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Chronic ankle instability

N Harrasser, K Eichelberg, F Pohlig, H Waizy, A Toepfer, R von Eisenhart-Rothe
Because of their frequency, ankle sprains are of major clinical and economic importance. The simple sprain with uneventful healing has to be distinguished from the potentially complicated sprain which is at risk of transition to chronic ankle instability. Conservative treatment is indicated for the acute, simple ankle sprain without accompanying injuries and also in cases of chronic instability. If conservative treatment fails, good results can be achieved by anatomic ligament reconstruction of the lateral ankle ligaments...
October 13, 2016: Der Orthopäde
A Rosen, J Ko, C Brown
Chronic ankle instability is a common pathological consequence of ankle sprains. However, screening tools which assess self-reported dysfunction offer little insight into clinical factors which may be useful to improve deficits. The purpose of this study was to identify factors that contribute most to self-reported dysfunction. 93 individuals completed the Cumberland Ankle Instability Tool (CAIT), active range of motion, dynamic postural stability assessments, and an arthrometer inversion stress test to assess lateral ankle laxity and stiffness...
October 5, 2016: International Journal of Sports Medicine
R Lopes, C Decante, L Geffroy, K Brulefert, T Noailles
Anatomical reconstruction of the lateral ankle ligaments has become a pivotal component of the treatment strategy for chronic ankle instability. The recently described arthroscopic version of this procedure is indispensable to ensure that concomitant lesions are appropriately managed, yet remains technically demanding. Here, we describe a simplified variant involving percutaneous creation of the calcaneal tunnel for the distal attachment of the calcaneo-fibular ligament. The rationale for this technical stratagem was provided by a preliminary cadaver study that demonstrated a correlation between the lateral malleolus and the distal footprint of the calcaneo-fibular ligament...
September 27, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ewout S Veltman, Ernst Ja Steller, Philippe Wittich, Jort Keizer
A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation...
September 18, 2016: World Journal of Orthopedics
Terry L Grindstaff, Nadyne Dolan, Sam K Morton
OBJECTIVES: To determine differences in ankle dorsiflexion range of motion (ROM) between three groups of individuals with chronic ankle instability (CAI) based on Lateral Step Down Test quality of movement. The secondary purpose was to quantify the relationship between ankle dorsiflexion ROM and Lateral Step Down Test scores. DESIGN: Descriptive laboratory study. SETTING: University research laboratory. PARTICIPANTS: Fifty-nine participants with CAI...
July 29, 2016: Physical Therapy in Sport
Tarang Kumar Jain, Clayton N Wauneka, Wen Liu
BACKGROUND: Balance training has been shown to be effective in preventing ankle sprain recurrences in subjects with chronic ankle instability (CAI) but the biomechanical pathways underlying the clinical outcomes are still unknown. This study was conducted to determine if a 4-week balance training intervention can alter the mechanical characteristics in ankles with CAI. METHODS: Twenty-two recreationally active subjects with unilateral CAI were randomized to either a control (n = 11, 35...
2016: International Journal of Sports and Exercise Medicine
Guilherme S Nunes, Marcos de Noronha
OBJECTIVES: To investigate the impact different ways to define reference balance can have when analysing time to stabilization (TTS). Secondarily, to investigate the difference in TTS between people with chronic ankle instability (CAI) and healthy controls. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Fifty recreational athletes (25 CAI, 25 controls). MAIN OUTCOME MEASURES: TTS of the center of pressure (CoP) after maximal single-leg vertical jump using as reference method the single-leg stance, pre-jump period, and post-jump period; and the CoP variability during the reference methods...
August 1, 2016: Physical Therapy in Sport
James M Cottom, Joseph S Baker, Phillip E Richardson
Lateral ankle sprains are a common injury that typically respond well to nonoperative therapy. When nonoperative therapy fails and patients develop chronic lateral ankle instability, they become candidates for surgical repair. The present study examined 45 consecutive patients (45 ankles) with chronic lateral ankle instability who underwent arthroscopic Broström repair using a double-row suture anchor construct. The 45 patients (27 females and 18 males) were followed up for a mean of 14 (range 12 to 20) months...
September 21, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kyeongtak Song, Christopher J Burcal, Jay Hertel, Erik A Wikstrom
PURPOSE: The underlying cause of balance impairments in chronic ankle instability (CAI) patients remains unknown, but an altered use of sensory information has been hypothesized as a potential cause. The purpose of this systematic review with meta-analysis was to determine whether CAI patients use somatosensory information to the same extent as uninjured controls during static single limb stance. METHODS: We searched PubMed, CINAHL, SPORTDiscus, and Scopus databases from origin to March 2016 using the combination of key words, including postural control, postural stability, single limb stance, single leg stance, single leg balance, single limb balance, and time to boundary (TTB)...
October 2016: Medicine and Science in Sports and Exercise
Taegyu Kim, Eunkuk Kim, Hokyung Choi
OBJECTIVE: To determine whether a neuromuscular rehabilitation program can improve postural stability, and ankle evertor strength, and to examine the temporal changes and persistence of the rehabilitation effects in athletes with chronic ankle instability (CAI). DESIGN: A total of 21 national women's field hockey players participated in this study (CAI, n = 12; control, n = 9). Main outcome measures included isokinetic ankle evertor strength (peak torque, PT; total work, TW) at 30°/s, 60°/s, 90°/s and 120°/s, mediolateral stability index (MSI), and dynamic stability test (TCT)...
August 24, 2016: Journal of Sport Rehabilitation
Cynthia J Wright, Shelley W Linens, Mary Spencer Cain
CONTEXT: There is minimal patient-oriented evidence regarding the effectiveness of interventions targeted to reduce symptoms associated with chronic ankle instability (CAI). Additionally, clinicians aiming to prioritize care by implementing only the most effective components of a rehabilitative program have very little evidence on comparative efficacy. OBJECTIVE: To assess the comparative efficacy of two common ankle rehabilitation techniques [wobble board (WB) balance training and ankle strengthening using resistance tubing (RT)] using patient-oriented outcomes...
August 24, 2016: Journal of Sport Rehabilitation
Mary Spencer Cain, Stacy Watt Garceau, Shelley W Linens
CONTEXT: Chronic Ankle Instability (CAI) describes the residual symptoms present after repetitive ankle sprains. Current rehabilitation programs in the high school population focus on a multi-station approach or general lower extremity injury prevention program. Specific rehabilitation techniques for CAI have not been established. OBJECTIVE: To determine the effectiveness of a 4-week Biomechanical Ankle Platform System (BAPS) Board protocol on balance of high school athletes with CAI...
August 24, 2016: Journal of Sport Rehabilitation
Christopher J Burcal, Alejandra Y Trier, Erik A Wikstrom
CONTEXT: Both balance training and selected interventions meant to target sensory structures (STARS) have been shown to be effective at restoring deficits associated with chronic ankle instability (CAI). Clinicians often utilize multiple treatment modalities in patients with CAI. However, evidence for combined intervention effectiveness in CAI patients remains limited. OBJECTIVE: To determine if augmenting a balance training protocol with STARS (BTS) results in greater improvements than balance training (BT) alone in those with CAI...
August 24, 2016: Journal of Sport Rehabilitation
Cameron J Powden, Kathleen K Hogan, Erik A Wikstrom, Matthew C Hoch
CONTEXT: Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI). OBJECTIVE: Examine the immediate effects of talocrural joint traction in those with CAI. DESIGN: Blinded, crossover. SETTING: Laboratory. PARTICIPANTS: Twenty adults (14 females; age=23.80±4.02years; height=169.55±12.38cm; weight=78.34±16.32kg) with self-reported CAI participated...
August 24, 2016: Journal of Sport Rehabilitation
Kathryn A Webster, Brian G Pietrosimone, Phillip A Gribble
CONTEXT:  Ankle instability is a common condition in physically active individuals. It often occurs during a jump landing or lateral motion, particularly when participants are fatigued. OBJECTIVE:  To compare muscle activation during a lateral hop prefatigue and postfatigue in individuals with or without chronic ankle instability (CAI). DESIGN:  Cross-sectional study. SETTING:  Sports medicine research laboratory...
September 14, 2016: Journal of Athletic Training
Adriano Russo, Paolo Giacchè, Enrico Marcantoni, Annalisa Arrighi, Luigi Molfetta
PURPOSE: this study was conducted to evaluate long-term results following treatment of chronic lateral ankle instability using the Broström-Gould technique in athletes. METHODS: eighteen athletes involved in competitive sports at different levels, who suffered from chronic lateral ankle instability, underwent Broström-Gould ligamentoplasty between 2000 and 2005. The results of the surgery were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale...
April 2016: Joints
Matthew D Sorensen, John Baca, Keith Arbuckle
Arthroscopic lateral ankle stabilization procedures have been described for many years. New technological advances and a deeper understanding of the pathobiomechanics involved in chronic lateral ankle instability have allowed an expansion of arthroscopic approaches to this common pathology. As experience is gained and outcomes within the patient profile are understood, the authors feel that the arthroscopic approach to lateral ankle stabilization may prove superior to traditional methods secondary to the risk and traditional complications that are mitigated within minimally invasive arthroscopic approaches...
October 2016: Clinics in Podiatric Medicine and Surgery
Amber M Shane, Christopher L Reeves, Ryan Vazales, Zachary Farley
Soft tissue impingement (STI) syndrome is one of 3 causes of a larger all-encompassing joint impingement pathologic condition, which also includes bone and neuropathic entrapment. Altered joint biomechanics and friction of joint tissues combine to cause chronic pain and often functional instability. Although the most common form of STI to the ankle is anterolateral in location, posterior and anteromedial impingement is also discussed in this article. Furthermore, a discussion of biomechanical deficiencies and how they may effect location and cause of STI of the ankle is explored along with pathophysiology, clinical and diagnostic evaluation, current treatments, and long-term outcomes...
October 2016: Clinics in Podiatric Medicine and Surgery
Ya-Lan Chiu, Ching-I Chang, Chueh-Ho Lin, Wen-Hsu Sung
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Kyung-Min Kim, Joseph M Hart, Susan Saliba, Jay Hertel
CONTEXT:  Individuals with chronic ankle instability (CAI) present with decreased modulation of the Hoffmann reflex (H-reflex) from a simple to a more challenging task. The neural alteration is associated with impaired postural control, but the relationship has not been investigated in individuals with CAI. OBJECTIVE:  To determine differences in H-reflex modulation and postural control between individuals with or without CAI and to identify if they are correlated in individuals with CAI...
September 1, 2016: Journal of Athletic Training
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