Systematic Review of Postural Control and Lateral Ankle Instability, Part II: Is Balance Training Clinically Effective? (original) (raw)
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Serial Testing of Postural Control After Acute Lateral Ankle Sprain
Journal of athletic training, 2001
OBJECTIVE: To identify subjects' changes in postural control during single-leg stance in the 4 weeks after acute lateral ankle sprain. DESIGN AND SETTING: We used a 2 x 2 x 3 (side-by-plane-by-session) within-subjects design with repeated measures on all 3 factors. All tests were performed in a university laboratory. SUBJECTS: Seventeen young adults (9 men, 8 women; age, 21.8 +/- 5.9 years; mass, 74.9 +/- 10.5 kg; height, 176.9 +/- 7.1 cm) who had sustained unilateral acute mild or moderate lateral ankle sprains. MEASUREMENTS: Measures of center-of-pressure excursion length, root mean square velocity of center-of-pressure excursions (VEL), and range of center-of-pressure excursions (RANGE) were calculated separately in the frontal and sagittal planes during 5-second trials of static single-leg stance. RESULTS: We noted significant side-by-plane-by-session interactions for magnitude of center-of-pressure excursions in a given trial (PSL) (P =.004), VEL (P =.011), and RANGE (P =.0...
Postural stability deficit could predict ankle sprains: a systematic review
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017
To perform a systematic review aimed to determine (1) if the postural stability deficit represents a risk factor for ankle sprains; (2) the most effective postural stability evaluation to predict ankle sprains and (3) eventual confounding factors that could influence postural stability and ankle sprain risk. A systematic electronic search was performed in MEDLINE, EMBASE and CINAHL using the search terms (balance) OR (postural stability) matched with (lower limb) OR (ankle) OR (foot) and (sprain) OR (injury) on October 2 2017. All prospective studies that evaluated postural stability as risk factor for ankle sprains were included. The PRISMA Checklist guided the reporting and data abstraction. Methodological quality of all included papers was carefully assessed. Fifteen studies were included, evaluating 2860 individuals. Various assessment tools or instruments were used to assess postural stability. The injury incidence ranged from 10 to 34%. Postural stability deficit was recognize...
Journal of athletic training
Chronic ankle instability (CAl) is a term used to identify a condition associated with recurrent ankle sprains and persistent symptoms. Balance deficits, evaluated using center-of-pressure (COP) force-plate measurements, have been shown to occur in people with CAl. To determine the differential abilities of selected force-plate postural-control measures to assess CAl. Case-control study. Laboratory. A total of 63 individuals with CAl (30 men, 33 women: age= 22.3± 3.7 years, height= 169.8 ±9.6 cm, mass= 70.7± 14.3 kg) and 46 healthy controls (22 men, 24 women: age= 21.2± 4.1 years, height= 173.3± 9.2 cm, mass =69.2± 13.2 kg) volunteered. Participants performed 3 10-second trials of quiet, single-limb stance on a force plate under 2 conditions: eyes open and eyes closed. Measures of COP area, COP velocity, COP SO, COP range of excursion, percentage of COP range used, time-to-boundary absolute minimum, time-to-boundary mean of the minima, and time-to-boundary SO of the minima were calc...
Postural stability and ankle sprain history in athletes compared to uninjured controls
Clinical Biomechanics, 2014
Background: Diminished postural stability is a risk factor for ankle sprain occurrence and ankle sprains result in impaired postural stability. To date, ankle sprain history has not been taken into account as a determinant of postural stability, while it could possibly specify subgroups of interest. Methods: Postural stability was compared between 18 field hockey athletes who had recovered from an ankle sprain (mean (SD); 3.6 (1.5) months post-injury), and 16 uninjured controls. Force plate and kinematics parameters were calculated during single-leg standing: mean center of pressure speed, mean absolute horizontal ground reaction force, mean absolute ankle angular velocity, and mean absolute hip angular velocity. Additionally, cluster analysis was applied to the 'injured' participants, and the cluster with diminished postural stability was compared to the other participants with respect to ankle sprain history. Findings: MANCOVA showed no significant difference between groups in postural stability (P = 0.68). A selfreported history of an (partial) ankle ligament rupture was typically present in the cluster with diminished postural stability. Subsequently, a 'preceding rupture' was added as a factor in the MANCOVA, which showed a significant association between diminished postural stability and a 'preceding rupture' (P = 0.01), for all four individual parameters (P: 0.001-0.029; Cohen's d: 0.96-2.23). Interpretation: Diminished postural stability is not apparent in all previously injured athletes. However, our analysis suggests that an (mild) ankle sprain with a preceding severe ankle sprain is associated with impaired balance ability. Therefore, sensorimotor training may be emphasized in this particular group and caution is warranted in return to play decisions.
No Impairments in Dynamic Postural Control Following an Acute Lateral Ankle Sprain
Lateral ankle sprains are the most common injury in sports, with an estimated 25,000 per day. Current research assesses postural control deficits following lateral ankle sprains; however most studies use static stances instead of dynamic stances. Most of the current research compares injured limb to non-injured limb, however bilateral impairments have been found to be present. Twenty Division I student athletes will be recruited to participate in this study, ten subjects will be NCAA Division I student athletes who have suffered a lateral ankle sprain. Control subjects will be healthy NCAA Division I student athletes, matched by height and gender with the injured subjects. Dynamic postural control will be evaluated by gait initiation, which will be assessed using the Vicon system and then compared to matched healthy control values. MANOVA revealed no significant difference in dynamic postural control following a lateral ankle sprain when compared to control group. Significant differences were found in range of motion assessment as well as perceived function assessment.
Dynamic Postural Stability Deficits in Subjects with Self-Reported Ankle Instability
Medicine & Science in Sports & Exercise, 2007
Purpose: A limited understanding of how functional ankle instability (FAI) affects dynamic postural stability exists because of a lack of reliable and valid measures. Therefore, the purpose of this investigation was to determine whether a new reliable index for dynamic postural stability could differentiate between those with stable ankles and those with FAI. Methods: Data were collected on 108 subjects (54 subjects with stable ankles (STABLE group); 54 subjects with functionally unstable ankles (FAI group)). Subjects performed a single-leg-hop stabilization maneuver in which they stood 70 cm from the center of a force plate, jumped off both legs, touched a designated marker placed at a height equivalent to 50% of their maximum vertical leap, and landed on a single leg. The dynamic postural stability index and directional stability indices (medial/lateral, anterior/posterior, and vertical) were calculated. The raw and normalized (to energy dissipated) indices were compared between groups. Results: Significant differences were noted for the anterior/posterior stability index (FAI = 0.36 T 0.09, STABLE = 0.30 T 0.06). Similar results were seen for the vertical stability index (FAI = 0.73 T 0.17, STABLE = 0.61 T 0.13), the normalized dynamic postural stability index (FAI = 0.85 T 0.17, STABLE = 0.73 T 0.12), the normalized vertical stability index (FAI = 0.007 T 0.004, STABLE = 0.005 T 0.001), and the dynamic postural stability index (FAI = 0.008 T 0.003, STABLE = 0.006 T 0.001). Conclusions: These results indicate that the dynamic postural stability index is a sensitive measure of dynamic postural stability and is capable of detecting differences between individuals with stable ankles and individuals with functionally unstable ankles.
Relationship Between Functional Ankle Instability and Postural Control
Journal of Orthopaedic & Sports Physical Therapy, 2008
Instability and Postural Control ateral ankle sprain is common in sports that involve highvelocity and high-impact movements such as jumping, hopping, and cutting. One of the consequences of lateral ankle sprain is ongoing instability, which can be mechanical, functional, or both. 4,11 Functional ankle instability (FAI) is characterized by symptoms of giving way, weakness, pain, and impaired function. 9,17 Though FAI has been linked to impairments in postural control, 15,34 = .05 and .009, respectively).