Is ankle taping effective to limit the ankle dorsiflexion in a single-training session? An observational study in semi-professional basketball players

ABSTRACT BACKGROUND: Ankle taping (AT) is effective in preventing ankle sprain injuries in most common sports and is employed in rehabilitation and prevention sports. OBJECTIVE: This study aimed to investigate the effectiveness of AT to restricting excessive frontal plane ankle movements in semi-professional basketball players throughout the training session. DESIGN AND SETTING: A cross-sectional study was performed at the Universidad Europea de Madrid. METHODS: Forty male and female semi-professional basketball players were divided into two groups. The ankle dorsiflexion range of motion (ROM) and interlimb asymmetries in a weight-bearing lunge position were evaluated at four time points: 1) with no tape, 2) before practice, at 30 min of practice, and 3) immediately after practice. RESULTS: In male basketball players, no differences were observed in the right and left ankles between the baseline and 30 min and between baseline and 90 min of assessment. In female athletes, significant differences were reported between baseline and pre-training assessments for the right ankle and also significant differences between baseline and 90 min in both ankles. CONCLUSIONS: Ankle taping effectively decreased the ankle dorsiflexion ROM in male and female basketball players immediately after application. However, ROM restriction was very low after 30 and 90 min, as assessed in a single basketball practice. Therefore, the classic taping method should be revised to develop new prophylactic approaches, such as the implementation of semi-rigid bracing techniques or the addition of active stripes during training or game pauses.

Exploring physical and functional factors associated with lateral ankle sprains in junior high school basketball players / 体力科学

Lateral ankle sprain (LAS) is one of the most common sport-related injuries among basketball players. Most basketball players experience a first LAS particularly in junior high school. Thus, it is crucial to develop effective prevention strategies for LAS in junior high school populations. However, the characteristics for first-time LAS are not clear. This study aimed to compare the physical and functional characteristics of junior high school basketball players with and without a history of LAS. Two hundred and thirty-eight junior high school basketball players (128 boys and 110 girls) volunteered for this study. We asked participants to complete a self-reported injury history questionnaire. We also assessed physical functions, including range of motion, muscular strength, dynamic balance, and performance. The prevalence of LAS was 75.6% (boys: 73.4%, girls: 78.2%). Boys with a history of LAS had significantly higher height, body mass, and BMI compared to those without a history of LAS (p<0.05). Girls with a history of LAS had significantly lower scores on the star excursion balance test in the anterior reaching direction compared with the control group (p=0.015). Various measures of physical function were associated with LAS, but these associations were different between boys’ and girls’ basketball players. These findings from this study indicate that clinicians should identify sex-specific impairments associated with LAS when designing targeted intervention programs.

Cross-sectional study on ankle sprain and its related factors in physical education college / 中国骨伤

OBJECTIVE@#To explore prevalence, risk factors and treatment of ankle sprain of young college student , in order to obtain accurate epidemiological data.@*METHODS@#From March 2019 to May 2019, 552 college students(1 104 sides of anke joints) from Xi'an Physical Education university were enrolled in study according to inclusion and excludion standard, including 309 males and 243 females aged from 16 to 24 years old with an average of (20.9±3.7) years old. Age, gender, and body mass indes(BMI) etc were recorded. Morbidity of acute and chronic ankle sprains of physical students, treatment after the first sprain (cold compress, cast or plaster bracing and medicine), visual analogue scale (VAS) during walking were assessed through ankle sprain questionnaire;Cumberland ankle instability tool (CAIT), Maryland foot score were applied to assess ankle function. Lateral ankle ligament injury was objectively assessed by musculoskeletal ultrasonography.@*RESULTS@#The prevalence of acute ankle sprain(AAS) was 96.20% (531/552), and the incidence of AAS was 59.96% (622/1 104). The prevalence of chronic ankle joint instability(CAI) was 16.85% (93/552), and the incidence of CAI was 8.97% (99/1 104). In the four categories of sports, college student suffered from multiple sprains in performance majors group was 22.20% (14/63), including of aerobicsand dance performance. The incidence of AAS of ball sports was 8.60%(14/163). After the first sprain, most college students(94.4%) were received cold compression, about 60% of them went to hospital;however, only 44.7% students were received standard treatmens(cast or plaster), only 35.3% of them were received hard ankle orthosis. In 552 college students, 44 students were suffered from more than 4 times of ankle sprain, and the total incidence was 7.97% (44/552). Cumberland score was 26.6±2.4, Cumberland score of students sprained ankle joint more than 4 times was (29.2±1.1), suggested it was a risk factor for ankle joint instability. VAS of students sprained ankle joint more than 4 times was higher than that of less than 4 times(P<0.05), Maryland foot score was significantly lower than that of that of <4 times(P<0.05). Musculoskeletal ultrasonography measured the thickness of anterior tibiofibular ligament(ATFL) was (2.41±0.41) mm, and the thickness of calcaneofibular ligament(CFL) was (1.92±0.21) mm, and had no statistical difference(P>0.05).@*CONCLUSION@#Ninty-four percent college students had at least once ankle sprain, ankle sprains were more common in erobics and ball sports. After the first sprain, the proportion of cast or plaster treatment was less than 50%. Sprained ankle joint more than 4 times is a risk factor, and musculoskeletal ultrasonography showed thickening of both ATFL and CFL, while no statstical difference.

Recovery of proprioception after lateral ankle sprain / 中国康复理论与实践

ObjectiveTo observe the recovery of proprioception of the affected ankle over time after lateral ankle sprain accepting routine rehabilitation. MethodsFrom June, 2020 to June, 2022, 18 patients with lateral ankle sprain in Kunshan Rehabilitation Hospital underwent routine rehabilitation for twelve weeks. They were measured active and passive position sense of bilateral ankles using an isokinetic dynamometer before treatment, and four, eight and twelve weeks after treatment, respectively. ResultsThe active presentation difference of affected ankle reduced after treatment (F = 22.533, P < 0.001), but it was more than that of the healthy ankle at the same time (t > 4.419, P < 0.001). No significant improvement was found in passive presentation difference of affected ankle after treatment (F = 1.175, P > 0.05), and it was not significantly different from those of the healthy ankle at the same time (|t| < 0.646, P > 0.05). ConclusionProprioception of affected ankle has been impaired after lateral ankle sprain, and it can be recovered after rehabilitation, but cannot achieve the healthy level even after three months of training. Passive position sense as an index of proprioception needs more researches.

Implementation of ottawa ankle rules in university hospital emergency room: pilot study / Implementação das regras de ottawa para tornozelo em pronto-socorro de hospital universitário: estudo piloto

ABSTRACT Ankle injuries are the most common musculoskeletal injuries in emergency rooms and are associated with a great social and economic impact. The need to request additional tests for ankle sprains is based on suspicion of fracture. The Ottawa Ankle Rules (OAR) establish criteria for ordering radiographs to avoid performing unnecessary examinations. Objective: To evaluate the implementation of the Ottawa Rules as a protocol for treating ankle sprains in the emergency department of a university hospital. Methods: This is a retrospective observational study, conducted over a period of three months before and three months after implementation of the protocol. Results: In the first phase, all patients complaining of ankle sprain underwent radiographs. In the second phase, after the application of the OAR, out of 85 patients evaluated, only 58 underwent complementary exams, showing a reduction of 31.8% in the request for imaging exams. There was no significant difference in fracture detection between the two groups (p=0.476). Conclusion: The OAR can be used as a tool in diagnosing ankle sprains, and their implementation reduced the request for imaging exams. Level of Evidence III, Retrospective Comparative Study.

RESUMO Os traumatismos de tornozelo são as lesões musculoesqueléticas mais comuns nas salas de emergência e estão associadas a um grande impacto social e econômico. A solicitação de exames complementares para a entorse de tornozelo baseia-se na suspeita de fratura. As Regras de Ottawa para Tornozelo (ROT) estabelecem critérios para a solicitação de radiografias com o intuito de evitar a realização de exames desnecessários. Objetivo: Avaliar a implementação das ROT como protocolo de atendimento das entorses de tornozelo no pronto-socorro de um hospital universitário. Métodos: Estudo observacional retrospectivo que visou comparar a solicitação de radiografias e a presença de fraturas três meses antes e três meses após a implantação do protocolo. Resultados: Na primeira fase, todos os pacientes com queixa de entorse de tornozelo realizaram radiografias. Na segunda fase, após aplicação das ROT, de 85 pacientes avaliados, apenas 58 realizaram exames complementares, apresentando uma redução de 31,8% na solicitação dos exames de imagem. Não houve diferença na detecção de fraturas entre os dois grupos (p=0,476). Conclusão: As ROT podem ser utilizadas como ferramenta no atendimento das entorses de tornozelo e sua implantação reduziu a solicitação de exames de imagem. Nível de Evidência III, Estudo Comparativo Retrospectivo.

Efectos de ejercicios especializados en la rehabilitación del esguince de tobillo grado 1 en futbolistas / Effects of specialized exercises in the rehabilitation of grade 1 ankle sprain in soccer players

Introducción: Las lesiones en los futbolistas provocan limitaciones en la movilidad osteomuscular, provocando un descanso pasivo, y por ende el no cumplimiento del principio de sistematicidad del entrenamiento; por lo cual, puede provocar abandono deportivo en casos extremos, y normalmente disminución del rendimiento. La recuperación mediante terapia requiere una valoración de su eficiencia, siendo necesario estudiar las acciones más efectivas desde el punto de vista terapéutico. Objetivo: Valorar los efectos de un proceso de intervención con ejercicios terapéuticos para la rehabilitación del esguince de tobillo grado 1 en futbolistas. Métodos: Investigación descriptiva/explicativa de orden cuasiexperimental y enfoque longitudinal (4 años de estudio), investigando a 43 futbolistas con una lesión previa en el tobillo por esguince grado 1 (Grupo 1: Experimental, Grupo 2: Control), interviniendo al grupo experimental con tres fases de tratamiento, que incluye un grupo de ejercicios físicos especializados para fortalecer y mantener las condiciones óptimas del musculo. Resultados: El grupo experimental requiere menos tiempo para recuperarse de una lesión por esguince (p ( 0,001), mientras que la reincidencia de la lesión fue menor que en el grupo control (p ( 0,019) en un periodo de cuatro años. Conclusiones: El proceso de intervención ha sido efectivo al lograse una mejor rehabilitación en la muestra experimental, en términos de prontitud en el proceso de recuperación, y en términos de disminución de las recaídas en un periodo de cuatro años. Una vez recuperado el deportista, se recomienda proseguir sistemáticamente con el proceso de fortalecimiento y prevención en las sesiones de entrenamiento, y en el hogar(AU)

Introduction: Injuries in soccer players cause limitations in musculoskeletal mobility, causing a passive rest, and therefore non-compliance with the principle of systematic training; Therefore, it can cause sports abandonment in extreme cases, and usually a decrease in performance. Recovery through therapy requires an assessment of its efficiency, and it is necessary to study the most effective actions from the therapeutic point of view. Objective: To assess the effects of an intervention process with therapeutic exercises for the rehabilitation of grade 1 ankle sprain in soccer players. Methods: Descriptive/explanatory research of quasi-experimental order and longitudinal approach (4 years of study), researching 43 soccer players with a previous ankle injury due to grade 1 sprain (Group 1: Experimental, Group 2: Control), intervening in the experimental group. with three phases of treatment, which includes a group of specialized physical exercises to strengthen and maintain optimal muscle conditions. Results: The experimental group required less time to recover from a sprain injury (p ( 0.001), while the recurrence of the injury was less than in the control group (p ( 0.019) in a period of four years. Conclusions: The intervention process has been effective in achieving better rehabilitation in the experimental sample, in terms of speed in the recovery process, and in terms of reducing relapses in a four years period. Once the athlete has recovered, it is recommended to systematically continue with the strengthening and prevention process in training sessions and at home(AU)

Quantitative Study on Kinematics of Ankle Rotating-Traction-Poking Manipulation for Treating Acute Lateral Ankle Sprain / 医用生物力学

Objective To quantify operation characteristics of the ankle rotating-traction-poking manipulation (RTPM) for treating acute lateral ankle sprain by using motion capture technology, so as to provide objective references for standardized operation of RTPM and its education inheritance. Methods A professional physiotherapist performed the RTPM on 60 volunteers with acute lateral ankle sprain. Motion capture system was used to acquire effective kinematic data during the RTPM, so as to make analysis and summarize rules. Results The average time of ankle rotating for six circles was 11.36 s and the average time of ankle traction and poking was 3.42 s. The average displacement of ankle traction was 36.94 mm and the average displacement of ankle poking was 22.44 mm. The average angle of ankle traction was 23.27°, and the average angle of ankle poking was 22.76°. During the RTPM for treating acute lateral ankle sprain, the average linear velocity of ankle rotating was 58.28 mm/s, and the average linear velocity of ankle traction and poking was 23.81 mm/s. The linear acceleration of ankle rotating was 0.43 mm/s2, and the linear acceleration of ankle traction and poking was 0.54 mm/s2. Conclusions The RTPM can be applied in clinical practice. During the RTMP, the principle of gentleness, rhythmicity and continuity should be followed. Under the premise of following physiological characteristics of ankle joint, treatment of the sprained ankle should be carried out with slow and uniform speed continuously.

Ankle and foot mechanics in individuals with chronic ankle instability during shod walking and barefoot walking: A cross-sectional study / 中华创伤杂志(英文版)

PURPOSE@#This study evaluated the angular kinematic and moment of the ankle and foot during shod walking and barefoot walking in individuals with unilateral chronic ankle instability (CAI).@*METHODS@#Recreational soccer players with unilateral CAI were recruited for this cross sectional study conducted between January and August 2019. A total of 40 participants were screened for eligibility but only 31 met the inclusion criteria based on the methods of Delahunt et al and Gribble et al. Except for 3 participants not attending the evaluation session, 28 participants were finally included. A three dimensional motion analysis system made up of ProReflex motion capture unit and an AMTIb Kistler force plate, embedded in the middle of nine meter walkway, were used to assess the ankle and foot angles and moment during shod walking and barefoot walking conditions. A Statistical Package for Social Sciences (version 20.0) was used to analyze data.@*RESULTS@#During shod walking, the ankle joint plantar-flexion range of motion (ROM) at 10% of the gait cycle (GC) and dorsiflexion ROM at 30% of the GC were significantly higher than those during barefoot walking for both feet (p = 0.001, 0.001, 0.027, and 0.036 respectively). The inversion ROM during shod walking was significantly higher than that during barefoot walking for both feet at 10% and 30% of the GC (p = 0.001. 0.001, 0.001, and 0.042 respectively). At 10% of the GC, the eversion moment was significantly higher between barefoot and shod walking for both feet (both p = 0.001). At 30% of the GC, there was no significant difference between shod and barefoot walking plantar-flexion moment of both feet (p = 0.975 and 0.763 respectively), and the eversion moment of both feet (p = 0.116 and 0.101 respectively).@*CONCLUSION@#At the early stance, shod walking increases the ankle plantar-flexion and foot inversion ROM, and decreases the eversion moment for both feet in subjects with unilateral CAI. Therefore, the foot wearing condition should be considered during evaluation of ankle and foot kinematics and kinetics.

Prevalence and Pattern of Musculoskeletal Injuries Among Malaysian Hockey League Players

@#Introduction: Hockey is a team sport that involves running, sprinting, and making sudden changes in directions of movement to control a ball against the opposing team. Therefore, due to its nature of fast movement, hockey players may be at risk of various musculoskeletal injuries. This study aimed to identify the prevalence and pattern of musculoskeletal injuries sustained among Malaysian Hockey League players. Materials and Method: Data were collected from 84 field hockey players that participated in the Malaysian Hockey League competition from June 2016 until December 2016. All injuries were recorded by the participating medical team using a structured questionnaire. A descriptive statistical analysis and Chi-Square test were used to explore the prevalence of the injury. Result: More than half of the players were reported to have lower limb injuries (51.6%). Sprain and strain were the most prevalent injuries (63%) and mostly affected the ankle (29%). Male players sustained more injuries (50.8%) compared to female players (49.2%). Conclusion: This study suggests that a guideline is needed for injury prevention strategies that will benefit the hockey players in preventing injuries.

Two Cases of Great Occipital Neuralgia as Meteorological Pain Successfully Treated with Goreisan / 日本東洋医学雑誌

Painful orthopedic diseases are sometimes aggravated because of weather changes ; this is referred to as meteorological pain. We report two cases of great occipital neuralgia (GON) due to traffic accident in patients whose pain was aggravated by weather changes. Case 1 involved a 41-year-old woman who developed lumbago and cervical pain following a traffic accident. Two months after the accident, she had irregular occipital pain. Three months after the accident, a great typhoon occurred, and she suffered from severe occipital pain since that morning. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Case 2 involved a 31-year-old woman who developed cervical pain following a traffic accident. Three months after the accident, she experienced severe occipital pain due to weather changes. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Goreisan is dramatically effective for GON as meteorological pain caused by cervical sprain.

Application of the Ottawa Protocol by Medical Students and Orthopedic Residents on Ankle Sprains at a Trauma Hospital / Aplicação do protocolo Ottawa por estudantes de medicina e residentes de ortopedia em entorses de tornozelo em um hospital de trauma

Abstract Objective To verify the applicability and agreement of the Ottawa ankle rules applied by medical students and orthopedic residents in a tertiary trauma service thus validating the Ottawa protocol for use on Brazilian soil. Prospective This was a prospective study, conducted in a tertiary hospital, including all patients with acute torsial trauma of the tibiotarsal joint. The patients underwent ankle and/or foot radiographs, and the questionnaire with the Ottawa ankle rules was applied by academics and, subsequently, by residents. The radiographs were evaluated by on-call orthopedists and specialist in foot and ankle, and the expert opinion was considered the gold standard for analysis. Results Two hundred and sixty-three patients were evaluated, and, after application of the established inclusion criteria, 226 cases remained for evaluation. The sensitivity to detect lesions and negative predictive value (NPV) was 100%. The most sensitive test with higher NPV for both academics and residents was palpation of the lateral malleolus. The study presented potential for a reduction of 30% in the total number of tests requested. Conclusion The data showed applicability and agreement between academics and residents, which allows for the validation of the Ottawa protocol in emergency care in Brazil.

Resumo Objetivo Verificar a aplicabilidade e a concordância das regras do tornozelo de Ottawa aplicadas por estudantes de medicina e residentes de ortopedia em um serviço de trauma terciário, validando assim as regras de Ottawa para utilização em solo brasileiro. Método Estudo prospectivo, realizado em um hospital terciário, incluindo todos os pacientes com trauma torcional agudo da articulação tibiotársica. Os pacientes realizaram radiografias de tornozelo e/ou pé, tendo sido aplicado o questionário com as regras do tornozelo de Ottawa por acadêmicos e, na sequência, por residentes. As radiografias foram avaliadas por ortopedistas plantonistas e especialista em pé e tornozelo, sendo a opinião do especialista considerada padrão-ouro da análise. Resultados Foram avaliados 263 pacientes e, após aplicados os critérios de inclusão estabelecidos, restaram para a avaliação 226 casos. A sensibilidade para detectar lesões e o valor preditivo negativo (VPN) foi de 100%. O teste mais sensível e com maior VPN para ambos, acadêmicos e residentes, foi a palpação do maléolo lateral. O estudo apresentou potencial de redução de 30% no total de exames solicitados. Conclusão Os dados demostraram aplicabilidade e concordância entre acadêmicos e residentes, o que permite a validação do protocolo de Ottawa nos atendimentos de urgência e emergência no Brasil.

Regenerative Medicine as a Potential and Future Intervention for Ankle Sprain

@#Ankle sprain is one of the most common injuries associated with physical activities. Complications including pain and ankle instability are associated with decreased physical activity, reduced sport performance, and increased risk of recurrent ankle injury leading to detrimental effect on activities of daily living. Current management of ankle sprain can be conservative or surgical for serious cases. However, long healing period is required for conservative management in addition to its side effects and the risk of post-operative complications for surgical management. Due to the current challenges and setbacks faced by existing intervention, this paper aims to generate ideas in incorporating regenerative medicine as an intervention for ankle sprain. This review will provide a brief review on the existing management for ankle sprain along with some history, application and the potential of regenerative medicine in speeding up the healing process of ankle sprains.

Terapia manual na recuperação funcional pós-entorse lateral de tornozelo: revisão sistemática / Manual therapy in the functional recovery after the ankle side entry: systematic review

INTRODUÇÃO: O tornozelo é considerado uma das regiões do corpo mais propensa às lesões esportivas, sendo 70% dessas lesões entorses de tornozelo. A recidiva de entorses pode provocar um prejuízo crônico na função proprioceptiva e sensório-motora. Não existe um tratamento específico para as entorses, sendo utilizados protocolos como o PRICE, abordagem passiva, imobilização da articulação e terapia manual. OBJETIVO: Trazer informações mais consistentes que elucidem os efeitos da terapia manual na recuperação da funcionalidade do paciente. MATERIAIS E MÉTODOS: Tratase de uma revisão sistemática baseada no PRISMA, com buscas realizadas nas bases de dados: PubMed, SciELO, LILACS e PEDro. Foram pesquisados apenas ensaios clínicos randomizados, com avaliação maior ou igual a 5/10 na escala PEDro, nos idioma português e inglês. Os estudos deveriam incluir população com idade entre 18 e 60 anos utilizando técnicas de terapia manual como: Mulligan, Maitland, mobilização neural, massoterapia, liberação miofascial, pompage e alongamento passivo. RESULTADOS: Foram incluídos 7 artigos com um total de 300 indivíduos. Os estudos incluídos investigaram a recuperação da funcionalidade de pacientes submetidos à terapia manual. Limitações: heterogeneidade no tempo de lesão. CONCLUSÃO: Os resultados evidenciaram melhora na capacidade física para correr, saltar, pousar e realizar movimentos de corte e laterais, melhora da cinemática, marcha, distribuição de descarga de peso e função global.

INTRODUCTION: The ankle is considered one of the regions of the body most prone to sports injuries, with 70% of these injuries ankle sprains. The recurrence of sprains can cause chronic impairment in proprioceptive and sensorymotor function. There is no specific treatment for sprains, using protocols such as PRICE, passive approach, immobilization of the joint and manual therapy. Manual therapy in patients who have undergone lateral ankle sprains can provide beneficial results by improving range of motion, subtalar joint slippage, speed and length of steps, distribution of gait forces, pain relief, and activities of daily living. OBJECTIVE: The objective of this study is to provide more consistent information that elucidates the effects of manual therapy on the recovery of the patient's functionality. MATERIALS AND METHODS: This is a systematic review that followed some PRISMA rules in the databases: PubMed, SciELO, LILACS and PEDro. The articles were searched in Portuguese and English. RESULTS: Seven articles with a total of 300 individuals were included. The included studies investigated the retrieval of the functionality of patients undergoing manual therapy. CONCLUSION: The results showed an improvement in physical ability to run, jump, land and perform lateral and lateral movements, improvement of kinematics, improvement of gait, better distribution of weight discharge and improvement of overall function.

Inestabilidad crónica lateral de tobillo. Técnica modificada / Chronic lateral ankle instability. Modified technique

Resumen: Introducción: La inestabilidad crónica de tobillo se define como un estado clínico caracterizado por la presencia de esguinces de repetición. Puede ser funcional o mecánica. Objetivo: El objetivo general del presente trabajo es determinar mediante la escala de AOFAS y radiografías, los resultados de la técnica de Broström-Gould modificada con anclas en pacientes con inestabilidad crónica lateral de tobillo en el Instituto Nacional de Rehabilitación (INR) en un período comprendido de 2008-2016. Material y métodos: Es un estudio transversal, prospectivo, descriptivo, con pacientes del INR que contaron con el diagnóstico de Inestabilidad crónica lateral de tobillo manejados mediante el procedimiento de Broström-Gould modificado con anclas. Resultados: Fueron 13 en seguimiento, un hombre y 12 mujeres, con promedio de edad de 38 años (± 13), con predominio del tobillo izquierdo siete (54%) sobre el derecho seis (46%). En la escala AOFAS, el promedio prequirúrgico obtenido fue de 39.3 (± 13.1) en comparación con el postquirurgico a seis meses de 73.4 (± 18). Conclusión: El uso de anclas aunado a la técnica de Broström-Gould modificado con anclas es una alternativa simple y efectiva, que permite la sustitución y/o reparación de los ligamentos peroneoastragalino anterior y peroneocalcáneo.

Abstract: Introduction: Chronic ankle instability is defined as a clinical condition characterized by the presence of repetitive sprains. It can be functional or mechanical. Objective: The general objective of this study is to determine the results of the technique using the AOFAS scale and radiographs. of Broström-Gould modified with anchors in patients with chronic lateral ankle instability in the INR in a period comprised of 2008-2016. Material and methods: This is a cross-sectional, prospective, descriptive study with INR patients who had the diagnosis of chronic lateral ankle instability managed using the Broström-Gould procedure modified with anchors. Results: 13 were in follow-up, 1 man and 12 women, with an average age of 38 years (± 13), with predominance of the left ankle 7 (54%) over the right 6 (46%). On the AOFAS scale, the pre-surgical average obtained was 39.3 (± 13.1) compared to the 6-month post-surgery of 73.4 (± 18). Conclusion: The use of anchors combined with the modified Broström-Gould technique with anchors is a simple and effective alternative that allows the replacement or repair of the anterior peroneal and peroneocalcaneal fibular ligaments.

Biomechanics Characteristics and Its Correlation with Proprioception of Ankle Post Sprain / 中国康复理论与实践

Objective:To quantitatively evaluate the biomechanical properties and proprioception by comparing the range of motion (ROM), muscle strength, stiffness and proprioception of ankle joint in patients with ankle sprain, in order to provide therapeutic strategy for the patients with ankle sprain. Methods:From April to July, 2019, 21 patients with ankle sprain were included. The ROM and muscle strength of bilateral ankle joint were recorded, and the stiffness was evaluated by ankle joint training assistant system, at the end of dorsiflexion and plantarflexion, and plantarflexion 20°. The proprioception of ankle was quantitatively evaluated, including motion perception threshold (MPT) and passive position sense (PAPS). The ROM, muscle strength, joint stiffness, MPT and PAPS were compared, and the correlation among ROM, joint stiffness and proprioception were analyzed. Results:Compared with the unaffected side, the dorsiflexion and plantarflexion ROM decreased (|t| > 2.817, P < 0.05), the dorsiflexion and plantarflexion muscle strength decreased (|t| > 5.785, P < 0.01), the stiffness at the end of plantarflexion increased (t = 3.036, P = 0.007) in the affected side. However, there was no significant difference in stiffness at the end of dorsiflexion and dorsiflexion 20° between two sides (t < 0.874, P > 0.05), nor in MPT and PAPS (t < 0.695, P > 0.05). The plantarflexion ROM on the affected side was negatively correlated with the stiffness at the end of plantarflexion (r = -0.466, P < 0.05) and MPT (r = -0.613, P < 0.05), and MPT was positively correlated with the stiffness at the end of plantarflexion (r = 0.469, P < 0.05). Conclusion:The dorsiflexion and plantarflexion ROM and muscle strength decreased in the patients with ankle sprain, while the stiffness at the end of plantarflexion increased, which was related to proprioception. Quantitative measurements of ankle joint biomechanics and proprioception contributed to making ankle rehabilitation strategies. Rehabilitation after ankle sprain included training for ROM and muscle strength, and plantarflexion stretch to improve the plantarflexion stiffness, which may promote the recovery of proprioception and ankle function.

Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace / 대한족부족관절학회지

PURPOSE: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. MATERIALS AND METHODS: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. RESULTS: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. CONCLUSION: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

Clinical study of Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule in the treatment of acute lumbar sprain / 国际中医中药杂志

Objective To evaluate the effect of Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule in the treatment of acute lumbar sprain. Methods A total of 102 patients with acute lumbar sprain were randomly divided into two groups, 51 in each group.The control group received ibuprofen sustained-release capsules orally. The study group was treated with Xuefu-Zhuyu decoction combined with interactive acupuncture on the basis of the control group. Both groups were treated for 2 weeks. The degree of low back pain was assessed by VAS and the improvement of lumbar function was assessed by modified Japanese Orthopaedic Association Scores (M-JOA). The Oswestry dysfunction index (ODI) was used to evaluate the degree of lumbar dysfunction. The serum hs-CRP, IL-6, IL-10 and prostaglandin E2 (PGE2) level was detected by ELISA. The clinical efficacy was evaluated. Results The total effective rate was 80.4% (41/51) in the study group and 62.8% (32/51) in the control group. There was significant difference between the two groups (χ2=3.903, P=0.048). After treatment, the VAS (1.85 ± 0.40 vs. 4.06 ± 0.67, t=20.226), M-JOA (4.41 ± 1.35 vs. 11.18 ± 2.25, t=18.426), and ODI (9.66 ± 3.34 vs. 16.37 ± 3.64, t=9.700) in the study group were significantly lower than those in the control group (P<0.01). The serum level of hs-CRP, IL-6, IL-10 and PGE2 in the study group were significantly lower than those in the control group after treatment (t were 6.694, 8.416, 22.110 and 12.137, respectively, all P s<0.01). Conclusions The Xuefu-Zhuyu decoction combined with interactive acupuncture and ibuprofen sustained-release capsule can improve the degree of lumbago and lumbar dysfunction in patients with acute lumbar sprain, reduce the level of serum inflammatory cytokines, and improve the clinical efficacy.

Revisión sistemática de la efectividad funcional del vendaje neuromuscular en sujetos con inestabilidad de tobillo / A systematic review of the functional effectiveness of kinesiotaping in individuals with ankle instability

INTRODUCCIÓN La inestabilidad de tobillo presenta mayor frecuencia en personas que han sufrido repetidos esguinces de tobillo. Aunque el Kinesio Tape es una técnica masificada en los últimos años en el tratamiento de esta lesión, se desconoce su efectividad. OBJETIVO Determinar la efectividad funcional del Kinesio Tape en individuos con inestabilidad de tobillo. DISEÑO Revisión sistemática. FUENTES DE DATOS Se realizó una búsqueda sistemática de artículos en donde se aplicó Kinesio Tape en sujetos con inestabilidad de tobillo en las siguientes bases de datos: PubMed Central; PubMed/Medline; Cochrane; Embase; Sciencedirect; Biomed Central; CINAHL; Lippincott Williams &Wilkins; SAGE y Wiley-Blackwell. MÉTODOS DE LA REVISIÓN Se seleccionaron solo estudios experimentales tipo ensayo clínico, en donde se interviniera a pacientes con inestabilidad de tobillo mediante la aplicación de Kinesio Tape y que incluyeran al menos una variable de resultado asociada a la función del tobillo. Se aplicó la escala PEDro a cada artículo para medir su calidad metodológica. RESULTADOS Se obtuvieron 364 artículos. Diez cumplieron los criterios de inclusión; cinco de alta y cinco de moderada calidad metodológica. En la mayoría de los artículos se midió más de una variable. Dos artículos presentaron mejoras en la fuerza muscular; cuatro artículos midieron equilibrio, dos observaron mejoras; un artículo observó mejoras en la propiocepción; dos artículos midieron control postural, sin mejoras significativas y un artículo no observó mejoras significativas en control neuromuscular. Estabilidad articular (un artículo), actividad muscular (un artículo) y funcionalidad (un artículo), no reportaron mejoras significativas con el uso de Kinesio Tape. CONCLUSIÓN El Kinesio Tape es efectivo para obtener mejoras en la fuerza muscular, el equilibrio y la propiocepción en individuos con inestabilidad de tobillo. Sin embargo, el Kinesio tape no reporta mejoras significativas en control postural, control neuromuscular, actividad muscular, estabilidad articular y funcionalidad en sujetos con inestabilidad de tobillo.

INTRODUCTION Ankle instability often seen in people who have suffered repeated ankle sprains. Kinesio Tape is a technique widely applied in recent years, despite not having enough evidence to support its application. OBJECTIVE To determine the functional effectiveness of Kinesio Tape in individuals with ankle instability. DESIGN Systematic review. DATA SOURCES A systematic search of articles was performed where Kinesio Tape was applied in subjects with ankle instability in the following databases: PubMed Central; PubMed/Medline; Cochrane; Embase; Sciencedirect; Biomed Central; CINAHL; Lippincott Williams & Wilkins; SAGE and Wiley-Blackwell. METHODS OF THE REVIEW Only clinical trials were selected, in which patients with ankle instability were intervened by applying Kinesio Tape and which included at least one outcome variable associated with ankle function. RESULTS364 articles were found. Ten met the inclusion criteria; five presented high and five moderate methodological quality. In most cases, one article measured more than one variable. Two articles showed improvements in muscle strength. Of four articles that evaluated balance, two observed improvements; one article observe improvements in proprioception; two articles measured postural control, without significant improvements; one article did not observe significant improvements in neuromuscular control. Stability (one article), muscular activity (one article) and functionality (one article) did not report significant improvements with the use of Kinesio Tape. On the other hand, Kinesio tape does not report significant improvements with respect to postural control, neuromuscular control, muscle activity, joint stability and functionality in subjects suffering from ankle instability. CONCLUSION Kinesio Tape is effective for improvement of muscle strength, balance and proprioception in subjects with ankle instability. However, Kinesio Tape does not report significant improvement of postural control, neuromuscular control, muscle activity, joint stability and functionality in people with ankle instability.

Tratamiento de esguince de tobillo grado II en adultos laboralmente activos: Inmovilización contra vendaje funcional / Grade II ankle sprain treatment in working adults: immobilization versus functional bandage

Resumen Introducción El esguince de tobillo es una patología frecuente y uno de los principales motivos de incapacidad laboral, a pesar de ello, no se cuenta con un tratamiento estandarizado y existe controversia con respecto a la inmovilización o una movilización temprana. Objetivo Determinar el mejor tratamiento para los esguinces de tobillo grado II, ofreciendo un resultado satisfactorio con periodos de incapacidad más cortos. Material y métodos Ensayo clínico-aleatorizado, ciego simple de enero a junio de 2016. Dos grupos: inmovilización y vendaje funcional. Se interrogó dolor inicial y al término del tratamiento con escala de EVA, ambos grupos con mismo manejo analgésico, antiinflamatorio y rehabilitación, se evaluó funcionalidad al mes del inicio del padecimiento con escala de Karlsson. Resultados Todos los pacientes con dolor inicial arriba de 70 (de moderado a severo), sin diferencia en media entre grupos (férula 86.3 ± 9.6 contra vendaje de 86.1 ± 8.5; p = 0.95), ambos con disminución del dolor; el grupo con vendaje obtuvo niveles más bajos (férula media 55.2 ± 15.5 contra vendaje 40.3 ± 12.8, p ≤ 0.001). Grupo con férula 24 (88.9%) al final calificaron su dolor como moderado y tres (11.1%) como leve contra el grupo con vendaje, de los cuales, 17 (73.1%) tuvieron dolor moderado y siete (26.9%) leve (p = 0.15). Conclusión El vendaje funcional es una excelente opción de manejo para esguince de tobillo grado II, ofrece buenos resultados con periodos de incapacidad y costos más reducidos.

Abstract Background The grade II ankle sprain it is one of the most frequent pathologies in the musculoskeletal system and one of the principal motives of laboral inability. Despite the fact this pathology is one of the most common reasons for ER visiting there is not a standard treatment for it, and exist controversy about the immobilization vs. an early mobilization. Objective Determine the best treatment for grade II ankle sprains, offering a satisfactory result with a minor time of labor inability. Material and methods Single-blind randomized controlled clinical trial with two groups immobilization versus functional bandage, both groups with VAS evaluation at the beginning and at the end of treatment, same AINES management and rehabilitation, 30 days after the injury we evaluate the functional outcome with Karlsson score. Results At the beginning all patients report pain over 70 (moderate-severe) without difference in the average of both groups (immobilization 86.3 ± 9.6 versus functional bandage treatment of 86.1 ± 8.5; p = 0.95). Both groups present less pain at the end of the treatment, the bandage group present lower values, (Immobilization average 55.2 ± 15.5 versus functional bandage treatment 40.3 ± 12.8, p ≤ 0.001). In the immobilization group 24 (88.9%) at the end of the treatment had moderate pain and 3 (11.1%) light pain against the functional treatment group where 17 (73.1%) had moderate pain and 7 (26.9%) light (p = 0.15). Conclusion Functional bandage is an excellent treatment option for grade II ankle sprain, offering good results with a lower time of inability and cost.

Resultados clínicos y funcionales de la plastía Broström-Gould para inestabilidad lateral de tobillo: evaluación con tres escalas / Clinical and functional results of the Broström-Gould technique for lateral ankle instability: evaluation with three scales

Resumen: Antecedentes: La secuela más frecuente del esguince de tobillo es la inestabilidad del complejo ligamentario lateral; los resultados del tratamiento quirúrgico no han sido evaluados con varias escalas simultáneamente. El objetivo del estudio fue evaluar los resultados clínicos y funcionales con tres escalas en pacientes con inestabilidad lateral de tobillo sometidos a plastía de Broström-Gould, utilizando para su fijación anclas con sutura al peroné distal. Material y métodos: El diseño del estudio fue transversal y descriptivo; se incluyeron pacientes con inestabilidad lateral de tobillo y ruptura parcial o completa del ligamento PAA y/o PC, sometidos a reparación con plastía de Broström-Gould. Se realizó resonancia magnética nuclear para confirmar el diagnóstico; los resultados clínicos y funcionales se determinaron con tres escalas: EVA, SF-36 y AOFAS. Los pacientes fueron evaluados a los seis meses o más posteriores al procedimiento quirúrgico. Resultados: Se incluyeron 13 pacientes; la calidad de vida (cuestionario SF-36) arrojó un resultado bueno con promedio de 90; 10 (77%) pacientes mostraron resultados excelentes en la función, ausencia de dolor y alineación del tobillo (AOFAS 90-100). Asimismo, se observó mejoría importante en el dolor (EVA prequirúrgico: 6, comparado con 1 en el período postquirúrgico). Conclusiones: El procedimiento quirúrgico demostró excelentes resultados en el corto plazo con resolución del dolor y estabilidad del tobillo.

Abstract: Background: The most frequent sequel to the ankle sprain is the instability of the lateral ligament complex; the results of surgical treatment have not been evaluated with multiple scales simultaneously. The objective of the study was to assess the clinical and functional results with three scales in patients with lateral instability of ankle undergoing Broström-Gould technique, using for fixation, anchors with suture to distal fibula. Material and methods: The design of the study was cross-sectional and descriptive; we included patients with lateral instability of ankle and partial or complete rupture of the APA or CP ligament subject to repair with Broström-Gould technique. Magnetic resonance imaging was performed to confirm the diagnosis; clinical and functional outcomes were determined with three scales: EVA, SF-36 and AOFAS. Patients were evaluated at six months, or more, after the surgical procedure. Results: We included 13 patients; quality of life (SF-36 questionnaire) showed a good result with average score of 90; 10 (77%) patients showed excellent results in function, absence of pain and alignment of the ankle (AOFAS 90-100). Also found significant improvement in pain (presurgical EVA: 6, compared with 1 in the postoperative period). Conclusions: The surgical procedure showed excellent results, in the short term with resolution of pain and ankle stability.