Plantar Cutaneous Sensitivity and Balance in Individuals With and Without Chronic Ankle Instability

Abstract

Individuals with CAI demonstrated deficits in light touch over the plantar aspect of the foot. The relationship between base of the fifth metatarsal sensation and TTB-mean AP may provide a starting point to link plantar cutaneous sensory deficits to changes in other aspects of sensorimotor function.

Interrater and intrarater reliability of the semmes-weinstein monofilament 4-2-1 stepping algorithm

“…The first examiner began the 4‐2‐1 stepping algorithm (Fig. ) by applying the 4.74 SWM over the marked location on the foot . SWMs were applied perpendicular to the target location until a “C” shaped bend was attained and held for approximately 1 s and then removed (Fig.…”

“…SWMs are used in a variety of settings, because they are noninvasive, economical, and feasible for clinical practice . While SWMs have been used to assess cutaneous sensation in patients with neurodegenerative conditions such as diabetic peripheral neuropathy or as a consequence of normal aging, few studies have investigated techniques to examine sensory deficits in younger individuals who make up a large number of orthopedic patients, particularly in sports medicine practice settings . Identifying reliable techniques to examine light touch sensory deficits in young, physically active adults is critical for incorporating this assessment into clinical practice for these types of patients.…”

“…However, a concern is the mixed results regarding interrater and intrarater reliability . This is particularly important for incorporating SWM assessments in patients with a history of lower extremity injury who have demonstrated subtle changes in sensory detection thresholds compared with the gross deficits exhibited by patients with conditions such as diabetic neuropathy . Therefore, a reliable method of using SWMs is needed to ensure that a high level of consistency is present for detecting subtle sensory detection threshold deficits and corresponding changes in sensation.…”

“…To promote greater consistency in detection threshold assessments, it may be beneficial to use techniques based on a stepping algorithm to systematically apply SWMs . Contrary to starting with the thinnest or thickest diameter monofilament and moving in an ascending or descending order through the SWM kit, the stepping algorithm starts with a middle diameter monofilament and progresses using a stepping approach . Movement to the next monofilament is based upon the patient's perception of the stimulus.…”

Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function

“…12 However, those with CAI have shown sensory impairments such as increased mechanoreceptor thresholds 13 and decreased proprioceptive acuity.…”