Chronic ankle instability is associated with proprioception deficits: A systematic review and meta-analysis

BackgroundAcute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability (CAI). We aimed to explore whether deficits of proprioception, including kinesthesia and joint position sense (JPS), exist in patients with CAI when compared with the uninjured contralateral side and healthy people. We hypothesized that proprioception deficits did exist in patients with CAI and that the deficits varied by test methodologies.MethodsThe study was a systematic review and meta-analysis. We identified studies that compared kinesthesia or JPS in patients with CAI with the uninjured contralateral side or with healthy controls. Meta-analyses were conducted for the studies with similar test procedures, and narrative syntheses were undertaken for the rest.ResultsA total of 7731 studies were identified, of which 30 were included for review. A total of 21 studies were eligible for meta-analysis. Compared with the contralateral side, patients with CAI had ankle kinesthesia deficits in inversion and plantarflexion, with a standardized mean difference (SMD) of 0.41 and 0.92, respectively, and active and passive JPS deficits in inversion (SMD = 0.92 and 0.72, respectively). Compared with healthy people, patients with CAI had ankle kinesthesia deficits in inversion and eversion (SMD = 0.64 and 0.76, respectively), and active JPS deficits in inversion and eversion (SMD = 1.00 and 4.82, respectively). Proprioception deficits in the knee and shoulder of patients with CAI were not statistically significant.ConclusionProprioception, including both kinesthesia and JPS, of the injured ankle of patients with CAI was impaired, compared with the uninjured contralateral limbs and healthy people. Proprioception varied depending on different movement directions and test methodologies. The use of more detailed measurements of proprioception and interventions for restoring the deficits are recommended in the clinical management of CAI.     

Balance and proprioception responses to FIFA 11+ in amateur futsal players: Short and long-term effects

ABSTRACT

Background: The FIFA 11+ has shown positive effects on balance and proprioception parameters in football players. As there have been very few research studies involving futsal, we examined the short and long term effects of the FIFA 11+ on static and dynamic balance, as well as proprioception in male amateur futsal players.

Methods: Seventy-one male futsal players were randomized to two groups (FIFA 11+: n = 37, age: 27.33 ± 4.33 years; Control: n = 34, age: 25.55 ± 4.65 years). Intervention lasted 10 weeks, 2 sessions per week, succeeded by a 10-week follow-up period. For balance testing, we assessed the single-legged postural sway with a force platform (static balance) and the Y balance test (dynamic balance). Proprioception was assessed with active joint position sense testing.

Results: Complete pre-post intervention and follow-up tests were available for 61 players. The FIFA 11+ group showed higher training exposure and lower body mass index and body weight. After adjustment for baseline differences, no significant differences between groups were observed in the pre-post changes for centre of pressure measures, Y-balance and proprioception parameters both at short and long-term.

Conclusions: Performing FIFA 11+ for 10 weeks did not improve static and dynamic balance as well as proprioception in amateur futsal players.     

Changes in ankle joint stiffness due to stretching: The role of tendon elongation of the gastrocnemius muscle

Abstract

The purpose of this study was to investigate changes in ankle joint stiffness and the associated changes in the gastrocnemius muscle and tendon due to static stretching. Seven healthy male participants lay supine with the hip and knee joints fully extended. The right ankle joint was rotated into dorsiflexion from a 30° plantar flexed position and the torque measured by a dynamometer. The ankle joint was maintained in a dorsiflexed position for 20 min (static stretching of the calf muscles). We performed surface electromyography of the medial and lateral gastrocnemii, the soleus, and the tibialis anterior of the right leg to confirm no muscle activity throughout static stretching and the passive test (passive dorsiflexion). During static stretching, the ankle joint angle and elongation of the gastrocnemius were recorded by goniometry and ultrasonography, respectively. Tendon elongation of the gastrocnemius was calculated based on the changes in the ankle joint angle and muscle elongation. In addition, the relationships between passive torques and ankle joint angles, and elongation of muscle and tendon, were examined before and after static stretching. The ankle dorsiflexion angle and tendon elongation increased significantly by 10 min after the onset of static stretching, while there was no further increase in muscle length. In addition, ankle dorsiflexion angle and tendon elongation at an identical passive torque (30 N · m) increased significantly (from 24±7° to 33±5° and from 17±2 mm to 22±1 mm, respectively) after static stretching. However, muscle elongation was unchanged. In conclusion, the current results suggest that an increase in the ankle joint dorsiflexion angle due to static stretching is attributable to a change in tendon not muscle stiffness.     

A lateral ankle sprain during a lateral backward step in badminton: A case report of a televised injury incident

BackgroundThis study presents a kinematic analysis of an acute lateral ankle sprain incurred during a televised badminton match. The kinematics of this injury were compared to those of 19 previously reported cases in the published literature.MethodsFour camera views of an acute lateral ankle sprain incurred during a televised badminton match were synchronized and rendered in 3-dimensional animation software. A badminton court with known dimensions was built in a virtual environment, and a skeletal model scaled to the injured athlete's height was used for skeletal matching. The ankle joint angle and angular velocity profiles of this acute injury were compared to the summarized findings from 19 previously reported cases in the published literature.ResultsAt foot strike, the ankle joint was 2° everted, 33° plantarflexed, and 18° internally rotated. Maximum inversion of 114° and internal rotation of 69° was achieved at 0.24 s and 0.20 s after foot strike, respectively. After the foot strike, the ankle joint moved from an initial position of plantarflexion to dorsiflexion—from 33° plantarflexion to 53° dorsiflexion (range = 86°). Maximum inversion, dorsiflexion, and internal rotation angular velocity were 1262°/s, 961°/s, and 677°/s, respectively, at 0.12 s after foot strike.ConclusionA forefoot landing posture with a plantarflexed and internally rotated ankle joint configuration could incite an acute lateral ankle sprain injury in badminton. Prevention of lateral ankle sprains in badminton should focus on the control and stability of the ankle joint angle during forefoot landings, especially when the athletes perform a combined lateral and backward step.     

Age-related changes in proprioception of the ankle complex across the lifespan

BackgroundAnkle complex proprioceptive ability, needed in active human movement, may change from childhood to elderly adulthood; however, its development across all life stages has remained unexamined. The aim of the present study was to investigate the across-the-lifespan trend for proprioceptive ability of the ankle complex during active ankle inversion movement.MethodsThe right ankles of 118 healthy right-handed participants in 6 groups were assessed: children (6–8 years old), adolescents (13–15 years old), young adults (18–25 years old), middle-aged adults (35–50 years old), old adults (60–74 years old), and very old adults (75–90 years old). While the participants were standing, their ankle complex proprioception was measured using the Active Movement Extent Discrimination Apparatus.ResultsThere was no significant interaction between the effects of age group and gender on ankle proprioceptive acuity (F (5, 106) = 0.593, p = 0.705, η²_p = 0.027). Simple main effects analysis showed that there was a significant main effect for age group (F (5, 106) = 22.521, p < 0.001, η²_p = 0.515) but no significant main effect for gender (F (1,106) = 2.283, p = 0.134, η²_p = 0.021) between the female (0.723 ± 0.092, mean ± SD) and the male (0.712 ± 0.083) participants. The age-group factor was associated with a significant linear downward trend in scores (F (1, 106) = 10.584, p = 0.002, η²_p = 0.091) and a strong quadratic trend component (F (1,106) = 100.701, p < 0.001, η²_p = 0.480), producing an asymmetric inverted-U function.ConclusionThe test method of the Active Movement Extent Discrimination Apparatus is sensitive to age differences in ankle complex proprioception. For proprioception of the ankle complex, young adults had significantly better scores than children, adolescents, old adults, and very old adults. The middle-aged group had levels of ankle proprioceptive acuity similar to those of the young adults. The scores for males and females were not significantly different. Examination of the range of the scores in each age group highlights the possible level that ankle complex movement proprioceptive rehabilitation can reach, especially for those 75–90 years of age.     

Association between knee-to-hip flexion ratio during single-leg vertical landings,and strength and range of motion in professional soccer players

Abstract

The aim of this study was to test the correlation between knee-to-hip flexion ratio during a single leg landing task and hip and knee strength, and ankle range of motion. Twenty-four male participants from a professional soccer team performed a continuous single leg jump-landing test during 10s, while lower limb kinematics data were collected using a motion analysis system. After biomechanical testing, maximal isometric hip (abduction, extension, external rotation), knee extension and flexion strength were measured. Maximum ankle dorsiflexion range of motion was assessed statically using the weight bearing lunge test. Pearson correlation coefficients were calculated to determine the associations between the predictor variables (knee and hip strength, and ankle ROM) and the main outcome measure (knee-to-hip flexion ratio). Correlation between knee-to-hip flexion ratio and hip abductors strength was significant (r = ?0.47; p = 0.019). No other significant correlations were observed among the variables (p > 0.05). These results demonstrated that a lower hip abductors strength in male soccer players was correlated with a high knee-to-hip flexion ratio during landing from a single leg jump, potentially increasing knee overload by decreasing energy absorption at the hip. The results provide a novel proposal for the functioning of hip muscles to control knee overload.     

足球运动对6~12岁儿童下肢本体感觉与平衡控制能力的影响及相关性研究

目的探讨足球运动对6~12岁儿童下肢本体感觉与平衡控制能力的影响及本体感觉、肌肉力量、平衡能力和运球能力间的关系。方法选取6~12岁的小学足球班学生38人(男女各19人)和同年级普通班学生19人(男10人、女9人)分别进行足球运动和一般性身体锻炼干预,使用运动加速度计监测锻炼强度,并在运动干预前后进行下肢本体感觉、肌肉力量、平衡能力和变向运球测试。结果 (1)2组学生下肢本体感觉的性别差异不显著,20周干预后,足球班学生的踝、膝、髋关节本体感觉要显著优于普通班学生(P<0.01);(2)2组学生下肢力量和平衡能力的性别差异不显著,20周干预后,足球班学生的平衡能力提高更多(P<0.01);(3)平衡能力的改善同下肢本体感觉和力量的提升正相关(P<0.05),运球能力的提高同本体感觉和平衡能力的提高正相关(P<0.05)。结论对于6~12岁儿童,同一般性锻炼相比,足球运动在提高下肢力量的同时还能更为全面地提高踝、膝、髋关节本体感觉,从而更好地改善平衡能力。性别差异对儿童本体感觉和平衡能力的影响不显著。同时,加强下肢本体感觉和平衡能力锻炼,可能会更好地提升运球能力。     

Do ankle braces provide similar effects on ankle biomechanical variables in subjects with and without chronic ankle instability during landing?

PurposeThe purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (Element?) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop landing activity in subjects with chronic ankle instability (CAI) compared to healthy subjects with no history of CAI.MethodsTen healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects, respectively. The CAI subjects were age, body mass index and gender matched with the control subjects. The arch index and ankle functions of the subjects were measured in a subject screening session. During the biomechanical test session, participants performed five trials of drop landing from 0.6 m, wearing no brace (NB), Element? brace and ASO brace. Simultaneous recording of three-dimensional kinematic (240 Hz) and GRF (1200 Hz) data were performed.ResultsThe CAI subjects had lower ankle functional survey scores. The arch index and deformity results showed greater arch deformity of Element? against a static load than in NB and ASO due to greater initial arch position held by the brace. CAI participants had greater eversion velocity than healthy controls. The ASO brace reduced the first peak vertical GRF whereas Element? increased 2nd peak vertical GRF. Element? brace reduced eversion range of motion (ROM) and peak eversion velocity compared to NB and ASO. In addition, Element? reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO.ConclusionResults of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact, and higher initial arch position and stiffer ankle for Element?.     

多模态功能训练对女大学生功能性踝关节不稳患者下肢肌力、本体感觉和动态平衡能力的影响

目的:探讨多模态功能训练对功能性踝关节不稳(Functional ankle instability,FAI)患者肌肉力量、本体感觉功能和动态平衡能力的影响。方法:45名FAI患者随机分为常规力量训练组(strengh training,ST组,n=22)和多模态功能训练组(multimodal function training,MFT组,n=23)。ST组常规力量训练,MFT组在常规力量力量训练的基础上增加本体感觉和姿势控制训练,康复训练共进行8周,2个训练周期。实验前后分别对2组实验对象患侧踝关节屈、伸、内翻和外翻肌群60°/s和180°/s等动向心收缩相对峰值力矩、本体感觉(踝关节屈、伸、内收和外翻运动感觉功能、腓骨肌反应时)和动态平衡能力(前方得分(A)、后内侧得分(PM)、后外侧得分(PL)和YBT-CS总得分)进行测试。结果:1)2组受试者患侧踝关节60°/s和180°/s等动向心踝关节肌群相对峰值力矩均显著大于实验前(P<0.05),且二者组间没有显著性差异(P>0.05);2)实验后,ST组本体感觉功能没有显著性改变(P>0.05),MFI组本体感觉各项指标均显著小于实验前(P<0.005,P<0.01,P<0.05),且均显著低于ST组(P<0.05);3)试验后,2组受试者动态平衡各指标均优于实验前(P<0.05,P<0.01),且MFI动态平衡各项指标均优于ST组(P>0.05)。结论:MFT康复训练能够显著改善FAI患者肌力、本体感觉和动态平衡能力,且效果更优于ST组。     

Examining the intrinsic foot muscles’ capacity to modulate plantar flexor gearing and ankle joint contributions to propulsion in vertical jumping

BackgroundDuring human locomotion, a sufficiently stiff foot allows the ankle plantar flexors to generate large propulsive powers. Increasing foot stiffness (e.g., via a carbon plate) increases the ankle's external moment arm in relation to the internal moment arm (i.e., increasing gear ratio), reduces plantar flexor muscles’ shortening velocity, and enhances muscle force production. In contrast, when activation of the foot's intrinsic muscles is impaired, there is a reduction in foot and ankle work and metatarsophalangeal joint stiffness. We speculated that the reduced capacity to actively control metatarsophalangeal joint stiffness may impair the gearing function of the foot at the ankle.MethodsWe used a tibial nerve block to examine the direct effects of the intrinsic foot muscles on ankle joint kinetics, in vivo medial gastrocnemius’ musculotendinous dynamics, and ankle gear ratio on 14 participants during maximal vertical jumping.ResultsUnder the nerve block, the internal ankle plantar flexion moment decreased (p = 0.004) alongside a reduction in external moment arm length (p = 0.021) and ankle joint gear ratio (p = 0.049) when compared to the non-blocked condition. Although medial gastrocnemius muscle–tendon unit and fascicle velocity were not different between conditions, the Achilles tendon was shorter during propulsion in the nerve block condition (p < 0.001).ConclusionIn addition to their known role of regulating the energetic function of the foot, our data indicate that the intrinsic foot muscles also act to optimize ankle joint torque production and leverage during the propulsion phase of vertical jumping.     

A Commentary On Children and Fitness: A Public Health Perspective

Abstract

Head rotation, shoulder extension and rotation, ankle plantar and dorsiflexion, hip flexion, and sit and reach (SR) scores were examined in 41 women and 39 men, aged 45–75 years. The SR gave more reproducible data than the other measurements (intraclass test/retest correlation over 8 months, r = .83). SR scores were independent of standing height (r ² = .068) but were greater in women (p < .002). The flexibility at all joints was less than reported for young adults. There were age-related decreases of flexibility scores for the head and shoulder joints (p < .01), with a parallel trend (p < .05) for ankle plantar flexion and SR scores (the last only after inclusion of an age-gender interaction term). A principal components analysis identified three factors (tentatively identified as general trunk, ankle, and shoulder flexibility) accounting for 55.9% of total variance. SR scores had a moderate correlation with the first factor (r = .61) but only weak correlations with the second and third. Although the SR test is the most reliable simple instrument, it provides only limited information about the flexibility at other joints in an older population.     

Using cognitive general imagery to improve soccer strategies

Abstract

We investigated the effects of static stretch duration on peak isometric plantarflexor moment and passive ankle moment in seven healthy volunteers. After the passive ankle plantarflexor moment was recorded on an isokinetic dynamometer, the peak isometric ankle moment was measured with simultaneous electromyographic monitoring of the medial gastrocnemius. The participants subsequently performed a single 5-s stretch, a single 15-s stretch, four 5-s stretches, four 15-s stretches or no stretch (control) before being re-tested. All participants randomly completed each condition with a 24-h rest between tests. The main finding of the study was a significant correlation between reductions in peak moment and stretch duration (r=0.68; P<0.05), which became significantly different from the control group after four 15-s stretches (16.7%, s=5.3; P<0.05). There was a similar decrease in passive moment (20.9%, s=1.3; P<0.05) after each stretch condition, but this was not accompanied by a change in hysteresis. The electromyographic activity recorded during maximal plantarflexion did not change significantly after stretching. Our results are the first to show a duration-dependent effect of stretch on force (moment) production of the plantarflexors. Further research is required to elucidate the mechanisms responsible, as alterations in the stiffness properties of the muscle–tendon complex or muscle recruitment cannot completely explain the changes.     

Changes in joint range of motion and muscle–tendon unit stiffness after varying amounts of dynamic stretching

The purpose of this study was to examine the effects of varying amounts of dynamic stretching (DS) on joint range of motion (ROM) and stiffness of the muscle–tendon unit (MTU). Fifteen healthy participants participated in four randomly ordered experimental trials, which involved one (DS1), four (DS4) and seven (DS7) sets of DS, or control conditions/seated at rest (CON). Each DS set consisted of 15 repetitions of an ankle dorsiflexion–plantarflexion movement. The displacement of the muscle–tendon junction (MTJ) was measured using ultrasonography while the ankle was passively dorsiflexed at 0.0174 rad · s^?1 to its maximal dorsiflexion angle. Passive torque was also measured using an isokinetic dynamometer. Ankle ROM was significantly increased after DS4 and DS7 compared with the pre-intervention values (P < 0.05), but there were no significant differences in ankle ROM between DS4 and DS7. No differences were observed in ankle ROM after DS1 and CON. In addition, the stiffness of the MTU, passive torque and displacement of the MTJ at submaximal dorsiflexion angles did not change in any of the experimental conditions. These results indicate that DS4 increased ankle ROM without changing the mechanical properties of the MTU, and that this increase in ankle ROM plateaued after DS4.     

Unilateral and bilateral patellofemoral pain in young female dancers: Associated factors

ABSTRACT

Aiming to evaluate the prevalence of unilateral/bilateral patellofemoral pain (PFP) among young dancers, and to investigate whether different factors are associated with PFP in young dancers, 132 dancers aged 12–14 years were assessed for PFP. Anthropometric parameters, proprioception ability, dynamic postural balance (DPB), and muscle strength were measured. PFP was found in 64.1% of the dancers. No significant differences in the prevalence of dancers with no, unilateral, or bilateral PFP at different ages were found. Significant age effects were found for anthropometric and developmental measurements, and for intensity of training. PFP effect was found for DPB asymmetry, ankle proprioception, and leg-length %height. A higher hip abductor/adductor ratio was associated with PFP in 14-year-old dancers. Binomial logistic regression showed that increased number of hours per day (h/day) and decreased number of hours per week (h/week), low proprioception scores, greater leg length as %height, and more anterior DPB asymmetry were significant predictors of PFP. In conclusion: unilateral/bilateral PFP is common among young dancers. Body morphology, reduced ankle proprioception ability, DPB asymmetry, and increased h/day of practice are associated with PFP. Dance teachers should start monitoring the impact of training and implement injury modification/prevention strategies when their students are at a young age.     

Corticospinal activity during a single-leg stance in people with chronic ankle instability

Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral ankle sprain copers,and healthy controls.Methods:Twenty-three participants with CAI,23 lateral ankle sprain copers,and 24 healthy control participants volunteered.Active motor threshold(AMT),normalized motor-evoked potential(MEP),and cortical silent period(CSP)were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.Results:Participants with CAI had significantly longer CSP at 100%of AMT and lower normalized MEP at 120%of AMT compared to lateral ankle sprain copers(CSP100%:p=0.003;MEP120%:p=0.044)and controls(CSP100%:p=0.041;MEP120%:p=0.006).Conclusion:This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI.Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.     

Noise-enhanced dynamic single leg balance in subjects with functional ankle instability

BackgroundStochastic resonance stimulation (SRS) transmits subsensory electrical Gaussian white noise into the body to enhance sensorimotor function. This therapy has improved static single leg balance in subjects with functional ankle instability. However, the effect of this stimulation on dynamic single leg balance is not known. Improvements in dynamic single leg balance with SRS may have implications for enhancing functional rehabilitation for ankle instability. Thus, the purpose of this study was to determine the effects of SRS on dynamic single leg balance in subjects with functional ankle instability.MethodsThis study was an experimental research design and data were collected in a sports medicine research laboratory. Twelve subjects with functional ankle instability (69 ± 15 kg; 173 ± 10 cm; 21 ± 2 years) reported a history of ankle sprains and instability at the ankle with physical activity. A single leg jump-landing test was used to assess dynamic balance. Subjects were required to jump between 50% and 55% of the maximal vertical jump height, land on a single leg atop a force plate, and stabilize as quickly as possible. Jump-landing tests were performed with and without SRS. Three trials were performed for each treatment condition (SRS and control). A randomized block design was used to determine test order. Anterior/posterior and medial/lateral time-to-stabilization were computed to assess dynamic balance. Lesser time indicated better stability. One-tailed paired samples t tests were used for analysis (α ≤ 0.05).ResultsSRS improved anterior/posterior time-to-stabilization (stochastic resonance = 1.32 ± 0.31 s, control = 1.74 ± 0.80 s, p = 0.03), but did not enhance medial/lateral time-to-stabilization (stochastic resonance = 1.95 ± 0.40 s, control = 1.92 ± 0.48 s, p = 0.07).ConclusionClinicians might use SRS to facilitate balance improvements with sagittal plane dynamic single leg balance exercises that patients may not be able to perform otherwise.     

Comparison of vibration rolling,nonvibration rolling,and static stretching as a warm-up exercise on flexibility,joint proprioception,muscle strength,and balance in young adults

Warm-up is an essential component for optimizing performance before an exercise session. This study investigated that the immediate effects of vibration rolling (VR), nonvibration rolling (NVR), and static stretching as a part of a warm-up regimen on the flexibility, knee joint proprioception, muscle strength, and dynamic balance of the lower extremity in young adults. Compared with the preintervention, VR induced the range of motion of knee flexion and extension significantly increased by 2.5% and 6%, respectively, and isokinetic peak torque and dynamic balance for muscle strength and dynamic balance increased by 33%–35% and 1.5%, respectively. In the three conditions, most outcomes between VR and NVR were comparable; however, the participants had a significantly higher knee joint reposition error after NVR than after VR, indicating that NVR would have a hampering knee joint proprioception effect. In particular, compared with static stretching, VR significantly increased the quadriceps muscle strength by 2-fold and dynamic balance by 1.8-fold. These findings suggest that athletic professionals may take VR into account for designing more efficient and effective preperformance routine to improve exercise performances. VR has high potential to translate into an on-field practical application.     

Three-dimensional analysis of a lofted instep kick by male and female footballers

There is a paucity of data describing the lofted instep kick and little information on the kinematic differences between male and female footballers. This study provides a preliminary investigation into the differences in motion patterns between the sexes. A four-camera motion analysis system videoed 13 amateur footballers (7 female and 6 male) attempting a standardised task that represented a lofted instep kick of approximately 35 m. Footballers performed 20 kicks, with the three trials categorised closest to the standardised distance retained for statistical analysis. Three-dimensional motion patterns for kicks of 35 m illustrated that female footballers produced greater fluctuation in movement patterns for pelvic, hip joint and thoracolumbar spine motion in the frontal plane; thorax and hip joint transverse rotation; and ankle dorsiflexion/plantarflexion motion. Peak hip extension (P = 0.018), impact hip abduction (P = 0.032), impact ankle plantar flexion (P = 0.030) and resultant ball velocity (P = 0.004) differed significantly between sexes. Principle component analysis highlighted associations between kinematic variables related to ball velocity and sex including a reduced hip abduction and increased internal rotation approaching impact, and greater peak knee flexion, respectively. In summary, increased variation in direction of segment motion, increased backswing and formation of a tension arc by females compared to males, may be related to anthropometric, strength and muscle activation differences. Specifically, this exploratory study indicates future research would benefit from exploring trunk, pelvis and hip kinematics and kinetics, and whether training the trunk, pelvis and hip musculature assists female footballers.     

Effects of arch-support orthoses on ground reaction forces and lower extremity kinematics related to running at various inclinations

ABSTRACT

While foot orthoses are commonly used in running, little is known regarding biomechanical risk potentials during uphill running. This study investigated the effects of arch-support orthoses on kinetic and kinematic variables when running at different inclinations. Sixteen male participants ran at different inclinations (0°, 3° and 6°) when wearing arch-support and flat orthoses on an instrumented treadmill. Arch-support orthoses induced longer contact time, larger initial ankle dorsiflexion, maximum ankle eversion, and knee sagittal range of motion (RoM) (p < 0.05). As incline slopes increased, vertical impact peak and loading rate, stride length, and ankle coronal RoM decreased, but contact time, stride frequency, initial ankle dorsiflexion and inversion, maximum dorsiflexion, initial knee flexion, and ankle sagittal RoM increased (p < 0.05). Furthermore, knee sagittal RoM was lowest when running at an inclination of 3°. The interaction effect indicated that in arch-support condition, participants running at 6° induced higher maximum ankle eversion than running at 0° (p < 0.05), while no differences were found in flat orthosis condition. These findings suggest that the use of arch-support orthoses would influence running biomechanics that is related to injury risks. Running at higher inclination led to more alterations to biomechanical variables than at lower inclination.