Dynamic Systems Theory as a Guide to Balance Training Development for Chronic Ankle Instability: A Review of the Literature

McKeon, Patrick O.

doi:10.3928/19425864-20120731-04

Cited by 21 publications

(16 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The central mechanism may relate to enhanced global perception-action and the ability to reincorporate the ankle and foot into effective movement strategies. 5,51 The theory that coordination training enhances proprioception may simply be scratching the tip of the perceptual iceberg. An evaluation of many of the coordination-training programs indicated that all progress occurred by increasing demands from simple to more complex tasks or from predictable to unpredictable environments (or both).…”

Section: Coordination Training: Restoring Global Body-self Perceptionmentioning

confidence: 99%

“…[53][54][55] Coordination is the mark of a goal-oriented dynamic system governed by internal and external constraints. 51,54 These constraints include the health of the individual, the complexity of the task being performed, and the predictability of relevant sensory cues from the environment. 51,56 Coordination of the body changes according to the demands of the movement goal in the context of task complexity and environmental predictability.…”

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

“…51,54 These constraints include the health of the individual, the complexity of the task being performed, and the predictability of relevant sensory cues from the environment. 51,56 Coordination of the body changes according to the demands of the movement goal in the context of task complexity and environmental predictability. Skill acquisition then becomes the process of exploring the regulatory conditions 57,58 of the skill (the task and environmental constraints) and learning to exploit them.…”

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

“…Therefore, it is critically important that the movement goal be perceived clearly by the learner to ensure that he or she can recognize success versus failure in attaining it. 5,51 The ability to reduce errors enhances the probability of success and is an important factor in promoting the perception of skill mastery. 17,18 As performance errors are reduced, the task and environmental constraints can be progressed in complexity and unpredictability, respectively, to increase the difficulty in perceiving the regulatory conditions governing coordination of the movement goal.…”

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

“…17,18 As performance errors are reduced, the task and environmental constraints can be progressed in complexity and unpredictability, respectively, to increase the difficulty in perceiving the regulatory conditions governing coordination of the movement goal. 5,51 As deliberate practice continues, the cognitive load concurrently decreases because changes in perception are more strongly associated with anticipated changes in action. The resulting actions are then associated with anticipated changes in perception and reduced cognitive demand.…”

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

See 4 more Smart Citations

A Perceptual Framework for Conservative Treatment and Rehabilitation of Ankle Sprains: An Evidence-Based Paradigm Shift

McKeon

Donovan

2019

Journal of Athletic Training

Self Cite

View full text Add to dashboard Cite

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 bodyself 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 perceptualinterdependence 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 perceptualinterdependence 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.

show abstract

Section: Coordination Training: Restoring Global Body-self Perceptionmentioning

confidence: 99%

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

Section: Coordination Training and The Dynamics Of Skill Acquisitionmentioning

confidence: 99%

See 3 more Smart Citations

A Perceptual Framework for Conservative Treatment and Rehabilitation of Ankle Sprains: An Evidence-Based Paradigm Shift

McKeon

Donovan

2019

Journal of Athletic Training

Self Cite

View full text Add to dashboard Cite

show abstract

Effects of a stocking on plantar sensation in individuals with and without ankle instability

2016

View full text Add to dashboard Cite

show abstract

Understanding and Treating Lateral Ankle Sprains and their Consequences

2013

View full text Add to dashboard Cite

Lateral ankle sprains are a common consequence of physical activity. If not managed appropriately, a cascade of negative alterations to both the joint structure and a person's movement patterns continue to stress the injured ligaments. These alterations result in an individual entering a continuum of disability as evidenced by the ~30 % of ankle sprains that develop into chronic ankle instability (CAI) and up to 78 % of CAI cases that develop into post-traumatic ankle osteoarthritis (OA). Despite this knowledge, no significant improvements in treatment efficacy have been made using traditional treatment paradigms. Therefore, the purpose of this review is to (1) provide an overview of the consequences associated with acute lateral ankle sprains, CAI and post-traumatic ankle OA; (2) introduce the patient-, clinician-, laboratory (PCL)-oriented) model that addresses the lateral ankle sprains and their consequences from a constraints perspective; and (3) introduce the dynamic systems theory as the framework to illustrate how multiple post-injury adaptations create a singular pathology that predisposes individuals with lateral ankle sprains to fall into a continuum of disability. The consequences associated with lateral ankle sprains, CAI and ankle OA are similar and encompass alterations to the structure of the ankle joint (e.g. ligament laxity, positional faults, etc.) and the sensorimotor function responsible for proper ankle joint function (e.g. postural control, gait, etc.). Further, the impairments have been quantified across a range of patient-oriented (e.g. self-report questionnaires), clinician-oriented (e.g. bedside measures of range of motion and postural control), and laboratory-oriented (e.g. arthrometry, gait analysis) outcome measures. The interaction of PCL-oriented outcomes is critically important for understanding the phenomenon of CAI across the continuum of disability. Through the integration of all three sources of evidence, we can clearly see that an ankle sprain is more than just a peripheral musculoskeletal pathology with only local consequences. The dynamic systems theory illustrates that the organization of human movement/function is shaped by the interaction of (1) organismic constraints (health of the person); (2) task constraints; and (3) environmental constraints. However, ankle sprains increase the organismic constraints (i.e. changes in joint structure and sensorimotor function) that significantly hinder an individual's function and may be the underlying cause for the continuum of disability associated with CAI. To treat and/or prevent an individual from entering the continuum of disability, greater protection of the ankle ligaments is needed immediately after injury. Subsequent rehabilitation should then focus on goal-oriented rehabilitation (i.e. quality of the movement pattern) rather that task-oriented rehabilitation (i.e. do these exercises). When evaluating patients with ankle inversion trauma and/or instability, it is imperative to remember that an ankle sprain is not simply a lo...

show abstract

Dynamic Systems Theory as a Guide to Balance Training Development for Chronic Ankle Instability: A Review of the Literature

Cited by 21 publications

References 13 publications

A Perceptual Framework for Conservative Treatment and Rehabilitation of Ankle Sprains: An Evidence-Based Paradigm Shift

A Perceptual Framework for Conservative Treatment and Rehabilitation of Ankle Sprains: An Evidence-Based Paradigm Shift

Effects of a stocking on plantar sensation in individuals with and without ankle instability

Understanding and Treating Lateral Ankle Sprains and their Consequences

Contact Info

Product

Resources

About