Clinical Research Directory

Distinct Directional Postural Stability Deficits Across Lower Limb Musculoskeletal Disorders

Lateral ankle sprain (LAS) and patellofemoral pain syndrome (PFPS) are common musculoskeletal conditions associated with postural instability. However, the direction-specific nature of balance deficits and comparative patterns across these conditions remain unclear. Therefore, the aim of this study is to compare overall, mediolateral, and anteroposterior postural stability indices among individuals with LAS, PFPS, and healthy controls using the Biodex Balance System

Ankle Instability Using Foot Intensive Rehabilitation

The overall objective of this study is to examine the effects of a 6-week foot-intensive rehabilitation (FIRE) program on lateral ankle sprain (LAS) re-injury rates, CAI symptoms, sensorimotor function, and self-reported disability in CAI patients.

Addressing Neuromuscular Deficits for Improved Outcomes in Ankle Rehabilitation

The purpose of this project is to compare a novel sensorimotor ankle rehabilitation training (SMART) protocol for Lateral ankle sprains (LASs) against a standard of care (SOC) protocol to determine if it is more successful at producing successful one-year outcomes and lower rates of re-injury and improved health. This will address the identified needs for evidence-support and reintegration strategies to improve understanding of the management of patient rehabilitation strategies throughout the rehabilitation process following neuromusculoskeletal injury. The project will validate an innovative rehabilitation approach while providing metrics of success using a variety of clinical and innovative markers.

Comparison of the Effects of Hip and Ankle Focused Progressive Exercise Training on Lower Extremity Function in Athletes With Chronic Ankle Instability

Chronic ankle instability refers to a combination of persistent mechanical and functional instability symptoms following an ankle sprain. Along with these symptoms, decreased proprioception, reduced neuromuscular control, poor postural control, limited dorsiflexion range of motion, decreased ankle strength, and altered lower-extremity biomechanics during functional activities are also observed. In addition, individuals with chronic ankle instability have been shown to exhibit limitations in energy transfer across the lower extremity. These symptoms may hinder patients' physical activity levels and athletic performance and negatively affect their quality of life. Since the lower extremity functions as a unit, changes in adaptive strategies at the ankle can lead to kinematic alterations in proximal joints. Although the instability originates at the ankle, higher-level joints are also affected, and it has even been reported that in this population, lower-extremity stability is primarily achieved through the hip joint. While the effectiveness of hip-focused exercises has begun to be investigated in the literature, the superiority of different muscle groups has not yet been compared.

Auditory Biofeedback Gait Training Individuals With Chronic Ankle Instability

The goal of this randomized clinical controlled trial is examine the effects of gait training with auditory biofeedback (AudFB) on gait biomechanics, clinical measures of ankle joint health, and patient-centered outcomes. The following specific aims will achieve this objective: * Specific Aim 1: Determine if a 6-week gait training with AudFB intervention improves lower extremity biomechanics compared to a Control condition in participants with CAI. * Specific Aim 2: Determine if a 6-week gait training with AudFB reduces talar cartilage deformation compared to a Control condition in participants with CAI. * Specific Aim 3: Determine if a 6-week gait training with AudFB reduces episodes of ankle giving-way and reduces self-perceived severity of symptoms relative to a Control condition in participants with CAI. Participants will: * Complete 12 intervention sessions over a 6-week period of walking, ruck marching, and runninig. * Complete testing sessions before and after the intervention, then after 6 and 12-months following the intervention.

Neurocognitive Exercises for Ankle Instability

In the general population, 19.0-26.6 per 1000 cases of ankle instability have been reported, while in the athletic population, the rate is 11.3 per 1000. Ankle instability also predisposes individuals to recurrent instability, leading to persistent symptoms. After ankle injuries, temporary increases in afferent activity, along with long-term deficits in somatosensory information from ligaments, may cause central neuroplasticity that affects sensorimotor function. This central neuroplasticity can lead to permanent dysfunctions in the affected limb, thereby increasing the likelihood of developing and maintaining chronic ankle instability (CAI). In addition to the association between impaired balance and reduced proprioception with CAI, it has been reported that the central nervous system may fail to manage joint stress due to its inability to discern load on the ligaments. Impaired neurocognition has been linked to decreased performance and higher rates of re-injury. Deficiencies in neuromuscular control, motor learning, or other neurocognitive components related to an individual's performance and safety may affect the ability to respond appropriately in a dynamic environment. Any deficiencies in these neurocognitive processes can hinder the successful completion of tasks. The aim of this study is to comparatively examine the effects of neurocognitively enriched rehabilitation versus traditional rehabilitation on re-injury risk, balance, and proprioception in individuals with a history of ankle instability.

The Applicability of the Cumberland Ankle Instability Tool in Basketball Athletes.

The aim of our study is to evaluate the applicability, validity, and reliability of the Cumberland Ankle Instability Tool (CAIT) in basketball athletes. Given that a significant proportion of injuries in basketball occur in the ankle, our study holds importance for instability assessments conducted in this population. If the Cumberland Ankle Instability Tool is found to be applicable in basketball athletes, it may be utilized in future research.

The Clinical Outcomes of the Modified Broström vs Anatomic Reconstruction Operation in CLAI and GJL

Investigators designed this prospective cohort study to compare the clinical outcomes of modified Broström operation and anatomical reconstruction for the treatment of CLAI and GJL.

Comparison of MBR + Suture Tape, MBR, and Anatomic Reconstruction for CLAI in GJL Cases: A Prospective Cohort Study

GJL is a risk factor for postoperative recurrent instability following an MBR for CLAI. BPR with suture tape augmentation and anatomic reconstruction may provide more strength and stability. However, BPR with suture tape augmentation may lead to rejection of the suture tape, while anatomic reconstruction may be associated with more trauma. In addition, the outcomes between the BPR with suture tape augmentation and anatomic reconstruction were unknown.

Design and Validation of a Mobile Health Application for Home-Based Musculoskeletal Therapy in Ankle Sprain

"Ankle sprain is a common musculoskeletal injury that can pointedly influence the quality of life of an indivual. Old rehabilitation approaches often require recurrent clinic visits, which can be time-consuming, costly, and unreachable to many. This study aims to design and validate a mobile health application for home-based musculoskeletal therapy in ankle sprain.

Spinal and Supraspinal Control in Chronic Ankle Instability

Ankle sprains are common sports injuries that often lead to chronic ankle instability (CAI). Patients with CAI experience deficits in neuromuscular control (NMC), including proprioception and strength. It is believed that damage to the ankle's ligament mechanoreceptors and the peroneal nerve after the initial ankle sprain can cause alterations in NMC, resulting in postural control and dynamic joint stability dysfunction. Inflammation related to recurrent ankle sprains may also contribute to neuromuscular impairments. Evidence suggests that bilateral postural control deficits occur after an ankle sprain, suggesting alterations in the central nervous system (CNS). Rehabilitation for CAI has been shown to lead to bilateral improvements in NMC, potentially due to neural alterations at both the spinal and supraspinal levels. Cross-education, which refers to the muscular crossed effect of unilateral training, has also been proposed as a mechanism for improving contralateral strength in neurologically healthy individuals. While the exact mechanisms underlying cross-education are not yet fully understood, evidence suggests that it involves neural adaptations at both spinal and supraspinal levels. This study aims to investigate the cross-education effect of a 6-week, unilateral balance training on corticomotor excitability, motor neuron pool excitability, and static and dynamic balance in athletes with chronic ankle instability.

Motor Control Prevention Strategies in Basketball Players

Ankle sprains have always been considered as isolated injury entities, in which the passive ankle stabilisation system suffered an elongation due to trauma. Today, this concept of an isolated injury has evolved into a more holistic concept, interrelated with various components from different sources.

Effect of ACL Reconstruction in Biomechanical Properties of Ankle Joint Complex

BACKGROUND: Anterior cruciate ligament (ACL) is an important ligamentous structure in the knee joint which contributes in maintaining stability. ACL injury contribute to approximately 50% of knee injuries .The incidence of ACL ruptures is estimated to be between 30 and 78 per 100,000 people per year . The incidence of ACL ruptures varies depending on a number of factors, including age, sex, sport participation, and genetics. ACL ruptures are most common in young adults, particularly women. The risk of an ACL rupture has been reported as 2-8 times higher for women than for men. A systematic review study found that the risk of ACL injury was highest in football, followed by soccer, basketball, and skiing . Nowadays, Peroneus longus tendon (PLT) autograft is used in orthopaedic surgeries. Some studies reported that PLT graft had maintained a possible more efficient ACL substitute for its tensile strength and regeneration ability after being inserted post-surgery . The PLT graft has additional benefit as it does not cause secondary injury to the knee and its adjacent structures . Ankle proprioception is one of the crucial components contributing to postural control . PLT graft for ACL reconstruction might affect the already compromised body balance by influencing postural stability and ankle stability at the donor ankle site. So, this study will be conducted to assess and compare the effect of ACLreconstruction with PLT graft to the effect of ACL reconstruction with HT graft on ankle stability and postural control .

Arthroscopic Versus Open Brostrom for Ankle Instability

Background: Ankle sprains are among the most prevalent lesions in primary care. A substantial number of these ligament lesions will develop ankle instability and require a surgical procedure. The Brostrom-Gould technique is the standard surgical approach for this condition, providing excellent results over the years. Thru the last decades, the arthroscopic Brostrom has gain popularity and support by several studies. Yet, there is no consensus regarding the best procedure to treat ankle instability nowadays. Hypothesis: The arthroscopic Brostrom technique will present better levels of pain and function when compared to the standard open approach. Design: blinded, in parallel groups, multicentric, randomized, clinical trial. Materials and Methods: 98 patients with a diagnosis of chronic ankle instability, referred from primary or secondary health care services, will be assessed and enrolled in this study. Participants will be divided in two groups (randomized by sequentially numbered identical envelopes, which will be administered serially to participants), one containing the open Brostrom repair technique and the other comprehending the arthroscopic Brostrom approach. The assessments will occur in 3, 6, 12, 24 and 48 weeks. Patients will be evaluated primarily by complications and secondarily the Cumberland Ankle Instability Tool (CAIT), American Orthopedic Foot and Ankle Society (AOFAS), the Visual Analogue Scale (VAS), the Foot Function Index (FFI) and the 36 Item Short Form Health Survey (SF-36). The investigators will use Comparison of Two Proportions via relative frequency analysis, the Pearson Correlation the Chi-Square test and the ANOVA for statistical analyses. Discussion: This study intends to establish if the arthroscopic Brostrom technique can produce excellent and reliable results when treating chronic ankle instability. A shorter surgical time, a better cosmetic appearance and a smaller soft tissue injury would support the choice for this procedure if the outcomes could be compared to the open approach.

A Mobile Recovery Guidance App for Children and Young Adults With Acute Ankle Inversion Injuries

Ankle sprains are the most common musculoskeletal complaint of children presenting to the emergency department (ED). Healing can often be protracted, leading to prolonged pain, missed school and work, and delayed return to a normal activity level. Smartphone apps have been shown to be associated with greater caregiver knowledge and improved outcomes in a number of conditions but have not been explored in ankle sprains. We would like to know if using a smartphone app for children with ankle inversion injuries leads to improved functional outcomes such as pain, mobility, and return to activity. We will be comparing a smartphone app that provides education and daily management reminders to a paper handout to see if the former leads to improved functional recovery.

Interest of Ultrasound in the Diagnosis of Severity of Lateral Ankle Sprain

Ankle sprain is a frequent and widely trivialized trauma. Misdiagnosed or poorly treated, it can recur and thus develop into chronic ankle instability. It can be associated with complications which, if not detected early, can lead to long-term sequelae.

The Effect of Taping on Plantar Pressure Distribution in Players With Chronic Ankle Instability

The goal of this study is to investigate whether there exists a difference in baropdometric readings of plantar pressure between individuals with chronic ankle instability and normal health individuals, in addition another goal of this study is to investigate the effect of rigid taping vs. kinesio taping on plantar pressure distribution as well as stability markers in individuals with chronic ankle instability. The main questions aimed to answer are: 1. Is there a difference in plantar pressure distribution between individuals with chronic ankle instability and individuals without chronic ankle instability? 2. What effect do rigid and kinesio taping have on plantar pressure distribution and ankle stability markers? 3. Which tape affects plantar pressure distribution and ankle stability better? Participants will: Firstly be divided into two macro groups, one with chronic ankle instability and one without, with an observational part of the study to be carried out to investigate the differences in plantar pressure between both groups. Secondly, the group with chronic ankle instability will be divided into two micro groups one receiving rigid taping and the other receiving kinesio taping, and the immediate effects of these tapes in terms of plantar pressure and ankle stability will be recorded and compared before and after within groups, and after between both groups.

Comparison of Virtual Reality and Motor Imagery Applications in Patients With Ankle Instability

In this study, the effects of different treatment methods for ankle instability patients are being compared aiming to find the optimal treatment. Via comparing virtual reality, motor imagery, and classic rehabilitation programs to clarify their effects on ankle static and dynamic balance, proprioception, range of motion, muscle strength, pain, function and patient satisfaction.