Balance in single-limb stance after surgically treated ankle fractures: A 14-month follow-up

Primary Healthcare Research Department, Lund University Hospital, Lund, Sweden.
BMC Musculoskeletal Disorders (Impact Factor: 1.72). 04/2006; 7:35. DOI: 10.1186/1471-2474-7-35
Source: PubMed


The maintenance of postural control is fundamental for different types of physical activity. This can be measured by having subjects stand on one leg on a force plate. Many studies assessing standing balance have previously been carried out in patients with ankle ligament injuries but not in patients with ankle fractures. The aim of this study was to evaluate whether patients operated on because of an ankle fracture had impaired postural control compared to an uninjured age- and gender-matched control group.
Fifty-four individuals (patients) operated on because of an ankle fracture were examined 14 months postoperatively. Muscle strength, ankle mobility, and single-limb stance on a force-platform were measured. Average speed of centre of pressure movements and number of movements exceeding 10 mm from the mean value of centre of pressure were registered in the frontal and sagittal planes on a force-platform. Fifty-four age- and gender-matched uninjured individuals (controls) were examined in the single-limb stance test only. The paired Student t-test was used for comparisons between patients' injured and uninjured legs and between side-matched legs within the controls. The independent Student t-test was used for comparisons between patients and controls. The Chi-square test, and when applicable, Fisher's exact test were used for comparisons between groups. Multiple logistic regression was performed to identify factors associated with belonging to the group unable to complete the single-limb stance test on the force-platform.
Fourteen of the 54 patients (26%) did not manage to complete the single-limb stance test on the force-platform, whereas all controls managed this (p < 0.001). Age over 45 years was the only factor significantly associated with not managing the test. When not adjusted for age, decreased strength in the ankle plantar flexors and dorsiflexors was significantly associated with not managing the test. In the 40 patients who managed to complete the single-limb stance test no differences were found between the results of patients' injured leg and the side-matched leg of the controls regarding average speed and the number of centre of pressure movements.
One in four patients operated on because of an ankle fracture had impaired postural control compared to an age- and gender-matched control group. Age over 45 years and decreased strength in the ankle plantar flexors and dorsiflexors were found to be associated with decreased balance performance. Further, longitudinal studies are required to evaluate whether muscle and balance training in the rehabilitation phase may improve postural control.

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    • "As an analysis result of the proprioceptive sense, there were no statistical similarity of the exercise group compared to the general group but not only did it show a higher level of tendency because for the injury group and a similar lowness in the level compared to the exercise group but it also showed low level tendency compared to the general group. These results are similar to many other reported studies and showed to be considered as the important cause of prolonging and increasing the risk of reinjury after ankle injury (Hertel, 2000: Holme et al., 1999; Nilsson et al., 2006). Therefore, not only for the rehabilitation process of these injuries but also for the prevention of ankle injuries, it is considered that an effort is required to increase the ability of proprioception of the ankle. "
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    ABSTRACT: This study was conducted to verify the effect of the ankle injury of athletes who attended the modern pentathlon for a long-term basis on ankle muscle's strength and proprioceptive sensory function. For this, 10 athletes of the modern pentathlon, with experience of having damaged one side of their ankles within 6 months, and 10 healthy male college students, who have similar personal characteristics, such as height, age, and weight and have no experience of participating in regular sports for 3 or more times a week. The experimental subject was divided into 3 groups in all. After the flexor power of the plantar and dorsal side and the muscle strength of the varus and valgus for an ankle were measured by the Biodex System III at an angular velocity of 60°/sec and 120°/sec, it was documented as the maximum couple of force per body weight. Also, specified receptive senses were measured by the Biodex System III using the stop button to find the position (angle) of the joint. As a result of the conclusive research, participation in modern pentathlons for a long-term basis has caused an increase in valgus muscle strength and flexor power of the plantar side of the ankle when compared to general college students. Sports-related injury of the ankle was also found to result into the weakening of the flexor power on the plantar side and valgus muscle strength and a decrease of the proprioceptive sensory function.
    10/2013; 9(5):481-488. DOI:10.12965/jer.130067
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    • "Further, it is important to ensure that each tool demonstrates adequate sensitivity, over time, within the population of interest [34]. The BSHS-B and ankle goniometry, were proven to be reliable, valid and sensitive in the burn population [35] [36] [37] [38] [39] [40] [41] [42]. The BSHS-B is a validated population specific quality of life measure that, to date, is the only existing measure of overall recovery from burn injury [35] [36] [43]. "
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    ABSTRACT: The measurement of recovery after burns to the lower limbs is hampered by an absence validated injury specific tools. This research aimed to select and validate a battery of outcome measures of recovery after lower limb burn injury (LLBI). Reliability study: Reliability of the single leg stance (SLS), the Timed Up and Go (TUG) and the tandem walk (TW) tests were measured using a test-retest trial involving 28 patients with LLBI. Validity study: Clinical data from 172 patients with LLBI were used to compare changes in each LL outcome measure with changes in the Burn Specific Health Scale-Brief (BSHS-B). All tests, except the SLS test with eyes closed, demonstrated excellent inter-rater reliability (ICCs=0.81-0.93). The TUG and the TW-forwards tests were shown to be valid and to provide additional information to the BSHS-B when combined as a battery. The TW-backwards test was redundant while the SLS and ankle DF measures did not correlate highly with the BSHS-B. This study shows that the TUG test and the TWF are reliable and valid in the burns population and along with the BSHS-B form a useful test battery for measuring recovery from LLBI.
    Burns: journal of the International Society for Burn Injuries 09/2010; 36(6):780-6. DOI:10.1016/j.burns.2009.10.019 · 1.88 Impact Factor
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    • "Balance skill problems according to the MABC showed a tendency to be increased, though not reaching statistical significance in this study of 20 children. Decreased plantar flexion power and mobility are commonly found in treated clubfeet [6,20], and are known factors influencing balance [21]. Primarily, one leg stand is a test specific for postural control incorporating motor control, sensory and cognitive processes. "
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    ABSTRACT: To study motor ability at seven years of age in children treated for idiopathic clubfoot and its relation to clubfoot laterality, foot status and the amount of surgery performed. Twenty children (mean age 7.5 years, SD 3.2 months) from a consecutive birth cohort from our hospital catchments area (300.000 inhabitants from southern Sweden) were assessed with the Movement Assessment Battery for Children (MABC) and the Clubfoot Assessment Protocol (CAP). Compared to typically developing children an increased prevalence of motor impairment was found regarding both the total score for MABC (p < 0.05) and the subtest ABC-Ball skills (p < 0.05). No relationship was found between the child's actual foot status, laterality or the extent of foot surgery with the motor ability as measured with MABC. Only the CAP item "one-leg stand" correlated significantly with the MABC (rs = -0.53, p = 0.02). Children with idiopathic clubfoot appear to have an increased risk of motor activity limitations and it is possible that other factors, independent of the clinical status, might be involved. The ability to keep balance on one leg may be a sufficient tool for determining which children in the orthopedic setting should be more thoroughly evaluated regarding their neuromotor functioning.
    BMC Pediatrics 12/2009; 9:78. DOI:10.1186/1471-2431-9-78 · 1.93 Impact Factor
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