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Ankle stability

Chul Hyun Park, Oog Jin Shon, Gi Beom Kim
BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. MATERIALS AND METHODS: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study...
September 2016: Indian Journal of Orthopaedics
Marie-Lyne Nault, Melissa Marien, Jonah Hébert-Davies, G Yves Laflamme, Vincent Pelsser, Dominique M Rouleau, Nayla Gosselin-Papadopoulos, Stéphane Leduc
BACKGROUND: Despite the common occurrence of syndesmotic injuries in ankle trauma, the distal tibiofibular relationship remains poorly understood. The aim of this study was to evaluate the anatomical impact of ankle sagittal positioning on the tibiofibular relationship in intact ankles by using a validated magnetic resonance imaging (MRI)-based measurement system. METHODS: In this radiologic study, 34 healthy volunteers underwent a series of ankle MRIs with the ankle stabilized in 3 positions: neutral position (NP), dorsiflexion (DF), and plantarflexion (PF)...
October 12, 2016: Foot & Ankle International
Marco Hagen, Gerrit Schwiertz, Karl B Landorf, Hylton B Menz, George S Murley
The pronators and supinators play a key role in the medio-lateral stability of the ankle joint complex (i.e. talo-crural and subtalar joints). We hypothesized that each shank muscle has a specific activation pattern determined by its anatomical course around the axes of the subtalar and talo-crural joints. A secondary objective was to examine the effect of foot posture on these activation patterns. Forty-nine young adults (25 normal-arched feet, 24 flat-arched feet) performed maximum voluntary isometric contractions against manual resistance in four movement directions: plantarflexion (PF), dorsiflexion (DF), pronation (PRO) and supination (SUP)...
October 6, 2016: Human Movement Science
Manuel González-Sánchez, Maria Ruiz-Muñoz, Ana Belén Ávila-Bolívar, Antonio I Cuesta-Vargas
BACKGROUND: To analyse the effect of real-time kinematic feedback (KRTF) when learning two ankle joint mobilisation techniques comparing the results with the traditional teaching method. METHODS: Double-blind randomized trial. SETTINGS: Faculty of Health Sciences. PARTICIPANTS: undergraduate students with no experience in manual therapy. Each student practised intensely for 90 min (45 min for each mobilisation) according to the random methodology assigned (G1: traditional method group and G2: KRTF group)...
October 6, 2016: BMC Medical Education
Tun Hing Lui
The open anatomic repair of the anterior talofibular and calcaneofibular ligaments (modified Brostrom procedure) is widely accepted as the standard surgical stabilization procedure for lateral ankle instability that does not respond to conservative measures. Arthroscopic Brostrom procedures with a suture anchor have been reported to achieve both anatomic repair of the lateral ankle ligaments and management of the associated intra-articular lesions. However, the complication rates are higher than open Brostom procedures...
August 2016: Arthroscopy Techniques
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
Erieta Nikolikj Dimitrova, Ivana Božinovikj, Simona Ristovska, Aleksandra Hadzieva Pejcikj, Aleksandra Kolevska, Mirjeta Hasani
BACKGROUND: Charcot-Marie-Tooth (CMT) disease is a hereditary disease with signs of chronic non-progressive motor-sensory neuropathy which is characterised by symmetric muscle atrophy and weakness of the distal portion of lower extremities. AIM: The aim is to present two cases with peroneal muscular atrophy, applied rehabilitation procedures and rehabilitation outcome. MATERIAL AND METHODS: Patient DR, aged 51, and patient KH, aged 78. Both patients had weakness and pronounced atrophy of the distal portion of lower extremities, numbness down the legs, contractures in the ankles and walking difficulties...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Charlotte Apps, Thorsten Sterzing, Thomas O'Brien, Mark Lake
Unstable shoes (US) continually perturb gait which can train the lower limb musculature, but muscle co-contraction and potential joint stiffness strategies are not well understood. A shoe with a randomly perturbing midsole (IM) may enhance these adaptations. This study compares ankle and knee joint stiffness, and ankle muscle co-contraction during walking and running in US, IM and a control shoe in 18 healthy females. Ground reaction forces, three-dimensional kinematics and electromyography of the gastrocnemius medialis and tibialis anterior were recorded...
September 20, 2016: Journal of Electromyography and Kinesiology
Thomas O Clanton, Brady T Williams, Jonathon D Backus, Grant J Dornan, Daniel J Liechti, Scott R Whitlow, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Biomechanical data and contributions to ankle joint stability have been previously reported for the individual distal tibiofibular ligaments. These results have not yet been validated based on recent anatomic descriptions or using current biomechanical testing devices. METHODS: Eight matched-pair, lower leg specimens were tested using a dynamic, biaxial testing machine. The proximal tibiofibular joint and the medial and lateral ankle ligaments were left intact...
September 28, 2016: Foot & Ankle International
Nicolas Perret, Rolf Frischknecht, Stefano Carda, Françoise Sandoz, Aurelien Fauquex, Yannick Charrotton
OBJECTIVE: To study the effect of a robot assisted motor training program of the lower limbs on locomotor functioning of chronic stroke patients. MATERIALS/PATIENTS AND METHODS: After ethical committee approval, 5 women and 2 men with chronic hemiplegia 2, 20 years after stroke (1 right, 6 left), age 35 and 79, underwent a robot assisted training of their lower limbs twice a week for 6 weeks. During the 30's exercise sessions (leg press and cycling), the participants used an end effector type rehabilitation robot (Lambda Health System plc) and were asked to follow actively the robot-guided movements...
September 2016: Annals of Physical and Rehabilitation Medicine
Juliette Ropars, Mathieu Lempereur, Sylvain Brochard, Carole Vuillerot, Vincent Tiffreau, Jean-Marie Cuisset, Yann Péréon, Fabien Leboeuf, Raphaël Gross, Ludovic Delporte, Yannick Delpierre
OBJECTIVE: The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD). MATERIALS/PATIENTS AND METHODS: Dynamic surface electromyography recordings (EMGs) of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF), vastus lateralis (VL), medial hamstrings (HS), tibialis anterior (TA) and gastrocnemius soleus (GAS) muscles was recorded and analyzed quantitatively and qualitatively...
September 2016: Annals of Physical and Rehabilitation Medicine
Pascal Edouard, Emmanuelle Cugy, Romain Dolin, Nicolas Morel, Kathrin Steffen
OBJECTIVE: The incidence of injuries in athletics is important, with consequences at short and long terms in sport, health, social and professional levels. It is therefore important to define strategies to reduce the incidence and severity of injuries in athletics. The objective of this study was to determine whether an injury prevention program (IPP) can reduce the occurrence and/or severity of injuries related to the practice of athletics. MATERIAL AND METHODS: The IPP has been developed, based on current scientific knowledge, targeting exercises on the most common injuries in athletics (hamstring muscle injury, Achilles and patellar tendinopathy, low back pain, ankle sprain) and selecting exercises known to treat and/or prevent these injuries (care stability, hamstrings and leg eccentric muscle strengthening, pelvis balance and stabilizing work)...
September 2016: Annals of Physical and Rehabilitation Medicine
Kathleen Hartwich, Alejandro Lorente Gomez, Jaroslaw Pyrc, Radosław Gut, Stefan Rammelt, René Grass
BACKGROUND: We performed a biomechanical comparison of 2 methods for operative stabilization of pronation-abduction stage III ankle fractures; group 1: Anterior-posterior lag screws fixing the posterior tibial fragment and lateral fibula plating (LSLFP) versus group 2: locked plate fixation of the posterior tibial fragment and posterior antiglide plate fixation of the fibula (LPFP). METHODS: Seven pairs of fresh-frozen osteoligamentous lower leg specimens (2 male, and 5 female donors) were used for the biomechanical testing...
September 26, 2016: Foot & Ankle International
Thomas O Clanton, Scott R Whitlow, Brady T Williams, Daniel J Liechti, Jonathon D Backus, Grant J Dornan, Adriana J Saroki, Travis Lee Turnbull, Robert F LaPrade
BACKGROUND: Significant debate exists regarding optimal repair for unstable syndesmosis injuries. Techniques range from screw fixation, suture-button fixation, or a combination of the two. In this study, 3 common repairs were compared using a simulated weightbearing protocol with internal and external rotation of the foot. METHODS: Twenty-four lower leg specimens with mean age 54 years (range, 38-68 years) were used for testing. Following creation of a complete syndesmotic injury (AITFL, ITFL, PITFL, interosseous membrane), specimens were repaired using 1 of 3 randomly assigned techniques: (1) one 3...
September 25, 2016: Foot & Ankle International
Tyler Snoap, Matthew Jaykel, Cayla Williams, Jason Roberts
BACKGROUND: Calcaneal fractures are commonly seen and treated in the emergency department. There are subsets of calcaneal fractures that pose a high risk to the adjacent soft tissue of the heel and can result in full-thickness tissue necrosis. OBJECTIVE: To identify which calcaneal fractures need to be managed within hours and triaged to the orthopedic team and which can be temporized in a neutral or plantarflexed ankle splint and seen in an outpatient setting. DISCUSSION: Tongue-type calcaneal fractures and tuberosity fractures must be triaged appropriately within the first few hours of presentation to prevent skin compromise...
September 19, 2016: Journal of Emergency Medicine
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
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
Ram Haddas, Steven F Sawyer, Phillip S Sizer, Toby Brooks, Ming-Chien Chyu, C Roger James
INTRODUCTION: Recurrent LBP (rLBP) and neuromuscular fatigue are independently thought to increase the risk of lower extremity (LE) injury. Volitional preemptive abdominal contraction (VPAC) is thought to improve lumbar spine and pelvis control in individuals with rLBP. The effects of VPAC on fatigued landing performance in individuals with rLBP are unknown. OBJECTIVES: To determine the effects of VPAC and LE fatigue on landing performance in a rLBP population. DESIGN: Cross-sectional pretest-posttest cohort control design...
August 24, 2016: Journal of Sport Rehabilitation
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