An Examination of Ankle, Knee, and Hip Torque Production in Individuals With Chronic Ankle Instability

Abstract

There is some debate in the literature as to whether strength deficits exist at the ankle in individuals with chronic ankle instability (CAI). Additionally, there is evidence to suggest that knee and hip performance is altered in those with CAI. Therefore, the purpose of this study was to determine whether CAI is associated with deficits in ankle, knee, and hip torque. Fifteen subjects with unilateral CAI and fifteen subjects with healthy ankles participated. Subjects reported to the laboratory for one session during which the torque production of ankle plantar flexion/dorsiflexion, knee flexion/extension, and hip flexion/extension were measured with an isokinetic device. Subjects performed 5 maximum-effort repetitions of a concentric/concentric protocol at 60 degrees .s for both extremities. Average peak torque (APT) values were calculated. The subjects with CAI demonstrated significantly less APT production for knee flexion (F1,28 = 5.40; p = 0.03) and extension (F1,28 = 5.34; p = 0.03). Subjects with CAI exhibited significantly less APT for ankle plantar flexion in the injured limb compared with their noninjured limb (F1,28 = 6.51; p = 0.02). No significant difference in ankle dorsiflexion or hip flexion/extension APT production existed between the 2 groups. Individuals with CAI, in addition to deficits in ankle plantar flexion torque, had deficits in knee flexor and extensor torque, suggesting that distal joint instability may lead to knee joint neuromuscular adaptations. There were no similar deficits at the hip. Future research should determine what implications this has for prevention and rehabilitation of lower-extremity injury. Clinicians may need to consider including rehabilitation efforts to address these deficits when rehabilitating patients with CAI.

Acute Ankle Sprain in a Mouse Model: Changes in Knee-Joint Space

“…Several groups [12][13][14][15][16] have reported alterations in kneejoint kinematics, neuromuscular control, and knee torque production in those with CAI. Most recently, Terada et al 12 demonstrated altered feed-forward patterns of the vastus medialis oblique (VMO) muscle in those with CAI.…”

Current concepts on the pathophysiology and management of recurrent ankle sprains and chronic ankle instability

“…Assessing balance remains a useful clinical tool as it can be measured over time to show changes and has been found to be useful in assessing deficits in those with CAI when compared to healthy individuals. Gribble et al [59][60][61] has reported proximal changes in subjects with CAI during walking, jump landing and dynamic balance tasks. These changes were hypothesized to occur following changes to the ankle joint due to centrally mediated changes in neuromuscular function [25,50].…”

Sagittal Plane Gait Kinematics in Individuals With Chronic Ankle Instability

“…Previous studies have identified alterations in gait initiation and termination, 16,17 proximal adaptations in muscle strength and activation, 18,19 and proximal changes during functional tasks such as jump landing. 20 Cumulatively, these studies point toward the possibility that central changes in sensorimotor function are responsibility for alterations in movement.…”