Increased Visual Use in Chronic Ankle Instability

Song, Kun; Burcal, Christopher J.; Hertel, Jay; Wikstrom, Erik A.

doi:10.1249/mss.0000000000000992

Cited by 108 publications

(76 citation statements)

References 51 publications

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“…Changes in PostCG cortical activation during single-limb stance showed that somatosensory perceptions may be affected among those with CAI compared with copers. Similarly, in a recent meta-analysis, Song et al 24 found that use of somatosensory perceptions was altered among individuals with CAI. Specifically, individuals with CAI tended to rely on vision more than and may integrate sensory information differently from those without a history of ankle sprain.…”

Section: Discussionmentioning

confidence: 83%

Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control

Rosen

Yentes

McGrath

et al. 2019

Journal of Athletic Training

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Context Chronic ankle instability (CAI) is characterized by repetitive ankle sprains and perceived instability. Whereas the underlying cause of CAI is disputed, alterations in cortical motor functioning may contribute to the perceived dysfunction. Objective To assess differences in cortical activity during single-limb stance among control, coper, and CAI groups. Design Cross-sectional study. Setting Biomechanics laboratory. Patients or Other Participants A total of 31 individuals (10 men, 21 women; age = 22.3 ± 2.4 years, height = 169.6 ± 9.7 cm, mass = 70.6 ± 11.6 kg), who were classified into control (n = 13), coper (n = 7), and CAI (n = 11) groups participated in this study. Intervention(s) Participants performed single-limb stance on a force platform for 60 seconds while wearing a 24-channel functional near-infrared spectroscopy system. Oxyhemoglobin (HbO2) changes in the supplementary motor area (SMA), precentral gyrus, postcentral gyrus, and superior parietal lobe were measured. Main Outcome Measure(s) Differences in averages and standard deviations of HbO2 were assessed across groups. In the CAI group, correlations were analyzed between measures of cortical activation and Cumberland Ankle Instability Tool (CAIT) scores. Results No differences in average HbO2 were present for any cortical areas. We observed differences in the standard deviation for the SMA across groups; specifically, the CAI group demonstrated greater variability than the control (r = 0.395, P = .02; 95% confidence interval = 0.34, 0.67) and coper (r = 0.38, P = .04; 95% confidence interval = −0.05, 0.69) groups. We demonstrated a strong correlation that was significant in the CAI group between the CAIT score and the average HbO2 of the precentral gyrus (ρ = 0.64, P = .02) and a strong correlation that was not significant between the CAIT score and the average HbO2 of the SMA (ρ = 0.52, P = .06). Conclusions The CAI group displayed large differences in SMA cortical-activation variability. Greater variations in cortical activation may be necessary for similar static postural-control outcomes among individuals with CAI. Consequently, variations in cortical activation for these areas provide evidence for an altered neural mechanism of postural control among populations with CAI.

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Section: Discussionmentioning

confidence: 83%

Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control

Rosen

Yentes

McGrath

et al. 2019

Journal of Athletic Training

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“…72 The ability to integrate different sensory inputs appears to be compromised in CAI. Song et al 73 performed a metaanalysis to investigate postural control in eyes-open and eyes-closed positions. Compared with healthy controls, patients with CAI relied more heavily on visual information than somatosensory information during unipedal-stance balance tasks.…”

Section: Sensory-perceptual Impairmentsmentioning

confidence: 99%

An Updated Model of Chronic Ankle Instability

Hertel

Corbett

2019

Journal of Athletic Training

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496

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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“…After suffering an LAS, the ligaments, muscles, and receptors surrounding the ankle joint become damaged, causing decreased function within that ankle [11]. Postural control is controlled by a number of body functions including neuromuscular, proprioceptive, and sensorimotor control [2,19]. The CAI population demon-strated higher force plate measurements than the healthy population during the single-leg balance (SLB) test [17].…”

Section: Introductionmentioning

confidence: 99%

“…SLBs with EO have shown that CAI individuals have increased foot lift, different COP strategies, and increased time to balance measurements when compared to healthy individuals [13]. An SLB with EC is much harder to complete compared with EO because an individual relies heavily on their proprioceptive and sensorimotor functions when trying to balance themselves in a normal balancing task [19]. CAI individuals have exhibited increased postural sway, increased BES, and increased time to balance measurements in EC tests compared to healthy individuals [19].…”

Section: Introductionmentioning

confidence: 99%

Static Postural Stability in Chronic Ankle Instability, an Ankle Sprain and Healthy Ankles

Kwon

2018

Int J Sports Med

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To identify the single leg balance (SLB) test that discriminates among healthy, coper, and chronic ankle instability (CAI) groups and to determine effects of ankle muscles on the balance error scoring system (BESS) among the three populations. 60 subjects (20 per group) performed the SLB test with eyes open (EO) and eyes closed (EC). Normalized mean amplitude (NMA) of the tibia anterior (TA), fibularis longus (FL), and medial gastrocnemius (MG) muscles and BESS were measured while performing the SLB test. The coper group had a lower error score than the CAI group in the EC. NMA was greater in the CAI group compared to in the healthy and coper groups regardless of muscle type. NMA of the TA was less than the PL and MG regardless of the group in the EO. The CAI group demonstrated greater NMAs of the PL and MG than the healthy and coper groups in the EC. The CAI group demonstrated greater NMA of the PL and MG by compensating their ankle muscles in the EO and EC. BESS suggests that the coper group may have coping mechanisms to stabilize static postural control compared to the CAI group. The EC may be better to detect static postural instability in the CAI or coper group.

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Increased Visual Use in Chronic Ankle Instability

Abstract: On the basis of our systematic review with meta-analysis, it appears that CAI patients do not use somatosensory information to the same extent as uninjured controls and instead upregulate the use of visual information during single limb stance.

Cited by 108 publications

References 51 publications

Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control

Alterations in Cortical Activation Among Individuals With Chronic Ankle Instability During Single-Limb Postural Control

An Updated Model of Chronic Ankle Instability

Static Postural Stability in Chronic Ankle Instability, an Ankle Sprain and Healthy Ankles

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