The effect of recurrent ankle inversion sprain and taping on proprioception at the ankle

PURPOSE: A common explanation for the tendency for ankle inversion sprains to recur is that proprioception is impaired by the initial sprain. It is further hypothesized that the application of tape prevents further sprains by enhancing proprioceptive acuity. The purpose of this study was to determine whether proprioception was impaired in people with recurrent ankle inversion sprain, and whether taping the ankle provided enhanced proprioceptive ability. METHODS: We compared the ability to perceive passive plantarflexion and dorsiflexion movements imposed at the relaxed ankle in 25 subjects with recurrent ankle inversion sprain, with a group of 18 healthy control subjects, matched for age, height, weight, and activity level. Subjects were tested with the ankle both taped and untaped. Detection thresholds were determined at three velocities, 0.1 degrees x s(-1), 0.5 degrees x s(-1), and 2.5 degrees x s(-1). Velocity of the imposed movements and testing of the taped and untaped conditions were randomized. RESULTS: There was no significant difference in the ability to perceive ankle movements between subjects with sprains and healthy controls at any velocity of movement tested. In addition, there was no significant difference in movement perception between the taped and untaped conditions for either subject group at any velocity. CONCLUSION: The ability to detect passive plantarflexion and dorsiflexion movements is not impaired in subjects with recurrent ankle inversion sprain. Furthermore, the protective effect of taping was shown not to arise from enhanced proprioception in the dorsiflexion-plantarflexion plane.     

Decreased ankle and hip isometric peak torque in young and middle-aged adults with chronic ankle instability

ObjectivesTo compare ankle, knee and hip isometric peak torque between young and middle-aged adults with CAI, copers and un-injured controls.DesignCross-sectional.SettingResearch Laboratory.ParticipantsOne hundred fifty-six young and middle-aged adults with or without CAI volunteered.Main outcome measuresA handheld dynamometer measured isometric dorsiflexion, plantarflexion, knee extension, hip extension and hip abduction peak force during a 5 s trial. Average peak torque was calculated and normalized to body mass.ResultsA significant Age by Injury interaction for dorsiflexion suggest middle-aged un-injured controls (p < 0.001) and copers (p < 0.001) had lower isometric peak torque compared to their young adult counterparts, but there were no differences between young and middle-aged adults with CAI (p > 0.05). Significant Injury main effects suggest the CAI group had decreased plantarflexion (p = 0.004) and hip extension (p = 0.010) strength compared to un-injured controls, but not copers (p > 0.05). Significant Age main effects for all primary outcome measures were observed, indicating peak torque decreased with age (p < 0.05).ConclusionsRegardless of age, isometric ankle and hip peak torque was lower in participants with CAI compared to un-injured controls, but not copers. These findings provide further evidence towards the impact of CAI in both young and middle-aged adults.     

Influence of dance training on challenging postural control task

BackgroundPrevious studies have shown that dance training affects postural control, particularly during challenging tasks. However, it is still unknown whether dance training also affects the ability to use vestibular, somatosensory, and visual cues, thus leading to postural control differences.ObjectiveThe main goal of the present study was to evaluate the influence of dance training on sensory weighting during static postural control.MethodThe center of pressure of 24 participants was recorded (12 dancers and 12 control non-dancers) using a force platform as well as the modified Clinical Test of Sensory Organization in Balance (mCTISB).ResultsThe results suggest that dancers perform significantly better than controls in conditions where somatosensory cues are disturbed. Moreover, a significant negative correlation between vestibular frequency band and training intensity was observed, along with, a significant positive correlation between visual frequency band and training intensity.SignificanceThis research outlines dancers’ increased ability to modulate sensory weighting differently than non-dancers during postural task where somatosensory cues are reduced.     

Effect of isokinetic training on strength,functionality and proprioception in athletes with functional ankle instability

The purpose of this study was to investigate the effects of isokinetic exercise on strength, joint position sense and functionality in recreational athletes with functional ankle instability (FAI). Strength, proprioception and balance of 24 recreational athletes with unilateral FAI were evaluated by using isokinetic muscle strength measurement, ankle joint position sense and one leg standing test. The functional ability was evaluated using five different tests. These were; single limb hopping course (SLHC), one legged and triple legged hop for distance (OLHD–TLHD), and six and cross six meter hop for time (SMHT–CSMHT). Isokinetic peak torque of the ankle invertor and evertor muscles were assessed eccentrically and concentrically at test speeds of 120°/s. Isokinetic exercise protocol was carried out at an angular velocity of 120°/s. The exercise session was repeated three times a week and lasted after 6 weeks. At baseline, concentric invertor strength was found to be significantly lower in the functionally unstable ankles compared to the opposite healthy ankles (p < 0.001). This difference was not present after executing the 6 weeks exercise sessions (p > 0.05). Ankle joint position sense in the injured ankles declined significantly from 2.35 ± 1.16 to 1.33 ± 0.62° for 10° of inversion angle (p < 0.001) and from 3.10 ± 2.16 to 2.19 ± 0.98° for 20° of inversion angle (p < 0.05) following the isokinetic exercise. One leg standing test score decreased significantly from 15.17 ± 8.50 to 11.79 ± 7.81 in the injured ankles (p < 0.001). Following the isokinetic exercise protocol, all of the worsened functional test scores in the injured ankles as compared to the opposite healthy ankles displayed a significant improvement (p < 0.01 for OLHD and CSMHT, p < 0.001 for SLHC, TLHD, and SMHT). These results substantiate the deficits of strength, proprioception, balance and functionality in recreational athletes with FAI. The isokinetic exercise program used in this study had a positive effect on these parameters.     

Kinesiology tape length and ankle inversion proprioception at step-down landing in individuals with chronic ankle instability

ObjectivesTo determine the effect of different lengths of kinesiology tape (KT) on ankle inversion proprioceptive performance in individuals with or without chronic ankle instability (CAI).DesignA repeated measures study.MethodsFifteen participants with unilateral CAI and fifteen participants with no CAI volunteered. The Ankle Inversion Discrimination Apparatus for Landing (AIDAL) was used to measure ankle proprioceptive acuity. All participants were tested under four KT conditions: no tape (baseline), short tape length (only foot and ankle complex involved), mid length (below the knee) and long length (above the knee) taping. After the baseline test, participants underwent the 3 different taping tests in a random order.ResultsRepeated measures ANOVA indicated that, compared to those without CAI, individuals with CAI performed significantly worse across the 4 different conditions (F = 8.196, p = 0.008). There was a significant KT main effect (F = 7.489, p < 0.001) and a significant linear effect (F = 17.083, p < 0.001), suggesting that KT significantly improved ankle proprioceptive performance in landing, and with longer tape length there was greater proprioceptive enhancement. Post-hoc analysis showed that for the CAI group, both mid length (p = 0.013, 95%CI = −0.063, −0.009) and long length (p = 0.010, 95%CI = −0.067, −0.011) taping can significantly improve ankle proprioceptive performance compared to no tape, whereas for the non-CAI group, ankle proprioceptive acuity was significantly improved only with long length taping (p = 0.007, 95%CI = −0.080, −0.015).ConclusionsKT can be used to improve ankle inversion proprioceptive performance during landing in both individuals with and without CAI and increasing tape length may achieve greater proprioceptive improvement.     

Running fatiguing protocol affects peak torque joint angle and peak torque differently in hamstrings vs. quadriceps

Sport Sciences for Health - The aim of the current study was to investigate the effects of a running fatiguing protocol on the peak torque joint angle and the peak torque in hamstrings vs....     

Effect of high velocity resistance training on peak torque, cross sectional area and myofibrillar ATPase activity.

The purpose of this investigation was to determine the effect of high velocity resistance (HVR) training on peak torque (PT), cross sectional area (CSA) and myofibrillar ATPase activity of the knee extensors. HVR training was performed in a circuit on hydraulic exercise equipment, 4 times a week for 5 weeks at an angular velocity of approximately 3.14 rad.s-1. Knee extension PT was determined on a Cybex II isokinetic dynamometer and CSA of the quadriceps femoris muscle was assessed using computer tomography (CT) scanning. Muscle biopsies were obtained from the lateral quadriceps muscle and were analyzed for myofibrillar ATPase activity. Knee extension peak torque was significantly increased at 1.57, 2.09, 3.14, 3.66 and 4.19 rad.s-1. Myofibrillar ATPase activity and CSA was also significantly increased after HVR training. These findings showed that short-term high velocity resistance training enhances the in vivo torque/velocity curve especially at fast angular velocities and these changes are partly attributed to an increase in muscle CSA and activity of myofibrillar ATPase.     

The influence of orthoses on the proprioception of the ankle joint

The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle joints were tested regarding their functional and proprioceptive capabilities. All of them were active athletes. Three tests were used of the study: single-leg stance test, single-leg jumping course test, angle-reproduction test. The influence of three stabilization devices (lace-on-brace/Mikros, stirrup-brace/ Aircast, taping) on the proprioceptivity of stable and unstable ankle joints was evaluated. The scores of the singleleg jumping course without any stabilizing device (category standard) ranged between 8.06 and 13.68 (10.65±1.29). In the categories Mikros (9.85±0.99), and Aircast (9.99±1.14) as well as with the tape bandage (10.27±0.81) better scores were achieved. The differences standard vs. Mikros and standard vs. Aircast revealed a significant reduction of the scores with orthoses (P<0.01). The error rate in the single-leg stance test was within the range of 0–16 (5.12±2.85) for the category standard. It was lower for the categories Mikros (3.65±2.65) and Aircast (4.17±2.59). The error rate was highest in the group with a tape bandage (5.79±3.53). The differences standard vs Mikros as well as standard vs. Aircast were significant (P<0.01). There was also a significant difference between these categories regarding injured and not injured ankle joints (P<0.01). The angle-reproduction-test showed higher values for the category standard (2.36°±0.97) in comparison to the categories Mikros (1.46°±0.72), Aircast (1.62°±0.91) and taping (1.84°±0.41). In the category standard the reproduction error was lower testing not injured ankle joints (2.30°±1.04) than testing the group of unstable ankle joints (2.44°±0.81), whereas in all other categories the reproduction error was higher in the group of not injured joints. The differences in all measurements between standard vs. Mikros and standard vs. Aircast were significant (P<0.01). The results of the three tests showed a highly significant difference between injured and not injured ankle joints (P<0.01).     

Effect of ankle joint stiffness during eccentric phase in rebound jumps on ankle joint torque at midpoint

The purposes of this study were to investigate firstly, the ankle joint stiffness during the eccentric phase in rebound jumps, and secondly, the effect of ankle joint stiffness during the eccentric phase on ankle joint torque at midpoint. Nine active males executed rebound drop jumps from a height of 30 cm (RDJ30) and 50 cm (RDJ50), and 5-repetition rebound jumps (5RJ). Force plate data, limb position and electromyogram (EMG) of the medial head of gastrocnemius (GAS), soleus (SOL), and tibialis anterior (TA) muscles were recorded simultaneously during all jumps. When compared with RDJ30 and RDJ50, 5RJ displayed significantly higher jumping height, ankle joint torque at midpoint, ankle joint stiffness during the eccentric phase, and integrated EMG (IEMG) of GAS and SOL. Furthermore, 5RJ displayed significantly lower contact time and IEMG of TA than RDJ30 and RDJ50 did. The ankle joint torque at midpoint showed a significant positive correlation with jumping height but a significant negative correlation with contact time in rebound jumps. There was a significant positive correlation between the ankle joint stiffness during the eccentric phase and ankle joint torque at midpoint in rebound jumps. These results suggested that for the rebound jumps to be effective, it may be important to enhance the ankle joint torque at midpoint by greater ankle joint stiffness during the eccentric phase. These results also suggested that compared to 5RJ, RDJ30 and RDJ50 may reduce ankle joint stiffness in order to protect the tendomuscular system from the stretch load. However, ankle joint stiffness is possibly increased in 5RJ because the restraint to defend the tendomuscular system is reduced by prediction or adaptation to the stretch load because it is a continuous jump.     

Effect of strength and proprioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability

OBJECTIVES: To examine the effect of six weeks of strength and proprioception training on eversion to inversion isokinetic strength ratios (E/I ratios) in subjects with unilateral functional ankle instability. METHODS: Thirty eight subjects were randomly assigned to one of four treatment groups: strength training (S); proprioception training (P); strength + proprioception training (B); control (C). Isokinetic strength was tested before and after training using a Kin Com 125 automatic positioning isokinetic dynamometer. Subtalar joint eversion and inversion motions were tested both concentrically and eccentrically through a range of motion involving 40 degrees. All peak torque and average torque values were normalised for body mass. E/I ratios were calculated from average torque and peak torque measures by taking the concentric eversion value and combining it with the eccentric inversion value. Data were analysed using a mixed model analysis of variance with repeated measures on the test factor. Average torque and peak torque E/I ratios at 30 and 120 degrees/s were analysed separately. RESULTS: There were no significant differences in average torque and peak torque E/I ratios of the functionally unstable ankle for any of the groups after training compared with before. CONCLUSIONS: Six weeks of strength and proprioception training (either alone or combined) had no effect on isokinetic measures of strength in subjects with self reported unilateral functional instability. Further studies examining this agonist (concentric) to antagonist (eccentric) muscle group strength ratio are needed.     

Poor peak dorsiflexor torque associated with incidence of ankle injury in elite field female hockey players

This study set out to determine the incidence of ankle injuries amongst provincial female field hockey players in KwaZulu-Natal (KZN), South Africa, during the 2004 field hockey season and relate this to their injury and playing profile, proprioceptive ability and peak isokinetic torque of the ankle plantar and dorsiflexor muscles. Players participating in the senior, U21 and U19/high school provincial A teams (n = 47) detailed their hockey playing and training history and injuries sustained during the 2004 season. A subsample of injured and matched, uninjured controls (n = 18) underwent anthropometric, proprioceptive and isokinetic testing. Incidence of injury in the 2004 season was 0.98 per player or 6.32 injuries per 1000 player/h⁻¹, with 25.5% of players (n = 12) reporting injuries to the ankle joint. All ankle injuries occurred on artificial turf and 75% occurred during a match. Forwards and links that had been playing for six to seven years presented with the highest incidence of ankle injuries. Injured players were able to maintain balance on a proprioceptive board for 10.31 ± 8.2 s versus 23.9 ± 15.3 s in matched, uninjured controls (p = 0.078). Both mean (27.4 ± 5.5 Nm versus 32.7 ± 4.7 Nm) and median (27.0, 23.0–31.5 versus 31.8, 30.0–35.1 Nm) peak isokinetic torque of the dorsiflexors of injured legs was significantly lower than in uninjured, contralateral legs of the injured players (p = 0.01 and 0.03, respectively). Poor peak dorsiflexion torque in the injured leg was identified as a factor associated with ankle injury in this sample of injured, elite field hockey players.     

Effects of graduated compression socks on ankle inversion proprioception of half-marathon runners at different running distances

ObjectivesTo determine the effect of graduated compression socks on ankle proprioception and the relationship between fatigue and ankle proprioception measures in half-marathon runners at successive 7 km intervals during a 21-km run.DesignRepeated measures study.MethodsTwenty well-trained half-marathon runners (mean ± SD: age 38.6 ± 11.3 y, weekly volume 42.3 ± 21.1 km, training experience 4.7 ± 3.5 y) performed two 21 km running trials on a treadmill wearing either graduated compression socks or looser, standard non-compression running socks. Each running trial was divided into three self-paced 7 km blocks, repeated at the same pace for each trial, heart rate was not controlled, but after each block, heart rate, blood lactate, rating of perceived exertion, and ankle inversion proprioception were measured, the latter by using the active movement extent discrimination apparatus.ResultsThere was no differences between the graduated compression sock and non-compression running sock conditions in rating of perceived exertion scores (F = 0.524, p = 0.478), heart rate (F = 0.001, p = 0.975) and blood lactate (F = 0.004, p = 0.951). Overall, wearing graduated compression socks was associated with significantly better ankle proprioception after 21 km of running (p = 0.024, 95% CI = ?0.066, ?0.005). Heart rate, rating of perceived exertion and blood lactate were not correlated with ankle proprioception sensitivity in the graduated compression sock and non-compression running sock conditions at any point during the run (all p > 0.05).ConclusionsWearing graduated compression socks provides a positive effect on proprioceptive control of the ankle joint only after 21 km and may therefore reduce the possibility of injury associated with proprioceptive ability diminishing over time during exercise.     

Effects of strength exercise on the knee and ankle proprioception of individuals with knee osteoarthritis

This study aims to investigate the effects of 8-week strength exercise on knee and ankle proprioception of individuals with knee osteoarthritis (KOA). Forty participants were randomly divided into control and strength exercise groups. Strength exercise group underwent squat training of three times a week for 8 weeks, while control group received an education programme. Threshold for detection of passive movement of knee and ankle joint was tested using an electrically driven movable frame. Between- and within-group differences were evaluated through repeated-measurement analysis of variance. After intervention, passive motion sense in knee flexion of participants in strength exercise group significantly improved (p = 0.033, 95% confidence interval of mean difference: 0.019–1.478) with significant difference between groups. No significant differences of passive motion senses were found in knee extension and ankle between strength exercise and control groups. Eight-week squat training significantly improves the motion sense of knee flexion in patients with KOA.     

Effects of stretching on peak torque and the H:Q ratio

The purpose of the present study was to examine the acute effects of hamstring and calf stretching on leg extension and flexion peak torque (PT) and the hamstrings-to-quadriceps (H : Q) ratio during maximal, concentric isokinetic muscle actions at 60, 180, and 300 degrees . s (-1) in women. Thirteen women (mean age +/- SD = 20.8 +/- 1.8 yrs; height = 163.0 +/- 5.7 cm; mass = 64.0 +/- 8.3 kg) performed 3 maximal concentric isokinetic leg extension and flexion muscle actions at 3 randomly ordered angular velocities (60, 180, and 300 degrees . s (-1)) before and after a bout of static stretching. The stretching protocol consisted of 1 unassisted and 3 assisted static stretching exercises designed to stretch the posterior muscles of the thigh and leg. Four repetitions of each stretch were held for 30 s with 20 s rest between repetitions. The results indicated that leg flexion PT decreased from pre- to post-stretching (34.9 +/- 3.5 and 32.4 +/- 3.2 Nm, respectively) collapsed across velocity. However, no other changes were observed from pre- to post-stretching for leg extension PT (78.5 +/- 5.9 and 77.8 +/- 5.5 Nm, respectively) and the H : Q ratio (0.47 +/- 0.04 and 0.44 +/- 0.03, respectively). Our findings suggested that despite the stretching-induced decreases in leg flexion PT, leg extension PT and the H : Q ratios were unaltered by the stretching.     

Prediction of torque acceleration energy and power of thigh muscles from peak torque

The purpose of this study was to assess the relationship between the isometric and isokinetic peak torque (PT) (speed of movement 0, 60, and 180 degrees.s-1) and the peak torque acceleration energy (PTAE) and average power (AP) of multiple contractions (180 degrees.s-1) of the quadriceps and hamstrings in 38 patients having a chronic, complete anterior cruciate ligament (ACL) insufficiency in the knee. At every test speed the Pearson product moment (r) and the Spearman rank (rs) correlation coefficients between the PT and PTAE were highly significant for both muscle groups in the uninjured (r = 0.79-0.94, rs = 0.78-0.94) as well as in the ACL-insufficient (r = 0.87-0.95, rs = 0.83-0.94) knees. The results were the same between the PT and AP (uninjured: r = 0.70-0.90, rs = 0.68-0.90; ACL insufficient: r = 0.86-0.93, rs = 0.82-0.93). In both knees and in both muscle groups the correlation coefficients increased simultaneously with the speed of movement, obviously since the PTAE and AP were registered at the highest test speed (180 degrees.s-1). In conclusion, concerning ACL-insufficient or uninjured knees, the PTAE or AP analysis may offer little additional information about thigh muscle function to that attained by more simple measurement, the PT analysis.