Position-specific deficit of joint position sense in ankles with chronic functional instability

Department of Orthopaedic Surgery, Graduate School of Medicine, Nagasaki University , Nagasaki, Japan.
Journal of sports science & medicine (Impact Factor: 1.03). 12/2008; 7(4):480-5.
Source: PubMed

ABSTRACT The present study was aimed to test a hypothesis that individuals with functional ankle instability (FAI) underestimate the joint angle at greater plantarflexion and inversion. Seventeen males with unilateral FAI and 17 controls (males without FAI) consented for participation in this IRB-approved, case-control study. Using a passive reproduction test, we assessed ankle joint position sense (JPS) for test positions between 30 and -10 degrees plantarflexion with an inclement of 10 degrees with or without 20° inversion at each plantarflexion angle. The constant error (CE) was defined as the value obtained by subtracting the true angle of a test position from the corresponding perceived angle. At plantarflexed and inverted test positions, the CE values were smaller in negative with greater in the FAI group than in the control group. That is, in the FAI group, the FAI group underestimated the true plantarflexion angle at combined 30° plantarflexion and 20° inversion. We conclude that the ankle with FAI underestimate the amount of plantarflexion, which increases the chance of reaching greater planterflexion and inversion than patients' intention at high risk situations of spraining such as landing. Key pointsJoint position sense (JPS) of the ankle with functional ankle instability was investigated utilizing a passive reproduction test.The FAI group demonstrated greater error of the joint position than the control group only when the ankle was positioned at combined inversion and plantarflexion.The FAI group underestimated plantarflexion angle when the ankle was placed at combined inversion and plantarflexion.

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Available from: Kazuyoshi Gamada, Sep 28, 2015
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    ABSTRACT: To identify the most precise and consistent variables using joint repositioning for identifying joint position recognition (JPR) deficits in individuals with chronic ankle instability (CAI). We conducted a computerized search of the relevant scientific literature from January 1, 1965, to July 31, 2010, using PubMed Central, CINAHL, MEDLINE, SPORTDiscus, and Web of Science. We also conducted hand searches of all retrieved studies to identify relevant citations. Included studies were written in English, involved human participants, and were published in peer-reviewed journals. Studies were included in the analysis if the authors (1) had examined JPR deficits in patients with CAI using active or passive repositioning techniques, (2) had made comparisons with a group or contralateral limb without CAI, and (3) had provided means and standard deviations for the calculation of effect sizes. Studies were selected and coded independently and assessed for quality by the investigators. We evaluated 6 JPR variables: (1) study comparisons, (2) starting foot position, (3) repositioning method, (4) testing range of motion, (5) testing velocity, and (6) data-reduction method. The independent variable was group (CAI, control group or side without CAI). The dependent variable was errors committed during joint repositioning. Means and standard deviations for errors committed were extracted from each included study. Effect sizes and 95% confidence intervals were calculated to make comparisons across studies. Separate meta-analyses were calculated to determine the most precise and consistent method within each variable. Between-groups comparisons that involved active repositioning starting from a neutral position and moving into plantar flexion or inversion at a rate of less than 5°/s as measured by the mean absolute error committed appeared to be the most sensitive and precise variables for detecting JPR deficits in people with CAI.
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