Hip strength and star excursion balance test deficits of patients with chronic ankle instability

McCann, Ryan S.; Crossett, Ian D.; Terada, Masafumi; Kosik, Kyle B.; Bolding, Brenn A.; Gribble, Phillip A.

doi:10.1016/j.jsams.2017.05.005

Cited by 88 publications

(86 citation statements)

References 37 publications

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“…Ankle joint strength can be measured in an objective and reliable manner using hand-held dynamometry (online supplementary appendix I). 53 Additionally, there is evidence to suggest that hip strength may be an important factor to also consider, as research has identified proximal strength deficits in individuals with chronic ankle instability 54…”

Section: Discussionmentioning

confidence: 99%

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium

et al. 2018

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Lateral ankle sprain injury is the most common musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities. Following initial injury, a high proportion of individuals develop long-term injury-associated symptoms and chronic ankle instability. The development of chronic ankle instability is consequent on the interaction of mechanical and sensorimotor insufficiencies/impairments that manifest following acute lateral ankle sprain injury. To reduce the propensity for developing chronic ankle instability, clinical assessments should evaluate whether patients in the acute phase following lateral ankle sprain injury exhibit any mechanical and/or sensorimotor impairments. This modified Delphi study was undertaken under the auspices of the executive committee of the International Ankle Consortium. The primary aim was to develop recommendations, based on expert (n=14) consensus, for structured clinical assessment of acute lateral ankle sprain injuries. After two modified Delphi rounds, consensus was achieved on the clinical assessment of acute lateral ankle sprain injuries. Consensus was reached on a minimum standard clinical diagnostic assessment. Key components of this clinical diagnostic assessment include: establishing the mechanism of injury, as well as the assessment of ankle joint bones and ligaments. Through consensus, the expert panel also developed the International Ankle Consortium Rehabilitation-Oriented ASsessmenT (ROAST). The International Ankle Consortium ROAST will help clinicians identify mechanical and/or sensorimotor impairments that are associated with chronic ankle instability. This consensus statement from the International Ankle Consortium aims to be a key resource for clinicians who regularly assess individuals with acute lateral ankle sprain injuries.

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Section: Discussionmentioning

confidence: 99%

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium

et al. 2018

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“…129 Similarly, diminished hip-abduction and external-rotation strength has also been correlated with reduced reach distances in patients with CAI. 121 In addition, patients exhibited more trunk and pelvis rotation when executing select SEBT reach tasks. 130 Altered Movement Patterns.…”

Section: Motor-behavioral Impairmentsmentioning

confidence: 99%

“…Weakness of the muscles proximal to the unstable ankle, including deficits in concentric knee flexion and extension, 116 isometric hip abduction, 115,121 extension, 115,121 external rotation, 121,122 and eccentric hip flexion, 123 has also been identified among patients with CAI. Distally, weakness in hallux and lesser toe-flexion strength 108 and diminished volume of the flexor hallucis brevis and adductor hallucis oblique muscles 59 have been reported in patients.…”

Section: Motor-behavioral Impairmentsmentioning

confidence: 99%

An Updated Model of Chronic Ankle Instability

Hertel

Corbett

2019

Journal of Athletic Training

492

386

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Lateral ankle sprains (LASs) are among the most common injuries incurred during participation in sport and physical activity, and it is estimated that up to 40% of individuals who experience a first-time LAS will develop chronic ankle instability (CAI). Chronic ankle instability is characterized by a patient's being more than 12 months removed from the initial LAS and exhibiting a propensity for recurrent ankle sprains, frequent episodes or perceptions of the ankle giving way, and persistent symptoms such as pain, swelling, limited motion, weakness, and diminished self-reported function. We present an updated model of CAI that aims to synthesize the current understanding of its causes and serves as a framework for the clinical assessment and rehabilitation of patients with LASs or CAI. Our goal was to describe how primary injury to the lateral ankle ligaments from an acute LAS may lead to a collection of interrelated pathomechanical, sensory-perceptual, and motor-behavioral impairments that influence a patient's clinical outcome. With an underpinning of the biopsychosocial model, the concepts of self-organization and perception-action cycles derived from dynamic systems theory and a patient-specific neurosignature, stemming from the Melzack neuromatrix of pain theory, are used to describe these interrelationships.

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“…In the last two decades, numerous studies have been conducted to identify the mechanisms of CAI, substantially studying a single component of sensorimotor impairments (eg, strength, proprioception, postural control, etc) . However, related to common mechanisms of LAS, the injury frequently occurs during jumping, landing, and cutting maneuvers .…”

Section: Introductionmentioning

confidence: 99%

“…5 In the last two decades, numerous studies have been conducted to identify the mechanisms of CAI, substantially studying a single component of sensorimotor impairments (eg, strength, proprioception, postural control, etc). 6,7 However, related to common mechanisms of LAS, the injury frequently occurs during jumping, landing, and cutting maneuvers. 1 Because of this, results of most previous studies primarily examining a static measure of sensorimotor impairments may not fully provide dynamic characteristics of altered movement strategies during functional tasks.…”

Section: Introductionmentioning

confidence: 99%

Altered movement strategies during jump landing/cutting in patients with chronic ankle instability

Kim

Son

Seeley

et al. 2019

Scandinavian Med Sci Sports

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Centrally mediated changes in sensorimotor function have been reported in patients with chronic ankle instability (CAI). However, little is known regarding supraspinal/spinal adaptations during lower‐extremity dynamic movement during a multiplanar, single‐leg landing/cutting task. The purpose of this study was to investigate the effect of CAI on landing/cutting neuromechanics, including lower‐extremity kinematic, electromyography (EMG) activation, and ground reaction force (GRF) characteristics. One hundred CAI patients and 100 matched healthy controls performed five trials of a jump landing/cutting task. Sagittal‐ and frontal‐plane ankle, knee and hip kinematics, EMG activation in eight lower‐extremity muscles, and 3D GRF were collected during jump landing/cutting. Functional analyses of variance (FANOVA) were used to evaluate between‐group differences for dependent variables throughout the entire ground contact of the task. Relative to the control group, the CAI group revealed (a) reduced dorsiflexion, increased knee and hip flexion angles, (b) increased inversion and hip adduction angles, (c) increased EMG activation of medial gastrocnemius, peroneus longus, adductor longus, vastus lateralis, gluteus medius, and gluteus maximus, and (d) increased posterior and vertical GRF during initial landing, and reduced medial, posterior, and vertical GRF during mid‐landing and mid‐cutting. CAI patients demonstrated alterations in landing/cutting movement strategies as demonstrated by a higher susceptibility of foot placement for lateral ankle sprains, and more flexed positions of the knee and hip with higher EMG activation of knee and hip extensors to modulate GRF to compensate for the unstable ankle. This apparent compensation may be due to mechanical (limited dorsiflexion angle) and/or sensorimotor deficits in the ankle.

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Hip strength and star excursion balance test deficits of patients with chronic ankle instability

Cited by 88 publications

References 37 publications

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium

An Updated Model of Chronic Ankle Instability

Altered movement strategies during jump landing/cutting in patients with chronic ankle instability

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