Concomitant osteochondral lesions of the talus affect the stair descent biomechanics of patients with chronic ankle instability: A pilot study |
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| Affiliation: | 1. Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China;2. Gait and Motion Analysis Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China;1. Ziauddin University, 128/2 14th Street off Khayaban e Muhafiz Phase 6 Defence Housing Authority Karachi, Pakistan;2. Shaheed Mohtarma Benazir Bhutto Medical College Liyari, Parsa citi, Garden East, Karachi, Pakistan;3. Dow University of Health Sciences, Bridge View Apartment, Frere Town, Clifton Block 8, Karachi 75600, Pakistan;1. Academy for Engineering & Technology, Fudan University, 220 Handan Road, Shanghai, PR China;2. National Clinical Research Center for Geriatric Diseases (NCRCGD), Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, PR China;3. Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences Suzhou, PR China;1. Department of Physical Education, Yonsei University, Seoul, Republic of Korea;2. International Olympic Committee Research Centre KOREA, Seoul, Republic of Korea;3. Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea;4. Department of Clinical Research on Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea;1. KU Leuven, Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, Belgium;2. KU Leuven, Laboratory for Clinical Motion Analysis, University Hospital Pellenberg, Belgium;3. Parnasse-ISEI, Department of Podiatry, Brussels, Belgium;4. KU Leuven, Department of Development & Regeneration, Belgium;5. KU Leuven, Department of Orthopaedics, Foot & Ankle Unit, University Hospitals Leuven, Belgium |
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| Abstract: | BackgroundPrevious studies on the kinematics of patients with chronic ankle instability (CAI) that did not incorporate MRI and arthroscopic assessment could not differentiate between patients with CAI without osteochondral lesion of the talus (OLT) and patients with CAI and OLT and have thus presented contradictory results.Research questionThis study aimed to investigate the kinematic and electromyographic differences between patients with and without OLT.MethodsSixteen subjects with CAI (eight without OLT and eight with OLT confirmed through MRI and arthroscopic assessment) and eight healthy subjects underwent gait analysis in a stair descent setting. The three groups’ patient-reported outcomes; ankle joint range of motion in flexion, inversion and rotation; and muscle activation of the peroneus, tibialis anterior, and gastrocnemius during a gait cycle were analyzed and compared. A curve analysis, namely, one-dimensional statistical parametric mapping, was performed to compare the dynamic ankle kinematics and muscle activation curves over the entire normalized time series.ResultsThe patients with and without OLT had no difference in patient-reported outcomes. The maximal ankle plantarflexion of the patients without OLT and the healthy subjects was significantly larger than that of patients with OLT (p = 0.005). The maximal ankle internal rotation of patients without OLT was significantly larger than that of patients with OLT (p = 0.048). The peroneal activation during 0–6% of the gait cycle of patients with OLT was reduced compared with the healthy subjects.SignificancePatients with CAI and OLT and patients with CAI without OLT have no difference in patient-reported outcomes, but patients with OLT can be differentiated using the post-initial-contact peroneal activation deficit and the restriction of ankle plantarflexion and internal rotation during stair descent. These variables can be utilized to monitor the function of patients with CAI and their possibility of developing OLT. |
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| Keywords: | Chronic ankle instability Osteochondral lesion of the talus Stair descent Kinematics Muscle activation |
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