Military personnel with self-reported ankle injuries do not demonstrate deficits in dynamic postural stability or landing kinematics

Bansbach, Heather M.; Lovalekar, Mita; Abt, John P.; Rafferty, Deirdre; Yount, Darcie L.; Sell, Timothy C.

doi:10.1016/j.clinbiomech.2017.05.008

Cited by 14 publications

(8 citation statements)

References 42 publications

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“…138 Due to the heterogeneity of pathomechanics and tissues injured during an inversion sprain, the role of these sensorimotor ROM deficits and movement system abnormalities is debated, as they are not always present or are present to varying degrees, with symptoms frequently lasting from a few weeks to 12 months or longer. 11,24,78,80,85,94,99,204,224,255,320,334,354,413,427,434 Individuals who recover from a LAS, as defined by returning to at least a moderate level of activity and having a near normal self-reported functional level of activity within 12 months, are identified as "copers," while those who continue to have complaints of instability are identified as having CAI. 468 Attempts to identify the sensorimotor ROM deficits in those with CAI have received considerable attention.…”

Section: Pathoanatomical Features Update 2021mentioning

confidence: 99%

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

Journal of Orthopaedic & Sports Physical Therapy

103

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B Clinicians should include patient age, body mass index, pain coping strategies, report of instability, history of previous sprain, ability to bear weight, pain with weight bearing, ankle dorsiflexion range of motion (ROM), medial jointline tenderness, balance, and ability to jump and land (as safely tolerated) in their initial assessment, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with an acute lateral ankle sprain (LAS). CLINICAL COURSE -CHRONIC ANKLE INSTABILITYC Clinicians may include previous treatment, number of sprains, pain level, and self-report of function in their evaluation, as well as an assessment of the sensorimotor movement systems of the foot, ankle, knee, and hip during dynamic postural control and functional movements, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with chronic ankle instability (CAI). DIAGNOSIS/CLASSIFICATION -ACUTE LATERAL ANKLE SPRAINB Clinicians should use special tests, including the reverse anterolateral drawer test and anterolateral talar palpation in addition to the traditional anterior drawer test, and a thorough history and physical examination to aid in the diagnosis of a LAS. DIAGNOSIS/CLASSIFICATION -CHRONIC ANKLE INSTABILITYB When determining whether an individual has CAI, clinicians should use a reliable and valid discriminative instrument, such as the Cumberland Ankle Instability Tool or the Identification of Functional Ankle Instability, as well as a battery of functional performance tests that have established validity to differentiate between healthy controls and individuals with CAI. EXAMINATION -OUTCOME MEASURESA Clinicians should use validated patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System physical function and pain interference scales, the Foot and Ankle Ability Measure, and the Lower Extremity Functional Scale, as part of a standard clinical examination. Clinicians should utilize these before and 1 or more times after the application of interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with an acute LAS or CAI.C Clinicians may use the Pain Self-Efficacy Questionnaire in the acute and postacute periods after a LAS to assess effective coping strategies for pain, and the 11-item Tampa Scale of Kinesiophobia and the Fear-Avoidance Beliefs Questionnaire to assess fear of movement and reinjury and fear-avoidance beliefs in those with CAI. EXAMINATION -PHYSICAL IMPAIRMENT MEASURESA Clinicians should assess and document ankle swelling, ROM, talar translation, talar inversion, and single-leg balance in patients with an acute LAS, postacute LAS, or CAI at baseline and 2 or more times over an episode of care. Clinicians should specifically include measures of dorsiflexion, using the weight-bearing lunge test, static single-limb balance on a firm surface with eyes...

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Section: Pathoanatomical Features Update 2021mentioning

confidence: 99%

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Martin¹,

Davenport²,

Fraser³

et al. 2021

Journal of Orthopaedic & Sports Physical Therapy

103

View full text Add to dashboard Cite

show abstract

“…Similar to our results, Hartley et al 27 found greater posterior-medial asymmetry in injured female athletes compared with non-injured, suggesting that asymmetry might be dependent on multiple factors such as gender, sport and injury definition. On the other hand, Bansbach et al 20 reported no significant differences in dynamic postural stability between injured and non-injured Special Operations Forces Operators. Surprisingly, in the present study, no interactions (time×injury) were found for DPB parameters.…”

Section: Discussionmentioning

confidence: 96%

“…It should be noted that musculoskeletal injuries remain a major contributor to morbidity, missed training time, discharges and fiscal burden; they are also associated with lost time from duty and impacting military readiness 5. As injuries such as ankle sprains have the potential for long-term functional deficits, and may lead to limited duty days in both training and combat soldiers,20 most authors suggested specific prevention and rehabilitation programmes for reduced risk of injuries.…”

Section: Discussionmentioning

confidence: 99%

“…It might be that the postural stability of the injured participants had either returned to baseline levels through daily military tasks, or their single injuries did not alter their postural stability. It should be noted that although injuries such as ankle injuries are mostly reported to have long-term effects, few studies showed that an injured subject might not demonstrate deficits in postural stability, proprioception or strength 20…”

Section: Discussionmentioning

confidence: 99%

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Incidence of injuries and factors related to injuries in combat soldiers

Yavnai¹,

Bar-Sela

Pantanowitz

et al. 2020

BMJ Mil Health

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IntroductionMusculoskeletal injuries to the lower extremities are major factors contributing to drop out from military tasks. The aim of the present study was to determine the incidence of musculoskeletal injuries and the parameters that differentiate between the soldiers who incurred these injuries and those who did not along 14 weeks of an infantry commanders course.MethodsOne-hundred and sixty-eight participants were recruited from an infantry commanders course. The soldiers were tested before (pre), in the middle (middle) and at the end (last) of the course for anthropometric measurements, proprioceptive ability and dynamic postural balance (DPB), and filled out an ankle stability questionnaire (Cumberland Ankle Instability Tool (CAIT). A physiotherapist followed and recorded all musculoskeletal injuries incurred by the participants during the course.ResultsFifty-eight participants out of the 168 (34.5%) reported some pain/injury. Time effects were found for body mass index, DPB asymmetry, DPB in posterior-medial (P-M) direction and proprioception ability. Injury effects were found for DPB asymmetry, DPB in P-M direction, CAIT and proprioception ability. An interaction was found for proprioception ability. The Cox regression showed that the variables that are mostly effecting injuries were pretesting proprioception ability, DPB asymmetry and CAIT.ConclusionsMore than one out of three participants incurred musculoskeletal injuries, with deficits in proprioception ability, DPB and ankle stability in pretesting as major factors contributing to injuries. Further studies should look at the effect of specific exercises such as proprioception, DPB and ankle stability exercises for prevention and treatment of musculoskeletal injuries among combat soldiers.

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“…[29][30][31][32] The first aim of this study was to determine whether Achilles tendon (AT) and patellar tendon (PT) structure are risk factors for musculoskeletal injuries in combat soldiers. As musculoskeletal injuries are a major contributor to morbidity and reduced military readiness, 33,34 there is a lack of research regarding the relationship between the initial (precourse) tendon structure and the risk for injuries (during the course) in military troops. It was hypothesized that soldiers who commence a period of increased physical loading such as a combat course with "worse" tendon structural integrity (increased areas of disorganized echo-type III and IV fibers)…”

mentioning

confidence: 99%

Can Achilles and patellar tendon structures predict musculoskeletal injuries in combat soldiers?

Steinberg

Pantanowitz

Funk

et al. 2020

Scandinavian Med Sci Sports

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Aiming to investigate whether Achilles tendon (AT) structure and patellar tendon (PT) structure are risk factors for musculoskeletal injuries in combat soldiers, 168 participants were recruited from an infantry commander's course. The AT and PT were examined pre‐course using UTC to capture the structure of four echo‐type fibers (I–IV). All injuries were assessed by military physicians pre‐course and throughout the 14‐week course. Soldiers who were injured during the course had a significantly higher pre‐course prevalence of AT and PT echo‐type III and echo‐type IV compared to soldiers that were not injured during the course. Variables that were found to be associated with injured/non‐injured participants were echo‐type III + IV of the PT (OR = 1.44, 95% CI = 1.24‐1.68) and echo‐type III of the AT (OR = 1.69, 95% CI = 1.35‐2.12). ROC analyses showed that the best model, exhibiting both high sensitivity and low specificity, was that participants with PT echo‐type III + IV > 10% or AT echo‐type III >8.5% had the highest risk of being injured during the course. In conclusions, the tendon structure at the beginning of high‐intensity activity or physical training program might be a risk factor for subsequent injury during the course. Soldiers and high‐level athletes should be aware of the cutoff points for fiber types in tendon structure that might put them at high risk for future injury. At‐risk soldiers/athletes should be provided with an intervention program before they start their training program, with the aim of improving the tendon structure and preventing subsequent injury.

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Military personnel with self-reported ankle injuries do not demonstrate deficits in dynamic postural stability or landing kinematics

Cited by 14 publications

References 42 publications

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

Incidence of injuries and factors related to injuries in combat soldiers

Can Achilles and patellar tendon structures predict musculoskeletal injuries in combat soldiers?

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