Effects of previous lateral ankle sprain and taping on the latency of the peroneus longus

The latency of the peroneus longus may be a key factor in the prevention of lateral ankle sprains (LASs). In addition, ankle taping is often applied to help prevent LASs. The purpose of this study was to determine the effects of a previous LAS and ankle taping on the latency of the peroneus longus after an inversion perturbation. Twenty-six participants, including 13 participants with no previous history of a LAS and 13 participants with a history of a single LAS completed the testing. Ankle taping was applied in a closed basket weave technique on one of the two testing days. The latency of the peroneus longus was determined by the onset of muscle activity exceeding 10 SD from baseline activity, after initiation of the 25° inversion perturbation. A significant main effect (p < 0.05) was present for the ankle support condition, with ankle taping causing a significant reduction in latency of the peroneus longus (65.04 ± 10.81 to 57.70 ± 9.39 ms). There was no difference (p>0.05) in latency between the injury groups. Ankle taping, immediately after application, reduces the latency of the peroneus longus among participants with and without a history of a LAS.     

Development of a fulcrum methodology to replicate the lateral ankle sprain mechanism and measure dynamic inversion speed

When the ankle is forced into inversion, the speed at which this movement occurs may affect the extent of injury. The purpose of this investigation was to develop a fulcrum device to mimic the mechanism of a lateral ankle sprain and to determine the reliability and validity of the temporal variables produced by this device. Additionally, this device was used to determine if a single previous lateral ankle sprain or ankle taping effected the time to maximum inversion and/or mean inversion speed. Twenty-six participants (13 with history of a single lateral ankle sprain and 13 with no history of injury) completed the testing. The participants completed testing on three separate days, performing 10 trials with the fulcrum per leg on each testing day, and tape was applied to both ankles on one testing day. No significant interactions or main effects were found for either previous injury or ankle taping, but good reliability was found for time to maximum inversion (ICC = .81) and mean inversion speed (ICC = .79). The findings suggest that although neither variable was influenced by the history of a single previous lateral ankle sprain or ankle taping, both variables demonstrated good reliability and construct validity, but not discriminative validity.     

Ankle taping can reduce external ankle joint moments during drop landings on a tilted surface

Ankle taping is commonly used to prevent ankle sprains. However, kinematic assessments investigating the biomechanical effects of ankle taping have provided inconclusive results. This study aimed to determine the effect of ankle taping on the external ankle joint moments during a drop landing on a tilted surface at 25°. Twenty-five participants performed landings on a tilted force platform that caused ankle inversion with and without ankle taping. Landing kinematics were captured using a motion capture system. External ankle inversion moment, the angular impulse due to the medio-lateral and vertical components of ground reaction force (GRF) and their moment arm lengths about the ankle joint were analysed. The foot plantar inclination relative to the ground was assessed. In the taping condition, the foot plantar inclination and ankle inversion angular impulse were reduced significantly compared to that of the control. The only component of the external inversion moment to change significantly in the taped condition was a shortened medio-lateral GRF moment arm length. It can be assumed that the ankle taping altered the foot plantar inclination relative to the ground, thereby shortening the moment arm of medio-lateral GRF that resulted in the reduced ankle inversion angular impulse.     

External ankle taping does not alter lower extremity side-step cut and straight sprint biomechanics in young adult males

Abstract

Lateral ankle sprains (LAS) are one of the most common musculoskeletal injuries and as a response, clinicians often use external ankle taping prophylactically to reduce the prevalence of injuries. External ankle taping techniques have been shown to significantly reduce passive ankle range of motion; however, there is limited research on the effects of external ankle taping on lower extremity kinematics or kinetics during sport specific tasks. Therefore, our objective was to compare the effects of external ankle taping on ankle, knee and hip kinematics and kinetics compared to no taping during an anticipated sidestep cutting task and a straight sprint task. We conducted a cross-over laboratory study with 16 healthy males. Three-dimensional kinematics and kinetics were collected with a motion capture system and in-ground force plate during 5 trials of a sprint and anticipated side-step cut with or without external ankle taping. Group means and associated 90% confidence intervals were plotted across 100 data points for each task, significance being identified when the confidence intervals did not overlap for three consecutive data points. No significant kinetic or kinematic differences were identified between conditions for the tasks. External ankle taping does not influence lower extremity biomechanics during a control cutting task.     

Fatigue increases ankle sprain risk in badminton players: A biomechanical study

ABSTRACT

Ankle sprains are the most common injury in regular badminton players and usually occur at the end of a match or training. The purpose of the present study was to examine the influence of fatigue produced by badminton practice on the lower limb biomechanics of badminton players. It was hypothesized that fatigue induces ankle kinematic and lower leg muscle activity changes which may increase the risk of ankle sprain. Ankle kinematics, ankle kinetics and muscles activities of 17 regular badminton players were recorded during lateral jumps before and after an intense badminton practice session. Post-fatigue, ankle inversion at foot strike and peak ankle inversion increased (+2.6°, p = 0.003 and +2.5°, p = 0.005, respectively). EMG pre-activation within 100 ms before foot landing significantly decreased after fatigue for soleus (?23.4%, p = 0.031), gastrocnemius lateralis (?12.2%, p = 0.035), gastrocnemius medialis (?23.3%, p = 0.047) and peroneus brevis (?17.4%, p = 0.036). These results demonstrate impaired biomechanics of badminton players when fatigue increases, which may cause a greater risk of experiencing an ankle sprain injury.     

Risk factors for chronic ankle instability after first episode of lateral ankle sprain: A retrospective analysis of 362 cases

BackgroundChronic ankle instability (CAI) is a common sequela following an acute lateral ankle sprain (LAS). To treat an acute LAS more effectively and efficiently, it is important to identify patients at substantial risk for developing CAI. This study identifies magnetic resonance imaging (MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.MethodsAll patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1, 2017 to December 1, 2019 were identified. Data were collected using the Cumberland Ankle Instability Tool at final follow-up. Demographic and other related clinical variables, including age, sex, body mass index, and treatment were also recorded. Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.ResultsA total 131 out of 362 patients with a mean follow-up of 3.0 ± 0.6 years (mean ± SD; 2.0–4.1 years) developed CAI after first-episode LAS. According to multivariable regression, development of CAI after first-episode LAS was associated with 5 prognostic factors: age (odds ratio (OR) = 0.96, 95% confidence interval (95%CI): 0.93–1.00, p = 0.032); body mass index (OR = 1.09, 95%CI: 1.02–1.17, p = 0.009); posterior talofibular ligament injury (OR = 2.17, 95%CI: 1.05–4.48, p = 0.035); large bone marrow lesion of the talus (OR = 2.69, 95%CI: 1.30–5.58, p = 0.008), and Grade 2 effusion of the tibiotalar joint (OR = 2.61, 95%CI: 1.39–4.89, p = 0.003). When patients had at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, or inversion tilt test, they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.ConclusionMRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, and inversion tilt test. Further prospective and large-scale studies are necessary for validation.     

Ankle muscle strength influence on muscle activation during dynamic and static ankle training modalities

Muscle weakness is considered a risk factor for ankle injury. Balance training and barefoot running have been used in an attempt to strengthen the muscles crossing the ankle. It is expected that training tasks that successfully strengthen the ankle would elicit increased muscular activity. However, it is unknown how an individual's ankle strength will influence the muscle activity used during a given task. Twenty-six participants performed dynamic (shod, barefoot running) and static tasks (squat on ground, squat on ®Bosu Ball) believed to strengthen the muscles surrounding the ankle. Electromyographic signals of the tibialis anterior, peroneus longus, gastrocnemius lateralis (GL) and gastrocnemius medialis (GM) were recorded and analysed using a non-linearly scaled wavelet analysis. Participants were divided into a strong group and a weak group according to their isometric plantar-flexion torque. The weak group required more relative GL and GM muscle activity during each training task compared to the strong group. No difference was observed between shod and barefoot running. There was a significant effect of training task on muscle activation level for the weak group. Differences in ankle strength had a significant impact on muscle activation.     

Leg muscle recruitment in highly trained cyclists

In this study, we examined patterns of leg muscle recruitment and co-activation, and the relationship between muscle recruitment and cadence, in highly trained cyclists. Electromyographic (EMG) activity of the tibialis anterior, tibialis posterior, peroneus longus, gastrocnemius lateralis and soleus was recorded using intramuscular electrodes, at individual preferred cadence, 57.5, 77.5 and 92.5 rev . min(-1). The influence of electrode type and location on recorded EMG was also investigated using surface and dual intramuscular recordings. Muscle recruitment patterns varied from those previously reported, but there was little variation in muscle recruitment between these highly trained cyclists. The tibialis posterior, peroneus longus and soleus were recruited in a single, short burst of activity during the downstroke. The tibialis anterior and gastrocnemius lateralis were recruited in a biphasic and alternating manner. Contrary to existing hypotheses, our results indicate little co-activation between the tibialis posterior and peroneus longus. Peak EMG amplitude increased linearly with cadence and did not decrease at individual preferred cadence. There was little variation in patterns of muscle recruitment or co-activation with changes in cadence. Intramuscular electrode location had little influence on recorded EMG. There were significant differences between surface and intramuscular recordings from the tibialis anterior and gastrocnemius lateralis, which may explain differences between our findings and those of previous studies.     

踝关节跖屈肌肌肉肌腱形态及收缩效应的相关研究

应用螺旋CT及体视学研究方法对普通大学生踝关节跖屈肌肌肉肌腱形态进行了较全面的测量分析,同时采用六维测力平台结合表面肌电测量仪测定最大跖屈力,探讨跖屈肌肌肉肌腱形态与收缩效应之间的关系。结果表明:①小腿跖屈肌横断面积、体积和小腿围度与肌肉力量之间存在密切的关系;②小腿长、腓肠肌长、比腓肠肌肌腱长与肌力有着明显的相关;比目鱼肌长只与提踵肌力有关;③跟腱长、比跟腱长和腓肠肌肌腱长与肌力之间不具相关性。     

Patterns of Lower Limb Muscle Activity in Young Boys during a One Foot Static Balance Task

Abstract

Activity patterns of four major muscles were studied in the support leg during a standard one foot balance test. Electromyographic (EMG) activity of the tibialis anterior (TA), peroneus longus (PL), gluteus medius (GM), and adductor magnus (AM) was recorded from 10 boys (aged 7-9 yr) during 30 s balance trials. Rectified, low-pass filtered EMG data, converted to percentages of maximum contractions, were used to establish muscle activation patterns. The results showed that lateral shifts in balance were primarily mediated by the ankle musculature, while the hip muscles appeared to stabilize the pelvis. Immediately prior to lateral shifts of the center of pressure (COP), the activity of each ankle muscle was similar to the activity of the following pose. The hip muscles, however, were not consistently linked to ankle activity. Thus, the control of one-legged lateral balance does not rely on fixed hip-ankle synergies.     

Unpredictable shoe midsole perturbations provide an instability stimulus to train ankle posture and motion during forward and lateral gym lunges

ABSTRACT

Unstable footwear may enhance training effects to the lower-limb musculature and sensorimotor system during dynamic gym movements. This study compared the instability of an unstable shoe with irregular midsole deformations (IM) and a control shoe (CS) during forward and lateral lunges. Seventeen female gym class participants completed two sets of ten forward and lateral lunges in CS and IM. Ground reaction forces, lower-limb kinematics and ankle muscle activations were recorded. Variables around initial ground contact, toe-off, descending and ascending lunge phases were compared statistically (p < .05). Responses to IM compared to CS were similar across lunge directions. The IM induced instability by increasing the vertical loading rate (p < .001, p = .009) and variability of frontal ankle motion during descending (p = .001, p < .001) and ascending phases (p = .150, p = .003), in forward and lateral lunges, respectively. At initial ground contact, ankle adjustments enhanced postural stability in IM. Across muscles, there were no activation increases, although results indicate peroneus longus activations increased in IM during the ascending phase. As expected, IM provided a more demanding training stimulus during lunge exercises and has potential to reduce ankle injuries by training ankle positioning for unpredictable instability.     

The association between the ACTN3 R577X polymorphism and noncontact acute ankle sprains

Ankle sprains are one of the most severe musculoskeletal soft tissue injuries during physical activity. Although many risk factors have been offered, it is unclear why some individuals develop noncontact ankle sprains when participating in comparable levels of physical exertion under identical environmental conditions and others do not. The ACTN3 gene that encodes the α-actinin-3 protein, which is, only expressed in the Z line of fast glycolytic muscle fibres was found to associate with power/strength performance. The aim of this study was therefore to investigate whether the ACTN3 gene polymorphism is associated with noncontact acute ankle sprains. One hundred and forty-two participants with clinically diagnosed noncontact acute ankle sprains as well as 280 physically active controls participants without any history of ankle sprains were included in this case–control genetic association study. The RR genotype (odds ratio (OR) = 0.56; 95% confidence interval (CI), 0.32–0.65, P = 0.011) and R allele (OR = 0.64; 95% CI, 0.37–0.68, P = 0.002) of the ACTN3 were significantly low-represented in the acute ankle sprains group compared with the control group. The ACTN3 R577X is associated with acute ankle sprains in Chinese participants in this study. This is the first study to suggest that an individual with a RR genotype is at a decreased risk of acute ankle sprains.     

The effect of patellar taping on EMG activity of vasti muscles during squatting in individuals with patellofemoral pain syndrome

Although patellar taping has been shown to reduce pain in participants with patellofemoral pain syndrome, the mechanisms of pain reduction have not completely been established following its application. The purpose of this study was to evaluate EMG activity of vastus medialis and vastus lateralis following the application of patellar taping during a functional single leg squat. Both vastus medialis obliquus-vastus lateralis onset and vastus medialis obliquus/vastus lateralis amplitude of 18 participants with patellofemoral pain syndrome and 18 healthy participants as controls were measured using an EMG unit. This procedure was performed on the affected knee of participants with patellofemoral pain syndrome, before, during, and after patellar taping during unilateral squatting. The same procedure was also performed on the unaffected knees of both groups. The mean values of vastus medialis obliquus-vastus lateralis onset prior to taping (2.54 ms, s = 4.35) were decreased significantly following an immediate application of tape (-3.22 ms, s = 3.45) and after a prolonged period of taping (-6.00 ms, s = 3.40 s) (P < 0.05). There was also a significant difference between the mean values of vastus medialis obliquus-vastus lateralis onset among controls (-2.03 ms, s = 6.04) and participants with patellofemoral pain syndrome prior to taping (P < 0.05). However, there were no significant difference between the ranked values of vastus medialis obliquus/vastus lateralis amplitude of the affected and unaffected knees of participants with patellofemoral pain syndrome and controls during different conditions of taping (P > 0.05). Decreased values of vastus medialis obliquus-vastus lateralis onset may contribute to patellar realignment and explain the mechanism of pain reduction following patellar taping in participants with patellofemoral pain syndrome.     

Neuromuscular control during stepping down in continuous gait in individuals with and without ankle instability

Abstract

Ankle sprains are a common injury and those affected are at a risk of developing chronic ankle instability (CAI). Complications of an acute sprain include increased risk of re-injury and persistent disability; however, the exact link between ankle sprains and chronic instability has yet to be elucidated. The purpose of this study was to investigate neuromuscular control (including kinematics, kinetics and EMG) during stepping down from a curb, a common yet challenging daily activity, in persons with ankle instability (n = 11), those with a history of ankle sprain without persistent instability, called ankle sprain “copers” (CPRs) (n = 9) and uninjured controls (CTLs) (n = 13). A significant group difference was noted as the CPR group demonstrated increased tibialis anterior activity in both the preparatory (pre-touchdown) and reactive (post-touchdown) phases when compared to healthy and unstable groups (P < 0.05). It follows that the CPR group also demonstrated a significantly less plantar-flexed position at touchdown than the other two groups (P < 0.05). This is a more stable position to load the ankle and this strategy differed from that used by participants with CAI and uninjured CTLs. These findings provide insight into the neuromuscular control strategies of CPRs, which may allow them to more appropriately control ankle stability following sprains.     

Biomechanical differences in elite beach-volleyball players in vertical squat jump on rigid and sand surface

The purpose of this investigation was to detect whether differences exist concerning the dynamic and kinematic parameters of vertical squat jump (SJ) on rigid (RS) and sand (SS) surface. Fifteen elite male beach volleyball players (age: 25.6 +/- 6.2 years; height: 188.0 +/- 3.5 cm; body mass: 83.2 +/- 6.0 kg; mean +/- SD, respectively) performed SJ. Force platform and kinematic analyses were used with paired sample T-tests to evaluate the differences. Vertical jump height was significantly smaller (p < .001) on SS than RS. Maximal force and maximal power were significantly higher on RS than SS (p < .05 and p < .01 respectively). Impulse time was larger in SS but with no significant difference (p = .286). Kinematic analysis revealed significant differences between the values of ankle joint during starting posture (p < .01) and of hip joint at the moment of take-off (p < .05). Ankle joint range of motion and angular velocity was larger in SS (p < .05). In conclusion, SJ height on SS was smaller than on RS because of the compliance and the instability of the sand. This resulted in a reduction in maximum force and take-off velocity. Furthermore, the compliance of SS made it hard for the ankle to push along the vertical axis of the movement of the body and as a result it slipped behind in an attempt to maximize propulsion. As a result, the body tries to balance and equalise this movement and move the hip to larger extension.     

慢性踝关节不稳人群的筛选及分型标准研究进展

踝关节扭伤被认为是最常发生的反复损伤。32%~74%的急性踝关节扭伤患者会转变为慢性踝关节不稳。由于慢性踝关节不稳的专业术语、定义以及在ICF（International Classification of Functioning, Disability, and Health）模式下的损伤因素均未达成统一看法,研究人员及临床从业者对其了解甚少。基于国际足踝联盟（International Ankle Consortium）提出的慢性踝关节不稳筛选标准、Hertel提出的慢性踝关节不稳模型及Hiller改良后的模型,为今后慢性踝关节不稳的相关研究提供筛选标准并针对性指导临床治疗。     

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.     

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.     

The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains

ABSTRACT

The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. Background: Lateral ankle sprains (LAS) are very common sports injuries, cause high health care costs and are associated with postural control deficits. From a preventive point of view, clinicians should dispose valid field tests to identify athletes at risk for a LAS. The aim of this study is to evaluate the predictive value of the multiple hop test (MHT) for first-time noncontact LAS. Methods: Non-elite athletes (n = 232) performed the MHT at baseline. During a 12-month follow-up period, all noncontact LAS related to health care costs were recorded. Outcomes of the MHT (completion time, balance errors and perceived difficulty) between the injured and uninjured group were compared and odds ratios (OR) and relative risks (RR) were calculated using a logistic regression analysis. Results: Ten first-time noncontact LAS were recorded (4.3%). Injured athletes made significantly more change-in-support strategy (CSS) errors when compared to uninjured athletes (p = .04). The OR of the number of CSS errors was 1.14 (p = .03), the RR 4.1 (p = .04). Conclusions: Athletes scoring > 12 CSS errors, have a four times increased risk for a first-time noncontact LAS. The MHT is a valid field test to identify athletes at risk for a first-time noncontact LAS.