13102-024-00936-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Proprioception, the ability to sense the body's position and movement, is essential for athletic performance and physical well-being. The literature highlights the importance of proprioceptive training in rehabilitation, sports performance, injury prevention, and motor function enhancement. Targeted training programs can improve balance, coordination, motor learning, and overall physical performance. This systematic review aimed to examine the effects of proprioceptive training methods on sports and athletic performance. METHODS A comprehensive search was conducted using the Web of Science, PubMed, and Scopus databases, and a literature review was performed based on the PICO criteria outlined in the abstract and title. RESULTS Following the search, 178 articles were identified using relevant keywords, of which 19 directly addressed sports performance and were included in this study. The findings revealed that proprioceptive training had a positive influence on various aspects of athletic performance, including physiological capacity, balance, explosive strength, speed, agility, postural stability, knee joint position sense, muscle activation, reduction of chronic joint instability, dribbling, passing, and technical ball-control skills. CONCLUSIONS These results indicate that proprioceptive training can be an effective strategy for experts and coaches to enhance athletes' physical performance. Primarily, proprioceptive exercises should be used inside and outside the training sessions to enable athletes to interact more effectively with their bodies, reduce the risk of injury, and improve power transfer.
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Affiliation(s)
- Osman Yılmaz
- School of Physical Education and Sports, Osmaniye Korkut Ata University, Osmaniye, Turkey.
| | - Yusuf Soylu
- Faculty of Sports Sciences, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Nurtekin Erkmen
- Faculty of Sports Sciences, Selcuk University, Konya, Turkey
| | | | - Ladislav Batalik
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic.
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
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Heß T, Milani TL, Kilper A, Mitschke C. Immediate Effects of Wearing an Ankle Bandage on Fine Coordination, Proprioception, Balance and Gait in the Subacute Phase of Ankle Sprains. Life (Basel) 2024; 14:810. [PMID: 39063565 PMCID: PMC11277678 DOI: 10.3390/life14070810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Ankle sprains are the most frequently occurring musculoskeletal injuries among recreational athletes. Ankle support through bandages following the initial orthotic treatment might be beneficial for rehabilitation purposes. However, the literature is sparse regarding the use of an ankle support directly after the acute phase of an ankle sprain. Therefore, this study investigates the hypothesis that wearing an ankle bandage immediately after an acute ankle sprain improves motor performance, stability and reduces pain. In total, 70 subjects with acute unilateral supination trauma were tested. Subjects were tested five weeks post-injury to assess immediate effects of the ankle bandage. On the testing day, subjects completed rating questionnaires and underwent comprehensive biomechanical assessments. Biomechanical investigations included fine coordination and proprioception tests, single leg stances, the Y-Balance test, and gait analysis. All biomechanical investigations were conducted for the subject's injured leg with and without a bandage (MalleoTrain® Bauerfeind AG, Zeulenroda-Triebes, Germany) and the healthy leg. Results indicated moderate to strong improvements in ankle stability and pain relief while wearing the bandage. Wearing the bandage significantly normalized single leg stance performance (p < 0.001), stance phase duration (p < 0.001), and vertical ground reaction forces during walking (p < 0.05). However, the bandage did not have a clear effect on fine coordination and proprioception. The findings of our study suggest that ankle bandages may play a crucial role in early-stage rehabilitation by enhancing motor performance and reducing pain.
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Affiliation(s)
- Tobias Heß
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Thomas L. Milani
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Anica Kilper
- Medical Center of Chemnitz, Department of Orthopaedics, Trauma and Hand Surgery, 09116 Chemnitz, Germany
| | - Christian Mitschke
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
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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.
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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
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Kawabata S, Ozone K, Minegishi Y, Oka Y, Terada H, Takasu C, Kojima T, Kano T, Kanemura N, Murata K. Chronic Ankle Joint Instability Induces Ankle Sensorimotor Dysfunction: A Controlled Laboratory Study. Am J Sports Med 2024; 52:739-749. [PMID: 38279796 DOI: 10.1177/03635465231217490] [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: 01/29/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is a clinical sequela that causes the recurrence of ankle sprain by inducing ankle sensorimotor dysfunction. Animal models of CAI have recently shown that ankle ligament injuries mimicking an ankle sprain result in chronic loss of ankle sensorimotor function. However, the underlying mechanisms determining the pathogenesis of CAI remain unclear. HYPOTHESIS Ankle instability after an ankle sprain leads to the degeneration of the mechanoreceptors, resulting in ankle sensorimotor dysfunction and the development of CAI. STUDY DESIGN Controlled laboratory study. METHODS Four-week-old male Wistar rats (N = 30) were divided into 2 groups: (1) the ankle joint instability (AJI) group with ankle instability induced by transecting the calcaneofibular ligament (n = 15) and (2) the sham group (n = 15). Ankle instability was assessed using the anterior drawer test and the talar tilt test at 4, 6, and 8 weeks after the operation (n = 5, for each group at each time point), and ankle sensorimotor function was assessed using behavioral tests, including ladder walking and balance beam tests, every 2 weeks during the postoperative period. Morphology and number of mechanoreceptors in the intact anterior talofibular ligament (ATFL) were histologically analyzed by immunofluorescence staining targeting the neurofilament medium chain and S100 proteins at 4, 6, and 8 weeks postoperatively (n = 5 per group). Sensory neurons that form mechanoreceptors were histologically analyzed using immunofluorescence staining targeting the mechanosensitive ion channel PIEZO2 at 8 weeks postoperatively (n = 5). RESULTS Ankle sensorimotor function decreased over time in the AJI group, exhibiting decreased ankle instability compared with the sham group (P = .045). The number of mechanoreceptors in the ATFL was reduced (P < .001) and PIEZO2 expression in the sensory neurons decreased (P = .008) at 8 weeks postoperatively. The number of mechanoreceptors was negatively correlated with ankle sensorimotor dysfunction (P < .001). CONCLUSION The AJI model demonstrated degeneration of the mechanoreceptors in the ATFL and decreased mechanosensitivity of the sensory neurons, which may contribute to CAI. CLINICAL RELEVANCE Ankle instability causes degeneration of mechanoreceptors and decreases the mechanosensitivity of sensory neurons involved in the development of CAI. This finding emphasizes the importance of controlling ankle instability after ankle sprains to prevent recurrence and the onset of CAI.
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Affiliation(s)
- Sora Kawabata
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kaichi Ozone
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
- Department of Rehabilitation, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Yuki Minegishi
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
- Physical Therapy Course, Department of Rehabilitation, Faculty of Health Sciences, Nihon Institute of Medical Science, Saitama, Japan
| | - Yuichiro Oka
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Hokkaido, Japan
| | - Hidenobu Terada
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Chiharu Takasu
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Takuma Kojima
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Takuma Kano
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan
| | - Naohiko Kanemura
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan
| | - Kenji Murata
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan
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Mailuhu AK, Verhagen EA, van Ochten J, Bindels PJ, Bierma-Zeinstra SM, van Middelkoop M. E-health intervention for preventing recurrent ankle sprains: a randomised controlled trial in general practice. Br J Gen Pract 2024; 74:e56-e62. [PMID: 38154933 PMCID: PMC10755994 DOI: 10.3399/bjgp.2022.0465] [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: 09/16/2022] [Accepted: 08/10/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Ankle sprains are frequent injuries in general practice. However, no effective treatment is available yet. AIM To examine the effectiveness of an unsupervised e-health-supported neuromuscular training programme in combination with usual care compared with usual care alone in patients with acute lateral ankle sprains in general practice. DESIGN AND SETTING Randomised controlled trial with 1-year follow-up among patients (14-65 years) who visited the GP with an acute lateral ankle sprain within 3 weeks of injury. METHOD The intervention group received, in addition to usual care, an unsupervised e-health-supported neuromuscular training programme and the control group received usual care alone. The primary outcome was self-reported re-sprains during 52 weeks of follow-up. Secondary outcomes were ankle function, pain in rest and during activity, subjective recovery, and return to the same type and level of sport. RESULTS In total, 165 participants (mean age 38.3 years and 69 [41.8%] male) were included. No statistically significant difference in the occurrence of a re-sprain were found between the intervention 20.7% (17/82) and control group 24.1% (20/83) (hazard ratio 1.14, 95% confidence interval = 0.59 to 2.21). Also, no statistically significant differences in secondary outcomes were found between groups. The adherence rate to the programme was low (6.1%, 5/82). CONCLUSION The rate of re-sprains was relatively high and an unsupervised e-health-supported neuromuscular training programme does not yield meaningful effects and does not encourage adherence in preventing re-sprains in patients in general practice. More research is necessary to indicate the best treatment modality and way of delivery for these patients.
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Affiliation(s)
- Adinda Ke Mailuhu
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Evert Alm Verhagen
- Department of Health Sciences & EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - John van Ochten
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Patrick Je Bindels
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Sita Ma Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
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Steinberg N, Shenhar M, Witchalls J, Waddington G, Dar G, Paulman O, Finestone A(RS. Chronic Ankle Instability and Neuromuscular Performance in Prerecruitment Infantry Soldiers. J Athl Train 2024; 59:73-80. [PMID: 37459361 PMCID: PMC10783473 DOI: 10.4085/1062-6050-0564.22] [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: 01/09/2024]
Abstract
CONTEXT Ankle instability can describe various impairments, including perceived instability (PI), mechanical instability (MI), and recurrent sprains (RSs), alone or combined. OBJECTIVE To examine the prevalence of 8 ankle impairment subgroups and their effect on neuromuscular performance in prerecruitment combat soldiers. DESIGN Cross-sectional study. SETTING Military infantry basic training base. PATIENTS OR OTHER PARTICIPANTS A total of 364 infantry male combat soldiers entering basic training (aged 18-21 years). MAIN OUTCOME MEASURE(S) Participants were assessed for PI (via the Cumberland Ankle Instability Tool), MI (using the Anterior Drawer Test and Medial Talar Tilt Test), and RSs (based on history) of their dominant and nondominant legs. Injuries were categorized in 8 subgroups: PI, RSs, PI + RSs, MI, PI + MI, MI + RSs, PI + MI + RSs, and none. Participants were screened for neuromuscular performance (dynamic postural balance, proprioceptive ability, hopping agility, and triceps surae muscle strength) during the first week of military basic training. RESULTS For the dominant and nondominant legs, RSs were reported by 18.4% (n = 67) and 20.3% (n = 74) of the participants, respectively; PI was reported by 27.1% (n = 99) and 28.5% (n = 104) of the participants, respectively; and MI was seen in 9.9% (n = 36) and 8.5% (n = 31) of the participants, respectively. A 1-way analysis of variance showed differences in the mean proprioceptive ability scores (assessed using the Active Movement Extent Discrimination Apparatus) of all subgroups with impairments in both the dominant and nondominant legs (F = 6.943, η2 = 0.081, P < .001 and F = 7.871, η2 = 0.091, P < .001, respectively). Finally, differences were found in the mean muscle strength of subgroups with impairment in the nondominant leg (F = 4.884, η2 = 0.056, P = .001). CONCLUSIONS A high prevalence of ankle impairments was identified among participants who exhibited reduced abilities in most neuromuscular assessments compared with those who did not have impairments. Moreover, participants with 1 impairment (PI, MI, or RSs) exhibited different neuromuscular performance deficits than those with >1 impairment.
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Affiliation(s)
- Nili Steinberg
- Levinsky-Wingate Academic College, Wingate Campus, Netanya, Israel
| | - Michal Shenhar
- Levinsky-Wingate Academic College, Wingate Campus, Netanya, Israel
| | | | | | - Gali Dar
- Physical Therapy, University of Haifa, Israel
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Owoeye OBA, Paz J, Emery CA. Injury severity at the time of sport-related ankle sprain is associated with symptoms and quality of life in young adults after 3-15 years. Ann Med 2023; 55:2292777. [PMID: 38092008 PMCID: PMC10880560 DOI: 10.1080/07853890.2023.2292777] [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: 09/21/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Ankle sprains are the most common sports-related injuries. Individuals with time-loss ankle sprains often experience residual symptoms and chronic ankle instability years after injury. Up to 90% of post-traumatic ankle osteoarthritis cases are associated with severe ankle sprain. This study aimed to examine whether ankle injury severity sustained during youth sports participation is associated with ankle symptoms and function. MATERIALS AND METHODS Cohort study included 50 young adults (mean age, 23 years) with a 3-to 15-year history of a youth-sport related 'significant ankle sprain' (SAS). The primary independent variable was injury severity, which was captured in the index SAS injury details through interviews. SAS was defined as ligament and other intra/extra-articular structure injuries that disrupted youth sport participation, at least 3 days of time loss, and required medical consultation. Severe SAS was defined as SAS involving >28 days of time loss, and non-severe SAS only involved ankle ligaments and/or with ≤28 days of time loss. The Foot and Ankle Outcome Score questionnaire was used to assess ankle symptoms and function. Descriptive statistics and multivariable linear regression models were used to examine the association between SAS severity and outcomes, with sex and time since injury as covariates. RESULTS Compared to participants with non-severe SAS, participants with a history of severe SAS demonstrated significantly poorer outcomes in symptoms [-18.4 (99% CI: -32.2 to -4.6)], pain [-10.1 (99% CI: -19.2 to -1.1)] and QoL [-17.1 (99% CI: -33.1 to -1.1)] in multivariable linear regression models. CONCLUSIONS Severe ankle sprain with a loss of > 4 weeks from sports participation at the time of injury is independently associated with poorer ankle symptoms, pain, and ankle-related quality of life after 3-15 years. Secondary prevention measures are needed in individuals with a history of severe ankle sprains to mitigate the potential health consequences.
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Affiliation(s)
- Oluwatoyosi B. A. Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St Louis, MO, USA
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Center of Excellence in Maternal and Child Health Education, Science and Practice, College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA
| | - Juan Paz
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St Louis, MO, USA
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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11
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Dolan P, Kenny I, Glynn L, Campbell M, Warrington GD, Cahalan R, Harrison A, Lyons M, Comyns T. Risk factors for acute ankle sprains in field-based, team contact sports: a systematic review of prospective etiological studies. PHYSICIAN SPORTSMED 2023; 51:517-530. [PMID: 35757862 DOI: 10.1080/00913847.2022.2093618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this systematic review was to identify prospectively measured ankle sprain risk factors in field-based team contact sports. METHODS Eight databases including SPORTDiscus, CINAHL Complete, MEDLINE (EBSCO), Education Source, Web of Science, Scopus, Embase, and Pubmed were searched using specific Boolean terms. A modified-CASP diagnostic test assessed the quality of the included studies. Extensive data extraction included but was not limited to injury definition, protocols for injury diagnosis and recording, and outcomes associated with ankle sprain. RESULTS 4012 records were returned from the online search and 17 studies met the inclusion criteria for this review. Twelve different risk factors including anatomic alignment of the foot and ankle, joint laxity, height, mass, BMI (body mass index), age, ankle strength, hip strength, single leg landing performance (ground reaction force, pelvic internal rotation, and knee varus), and single leg reach were all found to be associated with ankle sprain incidence. Injury definitions and methods of diagnosis and recording varied across the 17 studies. CONCLUSION This review updates the literature on prospective risk factors for ankle sprain in a specific population rather than heterogeneous cohorts previously studied. From more than 20 categories of risk factors investigated for ankle sprain association across 17 studies in field-based team contact sports, 12 variables were found to be associated with increased incidence of ankle sprain. In order to reduce the risk of ankle sprain, BMI, ankle plantar and dorsiflexion strength, hip strength, and single leg landing performance should be factored in to athlete assessment and subsequent program design. More studies utilizing standardized definitions and methods of recording and reporting are needed. Future prospective etiological studies will allow strength and conditioning coaches, physiotherapists, and physicians to apply specific training principles to reduce the risk and occurrence of ankle sprain injuries.
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Affiliation(s)
- Patrick Dolan
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ian Kenny
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- School of Medicine, University of Limerick, Limerick, Ireland
- HRB Primary Care Clinical Trials Network Ireland, Ireland
| | - Mark Campbell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Lero, The Irish Software Research Centre, University of Limerick, Limerick, Ireland
| | - Giles D Warrington
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Roisin Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, University of Limerick, Limerick, Ireland
| | - Andrew Harrison
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Mark Lyons
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Thomas Comyns
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
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12
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Endo Y, Miura M. Differences in the center of pressure movement during standing with running shoes of different constructions: A cross-sectional study. J Orthop 2023; 45:43-47. [PMID: 37841906 PMCID: PMC10570558 DOI: 10.1016/j.jor.2023.09.014] [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] [Received: 03/16/2023] [Revised: 09/14/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose This study examined the differences in the center of pressure movement in a one-leg standing position with bare feet, thin-soled shoes, and thick-soled shoes. Methods In total, 21 male university students participated in this study. The task involved standing on one leg with the dominant foot for 30 s, and the center of pressure movement was measured using a grab coder (G-620; ANIMA, Tokyo, Japan). Three shoe-wearing states, including bare feet, thin-soled shoes, and thick-soled shoes, with the eyes closed and open in each condition. Statistical analysis was performed, with the significance level set as 5%. Results In the multiple comparison results, the anteroposterior (AP) locus length, AP locus length per second, and maximum amplitude in the AP direction were significantly larger with thick-soled shoes than with bare feet in the closed eyes state. The locus length per unit area was significantly smaller with the thick-soled shoes than with the barefoot condition. Other items did not differ significantly between the shoe-wearing states. Conclusion Thick-soled shoes caused a greater center of pressure movement in the AP direction in the static one-leg standing position than did the barefoot state. Our findings suggest that the condition with thick-soled shoes was more unstable in static environments.
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Affiliation(s)
- Yasuhiro Endo
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Japan
| | - Masashi Miura
- Tokyo Rehabilitation Service Co., Ltd., Michinoku Rehabilitation Home-Visit Nursing Station, Aoba, Japan
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13
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Wenning M, Schmal H. Chronic Ankle Instability - Mechanical vs. Functional. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2023; 161:552-562. [PMID: 35158394 DOI: 10.1055/a-1696-2503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Chronic ankle instability arises from three interacting contributing factors: mechanical ankle instability, functional ankle instability, and perceived ankle instability. To decide on the most appropriate individual recommendation for therapeutic options, it is necessary to assess which of the two main aetiologies - functional vs. mechanical - is dominant in causing the perceived impairment. It is essential to perform a thorough analysis and diagnosis, even though quantifying mechanical ankle instability is still a challenge in the clinical approach to this common pathology. When diagnosing mechanical instability, the most established procedure is physical examination, although this unfortunately does not allow the deficit to be quantified. Additional options include stress-ultrasound, 3D stress-MRI (3SAM), ankle arthrometry, marker-based 3D motion analysis, and diagnostic ankle arthroscopy. Of these the latter is considered the gold standard, even though it is an invasive procedure, it may not be performed for diagnostic reasons only, and it also does not allow the mechanical instability to be quantified. For diagnosing functional instability there are non-instrumented tests such as the Star Excursion Balance Test or Y-Balance Test, posturography/stabilometry, and gait and running analysis, possibly combined with EMG acquisition and isokinetic strength testing.To date, the standard of care is conservative management of ankle instability, and the therapy should include sensorimotor training, strength training of the periarticular muscles, balance training, and gait and running exercises on different surfaces. However, it is increasingly clear that a certain degree of mechanical instability cannot be compensated for by functional training. Thus, it is the goal of differential diagnostics to identify those patients and guide them to mechanical therapy, including ankle bracing, taping, and surgical ligament reconstruction.
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Affiliation(s)
- Markus Wenning
- Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-Universität Freiburg Medizinische Fakultät, Freiburg, Deutschland
| | - Hagen Schmal
- Department of Orthopedic and Trauma Surgery, Albert-Ludwigs-Universitat Freiburg Medizinische Fakultat, Freiburg, Deutschland
- Department of Orthopedic Surgery, Odense University Hospital Department of Orthopaedic Surgery, Odense, Denmark
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14
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Zwipp H. Conservative Functional Treatment of Acute Fibular Ligament Rupture of the Ankle. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:454-460. [PMID: 37198926 PMCID: PMC10481941 DOI: 10.3238/arztebl.m2023.0118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/05/2022] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Acute rupture of the fibular ligament complex is one of the commonest injuries in sports. Prospective randomized trials in the 1980s led to a paradigm shift from primary surgical repair to conservative functional treatment. METHODS This review is based on publications retrieved by a selective search in PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) and meta-analyses on surgical versus conservative treatment from the years 1983 to 2023. RESULTS 10 of 11 prospective randomized trials of surgical versus conservative treatment conducted between 1984 and 2017 did not reveal any significant difference in the overall outcome. These findings were confirmed in two meta-analyses and two systematic reviews that were published between 2007 and 2019. Isolated benefits in the surgical group were outweighed by a variety of postoperative complications. The anterior fibulotalar ligament (AFTL) was ruptured in 58% to 100% of cases, followed by the fibulocalcaneal ligament combined with the LFTA in 58% to 85%, and the posterior fibulotalar ligament (mostly incomplete ruptures) in 1.9% to 3%. CONCLUSION Conservative functional treatment is now the standard treatment in acute fibular ligament rupture of the ankle because it is low-risk, low-cost, and safe. Primary surgery is indicated in only 0.5% to 4% of cases. Physical examination for tenderness to palpation and for stability, as well as stress ultrasonography, can be used to differentiate sprains from ligamentous tears. MRI is superior only for the detection of additional injuries. Stable sprains can be successfully treated with an elastic ankle support for a few days, and unstable ligamentous ruptures with an orthosis for 5 to 6 weeks. Subsequent physiotherapy with proprioceptive exercises is the best way to prevent recurrent injury.
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Affiliation(s)
- Hans Zwipp
- TU Dresden, Dresden University of Technology, Center for Orthopedics and Trauma Surgery,Dresden
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15
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Abstract
Despite the high frequency of ankle sprains, the ideal management is controversial, and a significant percentage of patients sustaining an ankle sprain never fully recover. There is strong evidence that residual disability of ankle joint injury is often caused by an inadequate rehabilitation and training program and early return to sports. Therefore, the athlete should start their criteria-based rehabilitation and gradually progress through the programmed activities, including cryotherapy, edema relief, optimal weight-bearing management, range of motion exercises for ankle dorsiflexion improvement, triceps surae stretching, isometric exercises and peroneus muscles strengthening, balance and proprioception training, and bracing/taping.
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Affiliation(s)
- Theodorakys Marín Fermín
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar.
| | - Ayyoub A Al-Dolaymi
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar
| | - Pieter D'Hooghe
- Aspetar Orthopaedic and Sports Medicine Hospital, Inside Aspire Zone, Sports City Street, Al Buwairda St, Doha 29222, Qatar
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Bak J, Thorborg K, Clausen MB, Johannsen FE, Kirk JW, Bandholm T. Using the app "Injurymap" to provide exercise rehabilitation for people with acute lateral ankle sprains seen at the Hospital Emergency Department-A mixed-method pilot study. PLOS DIGITAL HEALTH 2023; 2:e0000221. [PMID: 37186574 PMCID: PMC10184914 DOI: 10.1371/journal.pdig.0000221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/27/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Acute lateral ankle sprains (LAS) account for 4-5% of all Emergency Department (ED) visits. Few patients receive the recommended care of exercise rehabilitation. A simple solution is an exercise app for mobile devices, which can deliver tailored and real-time adaptive exercise programs. PURPOSE The purpose of this pilot study was to investigate the use and preliminary effect of an app-based exercise program in patients with LAS seen in the Emergency Department at a public hospital. MATERIALS AND METHODS We used an app that delivers evidence-based exercise rehabilitation for LAS using algorithm-controlled progression. Participants were recruited from the ED and followed for four months. Data on app-use and preliminary effect were collected continuously through the exercise app and weekly text-messages. Baseline and follow-up data were collected though an online questionnaire. Semi-structured interviews were performed after participants stopped using the app. Results: Health care professionals provided 485 patients with study information and exercise equipment. Of those, 60 participants chose to enroll in the study and 43 became active users. The active users completed a median of 7 exercise sessions. Most of the active users were very satisfied or satisfied (79%-93%) with the app and 95.7% would recommend it to others. The interviews showed that ankle sprains were considered an innocuous injury that would recover by itself. Several app users expressed they felt insufficiently informed from the ED health care professionals. Only 39% felt recovered when they stopped exercising, and 33% experienced a recurrent sprain in the study period. Conclusion: In this study, only few patients with LAS became active app users after receiving information in the ED about a free app-based rehabilitation program. We speculate the reason for this could be the perception that LAS is an innocuous injury. Most of the patients starting training were satisfied with the app, although few completed enough exercise sessions to realistically impact clinical recovery. Interestingly more than half of the participants did not feel fully recovered when they stopped exercising and one third experienced a recurrent sprain. TRIAL-IDENTIFIERS https://clinicaltrials.gov/ct2/show/NCT03550274, preprint (open access): https://www.medrxiv.org/content/10.1101/2022.01.31.22269313v1.
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Affiliation(s)
- Jonas Bak
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Kristian Thorborg
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager and Hvidovre, Denmark
| | - Mikkel Bek Clausen
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen N, Denmark
| | - Finn Elkjær Johannsen
- Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Injurymap Aps, Copenhagen N, Denmark
| | - Jeanette Wassar Kirk
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Thomas Bandholm
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager and Hvidovre, Denmark
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17
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Wang F, Guan Y, Bamber Z, Cao X, Qi Q, Niu W, Chen B. Preventive interventions for lateral ankle sprains: A systematic review and meta-analysis. Clin Rehabil 2023; 37:585-602. [PMID: 36630892 DOI: 10.1177/02692155221137640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the effect of preventive interventions for lateral ankle sprain in the general population. DATA SOURCES A search of PubMed, EMBASE, Cochrane CENTRAL, Medline, CINAHL, and ClinicalTrials.gov was conducted up to August 2022. REVIEW METHODS Randomized controlled trials and prospective cohort studies that evaluated any interventions for preventing lateral ankle sprain were included. Two reviewers independently conducted the search, screening, and data extraction. The methodological quality of each study was assessed using the revised Cochrane risk-of-bias tool for randomized trials or using the Cochrane Risk Of Bias In Non-Randomized Studies tool for prospective cohort studies. RESULTS Seventeen studies met the inclusion criteria. Proprioceptive training exhibited better effects on preventing future lateral ankle sprain compared with the control group (risk ratio = 0.59, p < 0.001), and a stronger preventive effect was observed in participants with a history of lateral ankle sprain in the subgroup analysis (risk ratio = 0.49, p = 0.02). Compared with no bracing, ankle bracing had no significant better effect in preventing lateral ankle sprain (risk ratio = 0.43, p = 0.05). Proprioceptive training and ankle bracing had similar preventive effects (risk ratio = 0.98, p = 0.97). Limited evidence hindered the synthesis of data on pain, swelling, costs, and time loss. CONCLUSION Proprioceptive training is recommended for preventing lateral ankle sprain, especially for people with a history of lateral ankle sprain. Bracing seems to have an ambiguous preventive effect and requires more further investigation.
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Affiliation(s)
- Fanjia Wang
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Yonghao Guan
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zoe Bamber
- Division of Orthopaedics, Trauma and Sports Medicine, Faculty of Medicine and Health Sciences, School of Medicine, 6123University of Nottingham, Nottingham, UK
| | - Xianxin Cao
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Qi Qi
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Wenxin Niu
- Department of Rehabilitation Sciences, 481875Tongji University School of Medicine, Shanghai, China
| | - Bin Chen
- Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
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TASKIN SENOL GAMZE, KÜRTÜL İ, AHMETOGLU G, RAY A. Effects of Presence Rate of the Palmaris Longus Tendon on Wrist Proprioception and Grip Strength. Cureus 2023; 15:e36779. [PMID: 37123680 PMCID: PMC10145763 DOI: 10.7759/cureus.36779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION The palmaris longus muscle displays a great variation in terms of incidence and shape. This study has documented the incidence ratio of this muscle among the students at Bolu Abant İzzet Baysal University, Faculty of Medicine, and has revealed the effects of its presence on wrist proprioception and grip strength. METHODS A total of 101 students between the ages of 18 and 25 were included in the study. Age, height, weight, body mass index (BMI), and dominant upper extremity of the individuals were recorded. After the presence of palmaris longus tendon (PLT) was determined by using the Schaeffer's test, wrist proprioception was evaluated by using a digital inclinometer, and grip strength was evaluated by using a hand dynamometer. RESULTS PLT absence rates were evaluated separately as right and left, and it was found as 16.8% and 17.8%. No correlation was found between the dominant upper extremity and BMI and the presence of PLT. The presence or absence of PLT has no effect on grip strength and wrist proprioception. Conclusion: PLT is used in many clinical areas, such as reconstructive and cosmetic surgery, graft applications, tendon repairs, ptosis correction operations, and ligament stabilization. We think there will be no significant loss in the sense of proprioception and grip strength in the absence of PLT.
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19
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Wagemans J, Bleakley C, Taeymans J, Kuppens K, Schurz AP, Baur H, Vissers D. Rehabilitation strategies for lateral ankle sprain do not reflect established mechanisms of re-injury: A systematic review. Phys Ther Sport 2023; 60:75-83. [PMID: 36716507 DOI: 10.1016/j.ptsp.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVES 1) determine the primary impairment addressed by each exercise included in exercise-based rehabilitation programs for patients with an acute ankle sprain; 2) Determine whether prescribed exercises incorporate complex tasks associated with ankle sprain injury mechanisms? METHODS We searched databases CINAHL, Web of Science, SPORTDiscus, Cochrane Register of Controlled Trials, PEDro, Google Scholar for RCT's including patients with acute ankle sprains, managed through exercise-based rehabilitation. Risk of bias was assessed by the Risk of Bias 2 tool. Exercises were analysed based on: the primary impairment(s) addressed; direction of movement; base of support; weightbearing status; flight phase. (PROSPERO: CRD42020210858) RESULTS: We included fourteen RCT's comprising 177 exercises. Neuromuscular function was addressed in 44% of exercises, followed by performance tasks (23%), and muscle strengthening (20%). Exercises were limited to movements across the sagittal plane (48%), with 31% incorporating multiplanar movements. Weight bearing exercises were almost divided equally between single-limb (59/122) and double leg stance exercises (61/122). Eighteen percent of all exercises incorporated a flight phase. CONCLUSIONS Rehabilitation after LAS comprises simple exercises in the sagittal plane that do not reflect mechanisms of re-injury. Future interventions should incorporate more open chain joint position sense training, multiplanar single limb challenges, and jumping and landing exercises.
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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. https://twitter.com/jentewagemans
| | - Chris Bleakley
- School of Health Science, Ulster University, Newtownabbey, Northern Ireland, UK
| | - 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; SOMT University of Physiotherpy Education, Amersfort, the Netherlands
| | | | - 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
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20
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Sit RWS, Wu RWK, Ling SKK, Yung PSH, Wang B, Chan DCC, Yip BHK, Wong SYS, Reeves KD, Rabago D. A protocol for a randomized clinical trial assessing the efficacy of hypertonic dextrose injection (prolotherapy) in chronic ankle instability. Trials 2022; 23:1063. [PMID: 36581935 PMCID: PMC9800057 DOI: 10.1186/s13063-022-07037-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/17/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Lateral ankle sprain (LAS) is a common injury. Conservative care is not uniformly effective. Chronic ankle instability (CAI) results in up to 70% of patients with LAS in the physically active population. LAS, together with subsequent osteochondral lesions and pain in many patients, leads to the development of post-traumatic osteoarthritis, resulting in a substantial direct and indirect personal and societal health burden. Dextrose prolotherapy (DPT) is an injection-based therapy for many chronic musculoskeletal conditions but has not been tested for CAI. This protocol describes a randomized controlled trial to test the efficacy of DPT versus normal saline (NS) injections for chronic ankle instability (CAI). METHODS AND ANALYSIS A single-center, parallel-group, randomized controlled trial will be conducted at a university-based primary care clinic in Hong Kong. A total of 114 patients with CAI will be randomly allocated (1:1) to DPT and NS groups. The primary outcome will be the Cumberland Ankle Instability Tool scores at 1 year. The secondary outcomes will be the number of re-sprains in 1 year, the Star Excursion Balance Test, the 5-level of EuroQol 5-dimension questionnaire, and the Foot and Ankle Ability Measure. All outcomes will be evaluated at baseline and at 16, 26, and 52 weeks using a linear mixed model. DISCUSSION We hypothesized the DPT is a safe, easily accessible, and effective treatment for patients with CAI. This RCT study will inform whether DPT could be a primary non-surgical treatment for CAI. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000040213 . Registered on 25 November 2020.
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Affiliation(s)
- Regina Wing Shan Sit
- The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
| | - Ricky Wing Keung Wu
- grid.10784.3a0000 0004 1937 0482The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China ,The Hong Kong Insititute of Musculoskeletal Medicine, Hong Kong, China
| | - Samuel Ka Kin Ling
- grid.10784.3a0000 0004 1937 0482The Department of Orthopedic and Traumatology, Chinese University of Hong Kong, Hong Kong, China
| | - Patrick Shu Hang Yung
- grid.10784.3a0000 0004 1937 0482The Department of Orthopedic and Traumatology, Chinese University of Hong Kong, Hong Kong, China
| | - Bo Wang
- grid.10784.3a0000 0004 1937 0482The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Dicken Cheong Chun Chan
- grid.10784.3a0000 0004 1937 0482The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Benjamin Hon Kei Yip
- grid.10784.3a0000 0004 1937 0482The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- grid.10784.3a0000 0004 1937 0482The Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | | | - David Rabago
- grid.29857.310000 0001 2097 4281Department of Family and Community Medicine, Pennsylvania State University, Hershey, USA
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21
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Shrier I, Stokes T, Wang C, Trejovargas J, Impellizzeri FM, Steele RJ. Investigating the Effect of Return-to-Play Timing After Injury on Performance: Does the Analysis Answer the Research Objective? Sports Med 2022; 53:949-958. [PMID: 36378413 DOI: 10.1007/s40279-022-01792-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
Abstract
Return-to-play decision making should be based on all the advantages and disadvantages of return to play for athletes, not just the risk of injury. For competitive athletes, this includes the effect of early versus delayed return to sport on performance. In this paper, we address the questions "How can I estimate the effect of injury on the individual's performance at return to play?" and "What is the effect of delaying return to sport on the individual's performance?". To address these questions, we describe (1) some foundational concepts, design and analytical challenges related to estimating the causal effect of return to play timing on performance in the athlete, (2) additional challenges if one is interested in the effects of delaying return to play and (3) differences when the questions relate to the team's performance. Although the analytical strategies described appear complicated, coaches and athletes make these judgements informally every day without explicitly stating their assumptions. Using a formal approach should help analysts provide the most valid answers to the questions asked by athletes and coaches. In brief, the choice of a comparison group depends on the research question and requires that one consider the hypothetical performance trajectory of the athlete had they never been injured. Thus, the optimal comparison group depends on the shape of the expected trajectory and the specific research question being asked.
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Affiliation(s)
- Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Cote Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada.
| | - Tyrel Stokes
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | - Chinchin Wang
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Jorge Trejovargas
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | | | - Russell J Steele
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
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22
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Tee E, Melbourne J, Sattler L, Hing W. Evidence for Rehabilitation Interventions After Acute Lateral Ankle Sprains in Athletes: A Scoping Review. J Sport Rehabil 2022; 31:457-464. [PMID: 34969012 DOI: 10.1123/jsr.2021-0244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/29/2021] [Accepted: 10/10/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Acute lateral ankle sprain (LAS) is a common injury in athletes and is often associated with decreased athletic performance and, if treated poorly, can result in chronic ankle issues, such as instability. Physical performance demands, such as cutting, hopping, and landing, involved with certain sport participation suggests that the rehabilitation needs of an athlete after LAS may differ from those of the general population. OBJECTIVE To review the literature to determine the most effective rehabilitation interventions reported for athletes returning to sport after acute LAS. EVIDENCE ACQUISITION Data Sources: Databases PubMed, Embase, CINAHL, SPORTDiscus, and PEDro were searched to July 2020. STUDY SELECTION A scoping review protocol was developed and followed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines and registered (https://osf.io/bgek3/). Study selection included published articles on rehabilitation for ankle sprain in an athletic population. DATA EXTRACTION Parameters included athlete and sport type, age, sex, intervention investigated, outcome measures, measurement tool, and follow-up period. DATA SYNTHESIS A qualitative synthesis for all articles was undertaken, and a quantitative subanalysis of randomized controlled trials and critical methodological appraisal was also conducted. EVIDENCE SYNTHESIS A total of 37 articles were included in this review consisting of 5 systematic and 20 narrative reviews, 7 randomized controlled trials, a single-case series, case report, position statement, critically appraised topic, and descriptive study. Randomized controlled trial interventions included early dynamic training, electrotherapy, and hydrotherapy. CONCLUSIONS Early dynamic training after acute LAS in athletes results in a shorter time to return to sport, increased functional performance, and decreased self-reported reinjury. The results of this scoping review support an early functional and dynamic rehabilitation approach when compared to passive interventions for athletes returning to sport after LAS. Despite existing research on rehabilitation of LAS in the general population, a lack of evidence exists related to athletes seeking to return to sport.
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23
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Forsyth L, Bonacci J, Childs C. A pilot randomised control trial of the efficacy of stability-based training with visualisation for people with chronic ankle instability. Med Biol Eng Comput 2022; 60:1199-1209. [PMID: 35247167 PMCID: PMC8933360 DOI: 10.1007/s11517-022-02533-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022]
Abstract
Chronic ankle instability (CAI) is associated with recurring symptoms that inhibit daily activity. Stability-based rehabilitative training is recommended for CAI. Visualisation (VIS) produces real-time feedback using motion capture and virtual reality. This pilot study aimed to determine the feasibility, adherence, safety, and efficacy of incorporating VIS into stability training for people with CAI. Efficacy was examined through effect of VIS training on dynamic stability, perception of stability, and rehabilitative experience. Individuals with CAI completed a 4-week stability-based training programme with VIS, or without visualisation (NO-VIS). Participants completed the Star Excursion Balance Test (SEBT) and Cumberland Ankle Instability Tool (CAIT) prior to, and after training. Enjoyment of training was recorded using the Physical Activity Enjoyment Scale (PACES-8). Of 17 participants (VIS = 10, NO-VIS = 7), there were 2 drop outs (VIS = 1, NO-VIS = 1). No adverse events were reported, and participant drop-out was due to injury unrelated to the study. The VIS group showed a significantly greater increase in average SEBT reach distance (d = 1.7, p = 0.02). No significant differences were reported for the CAIT or PACES-8. This study supports the feasibility and safety of stability-based training with VIS in those with CAI. The enhanced performance outcome on the SEBT suggests VIS may enhance stability-based training.
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Affiliation(s)
- L Forsyth
- Faculty of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
| | - J Bonacci
- Centre for Sports Research, School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - C Childs
- Faculty of Biomedical Engineering, University of Strathclyde, Glasgow, UK
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24
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Qu X, Li K, Nam S. Effects of Mobile-Based Rehabilitation in Adolescent Football Players with Recurrent Lateral Ankle Sprains during the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10030412. [PMID: 35326890 PMCID: PMC8950648 DOI: 10.3390/healthcare10030412] [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: 01/06/2022] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/25/2022] Open
Abstract
Football is a sport involving dynamic movements, and ankle sprains are common sports injuries experienced by football players. Ankle sprains exhibit a high recurrence rate, and rehabilitation training is effective; however, expert-supervised rehabilitation (SVR) at training centers is difficult due to the recent COVID-19 pandemic. This study investigated the effects of mobile-based rehabilitation (MBR) performed at home by high school football players. Sixty players (SVR: 30 and MBR: 30) with recurrent ankle sprains were analyzed. The rehabilitation program consisted of strength and balance training, and the training intensity was gradually increased from week 1 to week 8. The SVR group underwent training at the center with experts, and the BMR group were provided with programs and feedback using mobile devices. Ankle muscle strength was evaluated by measuring isometric eversion, inversion, plantarflexion, and dorsiflexion contraction using a hand-held dynamometer, and dynamic balance was assessed using the Y-balance test (YBT; anterior, posteromedial, and posterolateral); the Foot and Ankle Outcome Score (FAOS) was used for the subjective evaluation. Measurements were conducted at weeks 1, 4, and 8. The patients visited the clinic within 1 week after the injury, and the first test was conducted after consent to participate in the research. Patients underwent the second test at an average of 3.2 weeks after the first test, and the last test at an average of 4.4 weeks after the second test. Although only the SVR group exhibited improvement in strength (eversion and dorsiflexion), YBT and subjective satisfaction at week 4, these measurements improved in both the SVR and MBR groups at week 8. Therefore, mobile–based rehabilitation could be a suitable alternative for high school athletes with ankle sprains who cannot undergo supervised rehabilitation.
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Affiliation(s)
- Xiaobo Qu
- College of Physical Education, Pingdingshan University, Pingdingshan 467000, China;
| | - Kai Li
- Department of Physical Education, Jeonbuk National University, Jeonju 54896, Korea;
| | - Sangcheul Nam
- College of Physical Education, Pingdingshan University, Pingdingshan 467000, China;
- Correspondence: ; Tel.: +86-199-375-11345; Fax: +86-375-265-7598
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25
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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.
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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
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26
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Abdelkader N, Brown SHM, Beach TAC, Howarth SJ. Dynamic Balance is Similar Between Lower Extremities in Elite Fencers. Int J Sports Phys Ther 2021; 16:1426-1433. [PMID: 34909249 PMCID: PMC8637260 DOI: 10.26603/001c.29852] [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: 03/29/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Few studies have quantified dynamic balance in fencers despite previous suggestions that balance training may be beneficial for these athletes. Generally, asymmetry in dynamic balance performance between the left and right legs can be an indicator of lower extremity injury risk and used to monitor rehabilitation progress. Fencing is recognized as an asymmetric sport, therefore, differences in dynamic balance may exist among uninjured athletes. HYPOTHESIS/PURPOSE The primary objective of this investigation was to evaluate whether asymmetry of dynamic balance is present in uninjured national-level fencers. It was hypothesized that elite uninjured fencers would demonstrate superior dynamic balance on the lead-leg of their fencing stance. A secondary objective was to compare dynamic balance performance of elite fencers to previously published data from high-level athletes participating in other sports. STUDY DESIGN Descriptive Laboratory Study. METHODS Fourteen uninjured elite competitive fencers were recruited. Subjects self-reported the lead leg of their fencing stance. Each participant performed the Y-Balance test (YBT), which represented a measurement of dynamic balance control, on both legs. Reach distances were recorded directly from a commercially available YBT apparatus. Four reach distances were recorded: anterior, posteromedial, posterolateral, and a composite measure was calculated. Distances were leg length-normalized and expressed as a percentage. Sample averages and standard deviations were derived for the four YBT measurements. RESULTS There were no significant differences in reaching distance between the lead and trail legs in any of the four YBT measures (p ≥ 0.65). Fencers appeared to demonstrate larger normalized reach distances in the posterolateral and posteromedial directions than other athletes. CONCLUSIONS The results of this study indicate that dynamic balance is not significantly different between the lead and trail legs in elite fencers, despite the asymmetrical nature of their sport. The apparent symmetry of dynamic balance control in uninjured fencers means that the YBT could be used in this population for monitoring progress during training and rehabilitation. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Nader Abdelkader
- Division of Research and Innovation, Canadian Memorial Chiropractic College
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph
| | | | - Samuel J Howarth
- Division of Research and Innovation, Canadian Memorial Chiropractic College
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27
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Stephenson SD, Kocan JW, Vinod AV, Kluczynski MA, Bisson LJ. A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies. Orthop J Sports Med 2021; 9:23259671211035776. [PMID: 34734094 PMCID: PMC8558815 DOI: 10.1177/23259671211035776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/03/2021] [Indexed: 12/26/2022] Open
Abstract
Background A large volume of systematic reviews and meta-analyses has been published on the effectiveness of sports injury prevention programs. Purpose To provide a qualitative summary of published systematic reviews and meta-analyses that have examined the effectiveness of sports injury prevention programs on reducing musculoskeletal injuries. Study Design Systematic review; Level of evidence, 4. Methods We searched the PubMed, CINAHL, EMBASE, and the Cochrane databases for systematic reviews and meta-analyses that evaluated the effectiveness of sports injury prevention programs. We excluded published abstracts, narrative reviews, articles not published in English, commentaries, studies that described sports injury prevention strategies but did not assess their effectiveness, studies that did not assess musculoskeletal injuries, and studies that did not assess sports-related injuries. The most relevant results were extracted and summarized. Levels of evidence were determined per the Oxford Centre for Evidence-Based Medicine, and methodological quality was assessed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, revised version). Results A total of 507 articles were retrieved, and 129 were included. Articles pertaining to all injuries were divided into 9 topics: sports and exercise in general (n = 20), soccer (n = 13), ice hockey (n = 1), dance (n = 1), volleyball (n = 1), basketball (n = 1), tackle collision sports (n = 1), climbing (n = 1), and youth athletes (n = 4). Articles on injuries by anatomic site were divided into 11 topics: general knee (n = 8), anterior cruciate ligament (n = 34), ankle (n = 14), hamstring (n = 11), lower extremity (n = 10), foot (n = 6), groin (n = 2), shoulder (n = 1), wrist (n = 2), and elbow (n = 1). Of the 129 studies, 45.7% were ranked as evidence level 1, and 55.0% were evidence level 2. Based on the AMSTAR-2, 58.9% of the reviews reported a priori review methods, 96.1% performed a comprehensive literature search, 47.3% thoroughly described excluded articles, 79.1% assessed risk of bias for individual studies, 48.8% reported a valid method for statistical combination of data (ie, meta-analysis), 45.0% examined the effect of risk of bias on pooled study results, and 19.4% examined the risk for publication bias. Conclusion This comprehensive review provides sports medicine providers with a single source of the most up-to-date publications in the literature on sports injury prevention.
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Affiliation(s)
- Samuel D Stephenson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Joseph W Kocan
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Amrit V Vinod
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Melissa A Kluczynski
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Leslie J Bisson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
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28
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Seyedi M, Nobari H, Abbasi H, Khezri D, Oliveira R, Pérez-Gómez J, Badicu G, Afonso J. Effect of Four Weeks of Home-Based Balance Training on the Performance in Individuals with Functional Ankle Instability: A Remote Online Study. Healthcare (Basel) 2021; 9:healthcare9111428. [PMID: 34828475 PMCID: PMC8622790 DOI: 10.3390/healthcare9111428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 12/26/2022] Open
Abstract
The purpose of the current study is to evaluate the effect of 4 weeks of home-based balance training (HBBT) on the performance of individuals with functional ankle instability (FAI) in daily activities and sports. Thirty college students diagnosed with FAI and with a mean weight of 79.8 ± 3.4 kg, height of 182.5 ± 5.1 cm, age of 23.5 ± 1.2 years, and instability score of 20 ± 2.3 were selected to participate in this study and were randomly divided by computer-generated methods into two groups: the HBBT group and the control group (CG), each consisting of 15 subjects. The HBBT group performed the program at home for 4 weeks, while the CG was non-exercise. Before and after the 4 weeks of exercise program, a form containing the foot and ankle ability measure for daily activities and sports was completed by the individuals. For data analysis, intra- and inter-group comparisons were performed using paired and independent sample t-tests, respectively, at a significance level of p ≤ 0.05. The results showed that 4 weeks of progressive HBBT were sufficient to significantly improve the measurement of the ability of ankle and foot function in individuals with FAI, even with a total volume of only 60 min per week. Accordingly, it is suggested that individuals with FAI can benefit from short-term HBBT programs, which are simple yet powerful enough to promote improvements in daily activities.
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Affiliation(s)
- Mohammadreza Seyedi
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran 1587958711, Iran;
| | - Hadi Nobari
- Department of Physical Education and Sports, University of Granada, 18010 Granada, Spain
- HEME Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
- Correspondence: (H.N.); (H.A.)
| | - Hamed Abbasi
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran 1587958711, Iran;
- Correspondence: (H.N.); (H.A.)
| | - Davood Khezri
- Department of Sport Biomechanics and Technology, Sport Sciences Research Institute, Tehran 1587958711, Iran;
| | - Rafael Oliveira
- ESDRM-IPS—Sports Science School of Rio Maior–Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal;
- Research Centre in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, Complexo Andaluz, Apartado 279, 2001-904 Santarém, Portugal
| | - Jorge Pérez-Gómez
- HEME Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, 500036 Brasov, Romania;
| | - José Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, 4099-002 Porto, Portugal;
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29
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Correia FD, Molinos M, Neves C, Janela D, Carvalho D, Luis S, Francisco GE, Lains J, Bento V. Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study. JMIR Rehabil Assist Technol 2021; 8:e31247. [PMID: 34499038 PMCID: PMC8517823 DOI: 10.2196/31247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/16/2021] [Accepted: 07/30/2021] [Indexed: 12/21/2022] Open
Abstract
Background Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. Objective We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. Methods We performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. Results In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of –2.72 points (95% CI –3.31 to –2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM–ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Conclusions Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. Trial Registration ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022
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Affiliation(s)
- Fernando D Correia
- Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Maria Molinos
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Carlos Neves
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Dora Janela
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Diana Carvalho
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Sara Luis
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Gerard E Francisco
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, TX, United States.,TIRR Memorial Hermann, Houston, TX, United States
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal.,Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | - Virgilio Bento
- SWORD Health Technologies, Inc, Draper, UT, United States
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30
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Izaola-Azkona L, Vicenzino B, Olabarrieta-Eguia I, Saez M, Lascurain-Aguirrebeña I. Effectiveness of Mobilization of the Talus and Distal Fibula in the Management of Acute Lateral Ankle Sprain. Phys Ther 2021; 101:6231218. [PMID: 33877325 DOI: 10.1093/ptj/pzab111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 01/20/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Distal fibular mobilization with movement (MWM), with and without a posterior gliding fibular tape, and anteroposterior mobilization of the talus (MOB) are widely used to treat acute lateral ankle sprains. The purpose of this study was to investigate the short-term and long-term relative effectiveness of these techniques. METHODS In this double-blind randomized controlled trial, 45 amateur soccer players with acute (<72 hours) lateral ankle sprain were randomly allocated to 6 sessions (3/wk within the first 2 weeks) of either MWM, MWM with tape (MWMtape), or MOB. All participants also received general advice, transcutaneous electrical nerve stimulation, edema draining massage, and a program of proprioception exercises. Participant ratings of function on the Foot and Ankle Ability Measure and Patient Global Impression of Improvement Scale were the primary outcomes measured over 52 weeks. Secondary outcomes were ankle pain, pressure pain threshold, range of motion, volume, and strength. RESULTS MWM and MWMtape were equally effective and participants demonstrated greater function on the Foot and Ankle Ability Measure at 12 and 52 weeks when compared with those receiving MOB; however, the latter demonstrated superior function at 2 weeks. No differences between groups were observed for Patient Global Impression of Improvement Scale or any of the secondary outcomes. CONCLUSION There are limited differences in the short term among techniques, with the exception of better sport function with MOB. Over the longer term, the distal fibular MWM is most effective to achieve activities of daily living and sport function when added to usual physical therapy care. The addition of a posterior gliding fibular tape provides no additional benefit. IMPACT Distal fibular mobilization with movement may be the most appropriate choice of treatment for acute lateral ankle sprain to achieve long-term activities of daily living and sport function. In the short term, anteroposterior mobilization of the talus offers greater improvement in sport function. The use of fibular tape provides no added benefit as an adjunct to a treatment that includes distal fibular mobilization with movement.
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Affiliation(s)
- Loitzun Izaola-Azkona
- Physiotherapy Department, University of Deusto, San Sebastian, Spain.,Mugi Fisioterapia, Sabino Arana 30, Sopelana, Spain
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, Department of Physiotherapy, University of Queensland, St Lucia, Queensland, Australia
| | | | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ion Lascurain-Aguirrebeña
- Physiotherapy, Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain
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31
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Bowers LC, Gribble PA, Hoch MC, Villasante Tezanos AG, Kosik KB. Physical therapy referral and medication for ankle sprain visits to physician offices: an analysis of the national ambulatory medical care survey. PHYSICIAN SPORTSMED 2021; 49:176-181. [PMID: 32729762 DOI: 10.1080/00913847.2020.1800369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Supervised physical therapy is the recommended care for an ankle sprain. Yet, recent evidence indicates some ankle sprain patients may not receive the recommended care, and instead, prescribed medication to alleviate symptoms. Therefore, the purpose of this study is to describe the percentage of patients reporting to an office-based physician in the U.S. that were or were not referred to physical therapy. Secondly, to describe the percentage of ankle sprain patients with or without medication administered, supplied or ordered. METHODS This was a secondary analysis of the cross-sectional National Ambulatory Medical Care Survey (NAMCS) from 2007 to 2016. The NAMCS is a multi-stage probability sample survey of visits to office-based physicians. The percentage and associated 95% confidence intervals (CI) were calculated for visits that had a physical therapy referral or a non-steroidal anti-inflammatory drug (NSAID), opioid and non-opioid analgesics administered, supplied or ordered. Sampled data were weighted to produce national-level estimates. RESULTS A physical therapy referral was given for 16.8% (95% CI: 13.2, 21.2) of ankle sprain visits. Approximately 34.5% (95%CI: 30.5, 38.7) of all ankle sprain visits had a medication administered, supplied or ordered. NSAIDs (72.1%; 95% CI: 66.9,76.8) and opioids (21.0%; 95% CI: 16.3, 26.5) were the two most common types of medication. CONCLUSIONS NSAIDs and opioid medication combined were administered, supplied or ordered more frequently than a referral to physical therapy. These findings provide evidence that suggests many ankle sprain patients reporting to an office-based physician are not receiving the recommended care; physical therapy. Rather, medication appears to be the primary type of care provided to patients. These data are important because it gives a focused area to improve the treatment of an ankle sprain by developing strategies that ensure all patients are provided the recommended care from the onset of entering the healthcare system.
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Affiliation(s)
- Lucy C Bowers
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Phillip A Gribble
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Matthew C Hoch
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | | | - Kyle B Kosik
- Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA
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Miranda JP, Silva WT, Silva HJ, Mascarenhas RO, Oliveira VC. Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: A systematic review of randomized controlled trials. Phys Ther Sport 2021; 49:243-249. [PMID: 33813154 DOI: 10.1016/j.ptsp.2021.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/17/2021] [Accepted: 03/21/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Investigate effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain. METHODS Searches were conducted on six databases for randomized or quasi-randomized controlled trials (RCTs) evaluating effectiveness of cryotherapy for pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain. Selection of trials, data extraction and methodological quality assessment of included trials were conducted independently by two reviewers with discrepancies resolved by a third reviewer. Estimates were presented as mean differences (MDs) with 95% confidence intervals (CIs). The quality of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach. RESULTS Two RCTs with high risk of bias were included. Both evaluated the additional effects of cryotherapy, comparing cryotherapy combined with other intervention versus other intervention stand-alone. Uncertain evidence shows that cryotherapy does not enhance effects of other intervention on swelling (MD = 6.0; 95%CI: 0.5 to 12.5), pain intensity (MD = -0.03; 95%CI: 0.34 to 0.28) and range of motion (p > 0.05). CONCLUSIONS Current literature lacks evidence supporting the use of cryotherapy on management of acute ankle sprain. There is an urgent call for larger high-quality randomized controlled trials.
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Affiliation(s)
- Júlio Pascoal Miranda
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
| | - Whesley Tanor Silva
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
| | - Hytalo Jesus Silva
- Postgraduate Program in Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.
| | - Rodrigo Oliveira Mascarenhas
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
| | - Vinícius Cunha Oliveira
- Postgraduate Program in Rehabilitation and Functional Performance, Postgraduate Program in Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
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The Effect of Attending Physical Rehabilitation After the First Acute Lateral Ankle Sprain on Static Postural Control in Patients With Chronic Ankle Instability. J Sport Rehabil 2021; 30:1000-1007. [PMID: 33761463 DOI: 10.1123/jsr.2020-0346] [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: 07/29/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Static postural control deficits are commonly documented among individuals with chronic ankle instability (CAI). Evidence suggests individuals with CAI who seek medical attention after an ankle sprain report fewer subjective symptoms. It is unknown if seeking medical attention and receiving supervised physical rehabilitation has a similar effect on objective outcomes, such as static postural control. OBJECTIVE To compare measures of single-limb postural control and center of pressure (COP) location between participants with CAI who did or did not self-report attending supervised rehabilitation at the time of their first lateral ankle sprain. DESIGN Retrospective cohort. SETTING Laboratory. Patients (or Other Participants): Twenty-nine participants with CAI who did (n = 14) or did not (n = 15) self-report attending supervised rehabilitation. INTERVENTION(S) Self-reported attendance or not of supervised rehabilitation at the time of initial injury. MAIN OUTCOME MEASURES Participants performed three 20-second trials of single-limb stance on a force plate with eyes open. Main outcome measures included the COP velocities, time-to-boundary (TTB) absolute minima, mean of TTB minima, and SD of TTB minima in the anteroposterior and mediolateral directions. The spatial distribution of the COP data points under the foot was quantified within 4 equally proportional sections labeled anteromedial, anterolateral, posteromedial, and posterolateral. RESULTS Participants who reported attending supervised rehabilitation after their initial ankle sprain had a lower COP velocity in the anterior-posterior direction (P = .030), and higher TTB anterior-posterior absolute minimum (P = .033) and mean minima (P = .050) compared with those who did not attend supervised rehabilitation. CONCLUSIONS Among individuals with CAI, not attending supervised rehabilitation at the time of initial injury may lead to worse static postural control outcomes. Clinicians should continue advocating for patients recovering from an acute ankle sprain to seek medical attention and provide continued care in the form of physical rehabilitation.
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Abate Daga F, Agostino S, Peretti S, Beratto L. COVID-19 nationwide lockdown and physical activity profiles among North-western Italian population using the International Physical Activity Questionnaire (IPAQ). SPORT SCIENCES FOR HEALTH 2021; 17:459-464. [PMID: 33688376 PMCID: PMC7931493 DOI: 10.1007/s11332-021-00745-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/08/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The role of physical activity in enhancing health is well recognized. However, in the more industrialized countries, physical activity rates are declining, and the emerging COVID-19 pandemic may amplify this scenario. Thus, this study aimed to report the Italian population's physical activity profile living in the North-western regions during the national lockdown. METHODS Physical activity was assessed using the official Italian short form of IPAQ, intended for Social Networking Services (SNS). Participation was voluntary, and people could fill the questionnaire simply by clicking on a specific link. RESULTS The final sample size was 612 Italians, male and female, equally distributed (49.1% male and 50.9% female). Data showed a percentage of 15.4% of inactive subjects (MET < 700), 61.8% of moderate-active (MET 700-2500), and 22.9% of active people (MET > 2500). Women were more inactive than men (p < 0.01; 57.4% vs 42.6%). Furthermore, participants were classified into four classes of age: 18-29; 30-44; 45-59; and 60-79. Class 18-29 was prevalent (p < 0.01, 68.3%) and showed higher levels of physical activity (p < 0.05). CONCLUSIONS Italians living in North-western regions maintained a moderate amount of physical activity during the quarantine. This behavior should be encouraged, particularly among women that usually appear to be less active than men.
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Affiliation(s)
- Federico Abate Daga
- Department of Medical Sciences, University of Turin, Turin, Italy
- Adapted Training and Performance Research Group, School of Exercise and Sport Sciences, University of Turin, Turin, Italy
| | - Samuel Agostino
- Adapted Training and Performance Research Group, School of Exercise and Sport Sciences, University of Turin, Turin, Italy
| | - Serenella Peretti
- Adapted Training and Performance Research Group, School of Exercise and Sport Sciences, University of Turin, Turin, Italy
| | - Luca Beratto
- Department of Medical Sciences, University of Turin, Turin, Italy
- Adapted Training and Performance Research Group, School of Exercise and Sport Sciences, University of Turin, Turin, Italy
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Ross AG, Donaldson A, Poulos RG. Nationwide sports injury prevention strategies: A scoping review. Scand J Med Sci Sports 2021; 31:246-264. [PMID: 33080079 DOI: 10.1111/sms.13858] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/19/2020] [Accepted: 10/13/2020] [Indexed: 12/26/2022]
Abstract
National strategies to prevent sports injuries can potentially improve health outcomes at a population level and reduce medical costs. To date, a compilation of the strategies that countries have attempted, and their effectiveness, does not exist. This scoping review sets out to: identify nationwide attempts at implementing sports injury prevention strategies; examine the impact of these strategies; and map them onto the Translating Research into Injury Prevention Practice (TRIPP) framework. Using Levac's scoping review method, we: (a) identified the research questions, (b) identified relevant studies, (c) identified the study selection criteria, (d) charted the data, and (e) reported the results. A search of MEDLINE, Scopus, SPORTDiscus, CINAHL, and Web of Science databases for articles published pre-June 2019 was conducted. We identified 1794 studies and included 33 studies (of 24 strategies). The USA (n = 7), New Zealand (n = 4), Canada (n = 3), the Netherlands (n = 3), Switzerland (n = 2), Belgium (n = 1), France (n = 1), Ireland (n = 1), South Africa (n = 1), and Sweden (n = 1) have implemented nationwide sports injury prevention strategies with 29 (88%) of the included studies demonstrating positive results. Mapping the strategies onto the TRIPP framework highlighted that only four (17%) of the 24 included strategies reported on the implementation context (TRIPP Stage 5), suggesting an important reporting gap. Nationwide sports injury prevention efforts are complex, requiring a multidimensional approach. Future research should report intervention implementation data; examine the implementation context early in the research process to increase the likelihood of real-world implementation success; and could benefit from incorporating qualitative or mixed research methods.
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Affiliation(s)
- Andrew G Ross
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Alex Donaldson
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Vic., Australia
| | - Roslyn G Poulos
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
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Gabriela V, Rafael G, Felipe M, Cláudia L. Effects of proprioceptive training on ankle muscle strength in fencers: A clinical trial. J Bodyw Mov Ther 2021; 27:141-147. [PMID: 34391225 DOI: 10.1016/j.jbmt.2021.01.011] [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: 07/13/2020] [Revised: 01/07/2021] [Accepted: 01/23/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fencing is a combat sport, which depends of lower limbs muscular strength and neuromuscular function. Because of that, approximately half of all injuries occur in lower limbs, especially in ankle. Thus, the objective of this study was to verify the influence of a twelve-week proprioceptive training program on ankle muscular strength and muscular balance in fencers. METHODS The study was a clinical trial, with 19 fencing athletes from 14 to 35-year-old. The main outcome was ankle invertors, evertors, plantiflexors and dorsiflexors muscular strength and ankle muscle balance. The study was performed in six stages: familiarization of muscular strength test in isokinetic dynamometer; pre-intervention; intervention; post-intervention; three- and six-months follow-up. At pre-intervention stage, the muscular strength was evaluated. At intervention stage, the athletes performed 12-week proprioceptive training program, three times a week. At post-intervention, three- and the six-months follow-ups, same pre-intervention test was performed. RESULTS The proprioceptive training improved front leg ankle dorsiflexor strength at three- and six-months follow-ups compared to pre-intervention. Furthermore, training increased the front leg dorsiflexors/plantiflexors conventional ratio at three- and six-months follow-ups compared to pre-intervention; and evertors/invertors conventional ratio at three-months follow-up compared to pre-intervention; and evertors/invertors functional ratio at post-intervention and three- and six-months follow-ups compared to pre-intervention. CONCLUSIONS The improvement and/or maintenance of ankle muscle strength occurred in intervention group seems to be due to stimulus provided by proprioceptive training, with ankle dorsiflexors being the most stimulated group.
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Affiliation(s)
- Vasconcelos Gabriela
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil.
| | - Grazioli Rafael
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil
| | - Minozzo Felipe
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil
| | - Lima Cláudia
- Laboratório de Pesquisa do Exercício/ Universidade Federal do Rio Grande do Sul(UFRGS), Porto Alegre, RS, Brazil
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Kaiser P, Stock K, Benedikt S, Ellenbecker T, Kastenberger T, Schmidle G, Arora R. Acute Tennis Injuries in the Recreational Tennis Player. Orthop J Sports Med 2021; 9:2325967120973672. [PMID: 33457434 PMCID: PMC7789623 DOI: 10.1177/2325967120973672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/09/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Epidemiological studies on tennis injuries are mainly conducted in either elite professional or junior players. Injury patterns might differ in the recreational tennis player. Purpose: To investigate acute injuries in the recreational tennis–playing population with an additional focus on acute injuries that require surgical treatment. Study Design: Case series; Level of evidence, 4. Methods: A retrospective data analysis was conducted among patients who sustained an acute tennis injury between January 2013 and December 2018 and who had treatment administered at a single university hospital. Demographic data, diagnosis, body region of the trauma, injury mechanism, and treatment methods were recorded. Data were evaluated using descriptive statistics. Results: A total of 449 patients sustained 467 injuries (148 female, 301 male; mean age, 43.6 years; range, 8.2-84.4 years). The injuries occurred throughout the year, with an increased prevalence in the summer months. Injuries occurred in the lower extremity in 59%, the upper extremity in 30%, and the head and trunk in 11%. The main reason for an injury was a twist of a specific joint (n = 194) or a fall (n = 102). Harmless contusion or strains were the most common injury (49%). Ankle sprains were the most common serious injury, occurring in 11% of patients. Fractures occurred in 54 cases (12%). Overall, 9% of patients were treated surgically (fractures, n = 13; meniscal tears, n = 8; Achilles tendon ruptures, n = 6), and surgery was advised to another 1% who did not receive surgery at the study hospital. Conclusion: Typical acute injuries in recreational tennis players differ from acute injuries in elite and junior players, with an increased fracture occurrence. The main causes of acute tennis injuries are falls and twists, with 10% of injuries needing surgical treatment, mainly for fractures, meniscal tears, and Achilles tendon ruptures.
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Affiliation(s)
- Peter Kaiser
- Department for Orthopedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Kerstin Stock
- Department for Orthopedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Stefan Benedikt
- Department for Orthopedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Todd Ellenbecker
- ATP Medical Services Committee, ATP Tour, Ponte Vedra Beach, Florida, USA.,Rehab Plus Sports Therapy Scottsdale, Scottsdale, Arizona, USA
| | - Tobias Kastenberger
- Department for Orthopedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Gernot Schmidle
- Department for Orthopedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
| | - Rohit Arora
- Department for Orthopedics and Traumatology, Medical University Innsbruck, Innsbruck, Austria
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Halabchi F, Hassabi M. Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World J Orthop 2020; 11:534-558. [PMID: 33362991 PMCID: PMC7745493 DOI: 10.5312/wjo.v11.i12.534] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/04/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023] Open
Abstract
Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40% of all sports-related injuries. It is especially common in basketball, American football, and soccer. The majority of sprains affect the lateral ligaments, particularly the anterior talofibular ligament. Despite its high prevalence, a high proportion of patients experience persistent residual symptoms and injury recurrence. A detailed history and proper physical examination are diagnostic cornerstones. Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules. Several interventions have been recommended in the management of acute ankle sprains including rest, ice, compression, and elevation, analgesic and anti-inflammatory medications, bracing and immobilization, early weight-bearing and walking aids, foot orthoses, manual therapy, exercise therapy, electrophysical modalities and surgery (only in selected refractory cases). Among these interventions, exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process. An exercise program should be comprehensive and progressive including the range of motion, stretching, strengthening, neuromuscular, proprioceptive, and sport-specific exercises. Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables, manual tests for stability, and functional performance testing. There are some common myths and mistakes in the management of ankle sprains, which all clinicians should be aware of and avoid. These include excessive imaging, unwarranted non-weight-bearing, unjustified immobilization, delay in functional movements, and inadequate rehabilitation. The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.
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Affiliation(s)
- Farzin Halabchi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran 14167-53955, Iran
| | - Mohammad Hassabi
- Department of Sports and Exercise Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19979-64151, Iran
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Beelen PE, Kingma I, Nolte PA, van Dieën JH. The effect of foot type, body length and mass on postural stability. Gait Posture 2020; 81:241-246. [PMID: 32818860 DOI: 10.1016/j.gaitpost.2020.07.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 07/04/2020] [Accepted: 07/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Poor postural stability is associated with chronic ankle instability. Previous research showed an effect of foot type on postural stability. However, the specific effect of supinated feet remains unclear. RESEARCH QUESTION Our study aimed to assess the effect of foot type on postural stability, while taking potential confounding effects of body mass and body height into account. METHODS Forty-three healthy participants between 18 and 40 years old performed barefooted single leg stance tests with eyes open (EO) and closed (EC) on solid ground, and on a balance board (BB). Foot type was determined from pressure recordings during gait, using the arch index. Ground reaction forces were measured using a force plate. Outcome measures were Center of Pressure Velocity (COPV) divided by body height, and the Horizontal Ground Reaction Force (HGRF) divided by body mass. Generalized Estimating Equations models assessed the differences between supinated, normal and pronated feet during EO, EC and on a BB. RESULTS During EO an interaction between supinated feet and body mass showed an increase of COPV with 0.03 × 10-2 1/s per kilogram of mass relative to normal feet (p = .03). During EC this interaction was more pronounced with 0.22 × 10-2 1/s increase per kilogram mass (p < .01). The HGRF did not differ between foot types in any of the conditions. SIGNIFICANCE Supinated feet have a larger increase in COPV compared to normal feet with increasing mass when standing on solid ground during EO and EC. This indicates that people with supinated feet and a higher mass are less stable during single leg stance. LEVEL OF EVIDENCE Level 3, associative study.
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Affiliation(s)
- Paul Erik Beelen
- Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, Noord-Holland, the Netherlands
| | - Idsart Kingma
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Peter A Nolte
- Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, Noord-Holland, the Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands
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Alghadir AH, Iqbal ZA, Iqbal A, Ahmed H, Ramteke SU. Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5318. [PMID: 32718066 PMCID: PMC7432694 DOI: 10.3390/ijerph17155318] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022]
Abstract
Background: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including pain, episodes of giving way, compromised proprioception and neuromuscular control, and re-injury leading to chronic ankle instability. The aim of this study was to see the effect of chronic ankle sprain on pain, range of motion, proprioception, and, static and dynamic balance among athletes. Methods: A total of 80 athletes, aged 18 to 25 years, involved in track-and-field sports were invited to participate in this study. They were divided in two groups. Athletes with history of grade 1 or 2 ankle sprain on either side requiring medical care who reported at least three episodes of ankle giving way in past 12 months were included in group A. An equal number of healthy athletes without any history of ankle sprain or injury in the lower limbs in the past one year matched by sex, age, height, weight, and limb dominance, were included in group B (control). Outcome measures: Participant's pain, range of motion, proprioception and balance (static and dynamic) was measured using visual analog scale, half circle goniometer, degree of foot position sense, single leg stance time and Y-balance test respectively. Results: Although there were no differences in the active ankle joint range of motion (p > 0.05) in comparison to the control group, athletes with chronic ankle sprain reported mild pain and statistically significant (p < 0.05) deficits in foot proprioception, static and dynamic balance. Conclusions: Deficits in foot proprioception, static and dynamic balance even one year after the ankle sprain could be the reason for limitations in the dynamic defense system of the joint that predisposes to recurrent injury and instability. It is essential to understand the normal clinical course and risk factors for athletes who sustain sprain before devising a long term comprehensive rehabilitation program that focuses on mechanical and functional insufficiencies in order to improve their functional performance and prevent the risk of recurrent sprain.
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Affiliation(s)
- Ahmad H. Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Zaheen A. Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Amir Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Hashim Ahmed
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia;
| | - Swapnil U. Ramteke
- Department of Musculoskeletal & Sports Physiotherapy, Sancheti Institute College of Physiotherapy, Shivaji Nagar, Pune 411005, Maharashtra, India;
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Lopes M, Oliveira J, Ribeiro F. Injury prevention in futsal players: is the FIFA 11+ a simple answer to a complex problem? PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1731177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Mário Lopes
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Fernando Ribeiro
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
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Abstract
Purpose of Review The purpose of this review is to describe the current evidence on the most common sports-related ankle injuries. Joint anatomy, epidemiology, clinical findings, diagnostic approach, and treatment are presented with a specific focus on the available evidence towards return to play. Recent Findings Recent findings show that ankle sprain is the most common injury in the world of sports. Bony fractures, cartilage defects, and syndesmotic lesions are frequently seen in association with the more severe type of ankle sprains. Summary In summary, the majority of the athletes’ ankle sprains are managed conservatively with excellent outcomes and full return to their pre-injury level of play. However, it is essential to differentiate the single ligament sprain from a more complex injury to the ankle joint. The evidence-based treatment and rehabilitation programmes are associated with a better prognosis and a faster time to return to sport participation.
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Affiliation(s)
- P D'Hooghe
- Department of Orthopaedic Surgery, Aspetar Sports Medicine and Orthopedic Surgery Hospital, Sports City Street 1, Aspire Zone, P.O. Box: 29222, Doha, Qatar.
| | - F Cruz
- Department of Orthopaedic Surgery, Aspetar Sports Medicine and Orthopedic Surgery Hospital, Sports City Street 1, Aspire Zone, P.O. Box: 29222, Doha, Qatar
| | - K Alkhelaifi
- Department of Orthopaedic Surgery, Aspetar Sports Medicine and Orthopedic Surgery Hospital, Sports City Street 1, Aspire Zone, P.O. Box: 29222, Doha, Qatar
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de Vasconcelos GS, Cini A, Lima CS. Proprioceptive Training on Dynamic Neuromuscular Control in Fencers: A Clinical Trial. J Sport Rehabil 2020; 30:220-225. [PMID: 32369762 DOI: 10.1123/jsr.2019-0469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/10/2019] [Accepted: 02/23/2020] [Indexed: 09/07/2024]
Abstract
CONTEXT Fencing is a sport of agility, with a higher incidence of lower-limb injuries, of which the ankle sprain is the most prevalent. Injury prevention is very important to improve performance and decrease the withdrawal time of athletes. Proprioceptive training programs can be added to the training of athletes, since, in addition to easy application and low cost, proprioception has the function of stabilizing the ankle joint to prevent injuries. OBJECTIVE To verify the influence of a 12-week proprioceptive training program on dynamic neuromuscular control in fencing athletes. DESIGN The study was a clinical trial, and the athletes were allocated, for convenience, in the intervention group or in the control group. SETTING The study was developed in 4 stages (preintervention, intervention, postintervention, and follow-up of 3). The neuromuscular control during the star excursion balance test was evaluated. PARTICIPANTS The participants were 19 fencing athletes (intervention group: 10, and control group: 9), aged 14-35 years, from a multisport club. INTERVENTIONS The athletes performed the proprioceptive training during 12 weeks, 3 times a week, with a duration of 30 minutes. MAIN OUTCOME MEASURES Dynamic neuromuscular control. RESULTS The data and SE were considered for statistical analysis, submitted to the generalized estimates equations test with Bonferroni post hoc. The level of significance was .05. The distance reached in the star excursion balance test increased significantly in all 8 directions evaluated in the 2 legs of the intervention group. CONCLUSIONS The proprioceptive training program was able to improve dynamic neuromuscular control in fencing athletes.
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Mailuhu AKE, van Middelkoop M, Bierma-Zeinstra SMA, Bindels PJE, Verhagen EALM. Outcome of a neuromuscular training program on recurrent ankle sprains. Does the initial type of healthcare matter? J Sci Med Sport 2020; 23:807-813. [PMID: 32307227 DOI: 10.1016/j.jsams.2020.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To study the impact of initial healthcare for a lateral ankle sprain on the outcome of neuromuscular training (NMT) on recurrent sprains and describe athlete characteristics receiving different types of healthcare. DESIGN Secondary analysis of three randomized trials. METHOD From three previous trials evaluating NMT, data on athlete characteristics, type of initial healthcare and a recurrent sprain during one-year follow-up were collected (N = 705). Multilevel logistic regression analyses were used to test the impact of initial healthcare on the outcome of NMT on recurrent sprains. Potential differences in athlete characteristics between different types of healthcare were examined using one-way analysis of variance and Pearson chi-square test. RESULTS After NMT, 39.7% of the athletes visiting paramedical care reported a recurrent sprain, 21.8% of secondary and 34.0% of primary care. Athletes who visited a physiotherapist reported more recurrent sprains, than those not visiting a physiotherapist (adjusted OR 3.15;95%CI 1.88-5.23). Athletes visiting paramedical (49.7%) and primary care (48.4%) used more braces and/or tape during sport than those not visiting any care (34.2%). CONCLUSIONS The initial type of healthcare of athletes with an ankle sprain, that consecutively received NMT, seems to impact the occurrence of recurrent sprains. Physiotherapists may be visited by athletes with a poorer prognosis, which may be explained by different athlete characteristics.
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Affiliation(s)
- Adinda K E Mailuhu
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Evert A L M Verhagen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands
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Huurnink A, Fransz DP, de Boode VA, Kingma I, van Dieën JH. Age-Matched Z-Scores for Longitudinal Monitoring of Center of Pressure Speed in Single-Leg Stance Performance in Elite Male Youth Soccer Players. J Strength Cond Res 2020; 34:495-505. [DOI: 10.1519/jsc.0000000000002765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Pas HIMFL, Pluim BM, Kilic O, Verhagen E, Gouttebarge V, Holman R, Moen MH, Kerkhoffs GM, Tol JL. Effectiveness of an e-health tennis-specific injury prevention programme: randomised controlled trial in adult recreational tennis players. Br J Sports Med 2020; 54:1036-1041. [PMID: 32001517 DOI: 10.1136/bjsports-2019-101142] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite reported injury rates of up to 3 per 1000 hours exposure, there are no evidence-based prevention programmes in tennis. PURPOSE To evaluate the effectiveness of an e-health prevention programme for reducing tennis injury prevalence. STUDY DESIGN Two-arm, researcher-blinded randomised controlled trial. METHODS Adult tennis players of all playing levels were randomised in an unsupervised programme lasting 12 weeks (TennisReady group or control group). The primary outcome was the overall injury prevalence over a 16-week period, measured at 2 weekly intervals with the Oslo Sports and Trauma Research Centre questionnaire. Estimates for the primary outcome and associated 95% CIs were obtained using generalised estimating equation models. Secondary outcome scores included prevalence of substantial injuries, overall incidence, adherence and time-loss injuries. RESULTS A total of 579 (83%) (TennisReady n=286, control n=293) participants were included in the primary analysis. The mean injury prevalence was 37% (95% CI 33% to 42%) in the TennisReady vs 38% (95% CI 34% to 42%) in the control group (adjusted p-value 0.93). The prevalence of substantial injuries was 11% (95% CI 9% to 14%) in the TennisReady vs 12% (95% CI 9% to 15%) in the control group (p value of 0.79). Analysis of the secondary outcome scores showed no difference between groups. The mean prevalence rates between high (8%) and low (92%) adherent groups were 32% (95% CI 23% to 44%) and 37% (95% CI 33% to 42%), respectively (p value 0.36). CONCLUSION Providing an unsupervised e-health tennis-specific exercise programme did not reduce the injury rates and should not be implemented. TRIAL REGISTRATION NUMBER NTR6443.
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Affiliation(s)
- Haiko Ivo Maria Franciscus Lodewijk Pas
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam UMC, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Northwest Hospital group location Alkmaar, Department of Pulmonary Medicine, Alkmaar, The Netherlands
| | - Babette M Pluim
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Royal Netherlands Lawn Tennis Association, Amstelveen, The Netherlands.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Hatfield, South Africa
| | - Ozgur Kilic
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam UMC, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, VU University, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam UMC, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,Dutch Consumer Safety Institute, Amsterdam, The Netherlands
| | - Rebecca Holman
- Clinical Research Unit, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, The Netherlands
| | - Maarten H Moen
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Sports Medicine, Bergman Clinics, Naarden, The Netherlands.,The Sports Physician Group, Onze Lieve Vrouwe Gasthuis West, Amsterdam, The Netherlands
| | - Gino M Kerkhoffs
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam UMC, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands
| | - Johannes L Tol
- Academic Center for Evidence-based Sports medicine (ACES), Amsterdam UMC, Amsterdam Movement Sciences, Amsterdam, The Netherlands .,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Eechaute C, Leemans L, De Mesmaeker M, De Ridder R, Beckwée D, Struyf F, Roosen F, Buyl R, Putman K, Vaes P. The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. J Sports Sci 2019; 38:86-93. [PMID: 31707915 DOI: 10.1080/02640414.2019.1682891] [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: 10/25/2022]
Abstract
The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. BACKGROUND Lateral ankle sprains (LAS) are very common sports injuries, cause high health care costs and are associated with postural control deficits. From a preventive point of view, clinicians should dispose valid field tests to identify athletes at risk for a LAS. The aim of this study is to evaluate the predictive value of the multiple hop test (MHT) for first-time noncontact LAS. METHODS Non-elite athletes (n = 232) performed the MHT at baseline. During a 12-month follow-up period, all noncontact LAS related to health care costs were recorded. Outcomes of the MHT (completion time, balance errors and perceived difficulty) between the injured and uninjured group were compared and odds ratios (OR) and relative risks (RR) were calculated using a logistic regression analysis. RESULTS Ten first-time noncontact LAS were recorded (4.3%). Injured athletes made significantly more change-in-support strategy (CSS) errors when compared to uninjured athletes (p = .04). The OR of the number of CSS errors was 1.14 (p = .03), the RR 4.1 (p = .04). CONCLUSIONS Athletes scoring > 12 CSS errors, have a four times increased risk for a first-time noncontact LAS. The MHT is a valid field test to identify athletes at risk for a first-time noncontact LAS.
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Affiliation(s)
- Christophe Eechaute
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lynn Leemans
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Margo De Mesmaeker
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roel De Ridder
- Department of Physical Therapy and Rehabilitation, Universiteit Gent, Gent, Belgium
| | - David Beckwée
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Filip Struyf
- Department of Rehabilitation Sciences and Physical Therapy, Universiteit Antwerpen, Wilrijk, Belgium
| | - Filip Roosen
- Department of Physical Therapy and Rehabilitation, Universiteit Gent, Gent, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Koen Putman
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Vaes
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
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Functional assessment of women practising combat sports and team sports using the Functional Movement Screen. BIOMEDICAL HUMAN KINETICS 2019. [DOI: 10.2478/bhk-2019-0012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Summary
Study aim: The objective of the study was to reveal the functional limits of the motor system in women practising combat sports and team sports.
Material and methods: 102 women (mean age 25.2 years, body mass 62.2 kg, body height 168.3 cm) practising competitive ITF (International Taekwon-Do Federation) taekwon-do (n = 22), Brazilian jiu-jitsu (BJJ) (n = 15), football (n = 35) and basketball (n = 30) participated in the study. The assessment tool was the FMS test, comprising 7 movement patterns scored on a scale of 0–3.
Results: The studied female athletes earned medium scores. Women practising combat sports scored generally higher in the FMS test, although the difference was not significant (combat sports – mean value 15.57 ± 2.39, team sports – mean value 14.72 ± 1.93, difference – p = 0.07). Statistically significant differences (p < 0.05) were observed in the second (hurdle step) and the fifth pattern (active straight leg raise – ASLR). The aggregated FMS results of female taekwon-do (15.77) and BJJ athletes (15.22) were similar. Significant differences (p < 0.05) were observed in one pattern (ASLR). Women practising football (14.77) and basketball (14.67) attained a similar level of results in the test. Statistically significant differences were noted in two trials: footballers scored higher in the ASLR task (p < 0.05), and basketball players scored higher in rotary stability (p < 0.01).
Conclusion: A statistically significant result in the FMS test was obtained by martial arts athletes, which may point to a higher level of functional movement, which may be a result of more universal training.
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McKeon PO, Donovan L. A Perceptual Framework for Conservative Treatment and Rehabilitation of Ankle Sprains: An Evidence-Based Paradigm Shift. J Athl Train 2019; 54:628-638. [PMID: 31135210 PMCID: PMC6602398 DOI: 10.4085/1062-6050-474-17] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lateral ankle sprains are the most common injuries sustained during physical activity. The epidemiologic trends associated with chronic ankle instability (CAI) suggest that current rehabilitation approaches may be inadequate. We sought to synthesize best-practices evidence for the rehabilitation of patients with acute ankle sprains and CAI through the integration of emerging paradigms in perception, the dynamics of skill acquisition, and the biopsychosocial model of function, disability, and health. From the best available evidence, 4 key factors emerged for effective treatment and rehabilitation strategies: pain reduction, external ankle support for up to 1 year, progressive return to motion, and coordination training. We combined these factors into a meta-theoretical framework that centers on the perceptual interdependence of the cellular, local, and global functioning levels by linking insights from the body-self neuromatrix, the dynamics of skill acquisition, and the biopsychosocial model. Based on the best-practice recommendations from systematic reviews, ankle-sprain rehabilitation represents a multidimensional phenomenon governed by perception. The impairments, activity limitations, and participation restrictions associated with CAI may be linked to perceptual-interdependence alterations. Pain and edema reduction, the use of external ankle support for up to 1 year, progressive return to motion, and coordination training foster enhanced perceptual interdependence from cells to society. Using the perceptual-interdependence framework for ankle-sprain rehabilitation, we offer new insights for charting the course of effective strategies for enhancing function, reducing disability, and preventing the long-term sequelae associated with CAI.
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Affiliation(s)
- Patrick O. McKeon
- Department of Exercise Science and Athletic Training, Ithaca College, NY
| | - Luke Donovan
- Department of Kinesiology, University of North Carolina at Charlotte
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50
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Timpka T, Schyllander J, Stark Ekman D, Ekman R, Dahlström Ö, Hägglund M, Kristenson K, Jacobsson J. Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities. Eur J Public Health 2019; 28:94-99. [PMID: 28510641 DOI: 10.1093/eurpub/ckx053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. Methods An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Results Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries. Conclusions One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted.
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Affiliation(s)
- Toomas Timpka
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | | | - Diana Stark Ekman
- School of Public Health Sciences, Walden University, Minneapolis, MN, USA.,Department of Health and Learning, University of Skövde, Skövde, Sweden
| | - Robert Ekman
- Department of Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Örjan Dahlström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Karolina Kristenson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Jenny Jacobsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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