Deficits in proprioception and strength may contribute to the impaired postural stability among individuals with functional ankle instability.

Purpose: The correlations of postural stability with proprioception and strength may explain the recurrent sprains among individuals with functional ankle instability (FAI). This study aimed to compare anterior-posterior (AP) and medial-lateral (ML) postural stability, along with ankle proprioception and strength between individuals with and without FAI and investigated their correlations. Methods: Forty participants with FAI and another 40 without FAI were recruited. Their postural stability, represented by time to stabilization (TTS) in the AP (TTSAP) and ML (TTSML) directions, was calculated by the ground reaction force during jumping onto a force plate. Their ankle proprioception and strength during plantarflexion/dorsiflexion and inversion/eversion were measured using a proprioception device and a strength testing system, separately. Results: Individuals with FAI had longer TTSAP (p = 0.015) and TTSML (p = 0.006), larger ankle proprioception thresholds (p = 0.000-0.001), and less strength (p = 0.001-0.017) than those without FAI. Correlations between strength and TTSAP were detected among individuals with (ankle plantarflexion, r = -0.409, p = 0.009) and without FAI (ankle plantarflexion, r = -0.348, p = 0.028; ankle dorsiflexion, r = -0.473, p = 0.002). Correlations of proprioception (ankle inversion, r = 0.327, p = 0.040; ankle eversion, r = 0.354, p = 0.025) and strength (ankle eversion, r = -0.479, p = 0.002) with TTSML were detected among individuals without FAI but not among those with FAI. Conclusion: Individuals with FAI have worse postural stability and proprioception and less strength. Their proprioception and strength decreased to a point where they could not provide sufficient functional assistance to the ML postural stability. Improvements in proprioception and strength may be keys to prevent recurrent ankle sprains among individuals with FAI.

Randomized controlled trial study of intelligent rehabilitation training system for functional ankle instability.

To investigate the intervention effect of an intelligent rehabilitation training system on patients with functional ankle instability (FAI) and to advance the research to optimise the effect of FAI rehabilitation training. Thirty-four FAI patients who participated in this trial in Guilin City from April 2023 to June 2023 were recruited as research subjects, and all subjects were randomly divided into the control group (n = 17) and the observation group (n = 17). Both groups received the conventional rehabilitation training intervention for 6 weeks, and the observation group received the additional training using the intelligent rehabilitation training system training invented by our team. Visual analogue scale (VAS), ankle active mobility, ankle muscle strength and Y-balance test (YBT) were assessed before and after treatment. Two-way repeated measures ANOVA shows that the interaction effect between time and group of VAS scores was significant (F = 35.644, P < 0.05). The interaction effect between time and group of plantar flexion mobility was significant (F = 23.948, P < 0.05), the interaction effect between time and group of dorsiflexion mobility was significant (F = 6.570, P < 0.05), the interaction effect between time and group of inversion mobility was significant (F = 8.360, P < 0.05), the interaction effect between time and group of eversion mobility was significant (F = 10.113, P < 0.05). The interaction effect between time and group of inversion muscle strength was significant (F = 18.107, P < 0.05). The interaction effect between time and group of YBT scores was significant (F = 33.324, P < 0.05). The Intelligent Rehabilitation Training System can effectively reduce pain in FAI patients, improve joint range of motion, increase inversion strength, and improve dynamic balance of the affected limb.

The impact of whole-body vibration training and proprioceptive neuromuscular facilitation on biomechanical characteristics of lower extremity during cutting movement in individuals with functional ankle instability: A parallel-group study.

BACKGROUND: We compared the effects of whole-body vibration training and proprioceptive neuromuscular facilitation on the biomechanical characteristics of the lower limbs in functional ankle instability patients during cutting movement to ascertain the superior rehabilitation method. METHODS: Twenty-two male College students with unilateral functional ankle instability volunteered for this study and were randomly divided into whole-body vibration training group and proprioceptive neuromuscular facilitation group. Kinematics data and ground reaction forces were collected using infrared motion capture system and 3-D force plates synchronously during cutting. Repeated measures two-way ANOVA was performed to analyze the data. FINDINGS: Both training methods reduced the maximum hip abduction angle (p = 0.010, effect size: proprioceptive neuromuscular facilitation = 0.69; whole-body vibration training = 0.20), maximum knee flexion angle (p = 0.008, effect size: proprioceptive neuromuscular facilitation = 0.39, whole-body vibration training = 1.26) and angular velocity (p = 0.014, effect size: proprioceptive neuromuscular facilitation = 0.62, whole-body vibration training = 0.55), maximum ankle inversion angular velocity (p = 0.020, effect size: proprioceptive neuromuscular facilitation = 0.52, whole-body vibration training = 0.81), and knee flexion angle at the time of maximum vertical ground reaction forces (p = 0.018, effect size: proprioceptive neuromuscular facilitation = 0.27, whole-body vibration training = 0.76), and increased the maximum ankle dorsiflexion moment (p = 0.049, effect size: proprioceptive neuromuscular facilitation = -0.52, whole-body vibration training = -0.22). Whole-body vibration training reduced the maximum ground reaction forces value in the mediolateral directions (p = 0.010, effect size = 0.82) during cutting movement. INTERPRETATION: These findings suggested that the two types of training might increase neuromuscular conduction function around the ankle. After these two types of training, functional ankle instability patients showed a similar risk of injury to the lateral ankle ligaments during cutting.

What interventions can treat arthrogenic muscle inhibition in patients with chronic ankle instability? A systematic review with meta-analysis.

PURPOSE: To identify, critically appraise, and synthesize the existing evidence regarding the effects of therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability (CAI). MATERIALS AND METHODS: Two reviewers independently performed exhaustive database searches in Web of Science, PubMed, Medline, CINAHL, and SPORTDiscus. RESULTS: Nine studies were finally included. Five types of disinhibitory interventions were identified: focal ankle joint cooling (FAJC), manual therapy, fibular reposition taping (FRT), whole-body vibration (WBV), and transcranial direct current stimulation (tDCS). There were moderate effects of FAJC on spinal excitability in ankle muscles (g = 0.55, 95% CI = 0.03-1.08, p = 0.040 for the soleus and g = 0.54, 95% CI = 0.01-1.07, p = 0.046 for the fibularis longus). In contrast, manual therapy, FRT, WBV were not effective. Finally, 4 weeks of tDCS combined with eccentric exercise showed large effects on corticospinal excitability in 2 weeks after the intervention (g = 0.99, 95% CI = 0.14-1.85 for the fibularis longus and g = 1.02, 95% CI = 0.16-1.87 for the tibialis anterior). CONCLUSIONS: FAJC and tDCS may be effective in counteracting AMI. However, the current evidence of mainly short-term studies to support the use of disinhibitory interventions is too limited to draw definitive conclusions.

Therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability are scarce.Current studies incorporate mainly short-term therapeutic interventions.Focal ankle joint cooling seems effective to treat AMI.Several weeks of transcranial direct current stimulation may also be effective to counteract arthrogenic muscle inhibition but more studies are needed.

Relationship of balance in static single-leg stance to muscle strength and position sense of ankle in individuals with functional ankle instability / 中国康复理论与实践

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.

Effects of biofeedback on biomechanical factors associated with chronic ankle instability: a systematic review with meta-analysis.

BACKGROUND: Biofeedback may alter the biomechanics of lower extremities in patients with chronic ankle instability (CAI). We aimed to systematically review the literature on the effect of gait-training and biofeedback on biomechanical parameters in individuals with CAI and conduct a meta-analysis. METHODS: We searched four databases including PubMed, Web of Science, Scopus and Embase from their inception through 30th June 2022. The Downs and Black appraisal scale was applied to assess quality of included studies. Two reviewers screened studies to identify those reporting the effect of biofeedback on biomechanical factors associated with CAI. Outcomes of interest were kinetics and kinematics. Two authors separately extracted data from included studies. Data of interest were study design, number of sessions, intervention, tools, outcomes, number, sex, age, height, and body mass of participants. RESULTS: Thirteen studies with a total of 226 participants were included. Biofeedback was capable of shifting center of pressure (COP) and lateral plantar pressure medially and reducing foot inversion, adduction, propulsive vertical ground reaction force (vGRF), ankle joint contact force, peak pressure and pressure time integral in the lateral mid-foot and forefoot. Auditory biofeedback had agreater impact on modifying plantar pressure in individuals with CAI. The meta-analyses revealed that visual biofeedback reduces peak pressure in lateral mid-foot and pressure time integral at lateral and medial heel and pressure increases under the hallux. CONCLUSION: Biofeedback can alter pressure, vGRF, and foot inversion associated with CAI. Auditory biofeedback had greater impact on modifying plantar pressure in individuals with CAI. Further studies are required to assess the prolonged effect and clinical consequences of biofeedback or a combination of feedback on CAI in different age groups. Moreover, developing a low-cost and user-friendly device that can be evaluated in high quality RCTs is important prior to implementing the intervention in the clinical setting to reduce symptoms of CAI.

Relationship between ankle pain, range of motion, strength and balance in individuals with functional ankle instability: a cross-sectional study.

BACKGROUND: About 15-60% of individuals with ankle sprains may develop functional ankle instability (FAI), which is characterised by ankle pain, decreased muscle strength, limited range of motion, and impaired balance, causing a decline in social activity and quality of life. However, the relationship between those characters is still unclear. This study aimed to investigate whether a relationship existed between ankle pain, active range of motion (AROM), strength and balance and if ankle pain, AROM and strength can predict balance in individuals with FAI. METHODS: Seventy-seven subjects (46 males; 31 females) with unilateral FAI participated in this study. Ankle pain was measured by the visual analogue scale (VAS), ankle AROM was measured using a universal goniometer, ankle strength was measured using a handheld dynamometer, the static balance was measured by the Time in Balance Test (TBT) and the dynamic balance was measured by the modified Star Excursion Balance Test (mSEBT). Pearson product-moment correlations were used to determine the correlations between ankle pain, AROM, strength and balance. Multiple linear regressions were used to investigate if ankle pain, AROM and strength can predict balance in individuals with FAI. RESULTS: VAS and AROM-plantarflexion predicted 25.6% of the TBT (f2 = 0.344, P < 0.001). AROM-dorsiflexion predicted 24.6% of the mSEBT-anterior reach (f2 = 0.326, P < 0.001). VAS, AROM-plantarflexion and strength-plantarflexion predicted 33.5% of the mSEBT-posteromedial reach (f2 = 0.504, P < 0.001). AROM-plantarflexion and strength-plantarflexion predicted 28.2% of the mSEBT-posterolateral reach (f2 = 0.393, P < 0.001). CONCLUSION: This study shows that ankle plantarflexion strength, AROM of dorsiflexion and plantarflexion and pain are predictors of balance in individuals with FAI. These factors could be considered in the rehabilitation of FAI. TRIAL REGISTRATION: Trial registration number: ChiCTR2200063532.

The immediate effect of synergistic muscles kinesio taping on function and balance of volleyball players with functional ankle instability: A randomized controlled trial.

OBJECTIVES: To determine the immediate effect of synergistic muscles Kinesio taping (KT) on the function and balance of volleyball players with functional ankle instability (FAI). DESIGN: Parallel, superiority randomized controlled trial. METHODS: Twenty-six semi-professional volleyball players with FAI were randomly assigned to either the intervention or control group. All participants received KT of fibularis longus, gastrocnemius, and gluteus maximus muscles for one session. The intervention group received KT with 35 % tension, while the control group received KT without tension. The function was assessed using the side hop and single hop distance tests. Dynamic balance was assessed with the Y Balance test. The outcomes were measured at baseline, 20 min after KT, and 24 h after KT. Statistical analyses were performed using Mixed-model repeated measures analysis of variance (ANOVA) and one-way ANOVA. RESULTS: The interactions of time*group for the outcomes of function using the single hop test and stability in the anterior direction of the Y Balance test were significant (p < 0.05). Within-group comparisons showed after KT, both groups experienced significant improvements in all outcomes compared to the baseline. Results of between-group comparisons revealed that the application of KT with tension compared to no tension significantly improved function and balance in the anterior of the Y Balance test. CONCLUSIONS: Kinesio taping can be an effective treatment option to improve function and balance in FAI. Additionally, Kinesio taping with tension compared to KT without tension had superiority.

Effects of textured insoles and elastic braces on dynamic stability in patients with functional ankle instability.

BACKGROUND: Functional ankle instability (FAI) is a common condition that affects individuals who have experienced previous ankle sprains. Textured insoles and elastic ankle braces have been previously used as interventions to improve stability in FAI patients. However, the optimal combination of these interventions has not been fully explored. The objective of this study was to investigate the effects of different types of textured insoles and elastic ankle braces on the dynamic stability of individuals diagnosed with FAI. METHODS: The study involved 18 FAI patients who performed single-leg landing tasks with and without wearing an eight-band elastic ankle brace while wearing textured insoles with protrusion heights of 0 mm, 1 mm, and 2 mm. The dynamic posture stability index (DPSI) and its components in the anterior-posterior (APSI), mediolateral (MLSI) and vertical (VSI) directions were calculated from the ground reaction force collected from the Kistler force plate during the first three seconds of the landing tasks. RESULTS: A significant interaction was found between textured insole type and ankle brace for DPSI (P = 0.026), APSI (P = 0.001), and VSI (P = 0.021). However, no significant interaction was observed for MLSI (P = 0.555). With elastic ankle braces, textured insoles with 1-mm protrusions significantly enhanced anterior-posterior, mediolateral, vertical, and overall stability compared to textured insoles with no and 2 mm protrusions (P < 0.05). Without elastic ankle braces, textured insoles with 1-mm protrusions significantly improved the anterior-posterior (P = 0.012) and overall stability (P = 0.014) of FAI patients compared to smooth insoles. CONCLUSIONS: The combination of textured insoles with 1-mm protrusion heights and an elastic ankle brace could enhance the dynamic stability of individuals with FAI, potentially mitigating the risk of ankle sprains.

Effect of kinesio taping intervention on the muscle strength and balance of college basketball players with functional ankle instability.

Objective: The aim of this study was to investigate the effects of acute Kinesio Taping (KT) intervention on the muscle strength and balance ability of college basketball players with functional ankle instability (FAI). Methods: Thirty college basketball players with FAI were treated with acute KT to test the changes in their muscle strength and balance ability. Results: After acute KT intervention, the ankle dorsiflexion moment and the ankle plantar flexion moment increased by 34% and 19.9%, respectively. The stable plane test with the subjects' eyes open decreased by 1%, whereas that with the subjects' eyes closed decreased by 1.1%. The swaying environment test with the subjects' eyes open increased by 2.4%. The swaying plane test with the subjects' eyes open increased by 5.1%, whereas that with the subjects' eyes closed increased by 16.2%. The swaying environment test with the subjects' eyes open plus the use of a plane increased by 12.1%. Conclusion: KT can increase the isokinetic strength of the ankle dorsum muscle and plantar flexion of college basketball players with FAI. The effect of KT in the static balance test was weaker than that in the dynamic balance test. The findings indicate that KT can significantly improve the balance ability of college basketball players with FAI during dynamic sports.

Effects of mental fatigue on biomechanical characteristics of lower extremities in patients with functional ankle instability during unanticipated side-step cutting.

Background: Functional ankle instability (FAI) is the primary classification of ankle injuries. Competitive activities have complicated movements that can result in ankle re-injury among patients with FAI. Unanticipated movement state (MS) and mental fatigue (MF) could also happen in these activities, which may further increase their joint injury risk. Objective: This study aimed to clarify the biomechanical characteristics difference of the lower extremity (LE) between the injured side and the uninjured side among patients with FAI when they perform unanticipated side-step cutting after MF. Methods: Fifteen males with unilateral FAI participated in this study (age: 20.7 ± 1.3 years, height: 173.6 ± 4.4 cm, weight: 70.1 ± 5.0 kg). They used the injured side and the uninjured side of LE to complete anticipated and unanticipated side-step cutting before and after MF. The kinematic and kinetics data were evaluated using three-way ANOVA with repeated measures. Results: During patients with FAI performed anticipated side-step cutting, the ankle stiffness of both sides showed no significant change after MF; During they performed unanticipated side-step cutting, their injured side presented significantly lower ankle stiffness after MF, while the uninjured side did not have such change. In addition, after MF, the injured side exhibited increased ankle inversion, knee valgus and LR, but the uninjured side did without these changes. Conclusion: Influenced by MF, when patients with FAI use their injured side of LE to perform side-step cutting, this side LE has a higher risk of musculoskeletal injuries such as lateral ankle sprains and anterior cruciate ligament injury. The ankle stiffness of the injured side will be further reduced when patients with FAI perform unanticipated side-step cutting, which increases ankle instability and the risk of re-injury.

The Efficacy of Virtual Reality Training in the Rehabilitation of Orthopedic Ankle Injuries: A Systematic Review and Meta-analysis.

Introduction: Orthopedic ankle injuries are considered among the most common musculoskeletal injuries. A wide variety of modalities and techniques have been used for the management of these injuries, and virtual reality (VR) is one modality that has been examined in ankle injuries rehabilitation. Purpose: This study aims to systemically review previous studies evaluating the effect of virtual reality in rehabilitating orthopedic ankle injuries. Methods: We searched six online databases: PubMed, Web of Science (WOS), Scopus, the Physiotherapy Evidence Database (PEDro), Virtual Health Library (VHL), and Cochrane Central Register of Controlled Trials (CENTRAL). Results: Ten randomized clinical trials met the inclusion criteria. Our results showed that VR had a significant effect on overall balance compared to conventional physiotherapy (SMD = 0.359, 0.009-0.710 P = 0.04), [I 2= 17%, P = 0.30]. Compared with conventional physiotherapy, VR programs significantly improved gait parameters such as speed and cadence, muscle power, and perceived ankle instability; however, no significant difference was detected in the foot and ankle ability measure (FAAM). Additionally, significant improvements in static balance and perceived ankle instability were reported after the use of VR balance and strengthening programs. Finally, only two articles were deemed to have good quality, and the other studies' quality ranged from poor to fair. Conclusion: VR rehabilitation programs can be used to rehabilitate ankle injuries, as they are regarded as safe interventions and have promising effects. However, there is a need for studies with high quality since most included studies' quality varied from poor to fair.

Functional effects of arthroscopic modified Broström procedure on lateral ankle instability: A pilot study.

BACKGROUND: This study aims to assess the mechanical and functional effects of the arthroscopic modified Broström procedure (AMBP) on patients with lateral ankle instability. METHODS: Eight patients with unilateral ankle instability treated with AMBP and eight healthy subjects were recruited. Healthy subjects, preoperative and one-year postoperative patients were assessed using outcome scales and the Star Excursion Balance Test (SEBT) for dynamic postural control. One-dimensional statistical parametric mapping was performed to compare ankle angle and muscle activation curve during stair descent. RESULTS: The patients with lateral ankle instability showed good clinical outcomes and increased posterior lateral reach during the SEBT after the AMBP (p = 0.046). The medial gastrocnemius activation after initial contact was reduced (p = 0.049), and the peroneal longus activation after initial contact was promoted (p = 0.014). CONCLUSION: The AMBP has functional effects of promoting dynamic postural control and peroneal longus activation within one year of follow-up, which can benefit patients with functional ankle instability. However, the medial gastrocnemius activation was unexpectedly reduced post operation.

Evaluation method of dynamic postural stability for functional ankle instability based on acceleration signals / 中国康复理论与实践

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.

Comparing the Impact of Upper Body Control and Core Muscle Stabilization Training on Landing Biomechanics in Individuals with Functional Ankle Instability: A Randomized Controlled Trial.

Functional ankle instability (FAI), which is characterized by recurrent ankle sprains and perceived joint instability, arises from various factors contributing to compromised biomechanical control during activities, particularly those involving landing tasks. While current research predominantly addresses lower-extremity and core stabilization interventions for FAI, the contribution of upper body control to landing biomechanics in this population remains insufficiently explored. In this study, 42 participants (19 males, 23 females) with FAI were randomly assigned to either the upper-body control training group (UBCTG) or the core muscle stabilization training group (CMSTG). The groups underwent six-week interventions, with the UBCTG receiving a dynamic core exercise program including upper body control and the CMSTG receiving static core muscle training. Pre- and post-intervention assessments encompassed electromyography of the gastrocnemius, tibialis anterior, and peroneus longus, motion analysis of the lower extremities, and ground reaction force (GRF) readings during a single-leg-jump task. Additionally, dynamic balance was assessed using the Y balance test and self-reported measurements of ankle instability were performed. The results showed similar increases in muscle activation, joint movement, and self-reported ankle instability scores within both groups. However, significant between-group differences were observed in terms of knee flexion angle, dynamic balance, and ankle instability scores, favoring the UBCTG. Although the peak vertical GRF significantly decreased and the time to peak vertical GRF increased in both groups, more changes were noted in the UBCTG. Our results demonstrated that dynamic core exercises with additional upper body control training enhance landing biomechanics, dynamic balance, and stability in individuals with FAI. Consequently, we recommend incorporating shoulder girdle exercises, proprioceptive drills, and balance exercises into dynamic core training.

Effects of 12 weeks of Tai Chi Chuan intervention on the postural stability and self-reported instability in subjects with functional ankle instability: Study protocol for a randomized controlled trial.

Background: Tai Chi Chuan (TCC) is a physical activity modality that originated in China and is now widely popular around the world. Although there are a series of articles reporting that TCC can improve balance and other functional symptoms in a variety of populations, including the elderly, patients with stroke, and patients with Parkinson's disease, its efficiency has not been scientifically and methodically evaluated in subjects with functional ankle instability (FAI). Moreover, there is no literature directly comparing TCC and conventional balance training (CBT) interventions for FAI. The objective of this study is to investigate the comparative effects of TCC intervention and CBT protocols in improving postural balance and subjective instability feelings in patients with FAI. Methods: This study will be a single-center, parallel group, randomized controlled trial. Sixty-eight patients with FAI will be included and randomly assigned in a 1:1 ratio to either an intervention group (n =34) or a control group (n = 34). The participants in the intervention group will complete 12 weeks of TCC intervention (40 min/time, 3 times/week for 12 weeks) on the basis of health education treatment. The control group will receive health education and 36 CBT sessions during a 12-week period. Outcome measures include postural stability and self-reported feelings of instability at baseline, after the end of the intervention, and 3-month follow-up. The postural stability assessment of patients with FAI will be detected by performing static and dynamic postural tests, which will be carried out through a specific balance platform (TecnoBody ProKin). Self-reported feelings of instability will be assessed by Cumberland Ankle Instability Tool (CAIT), American Orthopedics Foot and Ankle Society's Ankle-Hindfoot Evaluation Scale (AOFAS-AHES), and the MOS item Short Form Health Survey (SF-36). Discussion: This trial will demonstrate whether a 12-week TCC intervention positively affects postural stability and self-reported outcomes in patients with FAI. At the same time, the superiority of its clinical efficacy will also be compared with that of CBT. This study may also help to redefine the value of traditional Chinese exercises in the treatment of chronic ankle instability. Clinical trial registration: Chinese Clinical Trial Registry: ChiCTR2100041790. Registration date: 22 March 2021. http://www.chictr.org.cn/edit.aspx?pid=119501&htm=4.

Acute effect of kinesio tape on postural control in individuals with functional ankle instability following ankle muscle fatigue.

Background: Kinesio taping (KT) is one of the therapeutic interventions in sports medicine practice. The study aims to assess the acute effect of different KT methods on postural control in individuals with functional ankle instability (FAI) after ankle muscle fatigue. Methods: Twenty-eight participants with FAI were recruited to complete maximum voluntary isometric contraction (MVIC) and proprioception of ankle using isokinetic dynamometer, dynamic postural control using Y-balance test and static postural control using a force platform after a fatigue protocol in four taping conditions: facilitatory KT (FKT), ankle balance taping (ABT), sham taping (ST) and no taping (NT). Results: No significant difference was observed for the data MVIC and proprioception after ankle muscle fatigue amongst the four taping treatments. A significant difference in Y-Balance Test was observed amongst the four taping treatments at posterolateral direction (p < 0.001) and posteromedial direction (p < 0.001), suggesting that KT may significantly improve dynamic postural control following ankle muscle fatigue. For Center of pressure (COP) measurements, the mediolateral COP sway range of NT was significantly larger than that of FKT (p = 0.003) and ST (p < 0.001), suggesting that the placebo effect of KT was inevitable. Conclusion: The effect of KT seems increased dynamic postural control in individuals with FAI after ankle muscle fatigue, and this effect is not strongly related to the taping methods. By preventing fatigue-related impairments of postural control, KT may help reduce the risk of injury in individuals with FAI.

Avascular Necrosis of the Talus Following Subchondroplasty: A Case Report and Review of Literature.

CASE: Avascular necrosis (AVN) of the talus in a 45-year-old female following subchondroplasty with calcium phosphate bone filler for treatment of anterolateral and posteromedial talar dome bone marrow lesions (BMLs). The patient subsequently presented as consultation, 18 months postoperatively, with AVN of the talus. After failing conservative management, the patient underwent a total ankle arthroplasty at 46 months after subchondroplasty with resolution of pain. CONCLUSION: There are few studies that have reported on the safety of subchondroplasty of the talus. Given the tenuous blood supply to the talar body and poor patient outcomes associated with AVN, caution should be taken before extrapolating the generally positive results of subchondroplasty in the knee. LEVEL OF EVIDENCE: Level IV.

Relationship between Kinesiophobia and Ankle Joint Position Sense and Postural Control in Individuals with Chronic Ankle Instability-A Cross-Sectional Study.

Functional ankle instability (FAI) is a condition that causes mechanical alterations to the ankle joint and leads to disability. Fear of movement can significantly influence physical factors, and understanding their relationship is crucial in assessing and managing individuals with FAI. The present study aimed to (1) assess the impact of kinesiophobia on ankle joint position sense (JPS) and postural control and (2) evaluate if kinesiophobia can predict JPS and postural control in FAI individuals. This cross-sectional study included 55 FAI individuals. The Tampa Scale of Kinesiophobia (TSK) score was used to measure kinesiophobia. The ankle JPS was evaluated using a digital inclinometer. The individuals were asked to actively reposition to the target position of 10° and 15° of dorsiflexion and plantarflexion. The reposition accuracy is measured in degrees. The static postural control was evaluated in unilateral stance using a stabilometric force platform, including assessments for the ellipse area, anterior to posterior sway, and medial to lateral sway in mm2. Kinesiophobia showed a significant positive correlation (moderate) with the ankle JPS errors in dorsiflexion (10°: r = 0.51, p < 0.001; at 15°: = r = 0.52, p < 0.001) and plantarflexion (10°: r = 0.35, p = 0.009; at 15°: = r = 0.37, p = 0.005). Kinesiophobia also showed significant positive (moderate) correlation with postural control variables (ellipse area: r = 0.44, p = 0.001; Anterior−Posterior sway: r = 0.32, p = 0.015; Medial−Lateral sway: r = 0.60, p < 0.001). Kinesiophobia significantly predicted ankle JPS (p < 0.05) and postural control (p < 0.05). Increased fear of movement is associated with increased ankle JPS errors and postural sway in FAI individuals. Therefore, assessment of these factors is critical in FAI individuals.

Effects of Tai Chi on the neuromuscular function of the patients with functional ankle instability: a study protocol for a randomized controlled trial.

BACKGROUND: Ankle instability limits physical activities and undermines a person's quality of life. Tai Chi's health benefits have been reported in different population groups. However, the effects of Tai Chi on neuromuscular function among young adults with functional ankle instability (FAI) remain unclear. Therefore, we aim to investigate the effect of Tai Chi on young adults with FAI. METHODS: This study will be conducted as a randomized controlled trial with blinded assessors. A total of 104 young adults with FAI will be recruited and randomly assigned to intervention and control groups. The participants in the simplified Tai Chi exercise program (STCEP) group will receive a 12-week Tai Chi training. The participants in the control group will receive a low-intensity exercise program and health education for 12 weeks. The primary and secondary outcomes will be assessed at baseline, 4th, 8th, and 12th weeks. Primary outcome measures will include the Cumberland Ankle Instability Tool (CAIT) score, kinematics/kinetics data, electromyography during single-leg landing tasks, and the modified Star Excursion Balance Test (mSEBT). Secondary outcome measures will include the total time of Dynamic Leap and Balance Test (DLBT), ankle muscle strength, and ankle proprioception. DISCUSSION: This study will investigate the effects of Tai Chi exercise on the neuromuscular function of patients with FAI, as indicated by ankle joint biomechanics, ankle proprioception, balance, ankle muscle strength, and ankle muscle activation. Results will demonstrate that Tai Chi can be an effective exercise for young adults with FAI. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100044089 . Registered on 10 March 2021.