Dataset Information

Morphologic evaluation of injured and contralateral uninjured ankles in patients with unilateral chronic ankle instability.

ABSTRACT:

Objective

To compare the morphological anatomy and abnormalities of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in unilateral chronic ankle instability (CAI).

Methods

22 patients (men: women, 13:9; mean age, 28.95 ± 8.127 years) with unilateral CAI and 18 healthy volunteers (men: women, 9:9, mean age, 28.33 ± 3.678 years) were recruited. MRI scans were divided into Group 1 (22 injured ankles), Group 2 (22 contralateral uninjured ankles), and Group 3 (36 healthy volunteer ankles). The morphologic variables, MRI signal intensity (SI) values were evaluated.

Results

The ATFL proximal, intermediate, and distal sites and the CFL proximal and distal sites in Group 3 were narrower than those in Group 1 (P ＜0.05). Both ATFL and CFL in Group 1 were thicker than those in Group 3 (P ＜0.01). The proximal and intermediate sites of the ATFL and the proximal site of the CFL in Group 3 were narrower than those in Group 2 (P ＜0.01). The intermediate site of the ATFL and the proximal and distal sites of the CFL in Group 2 were thicker than those in Group 3 (P ＜0.01). The mean SI values of the ATFL in Group 1 were higher than those in Groups 2 and 3 (P ＜0.01). The ATFL and CFL SI values were higher in Group 2 than those in Group 3 (P ＜0.05).

Conclusion

Both the injured and contralateral uninjured ankles had wider ATFL and CFL, more thickness, and higher SI values compared with those of healthy volunteer ankles.

Advances in knowledge

High-resolution three-dimensional MRI provides a potential tool assisting clinical decision on the treatment and rehabilitation therapy of patients with unilateral CAI.

SUBMITTER: Dai M

PROVIDER: S-EPMC10996958 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

Morphologic evaluation of injured and contralateral uninjured ankles in patients with unilateral chronic ankle instability.

Dai Meng M Liu Xiaoming X Yang Lian L Wang Jiazheng J Ye Fang F Zhao Hu H Duan Deyu D Liu Xi X

The British journal of radiology 20220711 1137

<h4>Objective</h4>To compare the morphological anatomy and abnormalities of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in unilateral chronic ankle instability (CAI).<h4>Methods</h4>22 patients (men: women, 13:9; mean age, 28.95 ± 8.127 years) with unilateral CAI and 18 healthy volunteers (men: women, 9:9, mean age, 28.33 ± 3.678 years) were recruited. MRI scans were divided into Group 1 (22 injured ankles), Group 2 (22 contralateral uninjured ankles), and Group 3 ...[more]

PMID: 35766941

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Project description:Background: The purpose of the study was to determine the effect of kinesiology tape (KT) on lower limb muscle activation during computerized dynamic posturography (CDP) tasks and ankle kinesthesia in individuals with chronic ankle instability (CAI). Methods: Thirty-five men with CAI participated in this study. The experimental procedure followed a repeated measures design. Muscle activation of lower extremity and ankle kinesthesia of participants were measured using four taping treatments, namely, KT, athletic tape (AT), sham tape (ST), and no tape (NT) in a randomized order. Muscle activation was assessed using surface electromyography (sEMG) synchronized with CDP tests from seven lower extremity muscles of the unstable limb. Ankle kinesthesia was measured by using a threshold to detect the passive motion direction of the unstable ankle. Parameters were analyzed by using a one-way repeated measures ANOVA and followed by pairwise comparisons with a Bonferroni correction. Results: No significant difference was observed among different taping treatments for the majority of parameters during CDP. Except for condition 4 with open eyes, sway-referenced surface, and fixed surround in the sensory organization test (SOT), gastrocnemius medialis root mean square (RMS) was 28.19% lower in AT compared with NT (p = 0.021, 95% CI = 0.002-0.039), while gastrocnemius lateralis RMS was 20.25% lower in AT compared with KT (p = 0.038, 95% CI = 0.000-0.021). In forward-small sudden translation from motor control test (MCT), for peroneal longus (PL), RMS was 24.04% lower in KT compared with ST (p = 0.036, 95% CI = 0.000-0.018). In toes-down sudden rotation from adaption test (ADT), for PL, RMS was 23.41% lower in AT compared with ST (p = 0.015, 95% CI = 0.002-0.027). In addition, no significant difference was observed for a threshold to the detection of passive motion direction among different taping treatments. Conclusion: This study indicated that KT had minimal effect on the muscle activation of the unstable lower limb during static stance, self-initiated, and externally triggered perturbation tasks from CDP and ankle kinesthesia among individuals with CAI, suggesting that the benefit of KT was too small to be clinically worthwhile during application for CAI.

Project description:BackgroundChronic ankle instability (CAI) is manifested by sensorimotor impairments in the sprained ankle, including deficits in sensation, motor function, and central integration or processing. These impairments have a significant impact on physical activities and daily life. Recently, some studies have suggested that bilateral deficits were observed in unilateral CAI, but contradictory evidence disputes this finding. Therefore, the objective of this study was to investigate whether bilateral sensorimotor deficits presented in individuals with unilateral CAI.MethodsWithout language restriction, the following databases were retrieved from database inception up until 3 November 2023, including PubMed, WOS, EMBASE, Cochrane, SPORTDiscus and CINAHL. Case-control and cross-sectional studies that investigated bilateral sensorimotor functions in individuals with unilateral CAI were included. Sensorimotor functions contained static and dynamic balance, functional performance, muscle strength and activation, as well as sensation. Outcome measures contained centre-of-pressure parameters, normalised reach distance, activation time and magnitude of muscle, sensory errors and threshold. The risk of bias and quality assessment of included studies were evaluated using a standardised tool recommended by the Cochrane Collaboration and the Epidemiological Appraisal Instrument, respectively. To explore the potential bilateral deficits associated with unilateral CAI, a comprehensive meta-analysis was conducted using Review Manager version 5.4. The analysis compared the injured limb of unilateral CAI with healthy controls and the uninjured limb with healthy controls. The main focus of this study was to investigate the differences between the uninjured limb and healthy controls. A random-effects model was employed and effect sizes were estimated using the standardised mean difference (SMD) with 95% confidence intervals (CIs). Effect sizes were deemed as weak (0.2-0.5), moderate (0.5-0.8), or large (> 0.8).ResultsA total of 11,442 studies were found; 30 studies were contained in the systematic review and 20 studies were included in the meta-analysis. Compared with healthy controls, those with unilateral CAI presented weak to moderate impairments in their uninjured limbs in static balance with eyes open (SMD = 0.32, 95% CI: 0.08 to 0.56), functional performance (SMD = 0.37; 95% CI: 0.08 to 0.67), kinesthesia (SMD = 0.52; 95% CI: 0.09 to 0.95) and tibialis anterior activation (SMD = 0.60, 95% CI: 0.19 to 1.01). There were no significant differences in other comparisons between the uninjured limb and healthy controls.ConclusionsPatients with unilateral CAI may present bilateral deficits in static balance with eyes open, functional performance and kinaesthesia. However, further evidence is required to confirm this point due to limited studies included in some analyses and small effect size.RegistrationThe protocol was registered in the International Prospective Register of Systematic Reviews platform (CRD: 42,022,375,855).

Project description:ContextResearchers have shown that rehabilitation programs incorporating resistance-band and balance-board exercises are effective for improving clinical measures of function and patient-reported outcomes in individuals with chronic ankle instability (CAI). However, whether combining the 2 exercises increases improvement is unknown.ObjectiveTo determine the effectiveness of 3 rehabilitation programs on clinical measures of balance and self-reported function in adolescent patients with CAI.DesignRandomized controlled clinical trial (Trail Registration Number: ClinicalTrails.gov: NCT03447652).SettingHigh school athletic training facilities.Patients or other participantsForty-three patients with CAI (age = 16.37 ± 1.00 years, height = 171.75 ± 12.05 cm, mass = 69.38 ± 18.36 kg) were block randomized into 4 rehabilitation groups.Intervention(s)Protocols were completed 3 times per week for 4 weeks. The resistance-band group performed 3 sets of 10 repetitions of ankle plantar flexion, dorsiflexion, inversion, and eversion with a resistance band. The Biomechanical Ankle Platform System group performed 5 trials of clockwise and counterclockwise rotations, changing direction every 10 seconds during each 40-second trial. The combination group completed resistance-band and Biomechanical Ankle Platform System programs during each session. The control group did not perform any exercises.Main outcome measure(s)Variables were assessed before and after the intervention: time-in-balance test, foot-lift test, Star Excursion Balance Test, side-hop test, figure-8 hop test, Foot and Ankle Ability Measure, and Cumberland Ankle Instability Tool. We conducted 4 separate multivariate repeated-measures analyses of variance, followed by univariate analyses for any findings that were different.ResultsUsing the time-in-balance test, foot-lift test, Star Excursion Balance Test (medial, posteromedial, and posterolateral directions), and figure-8 hop test, we detected improvement for each rehabilitation group compared with the control group (P < .05). However, no intervention group was superior.ConclusionsAll 3 rehabilitation groups demonstrated improvement compared with the control group, yet the evidence was too limited to support a superior intervention. Over a 4-week period, either of the single-task interventions or the combination intervention can be used to combat the residual deficits associated with CAI in an adolescent patient population.

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Dataset Information

Morphologic evaluation of injured and contralateral uninjured ankles in patients with unilateral chronic ankle instability.

Objective

Methods

Results

Conclusion

Advances in knowledge

Publications

Morphologic evaluation of injured and contralateral uninjured ankles in patients with unilateral chronic ankle instability.

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