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ObjectiveTo analyze the relationship of the static single-leg stance balance with ankle muscles strength and position sense in individuals with functional ankle instability (FAI). MethodsFrom March to May, 2023, 44 FAI individuals were recruited in Hebei Normal University, and the maximum isokinetic muscle strength (60°/s and 180°/s) and position sense as ankle flexion, extension, inversion and eversion were measured using isokinetic dynamometer; while the center of pressure (COP) sway distance and envelope area were measured as static single-leg stance with eyes open or closed using three-dimensional force plate. ResultsThe maximum isokinetic torque as ankle eversion at 180°/s correlated with the COP anterior-posterior sway distance with eyes closed (r = -0.378, P < 0.05). ConclusionExplosive ankle eversion strength is related with the balance in static single-leg stance, which may help to evaluate and intervent the ankle function of FAI individuals.
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PURPOSE@#To investigate the clinical effects of arthroscopically artificial ligament reconstruction with tensional remnant-repair in patients who are obese, and/or with demand for highly intensive sports, and/or with poor-quality ligament remnants.@*METHODS@#A retrospective case series study was performed on patients treated by arthroscopically anterior talofibular ligament (ATFL) reconstruction with tensional remnant repair technique from January 2019 to August 2021. General data, including demographics, surgical time, and postoperative adverse events, were recorded. The American Orthopaedic Foot and Ankle Society score (AOFAS), foot and ankle ability measure (FAAM), visual analog scale (VAS), and anterior talar translation were measured preoperatively and at 6 weeks, 3 months, and 2 years postoperatively. Ultrasonography examination was performed preoperatively and 2 years postoperatively to evaluate the ATFL. Data were analyzed using SPSS 19.0. F test was used to analyze the pre- and postoperative VAS, FAAM, and AOFAS scores. The significance was set at p < 0.05.@*RESULTS@#There were 20 males and 10 females among the patients with a mean age of (30.71 ± 5.81) years. The average surgical time was (40.21 ± 8.59) min. No adverse events were observed after surgery. At 2 years postoperatively, the anterior talar translation test showed grade 0 laxity in all patients. VAS score significantly decreased from preoperatively to 6 weeks, 3 months, and 2 years postoperatively (p < 0.001). Improvement of FAAM score and the AOFAS score from preoperatively to 6 weeks, 3 months, and 2 years postoperatively was statistically significant (p < 0.001). At 3 months postoperatively, most patients (23/30) could return to their pre-injured activities of daily living status. At 2 years postoperatively, all patients were able to return to their pre-injured activities of daily living status, and almost every patient (18/19) who expected highly intensive sports returned to sports with only 1 obese patient failing to achieve the goal. The ultrasonography examination at 2 years postoperatively showed that there was a linear band structure of soft tissue on the tension-rich fiber tape image from the fibular to the talar attachment sits of ATFL.@*CONCLUSION@#The novel arthroscopically artificial ligament reconstruction with tensional remnant-repair technique for ATFL achieved satisfactory clinical outcomes in the short and medium term after operation, and allowed early return to pre-injured activities, which could be a reliable option for patients with chronic lateral ankle instability.
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Male , Female , Humans , Young Adult , Adult , Ankle Joint/surgery , Retrospective Studies , Activities of Daily Living , Ankle Injuries/surgery , Lateral Ligament, Ankle/surgery , Joint Instability/surgery , Ligaments , Obesity , Arthroscopy/methodsABSTRACT
OBJECTIVE@#To explore clinical effect of repairing anterior talofibular ligament with knot-free anchors under total ankle arthroscopy in treating chronic lateral ankle instability.@*METHODS@#From April 2018 to August 2021, 24 patients with chronic lateral ankle instability were treated with knot-free anchors under total ankle arthroscopy to repair anterior talofibular ligament, including 16 males and 8 females, aged from 22 to 42 years old with an average of(28.6±5.8) years old;the time from injury to opertaion ranged from 6 to 10 months with an average of(7.7±1.3) months. Preoperative and postoperative American Orhopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), talar tilt, anterior talar translation(ATT) were recorded and compared.@*RESULTS@#All patients were followed up from 10 to 12 months with an average of (10.2±1.14) months. Incision were healed at stageⅠ, and no infection, nerve injury and lateral ankle instability occurred. AOFAS score improved from(52.79±8.96) before opertaion to (93.00± 4.01) at 6 months after operation, 23 patients got excellent result and 1 good;VAS decreased from (5.50±0.98) before opertaion to (1.04±0.80) at 6 months after operation(P<0.05);talar tilt decreased from(9.16±2.09)° to (3.10±1.72)° at 3 months after operation(P<0.05);ATT decreased from(8.80±2.55) mm to (2.98±1.97) mm at 3 months after operation(P<0.05). Twenty-four patients drawer test and varus-valgus rotation wer negative.@*CONCLUSION@#Repairing anterior talofibular ligament with knot-free anchors under total ankle arthroscopy for the treatment of chronic lateral ankle instability has advantages of less trauma, less complications safe and reliable, and good recovery of ankle joint function.
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Female , Male , Humans , Young Adult , Adult , Ankle Joint/surgery , Ankle , Arthroscopy , Lateral Ligament, Ankle/surgery , Joint Instability/surgeryABSTRACT
ObjectiveTo compare the retest reliability and discriminant validity of dynamic postural stability indices for functional ankle instability (FAI) obtained by different algorithms based on acceleration signals at different positions of human body. MethodsFrom April to June, 2021, 21 subjects with unilateral FAI and 21 subjects with normal ankle were recruited. Three inertial sensors were attached to the waist points, knee and ankle positions. The ground reaction force (GRF) and kinematics data of the subjects in multi-direction single leg landing test were collected synchronously by 3D force plate and inertial sensors. The unbounded third order polynomial (UTOP) fitting method was used to calculate the stability time, and the root mean square was used to caculate the stability index. ResultsMost of the indicators calculated based on acceleration signal correlated with that based on GRF with low coefficient (|r| = 0.116 to 0.368, P < 0.05). The stability time and stability index based on the acceleration signals of different positions of human body showed low to high retest reliability (CMC 0.30 to 0.91). For the females, among the stability time based on acceleration signal, eleven indexes achieved average to very high discriminant validity (AUC = 0.702 to 0.942, P < 0.05); eight of the stability indexes reached general level of discriminant validity (AUC = 0.717 to 0.782, P < 0.05). No algorithms achieved good discriminant effect in male subjects. ConclusionBased on the acceleration signal of waist point in single-leg landing stability test, the stability time calculated by UTOP algorithm can evaluate the dynamic postural stability of female FAI patients with high discriminant validity and medium to high retest reliability.
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ObjectiveTo observe the effect of proprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation on chronic ankle instability (CAI). MethodsFrom April, 2016 to December, 2021, 48 patients with CAI were randomly divided into control group (n = 24) and observation group (n = 24). Both groups accepted routine rehabilitation, and the observation group accepted proprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation additionally, for eight weeks. They were assessed with Visual Analogue Scale (VAS), peak torque to body weight of ankle dorsiflexors and plantarflexors (AD/W, AP/W), Y Balance Test (YBT) and Foot and Ankle Disability Index (FADI) before and after treatment. ResultsAfter treatment, VAS score, AD/W, AP/W, YBT and FADI improved in the observation group (|t| > 2.208, P < 0.05), while VAS score and AP/W improved in the control group (|t| > 2.156, P < 0.05); and all the VAS score, AD/W, AP/W, YBT and FADI were better in the observation group than in the control group (|t| > 2.067, P < 0.05). ConclusionProprioceptive neuromuscular facilitation combined with neuromuscular electrical stimulation can effectively relieve the pain of patients with CAI, and increase the muscle strength around the ankle, to improve the stability and balance.
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Objective:To observe the effect of taping on the kinematic characteristics of the ankle joint during forward and lateral jumps by male basketball players with chronic ankle instability (CAI).Methods:A Vicon 3D motion capture system and a Kistler 3D ergometer were used to collect data describing the landing data with or without taping from forward and lateral jumps of 29 male basketball players with CAI. The landing data included the dorsiflexion and plantarflexion angles, valgus and inversion angles and external and internal rotation angles. Dorsiflexion or plantarflexion angular velocity was also recorded along with valgus or inversion angular velocity and external or internal rotation angular velocity 200ms, 150ms, 100ms and 50ms before and after touchdown. The data obtained were modeled using three-dimensional motion analysis software, and then analyzed.Results:Taping reduced the ankle plantarflexion in landing from a forward jump by 3.27° 50ms before landing and by 2.70° at touchdown. The ankle inversion angle was reduced 2.13° 50ms before touchdown, while the angle of external rotation decreased by 2.59° 200ms before touchdown and 2.17° 150ms before. Moreover, the angle of external rotation 100ms after landing was reduced by a significant 1.59° compared with that without taping. In lateral jumps taping reduced the average ankle plantarflexion angle by 1.94° 50ms before landing and 3.23° at touchdown compared with no taping. Ankle inversion was reduced significantly by 2.86° 50ms before landing and by 2.87° at touchdown. External rotation was a significant 0.93° less 200ms before landing and 2.36° smaller 150ms before touchdown. In the forward jump landing, taping reduced the average angular velocity of ankle dorsiflexion on landing by a significant 58.5°/s and by 28.39°/s 100ms later. In the lateral jump landings the average ankle dorsiflexion velocity decreased by significant 20.5°/s with taping, but the valgus velocity increased by 49.7°/s compared with no taping. However, 50ms after touchdown the speed of external rotation with taping was 30.3°/s slower than without taping.Conclusions:Ankle taping can modify ankle rotation angles and angular velocities during landing from jumps. This is particularly helpful for basketball players with CAI.
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Objective:To evaluate the clinical effects of anatomical reconstruction of the deltoid ligament and medial migration calcaneal osteotomy in the treatment of chronic ankle instability after trauma.Methods:A retrospective study was conducted to analyze of the clinical data of 16 patients with chronic post-traumatic instability of the medial malleolus who had been treated at The Eighth Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine from December 2015 to February 2017. There were 14 males and 2 females with an age of (28.1±4.2) years. Seven left sides and 9 right sides were affected; the time from injury to operation was (8.9±2.4) months. Before operation, X-rays (anteroposterior, lateral and Saltzman views) and MRI of weight-bearing ankle were taken. All patients were treated by anatomical reconstruction of the deltoid ligament using the autologous semitendinosus and medial migration osteotomy of the calcaneus. The time for injury healing and occurrence of complications were recorded. The talus tilt angle, Meary angle, hindfoot valgus angle, visual analogue scale (VAS), and the American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot function score were compared between the preoperation and the last follow-up. The Sefton evaluation for efficacy in ankle ligament reconstruction was used to assess stability of the ankle joint.Results:Of this cohort, 14 patients were followed up for (16.4±4.9) months after operation and 2 patients lost to follow-up. The 14 patients all returned to normal physical activities 3 months after operation. All incisions healed at the first stage with no infection. One patient experienced pain at the site for harvest of the semitendinosus but the symptoms were relieved after rehabilitation treatment like massage and physical therapy. At the last follow-up, the talus tilt angle [1.0 (0.0, 2.0)°], Meary angle (1.4°±4.2°), hindfoot valgus angle (3.2°±2.4°), VAS score [0.5 (0.0, 1.0) points], and AOFAS ankle-hindfoot score [(89.2±6.1) points] were all significantly improved compared with the preoperative values [8.3°±1.8°, 0.8°±3.8°, 9.9°±3.4°, (5.7±2.5) points, and (49.6±9.8) points] (all P<0.05). According to the Sefton evaluation, the stability of the ankle joint was excellent in 9 cases, good in 4 cases, and fair in 1 case. Conclusion:In the treatment of chronic ankle instability after trauma, anatomical reconstruction of the deltoid ligament and medial migration calcaneal osteotomy is safe and effective, resulting in limited complications.
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ObjectiveTo investigate the effects of whole body vibration training on postural stability in patients with chronic ankle instability (CAI) using meta-analysis. MethodsRandomized controlled trials about whole body vibration training on patients with CAI in relation to postural stability were retrieved from PubMed, Cochrane Library, Web of Science, Physiotherapy Evidence Database (PEDro) scale, CNKI and WanFang data from inception to November, 2022. Reference lists of included studies were also traced to supplement the relevant literature. Two researchers independently searched the literature, and extracted relevant data. The PEDro scale was used to assess the quality, and the Cochrane Handbook was used to assess the risk of bias. The meta-analysis was conducted using Review Manager 5.3. And Stata 15.0 was used to conduct the Egger's test to assess publication bias. ResultsTwelve randomized controlled trials involving 440 individuals were included. Compared with the other exercises or no exercise, whole body vibration training could improve the center of pressure-area (MD = -0.70, 95% CI -0.97 to -0.43, P < 0.001) and the Star Excursion Balance Test in the direction of anterior (MD = 6.16, 95% CI 3.88 to 8.44, P < 0.001), posteromedial (MD = 6.22, 95% CI 3.68 to 8.76, P < 0.001), posterolateral (MD = 6.68, 95% CI 4.28 to 9.08, P < 0.001), anteromedial (MD = 8.78, 95% CI 6.71 to 10.85, P < 0.001), medial (MD = 4.16, 95% CI 1.46 to 6.86, P = 0.002), posterior (MD = 6.69, 95% CI 3.81 to 9.58, P < 0.001), lateral (MD =12.37, 95% CI 8.09 to 16.65, P < 0.001) and anterolateral (MD = 5.29, 95% CI 1.44 to 9.13, P = 0.007). However, there was no significant difference in the overall stability index (MD = 0.02, 95% CI -0.05 to 0.09, P = 0.643) and hop-test (MD = 6.24, 95% CI -8.80 to 21.28, P = 0.416) between whole body vibration training and other exercises or no exercise. ConclusionWhole body vibration training can improve the range of all directions of the Star Excursion Balance Test in individuals with CAI. However, more studies are needed to determine the improvement of center of pressure-area.
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Objective:To document the clinical efficacy of using electrical stimulation to guide acupuncture on the peroneal longus and the peroneal brevis of patients with functional ankle instability (FAI).Methods:Seventy FAI patients were randomly divided into an observation group and a control group, each of 35. Both groups received routine balance function training, proprioception training and manual activation of the peroneal muscles. The observation group also received acupuncture at the motor points of the peroneal longus and the peroneal brevis muscles under the guidance of electrical stimulation, once a day, for 3 weeks. Before and after the treatment, any curative effect was quantified using the CAIT ankle instability assessment questionnaire, electromyography (iEMG) of the peroneal longus and the peroneal brevis, as well as those muscles′ excitation times during simulated varus walking.Results:All of the measurements after the treatment were significantly better than before the treatment, with the improvements in the observation group significantly greater than in the control group.Conclusions:Acupuncture at the motor points of the peroneal longus and the peroneal brevis under the guidance of electrical stimulation can effectively activate the related muscles and relieve the symptoms of functional ankle instability.
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Objective:To investigate the immediate and short-term effects of virtual games on balance function in patients with functional ankle instability(FAI).Methods:Fifty-six FAI subjects from North China University of Science and Technology from September 2020 to December 2020 were selected by cruamberland ankle instability tool(CAIT). According to the computer random number method,the 56 subjects were randomly divided into the control group and the observation group with 28 subjects in each group,and the prospective cohort study method was used for this study. Control group accepted routine balance training,observation group based in the control group carries on the virtual game training. Before and immediately after intervention and 4 weeks after intervention,the static balance ability of subjects in the two groups was evaluated and compared by Tecnobody balance instrument,and the dynamic balance ability of subjects in the two groups was evaluated and compared by star excursion balance test(SEBT),and the CAIT score of subjects in the two groups was recorded and compared. The measurement data conforming to normal is expressed in xˉ ± s means independent sample t-test or paired t-test. χ2 test was used for counting data. Results:Immediately after intervention,the 8 directions of SEBT scores in the observation group are significantly improved compared with those before intervention: Anterior(69.06±7.57)% and (63.69±8.05)%, Anterolateral (61.14±6.68)% and (55.77±7.39)%, Lateral (67.71±7.99)% and (62.93±7.56)%, Posterolateral (76.43±6.98)% and (71.31±7.86)%, Posterior (75.45±6.78)% and (68.72±6.65)%, Posteromedial (79.13±8.09)% and (72.72±9.03)%, Medial(72.67±7.43)% and (65.67±8.16)%, Anteromedial (67.75±8.30)% and (63.18±8.95)% ( t values were 8.03, 11.88, 9.72, 6.43, 19.53, 9.36, 11.06 and 6.46, respectively; all P<0.001), and the observation group was significantly better than the control group (63.24±6.72)%, (55.41±7.74)%, (61.49±8.37)%, (70.02±6.81)%, (69.06±9.46)%, (72.41±7.20)%, (66.37±6.57)% and (62.15±6.89)%. There were significant differences between the two groups ( t values were 3.04, 2.97, 2.84, 3.47, 2.90, 3.28, 3.36 and 2.75, respectively; P values were 0.004, 0.004, 0.006, 0.001, 0.005, 0.002, 0.001 and 0.008,respectively). After 4 weeks of intervention,the static balance parameters in the observation group were significantly reduced compared with before intervention under the condition of opened eyes and closed eyes (open eyes: average AP speed of COP (24.68±6.85) mm/s and (27.57±7.15) mm/s,average ML speed of COP (26.25±6.20) mm/s and (30.61±6.99) mm/s, ellipse area of COP (915.75±356.08) mm and (1 286.54±530.05) mm, perimeter of COP (823.82±173.80) mm and (1 142.89±297.03) mm ( t values were 4.02, 3.09, 4.89 and 6.74, respectively; all P<0.001); closed eyes:average AP speed of COP (66.82±15.02) mm/s and (73.71±11.12) mm/s, average ML speed of COP (76.93±13.36) mm/s and (84.39±10.05) mm/s, ellipse area of COP (3 318.54±958.75) mm and (4 174.21±1 310.54) mm, perimeter of COP (2 156.96±665.80) mm and (2 817.75±528.22) mm ( t values were 3.23,3.29,4.95,5.02, respectively; P values were 0.003, 0.003,<0.001,<0.001,respectively). Average ML speed of COP (open eyes:(26.25±6.20) mm/s), ellipse area of COP (open eyes: (915.75±356.08) mm;closed eyes: (3 318.54±958.75) mm and perimeter of COP (open eyes: (823.82±173.80) mm; closed eyes: (2 156.96±665.80) mm) in the observation group were lower than those of the control group(30.68±9.81) mm/s, (1 137.25±423.27) mm, (3 973.36±1 306.61) mm, (1 038.79±242.90) mm, (2 603.43±703.81) mm, the differences were statistically significant ( t values were 2.02,2.12,2.14,3.81,2.44,respectively; P values were 0.049,0.039,0.037, <0.001,=0.018, respectively). After 4 weeks of intervention,the 8 directions of SEBT scores in both groups were significantly improved compared with those before intervention (Anterior:observation group (72.84±6.76)% and (63.69±8.05)%,control group (69.05±6.16)% and (62.96±6.56)%. Anterolateral:observation group (65.24±7.68)% and (55.77±7.39)%,control group (60.65±8.11)% and (54.65±8.98)%. Lateral: observation group(73.97±8.80)% and (62.93±7.56)%, control group (68.34±9.14)% and (61.24±9.42)%. Posterolateral: observation group (81.68±6.69)% and (71.31±7.86)%, control group (76.39±6.78)% and (69.74±8.11)%. Posterior: observation group (81.41±7.86)% and (68.72±6.65)%, control group (75.21±8.48)% and (68.45±9.96)%. Posteromedial: observation group (82.77±8.69)% and (72.72±9.03)%,control group (78.38±6.84)% and (72.36±7.34)%. Medial:observation group (77.47±7.85)% and(65.67±8.16)%, control group (72.66±6.93)% and (65.95±7.09)%. Anteromedial:observation group(73.33±8.91)% and (63.18±8.95)%, control group (68.35±6.53)% and (61.66±6.80)% ( t values were 14.19, 10.17, 12.71, 12.35, 12.32, 8.99, 11.38, 6.95, 12.66, 7.94, 9.54, 11.53, 11.89, 12.87, 11.69 and 12.53, respectively; all P<0.001)), and the observation group was significantly better than the control group,the differences were statistically significant ( t values were 2.19, 2.18, 2.35, 2.94, 2.84, 2.10, 2.43 and 2.38, respectively; P values were 0.033, 0.034, 0.023, 0.005, 0.006, 0.040, 0.018 and 0.021, respectively). After 4 weeks of intervention,the CAIT score of subjects in both groups was significantly improved compared with before intervention (observation group (18.89±3.62) points and (14.93±4.09) points,control group (16.96±3.18) points and (15.25±3.81) points ( t values were 10.54 and 5.65; all P<0.001), and The CAIT score in observation group was higher than that in control group,the differences were statistically significant ( t=2.12, P=0.039). Conclusion:Virtual games could immediately improve the dynamic balance ability of FAI patients,which combined with conventional balance training intervention for 4 weeks significantly also improved the balance ability and ankle joint stability of FAI patients.
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Objective:To observe the intervention effect of neuromuscular joint facilitation (NJF)in patients with functional ankle instability (FAI).Methods:Fifty-three FAI subjects from North China University of Science and Technology from October 2020 to January 2021 were selected by cruamberland ankle instability tool (CAIT). According to the computer random number method, the 53 subjects were randomly divided into the control group (27 cases) and NJF group (26 cases). The control group received routine rehabilitation training, while the NJF group received NJF manipulation intervention on the basis of routine rehabilitation training. Before intervention and 8 weeks after intervention,ankle joint isokinetic muscle strength (invertor\evertor relative reak tergue) and the ratio of invertor to evertor of subjects in the two groups was evaluated and compared by Biodex isokinetic test training system, and the static balance ability of subjects in the two groups was evaluated and compared by Tecnobody balance instrument,and the dynamic balance ability of subjects in the two groups was evaluated and compared by star excursion balance test (SEBT), and the two groups were recorded and compared using the CAIT. A prospective cohort study was used. The measurement data of normal distribution are expressed by ± s. The mean between the two groups is compared by independent sample t-test, and the comparison before and after Intervention in the group is compared by paired t-test; The counting data were expressed in cases (%), and the comparison between groups was adopted χ 2 inspection. Results:After intervention, the NJF group at 60°/s angular velocity: invertor relative reak tergue (30.28±5.17) 0%, evertor relative reak tergue (28.93±5.15)%, the ratio of invertor to evertor (1.05±0.08) and 180°/s angular velocity: invertor relative reak tergue (27.17±5.24)%, evertor relative reak tergue (24.62±3.57)%, the ratio of invertor to evertor (1.10±0.12) were better than control group (27.05±5.95)%, (23.90±3.81)%, (1.13±0.15) and (24.12±5.36)%, (20.35±3.74)%, (1.19±0.18), and the differences were statistically significant ( t value were 2.11, 4.06, 2.35, 2.09, 4.25, 2.10, respectively; P value were 0.040, <0.001, 0.024, 0.042, <0.001, 0.040, respectively). After intervention, average AP speed of COP in the NJF group (open eyes: (23.19±5.25) mm/s; closed eyes: (65.65±10.51) mm/s), average ML speed of COP (open eyes: (23.73±4.73) mm/s; closed eyes: (72.08±10.28) mm/s), ellipse area of COP (open eyes: (913.77±348.90) mm 2; closed eyes: (3 271.65±1 024.48) mm 2) and perimeter of COP (open eyes: (845.04±146.68) mm; closed eyes: (2 055.42±548.89) mm) were lower than those of the control group (26.41±4.89) mm/s, (71.52±9.85) mm/s, (27.56±7.68) mm/s, (78.67±11.74) mm/s, (1 174.33±424.20) mm 2, (3 989.41±1 410.00) mm 2, (1 041.93±291.28) mm, (2 490.93±541.94) mm, the differences were statistically significant ( t value were 2.31, 2.10, 2.17, 2.17, 2.44, 2.11, 3.13, 2.97, respectively; P value were 0.025, 0.041, 0.034, 0.035, 0.018, 0.040, 0.003, 0.005, respectively). After intervention,the 8 directions of SEBT scores in the NJF group:Anterior (73.16±6.04)%, Anterolateral (65.90±5.54)%, Lateral (74.36±7.77)%, Posterolateral (88.05±6.76)%, Posterior (83.31±6.64)%, Posteromedial (86.01±7.62)%, Medial (77.39±8.44)% and Anteromedial (72.36±6.74)% were all higher than the control group (67.65±6.03)%, (61.08±5.96)%, (67.72±8.28)%, (78.33±8.06)%, (76.22±8.71)%, (79.31±7.24)%, (71.36±7.00)%, and (67.12±7.21)%,the differences were statistically significant ( t value were 3.32, 3.05, 3.01, 4.75, 3.33, 3.28, 2.83, 2.73, respectively; P value were 0.002 ,0.004, 0.004, <0.001, 0.002, 0.002, 0.007, 0.009, respectively). After intervention, the CAIT score of NJF group (23.04±3.96) points was higher than that of control group (19.15±3.56) points, and the difference was statistically significant ( t=3.76, P<0.001). Conclusion:NJF can significantly improve the internal and external muscle strength of the ankle joint and enhance the coordination of the internal and external muscle group, and effectively improve the static and dynamic balance ability of FAI patients.
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ObjectiveTo investigate the immediate effect of wearing a soft ankle brace on dynamic and static balance function and biomechanics of affected lower limbs during walking in chronic ankle instability (CAI) patients. MethodsFrom January to August, 2021, 40 CAI patients from Musculoskeletal Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University were measured dynamic and static balance indexes with Zebris FDM-System and Y balance test, before and after wearing a soft ankle brace; while the kinetics indexes and surface electromyography of the affected lower extremities during walking were collected with Zebris FDM-System and a surface electromyography telemeter simultaneously. ResultsThe velocity and area of center of pressure reduced in both open and closed eye modes (|t| > 2.876, P < 0.01), the Y-balance scores increased in all the directions (|t| > 21.212, P < 0.001) after wearing brace; while the peak pressures and impulses increased in the midfoot and medial forefoot regions (|t| > 2.057, P < 0.05), and decreased in the lateral heel, lateral forefoot and toe regions (|t| > 2.464, P < 0.05), and the root mean square of surface electromyography increased in the tibialis anterior and lateral gastrocnemius (|t| > 2.159, P < 0.05) during walking. ConclusionWearing soft brace can immediately improve dynamic and static balance of CAI patients, and optimize plantar kinetic distribution and enhance activation of the anterior tibial and the lateral head of gastrocnemius of the affected limb during walking, to improve motor control of CAI patients.
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ObjectiveTo compare the effects of proprioceptive neuromuscular facilitation (PNF) and whole body vibration training (WBVT) on functional ankle instability (FAI). MethodsFrom May to July, 2021, 17 male FAI undergraduates from Beijing Sport University received PNF (n = 8) and WBVT (n = 9), for six weeks. They were assessed with Y-balance test, Pro-Kin, Kistler and Motion Analysis Raptor before and after invention, to observe Y-balance score, average trajectory error, kinematics and dynamics after jump-landing of affected limb. ResultsThe main effect of training was not significant for all the Y-balance score, average trajectory error, kinematics and dynamics (F < 4.090, P > 0.05). However, the interactive effect of training and time was significant for the range of motion of ankle flexion (F = 6.232, P = 0.030), and the effect size was more for PNF; it was also significant for the time arriving peak ground reaction force (left-right) after landing (F = 10.674, P = 0.008), and the time was latter for WBVT (P < 0.05). ConclusionPNF and WBVT are similarly effective on FAI.
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Objective To explore the effect of intensive hip adductor isometric strength training on the balance ability of functional ankle joint instability. Methods From November, 2019 to January, 2020, 18 college students with functional ankle instability were recruited from a university in Shenzhen and randomly divided into control group (n = 9) and experimental group (n = 9). Both groups received ankle stability training, and the experimental group received isometric muscle strength training of hip adductor in addition, one hour a time, three times a week, for four weeks. The Cumberland Ankle Instability Assessment Questionnaire (CAIT), Y Balance Test (YBT), Balance-check balance equipment and Back-check hip adductor maximum isometric strength test were performed before and after training. Results After training, the scores of CAIT, YBT and balance-check increased in both groups (t > 2.540, P < 0.05); the strength of adductor hip muscle significantly increased in the experimental group (t = 8.485, P < 0.001). The d-value of CAIT score, YBT distance, the score of Balance-check, and the strength of adductor hip muscle were more in the experimental group than in the control group (t > 2.168, P < 0.05); the d-value of the average rotation speed, the maximum rotation speed and the balance level were less in the experimental group than in the control group (t > 2.804, P < 0.05). Conclusion Hip adductor isometric muscle strength training may promote the recovery of the balance after functional ankle instability.
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@#Objective To identify the effectiveness of physical therapy on neuromuscular control dysfunction of chronic ankle instability (CAI). Methods CAI physiotherapy-related systematic reviews, meta-analysis, randomized controlled studies and case-controlled studies were systematically searched in PubMed, Web of Science, Cochrane, PEDro, EBSCO and CNKI from October 1st, 2010 to October 1st, 2020. After quality assessment, the research evidence regarding certain intervention was then graded according to the Oxford Center for Evidence-based Medicine. Results A total of 20 articles were included. Intervention based on unstable plane exercise training could significantly improve lower limb balance control ability (Ⅰ A) and muscle strength (Ⅱ A) for CAI patients. The efficiency of exercise-based intervention could be further raised (Ⅱ C) with the aid of external equipment, but either the benefits in muscle reaction (Ⅲ C) or proprioception (Ⅱ D) was limited. Six sessions or more of manual therapy could be used to enhance the balance ability of the lower limbs (Ⅱ B), while taping failed to provide improvements in ankle proprioception in short period or immediately (Ⅰ A). Conclusion Unstable plane training-based therapeutic exercise and manual therapy could effectively enhance the neuromuscular control with high-quality evidence supporting, which can be primary interventions for CAI patients. Meanwhile, taping and other external devices could be used as adjunct methods to improve the efficiency of physiotherapy program, while there is currently no evidence to support the application of modality treatment in neuromuscular control of CAI.
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OBJECTIVE@#To explore clinical effects of single-tunnel pullout structure fixation and anatomical reconstruction of lateral ligament complex in treating chronic lateral ankle instability.@*METHODS@#From January 2016 to December 2018, clinical data of 23 patients with chronic lateral malleolus instability who underwent anatomical reconstruction of lateral malleolus ligament complex with single-tunnel pullout structure fixation, were retrospectively studied. Among them, including 7 males and 16 females, aged from 17 to 33 years old with an avergae of (26.0±4.3) years old;16 patients classified to grage 0, and 7 patients classified to gradeⅠaccording to Kellgren-Lawrence(K-L) grading;the time of sprain ranged form 2 to 15 with an average of (5.7±2.9) times;the time from injury to operation ranged to 4 to 18 months with an average of (9.0±3.3) months. The range of movement of operative and uninjured ankle joints were measured at 24 months after opertaion, visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) were used to evaluate ankle joint function and improvement of pain, K-L grading and MRI scoring of osteoarthritis of ankle (MSOA) were used to evaluate degree of cartilage degeneration of ankle joint.@*RESULTS@#All patients were followed up from 24 to 48 months with an average of (33.4±6.7) months. All the anterior talofibular ligaments and calcaneofibular ligaments were dissected and reconstructed by single-tunnel pullout structure fixation. The range of motion of dorsiflexion, plantarflexion, varus, and valgus on the operative side of ankle joint were smaller than those on the healthy side. There were no statistically differences in dorsiflexion and eversion between operative side and healthy side of ankle joint (@*CONCLUSION@#Treatment of chronic lateral ankle instability with reconstruction of lateral ligament complex with single-tunnel pullout structure fixation could provide better tendon and bone healing conditions, improve surgical safety and could achieve satisfactory clinical outcomes.
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Aged , Female , Humans , Infant , Male , Ankle , Ankle Joint/surgery , Joint Instability/surgery , Lateral Ligament, Ankle/surgery , Retrospective StudiesABSTRACT
Objective:To investigate the effect of strength training of hip muscles on functional ankle instability (FAI), and be evaluated with surface electromyography (sEMG). Methods:From January, 2019 to June, 2020, 60 FAI patients were recruited in Qingdao Municipal Hospital. They were divided into control group (n = 30) and observation group (n = 30) randomly. The control group received conventional therapy, including ankle joint mobilization training, strength training and balance training for six weeks, while the observation group received strength training of hip muscles in addition. Cumberland Ankle Instability Tool (CAIT), Star Excursion Balance Test (SEBT) and sEMG were used to assess the function before and after intervention, and integrated electromyography (iEMG) was measured with sEMG. The correlation of CAIT and SEBT to iEMG was analyzed with Pearson coefficient. Results:No one dropped out. Before intervention, there was no significant difference between CAIT, SEBT and iEMG between two groups (P > 0.05). CAIT and SEBT improved significantly in both groups (t > 3.657, P < 0.001) after six-week intervention; the iEMG increased significantly in the observation group (t > 22.038, P < 0.001), while no significance was found in the control group (t < 1.916, P > 0.05); all the indexes were better in the observation group than in the control group (t > 2.125, P < 0.05). iEMG of gluteus medius and gluteus maximum correlated to CAIT and SEBT in the observation group (r = 0.712 to 0.866, P < 0.05). Conclusion:The strength training of the hip muscles could improve the ankle function of FAI patients. iEMG of gluteus medius and gluteus maximum could be a valid measure to assess the effect of strength training on FAI.
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@#Introduction: This study was designed to produce a validated and reliable Malay version of the Identification of Functional Ankle Instability (IdFAI-M) questionnaire. Materials and method: The cross-cultural adaptation was conducted based on standard guidelines to produce the Malay version of the Identification of Functional Ankle Instability (IdFAI-M) questionnaire. The reliability and validity testing were then performed among one hundred and twenty-three physically active University of Malaya students. Among them, twenty-two students also participated in the second return of the questionnaire over a two-week interval, which was then evaluated for test-retest reliability testing. Results: The content validity for item-level (I-CVI) and Kappa values for all items were more than 0.7, respectively and the all scales-level (S-CVI) values were 0.983 (consistency), 0.967 (representativeness), 1.00 (relevance) and 0.983 (clarity). The questionnaire also demonstrated excellent reliability with an intraclass correlation coefficient (ICC2.1) above 0.850 for all items. It was observed that outer loading of most items were more than the minimum acceptable value (0.7). Fornell-Larcker criterion demonstrate all values for each reflective construct was larger than the correlations with other constructs, indicating discriminant. The cross-loading values of each item has shown a weak correlation with all other constructs, except for the one to which it was theoretically associated. Conclusions: The Malay version of the IdFAI (IdFAI-M) is a reliable and valid instrument that can be readily utilised to subjectively assess ankle instability.
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Objective To study the effect of vibration training with adjusted frequency on changes in explosive force of lower limbs, balance and muscle function around ankle joints of patients with functional ankle instability (FAI), so as to provide an empirical basis for rehabilitation training of FAI patients in clinic. Methods Twenty-six FAI patients were randomly divided into the experimental group (n=14) and the control group (n=12). The experimental group received 8-week rehabilitation training with vibration intervention, while the control group only received 8-week rehabilitation training. Changes in maximum power, average power, maximum speed and average speed of the injured limb during vertical jump with single leg, changes in distances during long jump, changes in time during one-leg standing with eyes open and closed，changes in contract time (tc), relax time (tr) and displacement (Dm) of medial gastrocnemius (GM), lateral gastrocnemius (GL) and tibialis anterior (TA) muscles before and after training were measured and compared. Results In the experimental group, the maximum power and maximum speed of the injured limb during vertical jump with single leg, the distance during long jump with single leg and the time during one-leg standing with open and closed eyes were significantly improved, and the increase was higher than that of the control group. The increase of tc of all muscles in the experimental group was smaller than that of the control group, but tr and Dm did not show any regularity. Conclusions Vibration training with adjusted frequency can effectively improve the explosive force and balance ability of lower limbs of FAI patients, and promote the tc shortening of GL, GM and TA muscles, but whether vibration training with adjusted frequency can reduce muscle tension and promote muscle relaxation is still not clear.
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Objective: To assess the effectiveness of lateral ligament reconstruction with autogenous partial peroneus longus tendon for chronic lateral ankle instability. Methods: Between September 2014 and November 2018, 32 patients (32 sides) with chronic lateral ankle instability were treated with lateral ankle ligament reconstruction by using autogenous anterior half of the peroneus longus tendon. There were 25 males and 7 females, with an average age of 28.5 years (range, 20-51 years). The disease duration was 6-41 months (mean, 8.9 months). The preoperative Karlsson-Peterson ankle score was 53.7±9.7. The talar tilt angle was (14.9±3.7)°, and the anterior talar translation was (8.2±2.8) mm. Six patients combined with osteochondral lesion of talus and 4 patients combined with bony impingement. Results: All incisions healed by first intention postoperatively. All patients were followed up 12-53 months (mean, 22.7 months). At last follow-up, the Karlsson-Peterson ankle score was 85.2±9.6; the talar tilt angle was (4.3±1.4)°; the anterior talar translation was (3.5±1.1) mm. There were significant differences in all indexes between pre- and post-operation ( P<0.05). Seventeen patients were very satisfied with the results, 10 patients were satisfied, 4 patients were normal, and 1 patient was unsatisfied. After operation, the ankle sprain occurred in 7 cases, the tenderness around the compression screws at calcaneus in 5 cases, the anterolateral pain of ankle joint over 6 months in 4 cases. No patient had discomfort around the reciepient sites. At last follow-up, the ultrasonography examination showed that there was no significant difference in the density and diameter between bilateral peroneus longus tendons in 12 cases. Conclusion: For chronic lateral ankle instability, the lateral ankle ligament reconstruction with the autogenous partial peroneus longus tendon is a safe and effective surgical option.