The influence of premenstrual symptoms on postural balance and kinesthesia during the menstrual cycle.

Recent studies have indicated an increased incidence of female athletic injuries during the luteal phase and the first days of the menstrual period. The purpose of this study was to investigate whether postural sway and knee-joint kinesthesia very during the menstrual cycle, and whether premenstrual syndrome (PMS) influences postural balance and kinesthesia. A total of 13 subjects with regular menstrual cycles participated in the study. Postural sway and kinesthesia were measured in the early follicular phase, in the ovulation phase and in the mid-luteal phase. Postural sway was measured with an ankle disc placed on a Statometer, and kinesthesia was measured with a specially designed device. Menstrual cycle phases were determined by sex hormone analyses in serum and by luteinizing hormone (LH) detection in urine. The diagnosis of PMS was made prospectively using validated daily symptom ratings. Eight of 13 women were classified as having PMS. These women had a significantly greater postural sway (p = 0.002) and a greater threshold for detection of passive motion in the knee joints (p = 0.05) than women without PMS. A tendency (p = 0.06) towards greater postural sway in the mid-luteal phase was detected among women with PMS. This may explain the finding of an increased incidence of athletic injuries in the luteal phase, reported previously.

The injury panorama in a Swedish professional ballet company.

We performed a combined retro- and prospective study of injuries in a Swedish professional, classical ballet company during 5 consecutive years. There were 390 injuries incurred by 98 dancers over a 5-year period, i.e., 0.6 injuries/1000 dance hours. Most injuries were considered to be due to overuse. The median sick leave was 2.3 weeks per injury. The foot and ankle region is vulnerable in classical ballet dancers, and overuse injuries can result in long periods of sick leave. Of the dancers employed for more than 1 year 95% were suffered injuries during the study period. We found considerable differences in the injury profile between male and female and between younger and older dancers. Male dancers suffered more frequently from acute injuries to the knee joint. Traumatic injuries were seen most frequently in male soloists. Female dancers more often suffered overuse injuries, especially to the foot and ankle region. The younger dancers more often suffered traumatic injuries, for example, ankle sprain, and also stress fractures.

Early influence of an ankle sprain on objective measures of ankle joint function. A prospective randomised study of ankle brace treatment.

The purpose of this study was to analyse objective modalities of ankle joint function after an acute ankle sprain and to see whether treatment with an air-cushioned ankle brace could enhance the restoration of function compared with a traditionally used compression bandage. The study included 73 consecutive patients between 15 and 55 years of age with an acute grade II or III ankle sprain, who sought medical care within 24 h of the time of injury. Patients with recurrent sprain were excluded. The patients were allocated at random to treatment with compression bandage or an air-cushioned ankle brace (Air-Stirrup, Aircast). The regimen included early motion and weight-bearing in both groups. The patients were examined initially within 24 h, after 3-5 days, 2, 4 and 10 weeks after the injury by the following tests: clinical examination including range of motion, recording of postural sway by stabilometry, joint position sense test, isokinetic eversion-inversion muscle torques and figure-of-eight running. A decreased active range of motion in eversion-inversion was observed during the entire follow-up period. Increased postural sway was registered when standing on the injured foot up to 4 weeks after the injury, as were a deficit in evertor muscle peak torque and an evertor-invertor muscle imbalance compared with the uninjured side. Women demonstrated a greater impairment in postural sway than men. A longer curve running time with the injured ankle at the outside of the curve was noted at the 10-week follow-up. With the exception of running in a figure of eight, these measures were not influenced by treatment with a semi-rigid ankle brace. The methods used in the present study are well suited for further studies of objective modalities of ankle joint function, with the possible exception of the joint position sense test.

Proprioception in classical ballet dancers. A prospective study of the influence of an ankle sprain on proprioception in the ankle joint.

We studied prospectively the influence of ankle sprains on proprioception as measured by recording the postural sway of classical ballet dancers. Excellent balance and coordination are important for classical ballet dancers, and postural stability requires adequate proprioception from the ankle joint. Fifty-three professional dancers from the Royal Swedish Ballet, Stockholm, and 23 nonathletes, the control group, participated in the investigation. Postural sway was recorded and analyzed with a stabilimeter using a specially designed, portable, computer-assisted force plate. Six dancers sustained ankle sprains during followup. The recordings were obtained of these dancers before and after the injuries. The stabilometry results differed among the male and female dancers and the control group as follows: 1) the male dancers demonstrated a smaller total area of sway, and 2) both the male and female dancers had a smaller mean sway on the left foot than on the right (no mean difference in sway was found between the left and right foot in the control group). In comparison with the condition before injury and with the uninjured foot, the postural stability of the dancer was impaired for several weeks after the ankle sprain. Postural stability gradually improved during rehabilitation and improvement still occurred several weeks after professional dancing had resumed.

Taping of the ankle--the effect on postural sway during perturbation, before and after a training session.

The application of adhesive tape to the ankle prevents sprains and is therefore frequently used by athletes with functional instability of that joint. The purpose of the study was to investigate the effect of taping on postural sway during a sudden perturbation in subjects with unilateral functional instability of the ankle joint. Nine Swedish male elite soccer players with unilateral functional instability of the ankle joint after a sprain participated in the study. Their mean age was 25 years. All but one had sustained an ankle sprain during the last 1-12 months, and they applied adhesive tape on one ankle at every practice session and game. Eight moderately active male subjects served as controls (mean age 32 years). Recording and analysis of postural sway was performed by the use of stabilometry. We used a device previously tested for reliability and added a perturbation device. The perturbation device was an ankle disc standing on four bars on top of the force plate. At the start of each recording, the ankle disc was stable. The bars could be removed simultaneously by the test leader. The following parameters were analysed: (1) max sway, the maximal sway amplitude upon perturbation in mediolateral and anteroposterior directions; (2) mean sway, the mean sway during the recording in mediolateral and anteroposterior directions. There was no difference between the right and left ankles before the practice session. The postural sway during perturbation (max sway) decreased when the ankle was taped before the exercise. After the exercise there was no difference between the taped and untaped ankles. The maximum and mean amplitude of sway without tape were smaller after exercise than before exercise. The results in the present study indicate a positive effect of tape on postural sway during perturbation before a practice session. The decreased sway with an untaped ankle after the practice session could mean that the prophylactic effect of taping is most important during the first part of a practice session or a game. Warmer muscle units mean less uncontrolled muscle activity which could result in more effective stabilisation of the ankle joint.

Treatment of acute ankle sprain. Comparison of a semi-rigid ankle brace and compression bandage in 73 patients.

We randomized 73 patients with grades II and III ankle sprain to treatment with an Air-Stirrup ankle brace or a compression bandage. All patients were instructed to attempt early motion and weight bearing when comfortable. Ankle function was evaluated after 3-5 days and 2, 4, and 10 weeks with a clinical examination, the Sickness Impact Profile questionnaire, Karlsson's scoring scale and recording of sick leaves. The group treated with the Air-Stirrup ankle brace was more mobile in the initial phase of rehabilitation and had a shorter sick leave. Ankle brace treatment resulted in socioeconomic savings.

Ankle injuries in basketball players.

We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of them had suffered an ankle sprain while playing basketball, and of these 83% reported repeated sprains of one ankle. In the last two seasons, 78% of the players had injured at least one ankle. The injury frequency in the investigation was 5.5 ankle injuries per 1000 activity hours. 22% of the players used some kind of prophylactic support of their ankle joints. Because of the great number of ankle sprains and the disability in terms of time away from sports that they cause, prevention of these injuries is essential.

Ankle sprain and postural sway in basketball players.

The present study compares postural ankle stability between previously injured basketball players, uninjured players and a control/group. Postural sway was recorded and analysed by stabilometry using a specially designed computer-assisted forceplate. Recordings were obtained for 60 s on each foot. The stabilometric results in the players with no previous injuries did not differ from those in the controls. Players with a previously injured ankle differed significantly from the control group. These players had a larger mean postural sway and used a larger sway area.

Spinal sagittal mobility and joint laxity in young ballet dancers. A comparative study between first-year students at the Swedish Ballet School and a control group.

The present study compares spinal configuration, spinal range of motion and joint mobility in first-year students of the Swedish Ballet School and in nondancing students of corresponding age and sex in a state school. The study comprises all the first-year (fourth grade) students (n = 23) at the Swedish Ballet School: 11 boys and 12 girls. Their dance practice time was 10 h per week. Thirty-six children in the fourth grade at a state school comprised the control group. None of the controls took ballet classes or participated in organised gymnastics out of school. The neutral spine configuration in standing and the sagittal spine mobility were measured using Debrunner's kyphometer and Myrin's inclinometer. Joint laxity was measured by employing a modified form of the Contompasis method. Compared with the controls, the dancers showed a higher incidence of joint hypermobility, greater mobility of the thoracic spine, a less prominent lordosis of the lumbar spine and a less prominent kyphosis in the thoracic spine in the neutral standing position. The dancers had done little or no ballet training before entering the ballet school at the age of ten. The results agree with those of earlier studies and suggest that increased flexibility is an asset for those being selected as future ballet dancers.