Postural control differs between those with and without chronic ankle instability

Biodynamics Research Laboratory, Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC 28223,United States.
Gait & posture (Impact Factor: 2.75). 04/2010; 32(1):82-6. DOI: 10.1016/j.gaitpost.2010.03.015
Source: PubMed


Despite a history of a lateral ankle sprain, some individuals (copers) return to high-level activities (i.e. jumping, pivoting) without recurrent injury or loss of function while others develop chronic ankle instability (CAI). Understanding the differences between these groups may provide insight into the mechanisms of CAI. The objectives of this investigation were to: (1) compare traditional center of pressure [COP], time-to-boundary [TTB], and center of pressure-center of mass [COP-COM] moment arm measures of postural control among controls, established copers, and subjects with CAI and (2) determine the accuracy of these postural control measures at discriminating between established copers and subjects with CAI using receiving operating characteristic curves. 48 subjects (control=16, coper=16, CAI=16) completed two, 30-s trials of single-leg stance on a force plate with their eyes open. Coper and CAI subjects stood on their involved limb while controls stood on a matched limb. The results indicated that mediolateral (p<0.01) and anteroposterior (p<0.01) COP velocity was greater in individuals with CAI relative to both copers and controls. Similarly, the peak COP-COM moment arm in the anteroposterior direction (p<0.01) and the resultant mean COP-COM moment arm (p<0.01) were increased in individuals with CAI relative to copers. These measures also reached asymptotic significance (p<0.05) indicating that they successfully discriminated between established copers and individuals with CAI.

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Available from: Erik A Wikstrom,
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    • "We know from human research that patients after an ankle sprain as well as those with chronic ankle instability (CAI) have significantly more laxity or joint instability compared to healthy controls ( Brown et al., 2015; Hubbard et al., 2007; 2012; Croy et al., 2012). These changes in joint stability could also lead to the impairments in neuromuscular control seen in patients with CAI (Feger et al., 2015; Levin et al., 2015; Wikstrom et al., 2010). The combination of the joint instability and neuromuscular control impairments may decrease the ability to be physically active. "
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    ABSTRACT: We do not know the impact an ankle sprain has on physical activity levels across the lifespan. With the negative conse-quences of physical inactivity well established, understanding the effect of an ankle sprain on this outcome is critical. The objective of this study was to measure physical activity across the lifespan after a single ankle sprain in an animal model. Thir-ty male mice (CBA/J) were randomly placed into one of three groups: the transected calcaneofibular ligament (CFL) group, the transected anterior talofibular ligament (ATFL)/CFL group, and a SHAM group. Three days after surgery, all of the mice were individually housed in a cage containing a solid surface running wheel. Physical activity levels were recorded and aver-aged every week across the mouse’s lifespan. The SHAM mice ran significantly more distance each day compared to the re-maining two running groups (post hoc p = 0.011). Daily dura-tion was different between the three running groups (p = 0.048). The SHAM mice ran significantly more minutes each day com-pared to the remaining two running groups (post hoc p=0.046) while the ATFL/CFL mice ran significantly less minutes each day (post hoc p = 0.028) compared to both the SHAM and CFL only group. The SHAM mice ran at a faster daily speed versus the remaining two groups of mice (post hoc p = 0.019) and the ATFL/CFL mice ran significantly slower each day compared to the SHAM and CFL group (post hoc p = 0.005). The results of this study indicate that a single ankle sprain significantly de-creases physical activity across the lifespan in mice. This de-crease in physical activity can potentially lead to the develop-ment of numerous chronic diseases. An ankle sprain thus has the potential to lead to significant long term health risks if not treated appropriately.
    Journal of sports science & medicine 09/2015; 14(3):556-61. · 1.03 Impact Factor
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    • "Specific Exclusion Criteria 1 Had not attended specific program of prevention and/or treatment for ankle injuries (Hubbard & Kaminski, 2002; Wikstrom, Fournier, et al., 2010). 1 History of two or more lateral ankle sprain (Wikstrom, Fournier, et al., 2010). 2 Perceived pain, instability and/or ankle weakness at the moment of evaluation (Brown et al., 2004; Wikstrom, Fournier, et al., 2010). 1 Participate in sports that involve jumping as a principal motor skill. For example, basketball, volleyball, long jump etc. 2 History of two or more lateral ankle sprain (Wikstrom, Fournier, et al., 2010). "
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    ABSTRACT: Motor control evaluation in subjects with functional ankle instability is questionable when both ankles of the same subject are compared (affected vs non-affected). To compare the postural control and reaction time of ankle muscles among: basketball players with FAI (instability group), basketball players without FAI (non-instability group) and healthy non-basketball-playing participants (control group). Case-control study. Laboratory. Instability (n = 10), non-instability (n = 10), and control groups (n = 11). Centre of pressure variables (area, velocity and sway) were measured with a force platform. Reaction time of ankle muscles was measured via electromyography. A one-way ANOVA demonstrated that there were significant differences between the instability and non-instability groups in the fibularis longus (p < 0.001), fibularis brevis (p = 0.031) and tibialis anterior (p = 0.049) muscles. Repeated-measures ANOVA and post hoc analysis determined significant differences for the area between the instability and non-instability groups (p = 0.001). Basketball players with FAI have reduced postural control and longer reaction time of the fibularis and tibialis anterior muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Physical Therapy in Sport 08/2015; 16(3):242-247. DOI:10.1016/j.ptsp.2014.10.008 · 1.65 Impact Factor
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    • "Biomech. (2014), relapse (Wikstrom and Brown, 2014), are considered to adopt unique postural control strategies conducive with their injury outcome (Wikstrom et al., 2010). However, the research evaluating these postural control strategies at a specific time point occurring in the period between the acute episode (b2 weeks following injury) and the determination of recovery/chronicity (N1 year following injury), is sparse. "
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    ABSTRACT: Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants, 6-months after they sustained an acute, first-time lateral ankle sprain in comparison to a control group. Sixty-nine participants with a 6-month history of first-time lateral ankle sprain and 20 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-dimensional kinematic data for similarity in the aim of establishing patterns of lower-limb inter-joint coordination. The fractal dimension of the stance limb centre of pressure path was also calculated. Between-group analyses revealed significant differences in stance limb inter-joint coordination strategies for conditions 1 and 2, and in the fractal dimension of the centre-of-pressure path for condition 2 only. Injured participants displayed increases in ankle-hip linked coordination compared to controls in condition 1 (sagittal/frontal plane: 0.15 [0.14] vs 0.06 [0.04]; η(2)=.19; sagittal/transverse plane: 0.14 [0.11] vs 0.09 [0.05]; η(2)=0.14) and condition 2 (sagittal/frontal plane: 0.15 [0.12] vs 0.08 [0.06]; η(2)=0.23), with an associated decrease in the fractal dimension of the centre-of-pressure path (injured limb: 1.23 [0.13] vs 1.36 [0.13]; η(2)=0.20). Participants with a 6-month history of first-time lateral ankle sprain exhibit a hip-dominant coordination strategy for static unilateral stance compared to non-injured controls. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Clinical biomechanics (Bristol, Avon) 12/2014; 30(2). DOI:10.1016/j.clinbiomech.2014.12.011 · 1.97 Impact Factor
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