Ankle Instability Effects on Joint Position Sense When Stepping Across the Active Movement Extent Discrimination Apparatus

Abstract

Context Individuals with and without functional ankle instability have been tested for deficits in lower limb proprioception with varied results. Objective To determine whether a new protocol for testing participants' joint position sense during stepping is reliable and can detect differences between participants with unstable and stable ankles. Design Descriptive laboratory study. Setting University clinical laboratory. Patients or Other Participants Sample of convenience involving 21 young adult university students and staff. Ankle stability was categorized by score on the Cumberland Ankle Instability Tool; 13 had functional ankle instability, 8 had healthy ankles. Intervention(s) Test-retest of ankle joint position sense when stepping onto and across the Active Movement Extent Discrimination Apparatus twice, separated by an interim test, standing still on the apparatus and moving only 1 ankle into inversion. Main Outcome Measure(s) Difference in scores between groups with stable and unstable ankles and between test repeats. Results Participants with unstable ankles were worse at differentiating between inversion angles underfoot in both testing protocols. On repeated testing with the stepping protocol, performance of the group with unstable ankles was improved (Cohen d = 1.06, P = .006), whereas scores in the stable ankle group did not change in the second test (Cohen d = 0.04, P = .899). Despite this improvement, the unstable group remained worse at differentiating inversion angles on the stepping retest (Cohen d = 0.99, P = .020). Conclusions The deficits on proprioceptive tests shown by individuals with functional ankle instability improved with repeated exposure to the test situation. The learning effect may be the result of systematic exposure to ankle-angle variation that led to movement-specific learning or increased confidence when stepping across the apparatus.

Lateral Ankle Sprain and Chronic Ankle Instability

“…There are many studies suggesting that joint position sense in CAI ankles is significantly decreased based on similar measurements. 85,[87][88][89]92,93 However, some studies indicated contradictory findings, 84,86,90 and a consensus has not yet been obtained ( Table 1). The cause of this controversy is considered to involve differences in the inclusion criteria for CAI and the lack of standardized measurement systems.…”

The effect of intrinsic foot muscle training on medial longitudinal arch and ankle stability in patients with chronic ankle sprain accompanied by foot pronation

“…The position sense of the ankle decreases with deformation of the foot, such as flatfoot and foot pronation [3,24] In order to correct foot pronation, several studies on the MLA height have been carried out. Snyder et al [25] presented that increasing muscle strength of the IFM and EFM is the most effective and active method to correct pronation of the joint causing the lowering of the MLA.…”

“…Repeated ankle sprains have developed into a chronic instability, causing instability of the ankle [27]. Witchalls et al [24] pointed out that decreased proprioceptive sense or joint position sense as the biggest causes of ankle instability. McKeon et al [28] introduced the concept of the foot core and called for an increased awareness of the importance of foot core stability for normal feet and lower extremity functions.…”

The Effect of Acute Body Unloading on Somatosensory Performance, Motor Activation, and Visuomotor Tasks

“…Those in a higher class of sports performance, or hold a higher qualification in sport instructing, are significantly more accurate on the Ankle AMEDA than those in a lower class or without a qualification in sport instructing. Furthermore, research targeted at individuals with ankle instability who are at risk of injury and chronic pain have demonstrated an average of 0.03 reduction in Ankle AMEDA scores than people without ankle instability (Witchalls et al, 2012).…”