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1
Steinberg, Nili, Roger Adams, Moshe Ayalon, Nadav Dotan, Shiri Bretter, and Gordon Waddington. "Recent Ankle Injury, Sport Participation Level, and Tests of Proprioception." Journal of Sport Rehabilitation 28, no. 8 (November 1, 2019): 824–30. http://dx.doi.org/10.1123/jsr.2018-0164.
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Objective: Assessing the effects of ankle injury and sport participation level on ankle proprioceptive sensitivity using a joint position reproduction (JPR) test and an inversion movement extent discrimination test. Design: Cross-sectional. Setting: Biomechanics lab. Participants: Forty-five student athletes ages 21–30 (mean = 24.8 y). Main Outcome Measures: Participants were tested for ankle inversion sensitivity using 2 devices; movement reproduction error was obtained from JPR in a non-weight-bearing (N-WB) state at 10° and 15° of inversion, and an ankle proprioceptive sensitivity score was obtained from the active movement extent discrimination apparatus (AMEDA), representing the ability to differentiate 5 inversion movement extents between 10.5° and 14.5°, with testing in both N-WB and weight-bearing (WB) states. Results: For the 34 athletes with no ankle injury in the previous 12 months, the sensitivity scores achieved on the AMEDA were significantly higher (P < .01) than those for the 11 athletes with ankle injury, and the injury effect was significantly greater in WB (P = .01). In JPR testing, the 2.96° error of reproduction for athletes with no recent ankle injury was not significantly different from the 3.36° error for those with ankle injury (P = .46). Correlation of current sport participation level with JPR showed less error for higher-level performers (r = .49, P = .001) but no significant relationship to WB or N-WB AMEDA scores (both P > .61). WB AMEDA scores were significantly higher for athletes who had competed at a higher level of sport competition when <18 years old (r = −.57, P < .001). Conclusions: Previous ankle sprains affected proprioceptive scores on the WB AMEDA and N-WB AMEDA tests, indicating the sensitivity of the AMEDA movement discrimination test to the effects of ankle injury. The correlation between JPR scores and current level of sport participation suggests the sensitivity of the JPR test to current ankle use.
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Blackburn, Troy, Kevin M. Guskiewicz, Meredith A. Petschauer, and William E. Prentice. "Balance and Joint Stability: The Relative Contributions of Proprioception and Muscular Strength." Journal of Sport Rehabilitation 9, no. 4 (November 2000): 315–28. http://dx.doi.org/10.1123/jsr.9.4.315.
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Objectives:To determine whether proprioception or muscular strength is the dominant factor in balance and joint stability and define what type of ankle rehabilitation is most effective for these purposes.Setting:The University of North Carolina Sports Medicine Research Laboratory.Subjects:Thirty-two healthy volunteers free of head injury, dominant leg injury, and vestibular deficits.Design:Subjects were divided into control, strength-training, proprioceptive-training, and strength-proprioception combination training groups. Balance was assessed before and after 6-week training programs.Measurements:Static, semidynamic, and dynamic balance were assessed.Results:Subjects showed no improvement for static balance but improved significantly for semidynamic (P= .038) and dynamic (P = .002) balance. No significant differences were observed between groups.Conclusions:Enhancement of proprioception and muscular strength are equally effective in promoting joint stability and balance maintenance. In addition, no 1 type of training program is superior to another for these purposes.
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Switlick, Tiffany, Thomas W. Kernozek, and Stacey Meardon. "Differences in Joint-Position Sense and Vibratory Threshold in Runners With and Without a History of Overuse Injury." Journal of Sport Rehabilitation 24, no. 1 (February 2015): 6–12. http://dx.doi.org/10.1123/jsr.2013-0089.
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Context:A relationship between altered postural control and injury has been reported in sports. Sensorimotor function serves a fundamental role in postural control and is not often studied in runners. Persons who sustain running injury may have altered sensorimotor function contributing to risk of injury or reinjury.Objectives:To determine if differences in knee and ankle proprioception or plantar sensation exist between injured and noninjured runners.Design:Retrospective case-control study.Setting:University campus.Participants:Twenty runners with a history of lower-extremity overuse injury and 20 noninjured runners were examined. Injured runners were subcategorized into 2 groups based on site of injury: foot/ankle and knee/hip.Main Outcome Measures:Active absolute joint-repositioning error of the ankle at 20° inversion and 10° eversion and the knee at 15° and 40° flexion was assessed using an isokinetic dynamometer. Vibratory threshold at the calcaneus, arch, and great toe was determined for each subject using a handheld electric sensory threshold instrument.Results:Runners in the injured-foot/ankle group had increased absolute error during ankle-eversion repositioning (6.55° ± 3.58°) compared with those in the noninjured (4.04° ± 1.78°, P = .01) and the hip/knee (3.63° ± 2.2°, P = .01) groups. Runners in the injured group, as a whole, had greater sensitivity in the arch of the plantar surface (2.94 ± 0.52 V) than noninjured runners (2.38 ± 0.53 V, P = .02).Conclusions:Differences in ankle-eversion proprioception between runners with a history of ankle and foot injuries and noninjured runners were observed. Runners with a history of injury also displayed an increased vibratory threshold in the arch region compared with noninjured runners. Poor ankle-joint-position sense and increased plantar sensitivity suggest altered sensorimotor function after injury. These factors may influence underlying postural control and contribute to altered loading responses commonly observed in injured runners.
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Alghadir, Ahmad, Zaheen Iqbal, Amir Iqbal, Hashim Ahmed, and Swapnil Ramteke. "Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes." International Journal of Environmental Research and Public Health 17, no. 15 (July 23, 2020): 5318. http://dx.doi.org/10.3390/ijerph17155318.
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Background: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including pain, episodes of giving way, compromised proprioception and neuromuscular control, and re-injury leading to chronic ankle instability. The aim of this study was to see the effect of chronic ankle sprain on pain, range of motion, proprioception, and, static and dynamic balance among athletes. Methods: A total of 80 athletes, aged 18 to 25 years, involved in track-and-field sports were invited to participate in this study. They were divided in two groups. Athletes with history of grade 1 or 2 ankle sprain on either side requiring medical care who reported at least three episodes of ankle giving way in past 12 months were included in group A. An equal number of healthy athletes without any history of ankle sprain or injury in the lower limbs in the past one year matched by sex, age, height, weight, and limb dominance, were included in group B (control). Outcome measures: Participant’s pain, range of motion, proprioception and balance (static and dynamic) was measured using visual analog scale, half circle goniometer, degree of foot position sense, single leg stance time and Y-balance test respectively. Results: Although there were no differences in the active ankle joint range of motion (p > 0.05) in comparison to the control group, athletes with chronic ankle sprain reported mild pain and statistically significant (p < 0.05) deficits in foot proprioception, static and dynamic balance. Conclusions: Deficits in foot proprioception, static and dynamic balance even one year after the ankle sprain could be the reason for limitations in the dynamic defense system of the joint that predisposes to recurrent injury and instability. It is essential to understand the normal clinical course and risk factors for athletes who sustain sprain before devising a long term comprehensive rehabilitation program that focuses on mechanical and functional insufficiencies in order to improve their functional performance and prevent the risk of recurrent sprain.
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Semão, Florisvaldo Aparecido, Ana Claudia De Souza Hirata, Larissa Dragonetti Bertin, and Rodrigo Franco De Oliveira. "Proprioception influence in the balance of gymnastics rhythmic postural athletes." Manual Therapy, Posturology & Rehabilitation Journal 13 (December 21, 2015): 338. http://dx.doi.org/10.17784/mtprehabjournal.2015.13.338.
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Introduction: Rhythmic gymnastics (RG) is a sport that combines art biomechanical gestures of high complexity, which requires a high level of development of physical qualities such as agility, flexibility, strength, impulsion and dexterity. In this modality studies show that injuries are attributed more articulate knees, ankles, and in some cases ends wrist sprains being the most frequently recorded in athletes in competition level. Therefore, proprioception and muscle control play a fundamental role in dynamic joint stability, since after orthopedic injuries sensorimotor some characteristics are altered and should be focused on rehabilitation programs to get a better return so the activities prior to the injury. Objective: The objective of this project is to evaluate the effect of proprioceptive training on postural balance of athletes in rhythmic gymnastics - RG, from the use of a force platform BIOMEC400 (EMG System do Brazil, Ltda SP). Method: We performed a proprioceptive training in thirty days, in two stages, moving the complexity of the exercises each phase proprioceptive training. Results: We observed that there was a significant improvement in results of training, when it was used more complex exercises and agility exercises before. Conclusion: Because it is athletes RG high performance and present a predominance of activities in one foot, protocols proprioception should be more intensively, generating a higher level of disturbance and postural imbalances.
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Raina, Shakti, and Shibili Nuhmani. "FACTORS LEADING TO LATERAL ANKLE SPRAIN: A REVIEW OF THE LITERATURE." Journal of Musculoskeletal Research 17, no. 04 (December 2014): 1430001. http://dx.doi.org/10.1142/s0218957714300014.
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Objective of the review is to get to know the different factors which leads to the most common injury associated with sports persons to the ankle that is the lateral ankle sprain. Many factors cause ankle sprain — gender (whether females are more predisposed to ankle sprain than males); anthropometric variability and limb dominance, muscle strength including evertors–invertor's strength and pro-activation of peroneal muscles. Previous episode of ankle sprain also affects the stability as it alters the proprioception leading to impaired neuromuscular facilitation. Joint laxity (pathological — due to injury and nonpathological — generalized body laxity) is also considered as another causative factor. Type and duration of the game or putting the assistive device during the game or training also contribute to the ankle sprain. By knowing the predisposing factors, athletes will be given more specific rehabilitation according to their risk factor, especially focusing on their advance rehabilitation. Athletes can also be taught to take the preventive measures by determining their risk factor and preparing according to it.
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Otzel, Dana M., Chris J. Hass, Erik A. Wikstrom, Mark D. Bishop, Paul A. Borsa, and Mark D. Tillman. "Motoneuron Function Does not Change Following Whole-Body Vibration in Individuals With Chronic Ankle Instability." Journal of Sport Rehabilitation 28, no. 6 (August 1, 2019): 614–22. http://dx.doi.org/10.1123/jsr.2017-0364.
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Context: Following a lateral ankle sprain, ∼40% of individuals develop chronic ankle instability (CAI), characterized by recurrent injury and sensations of giving way. Deafferentation due to mechanoreceptor damage postinjury is suggested to contribute to arthrogenic muscle inhibition (AMI). Whole-body vibration (WBV) has the potential to address the neurophysiologic deficits accompanied by CAI and, therefore, possibly prevent reinjury. Objective: To determine if an acute bout of WBV can improve AMI and proprioception in individuals with CAI. Design and Participants: The authors examined if an acute bout of WBV can improve AMI and proprioception in individuals with CAI with a repeated-measures design. A total of 10 young adults with CAI and 10 age-matched healthy controls underwent a control, sham, and WBV condition in randomized order. Setting: Biomechanics laboratory. Intervention: WBV. Main Outcome Measures: Motoneuron pool recruitment was assessed via Hoffmann reflex (H-reflex) in the soleus. Proprioception was evaluated using ankle joint position sense at 15° and 20° of inversion. Both were assessed prior to, immediately following, and 30 minutes after the intervention (pretest, posttest, and 30mPost, respectively). Results: Soleus maximum H-reflex:M-response (H:M) ratios were 25% lower in the CAI group compared with the control group (P = .03). Joint position sense mean constant error did not differ between groups (P = .45). Error at 15° in the CAI (pretest 0.8 [1.6], posttest 2.0 [2.8], 30mPost 2.0 [1.9]) and control group (pretest 0.8 [2.0], posttest 0.6 [2.9], 30mPost 0.5 [2.1]) did not improve post-WBV. Error at 20° did not change post-WBV in the CAI (pretest 1.3 [1.7], posttest 1.0 [2.4], 30mPost 1.5 [2.2]) or control group (pretest −0.3 [3.0], posttest 0.8 [2.1], 30mPost 0.6 [1.8]). Conclusion: AMI is present in the involved limb of individuals with CAI. The acute response following a single bout of WBV did not ameliorate the presence of AMI nor improve proprioception in those with CAI.
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Samaan, Michael A., Eric K. Greska, Matthew C. Hoch, Joshua T. Weinhandl, Sebastian Y. Bawab, and Stacie I. Ringleb. "Dynamic Postural Control Two Years Following Anterior Cruciate Ligament Reconstruction in a Female Collegiate Soccer Player." International Journal of Athletic Therapy and Training 20, no. 2 (March 2015): 24–29. http://dx.doi.org/10.1123/ijatt.2014-0041.
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Context:ACL injury may cause a lack of knee joint proprioception and motor control due to knee joint instability. ACL reconstruction restores knee joint stability, yet dynamic postural control may still be affected while performing dynamic tasks.Objective:To examine the effects of ACL injury and reconstruction on dynamic postural control using the Star Excursion Balance Test (SEBT) and single leg hop (SLH).Participant:One Division I female athlete.Main Outcome Measure:The athlete’s dynamic postural control, both pre- and postreconstruction, was compared with preinjury data using the method of minimal detectable change using reach distances obtained from the SEBT and hop distances from the SLH.Results:ACL injury and reconstruction affected the anterior, posteromedial, and posterolateral reach distances of the SEBT. Despite restoration of joint stability, anterior reach distance in the SEBT did not return to preinjury levels 27 months after ACL reconstruction. SLH distances decreased following injury but returned to preinjury levels 27 months after ACL reconstruction.Conclusion:Dynamic postural control and performance during the SEBT and SLH were affected by ACL injury and for extended periods of time after ACL reconstruction. Quadriceps inhibition and muscle strength of the involved limb may affect dynamic postural control both after ACL injury and reconstruction while performing the SEBT. Compensatory mechanisms at the hip and ankle may aid in performance of the SLH after reconstruction. Using baseline measurements, where possible, may help researchers better understand the effects of ACL injury and reconstruction on dynamic postural control.
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Barkoukis, Vassilis, Evaggelos Sykaras, Frosoula Costa, and Haralambos Tsorbatzoudis. "Effectiveness of Taping and Bracing in Balance." Perceptual and Motor Skills 94, no. 2 (April 2002): 566–74. http://dx.doi.org/10.2466/pms.2002.94.2.566.
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Taping and bracing are thought to be effective methods in restricting the ankle's joint motion and assisting prevention of injuries. Research evidence suggests that taping and bracing enhance both the mechanical support and the proprioception of the ankle However, there is little research concerning the influence of taping and bracing on sport performance. Research has mainly examined tasks with demands on the frontal plane. Therefore, the present study examined the effect of taping and bracing on the performance of a task with demands on the frontal plane. A sample of 30 physical education students ( Mage =21.9 yr.) performed a balance task requiring estimation of balance and both right and left deviations. The subjects performed the balance task on four different conditions, with tape, with Swede-O (a lace-up, boot style stabilizer), with Aircast (an inflatable cast), and without any stabilizer. There were no significant differences among the conditions. These findings indicate that taping and bracing do not have negative effects on balance in the frontal plane. This study created concerns regarding the appropriate stabilizer for different tasks, bilateral coordination after the application of a stabilizer, and the influence of psychological factors on prevention of injury.
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Fousekis, Konstantinos, Evdokia Billis, Charalampos Matzaroglou, Konstantinos Mylonas, Constantinos Koutsojannis, and Elias Tsepis. "Elastic Bandaging for Orthopedic- and Sports-Injury Prevention and Rehabilitation: A Systematic Review." Journal of Sport Rehabilitation 26, no. 3 (May 2017): 269–78. http://dx.doi.org/10.1123/jsr.2015-0126.
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Context:Elastic bandages are commonly used in sports to treat and prevent sport injuries.Objective:To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic- and sports-injury prevention and rehabilitation.Evidence Acquisition:The researchers searched the electronic databases MEDLINE, CINAHL, SPORTDiscus, EMBASE, and Physiotherapy Evidence Database (PEDro) with keywords elastic bandaging in combination, respectively, with first aid, sports injuries, orthopedic injuries, and sports injuries prevention and rehabilitation. Research studies were selected based on the use of the term elastic bandaging in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were peer-reviewed clinical trials written in English on the effects of elastic bandaging for orthopedic-injury prevention and rehabilitation.Evidence Synthesis:Twelve studies met the criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures, and results. Studies were critically analyzed using the PEDro scale.Conclusions:The studies in this review fell into 2 categories: studies in athletes (n = 2) and nonathletes (n = 10). All included trials had moderate to high quality, scoring ≥5 on the PEDro scale. The PEDro scores for the studies in athletes and nonathletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher- to moderate-quality methodological clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of elastic bandaging could not be confirmed.
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Fu, Amy S. N., and Christina W. Y. Hui-Chan. "Ankle Joint Proprioception and Postural Control in Basketball Players with Bilateral Ankle Sprains." American Journal of Sports Medicine 33, no. 8 (August 2005): 1174–82. http://dx.doi.org/10.1177/0363546504271976.
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Background Deficiencies in ankle proprioception and standing balance in basketball players with multiple ankle sprains have been reported in separate studies. However, the question of how ankle proprioceptive inputs and postural control in stance are related is still unclear. Hypothesis Ankle repositioning errors and the amount of postural sway in stance are increased in basketball players with multiple ankle sprains. Study Design Controlled laboratory study. Methods Twenty healthy male basketball players and 19 male basketball players who had suffered bilateral ankle sprains within the past 2 years were examined. Both groups were similar in age. Passive ankle joint repositioning errors at 5° of plantar flexion were used to test for ankle joint proprioception. The Sensory Organization Test was applied with dynamic posturography to assess postural sway angle under 6 sensory conditions. Results A significant increase in ankle repositioning errors was demonstrated in basketball players with bilateral ankle sprains (P < .05). The mean errors in the right and left ankles were increased from 1.0° (standard deviation, 0.4°) and 0.8° (standard deviation, 0.2°), respectively, in the healthy players to 1.4° (standard deviation, 0.7°) and 1.1° (standard deviation, 0.5°) in the injured group. A significant increase in the amount of postural sway in the injured subjects was also found in conditions 1, 2, and 5 of the Sensory Organization Test (P < .05). Furthermore, there were positive associations between averaged errors in repositioning both ankles and postural sway angles in conditions 1, 2, and 3 of the Sensory Organization Test (r = 0.39-0.54, P < .05). Conclusions Ankle repositioning errors and postural sway in stance increased in basketball players with multiple ankle sprains. A positive relationship was found between these 2 variables. Clinical Relevance Such findings highlight the need for the rehabilitation of patients with multiple ankle sprains to include proprioceptive and balance training.
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Vásquez-Orellana, Karina, Matías López-Vásquez, Guillermo Méndez-Rebolledo, and Eduardo Guzman Muñoz. "Efectos de un entrenamiento neuromuscular sobre el equilibrio postural dinámico y propiocepción en basquetbolistas juveniles con inestabilidad funcional de tobillo (Effects of neuromuscular training on dynamic postural balance and proprioception in youth." Retos 44 (February 23, 2022): 1104–12. http://dx.doi.org/10.47197/retos.v44i0.91257.
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Introducción: La prevención de lesiones depende de varios factores en el deportista, en donde un buen equilibrio postural y propiocepción son claves para lograrlo. Se plantea que el entrenamiento neuromuscular podría mejorar el equilibrio postural dinámico y propiocepción en basquetbolistas con inestabilidad funcional de tobillo (IFT). Método: Ensayo clínico controlado y aleatorizado. La muestra fue compuesta por 27 jugadoras de basquetbol entre 15 a 17 años, pertenecientes a un Club Deportivo de la comuna de Maipú (Santiago de Chile). 13 de ellas asignadas al grupo control y 14 a un grupo experimental. Este ultimo grupo recibió una intervención neuromuscular de 6 semanas, de 2 días no consecutivos. Se trabajaron ambas extremidades en superficies estables, inestables, con y sin inhibición visual. Se midió el equilibrio postural con la prueba SEBTm y la propiocepción a través de una prueba de reposicionamiento articular activo. Resultados: tanto el grupo control como experimental mejoraron significativamente el equilibrio postural, no obstante, el grupo experimental evidenció mayores cambios porcentuales y tamaños del efecto (TE) más grandes. El mayor cambio en el grupo control fue de 7,8% en la dirección posterolateral del SEBTm (p=0,046; TE=0,74). En el grupo experimental el mayor cambio fue de 21% en la dirección anterior del SEBTm (p=0,001; TE=2,2). En la prueba de reposicionamiento activo no se observaron cambios significativos en el grupo control, mientras que el grupo experimental mejoró hasta un 82,8% en la articulación de cadera (p=0,001; TE=2,72). Conclusión: Un entrenaiento neuromuscular de seis semanas mejoró el equilibrio postural dinámico y la propiocepción en basquetbolistas mujeres con IFT.
Abstract. Introduction: Injury prevention depends on several factors in the athlete, where an optimal postural balance and proprioception are key to achieving it. It is suggested that neuromuscular training could improve dynamic postural balance and proprioception in basketball players with functional ankle instability (FAI). Method: Randomized controlled clinical trial. The sample consisted of 27 female basketball players between the ages of 15 and 17, belonging to a Sports Club in the Maipú city (Santiago, Chile). 13 of them assigned to the control group and 14 to an experimental group. This last group received a neuromuscular intervention of 6 weeks, of 2 non-consecutive days. Both extremities were worked on stable, unstable surfaces, with and without visual inhibition. Postural balance was measured with the SEBTm test and proprioception through an active joint repositioning test. Results: both the control and experimental groups significantly improved postural balance, however, the experimental group showed greater percentage changes and larger effect sizes (ES). The greatest change in the control group was 7.8% in the posterolateral direction of the SEBTm (p=0.046; ES=0.74). In the experimental group, the greatest change was 21% in the anterior direction of the SEBTm (p=0.001; ES=2.2). In the active repositioning test, no significant changes were observed in the control group, while the experimental group improved up to 82.8% in the hip joint (p=0.001; ES=2.72). Conclusion: A six-week neuromuscular training improved dynamic postural balance and proprioception in female basketball players with IFT.
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Mawani, Dhruti, Mayuri Ghumatkar, and Ajay Kumar. "Assessment of Ankle Joint Proprioception in Cricket Players." International Journal of Health Sciences and Research 11, no. 10 (October 9, 2021): 196–201. http://dx.doi.org/10.52403/ijhsr.20211025.
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Background and Aims: Superior balance ability is necessary to achieve the highest competitive level and avoid lower limb injuries. Balance control improvement is one of the most important goals in sports and exercise. Better the balance, better is the performance. Proprioception plays an important role in balance control and ankle proprioception is arguably the most important. Cricket is an evolving sport and it the ankle-foot complex in the only part that comes in contact with the ground which further leads to ankle injuries. Ankle proprioception is altered by sport related injuries or fatigue all of which subsequently leads to altered balance mobility. Ankle injuries often leads to disruption of muscles and tendons with associated damage to inherent mechanoreceptors which detrimentally alters the quality of proprioceptive information required for balance control. This study consists of an assessment of ankle joint proprioception in cricket players using an active to active reproduction test. Methodology: An observational study was conducted among 40 cricket players. Ankle proprioception was assessed using an active to active reproduction test. The mean difference between both the positions were then calculated. Results: The result of this study showed a clinically significant difference in both ankle plantarflexion and ankle dorsiflexion. The results also showed that right sided movements were affected in subjects who are right sided dominant and the same was there for left sided dominant subjects. The mean errors in Right PF and Left PF was 4.15º and 1.75º respectively which signifies that Right PF is affected in cricket players. The mean errors in Right DF and Left DF was 2.825º and 2.025º respectively which signifies that Right DF is more affected than that of Left DF. Conclusion: The ankle proprioception was affected in majority of the individuals. A clinically significant increase is noted in Right PF, Right DF and Left DF. Right plantarflexion was affected more than that of left plantarflexion and right dorsiflexion was affected more than that of left dorsiflexion. Hence, right sided dominant people showed affection in right sided movements and those who were left sided dominant showed affection in left sided movements. These results thus signify that the players are at mild risk of having ankle injuries because ankle proprioception is associated with ankle injuries which then indirectly affects the performance of the player. Key words: Ankle proprioception, Cricket Players, Balance, Active to Active reproduction test.
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Han, Jia, Judith Anson, Gordon Waddington, Roger Adams, and Yu Liu. "The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury." BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/842804.
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Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport.
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Kim, Hyun-Jung, Jin-Hyuck Lee, and Dae-Hee Lee. "Proprioception in Patients With Anterior Cruciate Ligament Tears: A Meta-analysis Comparing Injured and Uninjured Limbs." American Journal of Sports Medicine 45, no. 12 (January 6, 2017): 2916–22. http://dx.doi.org/10.1177/0363546516682231.
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Background: Because of a reduction in the number of mechanoreceptors or alterations of their characteristics, anterior cruciate ligament (ACL) tears lead not only to mechanical instability but also to impaired proprioception. Purpose/Hypothesis: This study analyzed whether ACL tears cause a greater decrease in proprioception in injured than in uninjured knees. The hypothesis was that knee proprioception after ACL tears would decrease more in injured than in contralateral uninjured knees, regardless of the method used to measure knee proprioception. Study Design: Meta-analysis. Methods: We identified studies comparing proprioception in ACL-injured and contralateral intact knees using threshold for detection of passive motion (TTDPM) or joint position sense (JPS) tests. JPS was assessed by measuring the reproduction of passive positioning (RPP) or active repositioning (RAP) of the knee. Results: Sixteen studies were included in this meta-analysis. The pooled results of subgroup analyses of TTDPM for both 20° and 40° of knee flexion showed that mean angle of error was 0.23° (95% CI, 0.08°-0.37°) greater in ACL-injured than in contralateral intact knees ( P = .002). Pooled data RAP and RPP subgroup analyses also showed that the mean angle of error was 0.94° higher in ACL-injured than in contralateral intact knees. The mean difference in angle of error between ACL-injured and contralateral intact knees was 0.71° greater (95% CI, 0.68°-0.74°; P < .001) by JPS than by TTDPM. Conclusion: Proprioception of ACL-injured knees was decreased compared with contralateral intact knees, as determined by both joint movement (kinesthesia) and joint position. The magnitude of loss of proprioception was greater in joint position than in joint movement.
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Antohe, Bogdan, Marinela Rață, and Gloria Rață. "Muscle Coactivation Index Improvement in Junior Handball Players by Using Propioceptive Exercises." BRAIN. BROAD RESEARCH IN ARTIFICIAL INTELLIGENCE AND NEUROSCIENCE 11, no. 4Sup1 (December 28, 2020): 01–12. http://dx.doi.org/10.18662/brain/11.4sup1/152.
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Ankle sprain is the most common injury in performance sports. Two of the most common residual symptoms of an ankle sprain are: the occurrence of chronic joint instability and agonist-antagonist muscle imbalances, expressed numerically by the values of the muscle coactivation index. The purpose of the research was to demonstrate that the use of proprioceptive exercises leads to the improvement of the degree of chronic joint instability and of the values of the muscle coactivation index. The research had a number of 22 subjects, handball players, whose age was between 15 and 16 years. The degree of joint instability was established by using the “Foot and Ankle Disability Index” Questionnaire, while the values of the muscle coactivation index were calculated following the electromyographic measurements. The obtained results highlight the efficiency of the proposed proprioceptive exercise programme, the statistical significance of the obtained results (by improving the initial and final values), as well as the existence of correlations between all evaluated parameters (muscle coactivation index, number of ankle sprains and degree of joint instability). The conclusions of the research underline the efficiency of proprioceptive exercises in diminishing the degree of chronic joint instability and in improving the values of the muscle coactivation index. Based on the results obtained, the research acquires an important practical value, because the proposed intervention programme has applicability in all sports sectors.
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Antohe, Bogdan, Marinela Rață, and Gloria Rață. "Muscle Coactivation Index Improvement in Junior Handball Players by Using Propioceptive Exercises." BRAIN. BROAD RESEARCH IN ARTIFICIAL INTELLIGENCE AND NEUROSCIENCE 11, no. 4Sup1 (December 28, 2020): 01–12. http://dx.doi.org/10.18662/brain/11.4sup1/152.
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Ankle sprain is the most common injury in performance sports. Two of the most common residual symptoms of an ankle sprain are: the occurrence of chronic joint instability and agonist-antagonist muscle imbalances, expressed numerically by the values of the muscle coactivation index. The purpose of the research was to demonstrate that the use of proprioceptive exercises leads to the improvement of the degree of chronic joint instability and of the values of the muscle coactivation index. The research had a number of 22 subjects, handball players, whose age was between 15 and 16 years. The degree of joint instability was established by using the “Foot and Ankle Disability Index” Questionnaire, while the values of the muscle coactivation index were calculated following the electromyographic measurements. The obtained results highlight the efficiency of the proposed proprioceptive exercise programme, the statistical significance of the obtained results (by improving the initial and final values), as well as the existence of correlations between all evaluated parameters (muscle coactivation index, number of ankle sprains and degree of joint instability). The conclusions of the research underline the efficiency of proprioceptive exercises in diminishing the degree of chronic joint instability and in improving the values of the muscle coactivation index. Based on the results obtained, the research acquires an important practical value, because the proposed intervention programme has applicability in all sports sectors.
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Cho, Nora M. Y., Hedda P. Giorgi, Karen P. Y. Liu, Young-Hyeon Bae, Louisa M. Y. Chung, Kitchana Kaewkaen, and Shirley S. M. Fong. "Proprioception and Flexibility Profiles of Elite Synchronized Swimmers." Perceptual and Motor Skills 124, no. 6 (August 11, 2017): 1151–63. http://dx.doi.org/10.1177/0031512517724965.
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This study compared the full-body flexibility and joint proprioception (on land and underwater) of (a) 20 elite female synchronized swimmers (mean age ± standard deviation = 18.5 ± 1.9 years) and (b) 20 college female swim team members with no training in synchronized swimming (control participants; mean age ± standard deviation = 20.6 ± 1.3 years). Flexibility of the trunk and upper and lower limbs was measured using plastic tape and a goniometer, respectively. Joint proprioception (joint position sense) of the upper and lower limbs on land and underwater was measured by an active joint angle repositioning test. Principle outcome measures were passive joint range of motion (flexibility) and active joint repositioning error (proprioception). Multivariate analysis of covariance revealed that, compared with control swimmers, synchronized swimmers had greater passive joint ranges of motion in the spinal and upper and lower limb joints ( p < .05) and fewer active joint repositioning errors in the shoulder, wrist, and ankle on land ( p < .05) and in the hip and ankle underwater ( p < .05). These results help characterize peak synchronized swimmer capabilities, provide valuable reference details for coaches, and may be useful for talent identification and skill development in this sport.
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Sousa, Andreia S. P., João Leite, Bianca Costa, and Rubim Santos. "Bilateral Proprioceptive Evaluation in Individuals With Unilateral Chronic Ankle Instability." Journal of Athletic Training 52, no. 4 (April 1, 2017): 360–67. http://dx.doi.org/10.4085/1062-6050-52.2.08.
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Context: Despite extensive research on chronic ankle instability, the findings regarding proprioception have been conflicting and focused only on the injured limb. Also, the different components of proprioception have been evaluated in isolation. Objective: To evaluate bilateral ankle proprioception in individuals with unilateral ankle instability. Design: Cohort study. Setting: Research laboratory center in a university. Patients or Other Participants: Twenty-four individuals with a history of unilateral ankle sprain and chronic ankle instability (mechanical ankle instability group, n = 10; functional ankle instability [FAI] group, n = 14) and 20 controls. Main Outcome Measure(s): Ankle active and passive joint position sense, kinesthesia, and force sense. Results: We observed a significant interaction between the effects of limb and group for kinesthesia (F = 3.27, P = .049). Increased error values were observed in the injured limb of the FAI group compared with the control group (P = .031, Cohen d = 0.47). Differences were also evident for force sense (F = 9.31, P < .001): the FAI group demonstrated increased error versus the control group (injured limb: P < .001, Cohen d = 1.28; uninjured limb: P = .009, Cohen d = 0.89) and the mechanical ankle instability group (uninjured limb: P = .023, Cohen d = 0.76). Conclusions: Individuals with unilateral FAI had increased error ipsilaterally (injured limb) for inversion movement detection (kinesthesia) and evertor force sense and increased error contralaterally (uninjured limb) for evertor force sense.
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Lin, Jian-Zhi, Yu-An Lin, Wei-Hsun Tai, and Chung-Yu Chen. "Influence of Landing in Neuromuscular Control and Ground Reaction Force with Ankle Instability: A Narrative Review." Bioengineering 9, no. 2 (February 10, 2022): 68. http://dx.doi.org/10.3390/bioengineering9020068.
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Ankle sprains are generally the most common injuries that are frequently experienced by competitive athletes. Ankle sprains, which are the main cause of ankle instability, can impair long-term sports performance and cause chronic ankle instability (CAI). Thus, a comprehensive understanding of the key factors involved in repeated ankle strains is necessary. During jumping and landing, adaptation to the landing force and control of neuromuscular activation is crucial in maintaining ankle stability. Ankle mobility provides a buffer during landing, and peroneus longus activation inhibits ankle inversion; together, they can effectively minimize the risk of ankle inversion injuries. Accordingly, this study recommends that ankle mobility should be enhanced through active and passive stretching and muscle recruitment training of the peroneus longus muscles for landing strategies should be performed to improve proprioception, which would in turn prevent ankle sprain and injury to neighboring joints.
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Forbes, Hollie, Sarah Thrussell, Nick Haycock, Monika Lohkamp, and Matthew White. "The Effect of Prophylactic Ankle Support During Simulated Soccer Activity." Journal of Sport Rehabilitation 22, no. 3 (August 2013): 170–76. http://dx.doi.org/10.1123/jsr.22.3.170.
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Objective:Ankle injuries are common in soccer and may result in ongoing functional deficiency. Ankle-joint prophylactic support is hypothesized to reduce the risk of injury. Analysis of the effects of prophylactic support has so far lacked application to soccer. Therefore, the purpose of this study was to illustrate the effects of tape and brace on selected proprioceptive components and range of motion (ROM) before, after, and during a soccer-match-simulation protocol.Design and Setting:A crossover study design was used to investigate plantarflexion (PF) ROM, inversion (INV) ROM, and joint-position sense (weight bearing and non-weight-bearing [NWBJPS]; ± °error) in tape, brace, and control conditions. Measures were gathered from the dominant leg in a biomechanics laboratory at 0, 15, 30, and 45 min of a soccer-specific aerobic field test 90-min (SAFT90) protocol.Participants:Eight healthy male subjects (age 20.5 ± 0.5 y) experienced the 3 conditions in random order with 7 d between conditions.Intervention:The tape condition used an open basket-weave technique; the brace was an AirCast AirSport brace. For the control condition no prophylactic support was applied.Results:Application of prophylactic support significantly decreased active ROM in PF and INV (P < .05), with tape performing better than the brace (0 min). Tape lost its restrictive benefits by 15 min (P < .001) and was no different than control, while the brace maintained some effect until 45 min. Application of prophylactic support increased NWBJPS performance (P < .01; 0 min); by 15 min the tape had lost its proprioceptive benefit (P < .01) compared with the brace.Conclusions:Our findings suggest that the clinical usefulness of ankle-joint prophylactic support is limited if the aim is to restrict ROM and improve proprioceptive capability under soccer-specific conditions. The relative benefits of each type of support need to be considered in the context of the time-specific nature of the activity.
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Büyükafşar, Enes, Selda Başar, and Ulunay Kanatli. "Proprioception following the Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Tendon Allograft." Journal of Knee Surgery 33, no. 07 (April 8, 2019): 722–27. http://dx.doi.org/10.1055/s-0039-1684010.
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AbstractAfter the anterior cruciate ligament (ACL) reconstruction, a loss of proprioception is observed and it can continue years after the operation. The aim of this study is to evaluate proprioception in standing position at different knee flexion angles in patients who underwent ACL reconstruction with tibialis anterior tendon allograft. The study included 34 patients who underwent ACL reconstruction with tibialis anterior tendon allograft and 34 healthy individuals. Proprioception was evaluated in standing position at 15°, 30°, 60° flexion angles with the active joint position sense (AJPS) method using digital inclinometer. Proprioception deviation angle was found to be higher in the operated leg at 30° and 60° flexion angles in the patient group compared with the other leg (p < 0.05), the biggest proprioception difference was between the 15° and 60° flexion angles in both the patient and the control group (p < 0.05) that the difference between 15° and 30° flexion angles is lowest (p < 0.05), and that these differences are higher in the operated leg of the patient group compared with the other leg of the patient group and to the dominant leg of the control group (p < 0.05). As approximately 4 years after ACL reconstruction with tibialis anterior tendon allograft, loss of proprioception at 60° knee flexion continued, ACL injury related to loss of proprioception may occur at angles higher than 30° flexion. Thus, patients may be provided with proprioception-enhancing rehabilitation in the long term, particularly, at flexion angles above medium levels.
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Bottoni, Giuliamarta, Dieter Heinrich, Philipp Kofler, Michael Hasler, and Werner Nachbauer. "The Effect of Uphill and Downhill Walking on Joint-Position Sense: A Study on Healthy Knees." Journal of Sport Rehabilitation 24, no. 4 (November 2015): 349–52. http://dx.doi.org/10.1123/jsr.2014-0192.
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Context:During sport activity, knee proprioception might worsen. This decrease in proprioceptive acuity negatively influences motor control and therefore may increase injury risk. Hiking is a common activity characterized by a higher-intensity-exercise phase during uphill walking and a lower-intensity-exercise phase during downhill walking. Pain and injuries are reported in hiking, especially during the downhill phase.Objective:To examine the effect of a hiking-fatigue protocol on joint-position sense.Design:Repeated measures.Setting:University research laboratory.Participants:24 nonprofessional sportswomen without knee injuries.Main Outcome Measures:Joint-position sense was tested at the beginning, after 30 min uphill walking, and after 30 min downhill walking on a treadmill (continuous protocol).Results:After downhill walking, joint-position sense was significantly worse than in the test at the beginning (P = .035, α = .05). After uphill walking, no differences were observed in comparison with the test at the beginning (P = .172, α = .05) or the test after downhill walking (P = .165, α = .05).Conclusion:Downhill walking causes impairment in knee-joint-position sense. Considering these results, injury-prevention protocols for hiking should focus on maintaining and improving knee proprioception during the descending phase.
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Liu, Yu, Wing-Kai Lam, Hok-Sum Man, and Aaron Kam-Lun Leung. "Influence of Sport Type on Metatarsophalangeal and Ankle Joint Stiffness and Hopping Performance." Journal of Healthcare Engineering 2020 (March 14, 2020): 1–7. http://dx.doi.org/10.1155/2020/9025015.
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While individual ankle and metatarsophalangeal joint stiffness is related to training intensity and sport performances, sport athletes may develop specific passive joint stiffness among the spectrum from endurance to powerful types of sports. The objective of this study examined whether marathon runners, basketball players, and other sports athletes would demonstrate distinct passive ankle and metatarsophalangeal joint stiffness as well as vertical stiffness. Fifteen marathon runners, nineteen basketball players, and seventeen other sports athletes performed both joint stiffness measurement and single-leg hopping tests. We used a computerized dynamometer to control foot alignment and speed for passive ankle and metatarsophalangeal joint stiffness measurements. We calculated vertical stiffness by body deceleration and body mass displacement during hopping on the force platform. One-way ANOVA was performed to identify the group differences. Bivariate correlation test was also performed among ankle, metatarsophalangeal, and vertical stiffness. The basketball group displayed 13% higher ankle passive stiffness than the other sports players group (P=0.03). Metatarsophalangeal joint passive stiffness in sitting and standing positions was 23% higher in the basketball group than the runner and other sports athlete groups (P<0.01). However, there was no significant group differences in metatarsophalangeal joint passive stiffness and vertical stiffness. Significant correlations among all stiffness variables were determined (P<0.05). These findings indicate that ankle and metatarsophalangeal joint passive stiffness, rather than vertical leg stiffness, would be in relation to types of sports participation. Ankle and toe strengthening exercises could improve basketball players’ performance and prevent injury.
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Chinnasee, Chamnan, Gillian Weir, Siriporn Sasimontonkul, Jacqueline Alderson, and Cyril Donnelly. "A Biomechanical Comparison of Single-Leg Landing and Unplanned Sidestepping." International Journal of Sports Medicine 39, no. 08 (June 14, 2018): 636–45. http://dx.doi.org/10.1055/a-0592-7422.
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AbstractUnplanned sidestepping and single-leg landing have both been used to screen athletes for injury risk in sport. The aim of this study was to directly compare the lower limb mechanics of three single-leg landing tasks and an unplanned sidestepping task. Thirteen elite female team sport athletes completed a series of non-contact single-leg drop landings, single-leg countermovement jumps, single-leg jump landings and unplanned sidestepping in a randomized counterbalanced design. Three dimensional kinematics (250 Hz) and ground reaction force (2,000 Hz) data with a participant specific lower limb skeletal model were used to calculate and compare hip, knee and ankle joint kinematics, peak joint moments, instantaneous joint power and joint work during the weight acceptance phase of each sporting task (α=0.05). Peak knee joint moments and relevant injury risk thresholds were used to classify each athlete's anterior cruciate ligament injury risk during unplanned sidestepping and single-leg jump landing. Results showed that peak joint moments, power and work were greater during the single-leg jump landing task when compared to the single-leg drop landings and single-leg countermovement jumps tasks. Peak frontal and sagittal plane knee joint moments, knee joint power, as well as hip and knee joint work were greater during unplanned sidestepping when compared to the landing tasks. Peak ankle joint moments, power and work were greater during the landing tasks when compared to unplanned sidestepping. For 4 of the 13 athletes tested, their anterior cruciate ligament injury risk classification changed depending on whether they performed an unplanned sidestepping or single-leg jump landing testing procedure. To summarize, a single-leg jump landing testing procedure places a larger mechanical on the ankle joint when compared to single-leg drop landings, single-leg countermovement jumps and unplanned sidestepping. An unplanned sidestepping testing procedure places a larger mechanical demand on the knee joint when compared to single-leg landing tasks. Both unplanned sidestepping and single-leg jump landing testing procedures are recommended for classifying an athlete's anterior cruciate ligament injury risk in sport.
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RUPP, TILLE KAROLINE, and SYN SCHMITT. "INVERSE DYNAMICS OF THE LOWER EXTREMITIES: NOVEL APPROACH CONSIDERING TALOCRURAL AND SUBTALAR JOINT AXIS." Journal of Mechanics in Medicine and Biology 11, no. 03 (June 2011): 515–27. http://dx.doi.org/10.1142/s0219519411004009.
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A recent survey of epidemiological studies lists ankle injuries as one common sport injury. However, the details of the injury mechanisms of ankle sprains — the majority of ankle injuries — remain not well understood. The purpose of the presented study is twofold. The first aim is to introduce a new, widely applicable method to calculate ankle joint torques during movement using inverse dynamics. The subtalar and talocrural joint are modeled as anatomically based revolute joints. The kinematics of the lower extremities and ground reaction force are used as input data. Second, a comparison of two calculation approaches (dynamic versus static) is reported, aimed at verifying and simplifying the introduced method to have a more convenient tool at hand for applications in the field. For one first movement measurement (hopping), the calculated joint torques show a good match for the two calculation approaches. After further application, the evaluation of the resulting joint torques will provide further insights into the joint mechanics and can contribute to a better understanding of the respective injury mechanisms. Hence, this approach is interesting for researchers to be used in order to understand ankle injuries and to determine the influence of landing grounds and shoes on ankle joint torques.
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Zhang, Wenbo. "Deep-Learning-Based MRI Images for Analysis of Sport-Induced Ankle Joint Injury." Scientific Programming 2021 (May 10, 2021): 1–9. http://dx.doi.org/10.1155/2021/5544160.
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This study was to analyze the sport-induced ankle joint injury (AJI) images based on the neural network algorithms using the magnetic resonance imaging (MRI). 20 patients and 20 volunteers were included in the experimental and control groups, respectively. The hybrid diffusion equation (HDE) neural network (HDENN) algorithm was compared with the fully convolutional neural network (FCNN) and the FCNN preprocessing, and the HDE was applied to the MRI analysis of sport-induced AJI. The results showed that the total score of MRI image for the conventional position of the anterior talofibular ligament (ATFL) and posterior talofibular ligament (PTFL) was concentrated in 4 (55%) and 5 (65%), respectively. The number of patients with good prognosis with grade II injury (11 cases) was much higher than that of grade III injury (2 cases), and the number of patients with poor prognosis (4 cases) was lower than that of grade III injury (6 cases) ( P < 0.05 ). Conventional MRI was recommended to observe the ATFL and PTFL, and the valgus position MRI was recommended for the calcaneofibular ligament (CFL); conservative treatment was recommended for patients with grades I and II AJI, but surgical treatment was recommended for patients with grade III AJI.
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Fu, Lin, Feng Ren, and Julien S. Baker. "Comparison of Joint Loading in Badminton Lunging between Professional and Amateur Badminton Players." Applied Bionics and Biomechanics 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/5397656.
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The knee and ankle are the two most injured joints associated with the sport of badminton. This study evaluates biomechanical factors between professional and amateur badminton players using an injury mechanism model. The aim of this study was to investigate the kinematic motion and kinetic loading differences of the right knee and ankle while performing a maximal right lunge. Amateur players exhibited greater ankle range of motion (p<0.05,r=0.89) and inversion joint moment (p<0.05,r=0.54) in the frontal plane as well as greater internal joint rotation moment (p<0.05,r=0.28) in the horizontal plane. In contrast, professional badminton players presented a greater knee joint moment in the sagittal (p<0.05,r=0.59) and frontal (p<0.05,r=0.37) planes, which may be associated with increased knee ligamentous injury risk. To avoid injury, the players need to forcefully extend the knee with internal rotation, strengthen the muscles around the ankle ligament, and maximise joint coordination during training. The injuries recorded and the forces responsible for the injuries seem to have developed during training activity. Training programmes and injury prevention strategies for badminton players should account for these findings to reduce potential injury to the ankle and knee.
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Salles, José Inácio, Bruna Velasques, Victor Cossich, Eduardo Nicoliche, Pedro Ribeiro, Marcus Vinicius Amaral, and Geraldo Motta. "Strength Training and Shoulder Proprioception." Journal of Athletic Training 50, no. 3 (March 1, 2015): 277–80. http://dx.doi.org/10.4085/1062-6050-49.3.84.
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Context: Proprioception is essential to motor control and joint stability during daily and sport activities. Recent studies demonstrated that athletes have better joint position sense (JPS) when compared with controls matched for age, suggesting that physical training could have an effect on proprioception. Objective: To evaluate the result of an 8-week strength-training program on shoulder JPS and to verify whether using training intensities that are the same or divergent for the shoulder's dynamic-stabilizer muscles promote different effects on JPS. Design: Randomized controlled clinical trial. Setting: We evaluated JPS in a research laboratory and conducted training in a gymnasium. Patients or Other Participants: A total of 90 men, right handed and asymptomatic, with no history of any type of injury or shoulder instability. Intervention(s): For 8 weeks, the participants performed the strength-training program 3 sessions per week. We used 4 exercises (bench press, lat pull down, shoulder press, and seated row), with 2 sets each. Main Outcome Measure(s): We measured shoulder JPS acuity by calculating the absolute error. Results: We found an interaction between group and time. To examine the interaction, we conducted two 1-way analyses of variance comparing groups at each time. The groups did not differ at pretraining; however, a difference among groups was noted posttraining. Conclusions: Strength training using exercises at the same intensity produced an improvement in JPS compared with exercises of varying intensity, suggesting that the former resulted in improvements in the sensitivity of muscle spindles and, hence, better neuromuscular control in the shoulder.
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DiCesare, Christopher A., Adam W. Kiefer, Scott Bonnette, and Gregory D. Myer. "High-Risk Lower-Extremity Biomechanics Evaluated in Simulated Soccer-Specific Virtual Environments." Journal of Sport Rehabilitation 29, no. 3 (March 1, 2020): 294–300. http://dx.doi.org/10.1123/jsr.2018-0237.
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Context: Laboratory-based biomechanical analyses of sport-relevant movements such as landing and cutting have classically been used to quantify kinematic and kinetic factors in the context of injury risk, which are then used to inform targeted interventions designed to improve risky movement patterns during sport. However, the noncontextual nature of standard assessments presents challenges for assessing sport-relevant skill transfer. Objective: To examine injury-risk biomechanical differences exhibited by athletes during a jump-landing task performed as part of both a standard biomechanical assessment and a simulated, sport-specific virtual reality (VR)-based assessment. Design: Observational study. Setting: Medical center laboratory. Participants: Twenty-two female adolescent soccer athletes (age = 16.0 [1.4] y, height = 165.6 [4.9] cm, and weight = 60.2 [11.4] kg). Interventions: The landing performance was analyzed for a drop vertical jump task and a VR-based, soccer-specific corner-kick scenario in which the athletes were required to jump to head a virtual soccer ball and land. Main Outcome Measures: Hip, knee, and ankle joint kinematic differences in the frontal and sagittal planes. Results: Athletes exhibited reduced hip and ankle flexion, hip abduction, and frontal plane ankle excursion during landing in realistic sport scenario compared with the standard drop vertical jump task. Conclusion: VR-based assessments can provide a sport-specific context in which to assess biomechanical deficits that predispose athletes for lower-extremity injury and offer a promising approach to better evaluate skill transfer to sport that can guide future injury prevention efforts.
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Leonchuk, S. S., L. A. Ostrovskikh, and N. V. Sazonova. "Ankle distraction arthroplasty using the Ilizarov external fixation and arthroscopy: first clinical experience." Genij Ortopedii 27, no. 1 (February 2021): 92–96. http://dx.doi.org/10.18019/1028-4427-2021-27-1-92-96.
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We report a clinical case of a 27-year-old patient with posttraumatic painful ankle arthritis following sport injury treated with combined methods. The patient underwent ankle distraction arthroplasty with original Ilizarov apparatus and arthroscopic diagnosis and treatment of the ankle injury followed by the joint unloading and exercise therapy with frame on performed for 6 weeks at the Kurgan Ilizarov Center. The patient could improve pain relief and function at a long term following comprehensive treatment including surgical intervention, a course of physical procedures and exercise therapy. The combined technique can be used as an alternative treatment for patients with posttraumatic ankle arthritis.
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Gianakos, Arianna L., Axel Ivander, Christopher W. DiGiovanni, and John G. Kennedy. "Outcomes Following Arthroscopy for Anterior Impingement in the Ankle Joint in the General and Athletic Populations: Does Gender Play a Role?" Foot & Ankle Orthopaedics 7, no. 1 (January 2022): 2473011421S0020. http://dx.doi.org/10.1177/2473011421s00207.
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Category: Ankle; Arthroscopy; Sports Introduction/Purpose: To provide an overview of the clinical outcomes of arthroscopic procedures used as a treatment strategy for anterior ankle impingement and to determine if gender affects outcomes. Methods: A systematic literature search of the Medline, Embase, and Cochrane databases was performed during June of 2019. The combination of search terms utilized included the following: 'ankle', 'impingement', 'talus', 'osteophyte', 'arthroscopy', 'surgery', 'procedures', and 'treatment'. Two reviewers independently performed data extraction consisting of demographic data, intraoperative arthroscopic data, functional outcome scores, patient satisfaction, complications, return to play, and gender differences. Results: Twenty-eight articles evaluating a total of 1,506 patients were included in this systematic review. Sixty percent (17 of 28) and 14% (4 of 28) of studies assessed anterolateral and anteromedial impingement, respectively. Overall, good to excellent results were reported following arthroscopic treatment in patients with anterior ankle impingement with an average success rate of 81.04%. Eleven studies reported return to sport with an average return to sport of 8 weeks. The most common concomitant pathology found during arthroscopic evaluation included synovitis, osteophytes, meniscoid lesions, and AITFL injury. Four studies (15%) failed to report gender as a demographic variable. Only 7 (25%) studies reported gender analysis with four (57%) studies demonstrating differences when comparing gender outcomes. Female patients have higher rates of traumatic ankle sprains, chondral injury, and chronic ankle instability associated with anterior ankle impingement when compared with male patients. Conclusion: Our systematic review demonstrates that arthroscopic treatment for anterior ankle impingement provides good to excellent functional outcomes, and good return to sports rates in the athletic population. This study underscores that lack of statistical analysis evaluating outcomes comparing male and female populations. Our study does demonstrate that female patients have higher rates of traumatic ankle sprains, chondral injury, and chronic ankle instability associated with anterior ankle impingement when compared with male patients. Therefore, women may benefit from both AMI/ALI resection as well as lateral ankle ligament repair or reconstruction in order to address both impingement and chronic lateral ankle instability.
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Krueger, Brett, Laura Becker, Greta Leemkuil, and Christopher Durall. "Does Talocrural Joint-Thrust Manipulation Improve Outcomes After Inversion Ankle Sprain?" Journal of Sport Rehabilitation 24, no. 3 (August 2015): 315–21. http://dx.doi.org/10.1123/jsr.2013-0144.
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Clinical Scenario:Ankle sprains account for roughly 10% of sport-related injuries in the active population. The majority of these injuries occur from excessive ankle inversion, leading to lateral ligamentous injury. In addition to pain and swelling, limitations in ankle range of motion (ROM) and self-reported function are common findings. These limitations are thought to be due in part to loss of mobility in the talocrural joint. Accordingly, some investigators have reported using high-velocity, low-amplitude thrust-manipulation techniques directed at the talocrural joint to address deficits in dorsiflexion (Df) ROM and function. This review was conducted to ascertain the impact of talocrural joint-thrust manipulation (TJM) on DF ROM, selfreported function, and pain in patients with a history of ankle sprain.Focused Clinical Question:In patients with a history of inversion ankle sprain, does TJM improve outcomes in DF ROM, self-reported function, and/or pain?
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Lytle, Joseph B., Kisan B. Parikh, Armin Tarakemeh, Bryan G. Vopat, and Mary K. Mulcahey. "Epidemiology of Foot and Ankle Injuries in NCAA Jumping Athletes in the United States During 2009-2014." Orthopaedic Journal of Sports Medicine 9, no. 4 (April 1, 2021): 232596712199805. http://dx.doi.org/10.1177/2325967121998052.
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Background: Foot and ankle injuries comprise a significant proportion of all injuries sustained by National Collegiate Athletic Association (NCAA) athletes. In particular, sports that combine jumping and rapid changes in direction are associated with increased lower extremity injuries. Purpose: To describe the epidemiology of foot and ankle injuries in men’s and women’s jumping sports, including NCAA men’s and women’s basketball, women’s volleyball, and women’s gymnastics, during the 2009-2010 through 2013-2014 seasons. Study Design: Descriptive epidemiology study. Methods: Injury-surveillance data were obtained from the NCAA Injury Surveillance Program for the 2009-2010 through 2013-2014 seasons. Injuries were examined by mechanism, activity during injury, and participation restriction time. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios, and risk ratios with 95% CIs were calculated. Reported sex differences were calculated for men’s and women’s basketball. All 95% CIs not containing 1.0 were considered statistically significant. Results: A total of 1136 players sustained foot and ankle injuries (483 male and 653 female) over 612,680 AEs. These injuries resulted in a combined rate of 1.85 per 1000 AEs (95% CI, 1.75-1.97). Ankle sprains were the most common injury (63.7%), with lateral ligamentous complex injuries making up 77.1% of all ankle sprains. The most common foot injury varied based on sport and sex. Ankle injury rates were higher in male versus female basketball players (injury rate ratio, 1.33 [95% CI, 1.13-1.57]), but foot injury rates did not differ. Among basketball and volleyball players, player contact during jumping was the most common injury mechanism. Female gymnasts had higher overuse injury rates than other athletes (0.49/1000 AEs [95% CI, 0.30-0.74]; P < .002). Overall, female basketball players were 1.81 times more likely to sustain an overuse injury than male basketball players (95% CI, 1.02-3.20; P = .02). Conclusion: The most common foot and ankle injury sustained in collegiate jumping sports was a lateral ligamentous complex ankle sprain. Injury-prevention programs focusing on ankle flexibility, strength, and proprioception may help to alleviate the injury burden and lessen severity. Improving the anticipation of contact during jumping and landing may reduce injury rates and increase player safety. The increased prevalence of overuse injuries in female collegiate athletes competing in jumping sports necessitates further investigation to reduce injury rates through prevention and training programs.
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Willauschus, Maximilian, Johannes Rüther, Michael Millrose, Matthias Walcher, Christophe Lambert, Hermann Josef Bail, and Markus Geßlein. "Foot and Ankle Injuries in Elite Taekwondo Athletes: A 4-Year Descriptive Analysis." Orthopaedic Journal of Sports Medicine 9, no. 12 (December 1, 2021): 232596712110611. http://dx.doi.org/10.1177/23259671211061112.
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Background: Foot and ankle injuries are a common but underestimated problem in taekwondo. Detailed data on injury incidence rates (IIRs), patterns, and injury mechanism are missing. Purpose: The primary aims were to evaluate the prevalence of foot and ankle injuries and the exposure-adjusted IIR of elite taekwondo athletes during matches while training (ie, sparring) and in competitions. The secondary aims were to evaluate injury site, type, sport-specific mechanism, and time loss. Study Design: Descriptive epidemiology study. Methods: Athletes from a single national Olympic taekwondo training center were assessed prospectively for foot and ankle injuries over 4 years (between January 1, 2016, and December 31, 2019). Data were collected regarding number and type of injuries, anatomic location, and total exposure time during training and competition for each athlete. Injury mechanism and dominant foot were assessed via personal interview. Time loss from sport was analyzed retrospectively. The injury prevalence and IIR were calculated. Correlation between mechanism and injury type, location, and dominant foot was evaluated. Time loss according to location and injury type was assessed. The chi-square test and Fisher exact test were used to test for differences in sex, age, and taekwondo experience and for comparison of injury location and type, injury mechanism, and side dominance, respectively. Training and competition IIRs and prevalence were calculated with 95% CIs (for Poisson rates). Results: From an initial 107 athletes, 79 (73.8%) were included in the final data set. Of these athletes, 38 were injured (n = 112 injuries) for a prevalence of 48.1% (95% CI, 43%-52%). The overall IIR of the ankle joint was 13.14 injuries per 1000 athletes (95% CI, 1.5-25.9) and was significantly higher during competition versus training ( P < .001). Ankle joint injuries were most common (n = 71; 63%). Significantly more noncontact versus contact ankle ligament injuries (n = 46; 83%) occurred ( P < .001). The forefoot (n = 18; 66%) was mainly affected by contact injuries ( P < .001). Time loss was the highest for midfoot fractures (mean ± SD, 23.0 ± 0.6 days; range, 23-24 days). Conclusion: Noncontact ligamentous ankle injuries were most common, with a higher incidence during competition. Improvement of strength, endurance, and postural stability under strain is recommended for prevention.
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Nunes, Guilherme S., Alessandro Haupenthal, Manuela Karloh, Valentine Zimermann Vargas, Daniela Pacheco dos Santos Haupenthal, and Bruna Wageck. "Sport injuries treated at a physiotherapy center specialized in sports." Fisioterapia em Movimento 30, no. 3 (September 2017): 579–85. http://dx.doi.org/10.1590/1980-5918.030.003.ao16.
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Abstract Introduction: The risk of injuries related to physical activity and sports may increase if there is predisposition, inappropriate training and/or coach guidance, and absence of sports medicine follow-up. Objective: To assess the frequency of injuries in athletes treated at a physiotherapy center specialized in sports. Methods: For the data collection was carried out the survey of injuries in records of athletes treated in eight years of activities. The data collected included: characteristics of patients, sport, injury kind, injury characteristics and affected body part. Results: From 1090 patient/athlete records, the average age was 25 years old, the athletes were spread across 44 different sports modalities, being the great majority men (75%). The most common type of injury was joint injury, followed by muscular and bone injuries. Chronic injury was the most frequent (47%), while the most common body part injured was the knee, followed by ankle and shoulder. Among all the sports, soccer, futsal, and track and field presented the highest number of injured athletes, respectively. Conclusion: Soccer was the most common sport among the injured athletes, injury kind most frequent was joint injuries and knee was the body part most injured. Chronic injuries were the most common.
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Arumugam, Ashokan, Martin Björklund, Sanna Mikko, and Charlotte K. Häger. "Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: a systematic review and GRADE evidence synthesis." BMJ Open 11, no. 5 (May 2021): e049226. http://dx.doi.org/10.1136/bmjopen-2021-049226.
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ObjectiveTo systematically review and summarise the evidence for the effects of neuromuscular training compared with any other therapy (conventional training/sham) on knee proprioception following anterior cruciate ligament (ACL) injury.DesignSystematic Review.Data sourcesPubMed, CINAHL, SPORTDiscus, AMED, Scopus and Physical Education Index were searched from inception to February 2020.Eligibility criteriaRandomised controlled trials (RCTs) and controlled clinical trials investigating the effects of neuromuscular training on knee-specific proprioception tests following a unilateral ACL injury were included.Data extraction and synthesisTwo reviewers independently screened and extracted data and assessed risk of bias of the eligible studies using the Cochrane risk of bias 2 tool. Overall certainty in evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.ResultsOf 2706 articles retrieved, only 9 RCTs, comprising 327 individuals with an ACL reconstruction (ACLR), met the inclusion criteria. Neuromuscular training interventions varied across studies: whole body vibration therapy, Nintendo-Wii-Fit training, balance training, sport-specific exercises, backward walking, etc. Outcome measures included joint position sense (JPS; n=7), thresholds to detect passive motion (TTDPM; n=3) or quadriceps force control (QFC; n=1). Overall, between-group mean differences indicated inconsistent findings with an increase or decrease of errors associated with JPS by ≤2°, TTDPM by ≤1.5° and QFC by ≤6 Nm in the ACLR knee following neuromuscular training. Owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness or imprecision associated with the findings) for each outcome of interest across studies, the certainty of evidence was very low.ConclusionsThe heterogeneity of interventions, methodological limitations, inconsistency of effects (on JPS/TTDPM/QFC) preclude recommendation of one optimal neuromuscular training intervention for improving proprioception following ACL injury in clinical practice. There is a need for methodologically robust RCTs with homogenous populations with ACL injury (managed conservatively or with reconstruction), novel/well-designed neuromuscular training and valid proprioception assessments, which also seem to be lacking.PROSPERO registration numberCRD42018107349.
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Zou, Longqiang, Yibin Yang, and Yihai Wang. "A Meta-Analysis of Systemic Evaluation of Knee Ligament Injury or Intervention of Knee Proprioceptive Function Recovery." Journal of Healthcare Engineering 2022 (February 17, 2022): 1–9. http://dx.doi.org/10.1155/2022/9129284.
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Objective. The knee ligaments, as a passive knee joint stability device, provide protection for the knee joint and ensure its functional integrity. This role has long been known and recognized by people. The original purpose of knee ligament reconstruction after knee ligament injury is to restore its anatomical structure and mechanical stability mechanism. Methods. Taking athletes as the research object, randomized controlled trials (RCTs) on improving ankle joint function of athletes related to proprioception training at home and abroad were included. The search time was from the establishment of the database to December 31, 2019, and the references of related documents were traced. Two researchers independently screened the literature, extracted data, and evaluated the quality of the literature. RevMan 5.3 software was used for data analysis. Results. The extensor strength, flexor strength, and flexor strength/extensor strength of the affected limb were higher than before the operation one year after surgery ( P < 0.01 ). The Lysholm score, Lysholm instability score, and one-foot jump distance were all higher than those before surgery ( P < 0.05 ); the difference of KT-2000 for both knees was smaller than that before surgery ( P < 0.05 ). Conclusion. In maintaining the anterior stability of the knee joint, the knee ligament provides 85% static resistance to prevent the tibia from moving forward, so knee ligament injury will cause knee instability. The proprioceptive feedback mechanism plays an important role in maintaining the functional stability of joints.
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Yang, Changsop, Eunyoung Lee, Eui-Hyoung Hwang, Ojin Kwon, and Jun-Hwan Lee. "Management of Sport Injuries with Korean Medicine: A Survey of Korean National Volleyball Team." Evidence-Based Complementary and Alternative Medicine 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/8639492.
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The purpose of this study was to report the current state of Korean medicine (KM) treatment on sports injury by implementing survey with volleyball team medical doctors participating in 2013-2014 season. Six KM doctors completed a questionnaire that includes injury parameters: type, location, situation, and pain scores. We collected 166 injury cases from 94 Korean male and female national volleyball players. Knee (25.9%), low back (13.3%), elbow, and ankle (8.4%) injuries were most common. Joint (41.6%) and muscle (30.7%) were major injured tissues. KM team medical doctors utilized acupuncture (40.4%), chuna manual therapy (16.0%), physical therapy (15.2%), taping (9.0%), and cupping (7.8%) to treat volleyball injuries. Any types of medications were used infrequently. Additional physical and exercise therapy were preferred after receiving acupuncture (both 46.9%). This study presented the preliminary injury profile of Korean elite volleyball players. Injury and treatment parameters could be useful to build advanced KM model in sport medicine.
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Monisha, R., M. Manikumar, Pahinian A, and Simulia Dhinju B. "Effect of Cryotherapy on Proprioception and Throwing Accuracy In the Dominant Shoulder among Female Recreational Players." Biomedical and Pharmacology Journal 11, no. 2 (June 27, 2018): 1031–34. http://dx.doi.org/10.13005/bpj/1462.
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Throwing is one of the most complex activities within all athletic activity. The integrity of the receptors responsible for movement and proprioception with neural pathways plays a important role in maximizing the shoulder mobility in throwing skill. After an acute shoulder injury in sport, an athlete may return to practice or competition following a cryotherapy treatment to the injured shoulder. To find the effect of Cryotherapy on proprioception and throwing efficiency of shoulder in recreational players. 10 female basketball players will be selected as per the inclusion and exclusion criteria. The procedures were explained and an informed consent statement was obtained from the participants. Crushed ice with terry towels were employed to all the players included to the study. Treatment duration was 15 minutes, immediately at the end of the treatment, the post-test documentation on throwing efficiency was documented. Throwing performance index was used to assess the Functional ability of the shoulder joint. Paired t-test was used to compare in mean values of pre-test and post-test. There was a statistically significant changes obtained in the throwing accuracy after 15 minutes of cryotherapy application.
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Ricci, R. Daniel, James Cerullo, Robert O. Blanc, Patrick J. McMahon, Anthony M. Buoncritiani, David A. Stone, and Freddie H. Fu. "Talocrural Dislocation With Associated Weber Type C Fibular Fracture in a Collegiate Football Player: A Case Report." Journal of Athletic Training 43, no. 3 (May 1, 2008): 319–25. http://dx.doi.org/10.4085/1062-6050-43.3.319.
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Abstract Objective: To present the case of a talocrural dislocation with a Weber type C fibular fracture in a National Collegiate Athletic Association Division I football athlete. Background: The athlete, while attempting to make a tackle during a game, collided with an opponent, who in turn stepped on the lateral aspect of the athlete's ankle, resulting in forced ankle eversion and external rotation. On-field evaluation showed a laterally displaced talocrural dislocation. Immediate reduction was performed in the athletic training room to maintain skin integrity. Post-reduction radiographs revealed a Weber type C fibular fracture and increased medial joint clear space. A below-knee, fiberglass splint was applied to stabilize the ankle joint complex. Differential Diagnosis: Subtalar dislocation, Maisonneuve fracture, malleolar fracture, deltoid ligament rupture, syndesmosis disruption. Treatment: The sports medicine staff immediately splinted and transported the athlete to the athletic training room to reduce the dislocation. The athlete then underwent an open reduction and internal fixation procedure to stabilize the injury: 2 syndesmosis screws and a fibular plate were placed to keep the ankle joint in an anatomically reduced position. With the guidance of the athletic training staff, the athlete underwent an accelerated physical rehabilitation protocol in an effort to return to sport as quickly and safely as possible. Uniqueness: Most talocrural dislocations and associated Weber type C fibular fractures are due to motor vehicle accidents or falls. We are the first to describe this injury in a Division I football player and to present a general rehabilitation protocol for a high-level athlete. Conclusions: Sports medicine practitioners must recognize that this injury can occur in the athletic environment. Prompt reduction, early surgical intervention, sufficient resources, and an accelerated rehabilitation protocol all contributed to a successful outcome in the patient.
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DiCesare, Christopher A., Alicia Montalvo, Kim D. Barber Foss, Staci M. Thomas, Timothy E. Hewett, Neeru A. Jayanthi, and Gregory D. Myer. "Sport Specialization and Coordination Differences in Multisport Adolescent Female Basketball, Soccer, and Volleyball Athletes." Journal of Athletic Training 54, no. 10 (October 1, 2019): 1105–14. http://dx.doi.org/10.4085/1062-6050-407-18.
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Context Early sport specialization, or the participation in 1 sport year-round to the exclusion of all others, is a growing concern in youth athletics because of its possible association with musculoskeletal injury. The underlying injury risk may be the result of coordination differences that sport-specialized athletes have been speculated to exhibit relative to multisport athletes; however, little evidence exists to support or refute this notion. Objective To examine relative hip- and knee-joint angular-motion variability among adolescent sport-specialized and multisport female adolescent athletes to determine how sport specialization may affect coordination. Design Cohort study. Setting Research laboratory. Patients or Other Participants A total of 366 sport-specialized and 366 multisport adolescent female basketball, soccer, and volleyball players. Intervention(s) Drop–vertical-jump (DVJ) assessment. Main Outcome Measure(s) Average coupling-angle variability (CAV) for hip flexion and knee flexion, knee flexion and ankle flexion, hip flexion and knee abduction, knee flexion and knee abduction, knee flexion and knee internal rotation, and knee abduction and knee internal rotation. Results The sport-specialized group exhibited increased coupling variability in dominant-limb hip flexion and knee flexion (P = .015), knee flexion and knee abduction (P = .014), and knee flexion and knee internal rotation (P = .048) while landing during the DVJ, although they had small effect sizes (η2 = 0.010, 0.010, and 0.007, respectively). No differences were present between groups for any of the other CAV measures of the dominant limb, and no differences were found for any CAV measures of the nondominant limb (all P values > .05). Conclusions Sport specialization was associated with increased variability of critical hip- and knee-joint couplings responsible for effective landing during the DVJ. Altered coordination strategies that involve the hip and knee joints may underlie unstable landings, inefficient force-absorption strategies, or greater contact forces that can place the lower extremities at risk for injury (or a combination of these).
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Estevan, Isaac, Gonzalo Monfort-Torres, Roman Farana, David Zahradnik, Daniel Jandacka, and Xavier García-Massó. "Children’s Single-Leg Landing Movement Capability Analysis According to the Type of Sport Practiced." International Journal of Environmental Research and Public Health 17, no. 17 (September 3, 2020): 6414. http://dx.doi.org/10.3390/ijerph17176414.
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(1) Background: Understanding children’s motor patterns in landing is important not only for sport performance but also to prevent lower limb injury. The purpose of this study was to analyze children’s lower limb joint angles and impact force during single-leg landings (SLL) in different types of jumping sports using statistical parametric mapping (SPM). (2) Methods: Thirty children (53.33% girls, M = 10.16 years-old, standard deviation (SD) = 1.52) divided into three groups (gymnastics, volleyball and control) participated in the study. The participants were asked to do SLLs with the dominant lower limb (barefoot) on a force plate from a height of 25 cm. The vertical ground reaction force (GRF) and lower limb joint angles were assessed. SPM{F} one-way analysis of variance (ANOVA) and SPM{t} unpaired t-tests were performed during the landing and stability phases. (3) Results: A significant main effect was found in the landing phase of jumping sport practice in GRF and joint angles. During the stability phase, this effect was exhibited in ankle and knee joint angles. (4) Conclusions: Evidence was obtained of the influence of practicing a specific sport in childhood. Child volleyball players performed SLL with lower impact force and higher knee flexion than child gymnasts. Training in specific jumping sports (i.e., volleyball and gymnastics) could affect the individual capacity to adapt SLL execution.
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Milankov, Miroslav, Vaso Kecojevic, Nemanja Gvozdenovic, and Mirko Obradovic. "Dislocation of the proximal tibiofibular joint." Medical review 66, no. 9-10 (2013): 387–91. http://dx.doi.org/10.2298/mpns1310387m.
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Introduction. Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by different methods have been published so far. Case Report. A 23-year-old male soccer player sustained an injury after he had joined the game without previous warming-up. He fell on his right side because of a sudden change of direction while his foot was fixed to the base. He felt a severe pain and had a sensation as if something had snapped in his right knee. Pain and swelling at the head of fibula were found by physical examination, which, however, did not reveal any pain, swelling and instability of the ankle or peroneal nerve palsy. The x-ray showed anterolateral dislocation of the proximal tibiofibular joint, Ogden type II. Since manual reposition in general anesthesia failed, open reduction internal fixation was performed and proximal tibiofibular joint was transfixed with a screw. After the wound closure, the above-the-knee plaster cast was applied. The screw was extracted six weeks later, full weight bearing was allowed and he started with physical therapy. Four months after the injury he returned to sports activities. On the follow- up one year after the injury he had the full range of motion of the knee, no complains, and continued with active soccer playing. X-ray showed no signs of arthrosis of the proximal tibiofibular joint. Conclusion. The proximal tibiofibular joint dislocation may be the cause of the chronic pain of the knee so it has to be taken into account when making differential diagnosis in case of the pain at the lateral side of the knee. The key for making the accurate diagnosis is the technically correct X-ray of the injured knee compared with the opposite one, showing the displacement of fibular head. If manual reposition fails, open reduction internal fixation and screw transfixation of the proximal tibiofibular joint allow good results and fast return to sport activities.
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Mladenović, Marko, Predrag Stojiljković, Desimir Mladenović, Andrija Krstić, and Vladimir Anđelković. "Role and importance of posterior malleolus fixation in trimaleolar fractures." Timocki medicinski glasnik 46, no. 2 (2021): 79–85. http://dx.doi.org/10.5937/tmg2102079m.
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Introduction - ankle fractures are third when it comes to frequency, right after hip and wrist joint fractures. Posterior malleolus fractures are common, comprising 7% to 44% of all ankle fractures, and are very rare on their own; that is a Volkmann triangle fracture. Ankle is a supporting joint in the human body, and fractures generally occur within rotation of the body with different fixed foot positions. The posterior malleolus is a very important structure in distal tibiofibular joint. Material and methods - we retrospectively present a group of 21 patients who had a fracture of the ankle and were surgically treated at the Clinic for Orthopedics and Traumatology in Niš during the period from January 2013 to December 2015. The basic criterion for surgical treatment was the size of the fragment, > 25% from tibial joint surface and dislocation >2mm. We systemized all ankle fractures according to the Lauge Hansen system, which is based on the mechanism of injury. We evaluated treatment results according to the Olerud-Molander classification, followed by subjective and objective signs. We systemized posterior malleolus fractures into three types, according to the Haraguchi classification. Results - etiological causes of the fractures are: a fall at the same level - sport, skating in 11 (52.3%) patients, a fall from a height in 6 (28.6%) and traffic accident in 4 (21.1%) patients. According to the Lauge Hansen classification, there were 15 (71.4%) patients with a SER-type fracture, 4 (19%) of the PER type, and 2 (9.6%) of the PA type. End result of the treatment was excellent in 13 (61.9%) patients, good in 7 (33.4%) and poor in 1 (4.7%) patient. Post-traumatic arthritis (PTA) was assessed one year after the surgery and level 1 and 2 were present in 12 (57.1%) patients.
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Avedesian, Jason M., Tracey Covassin, and Janet S. Dufek. "Landing Biomechanics in Adolescent Athletes With and Without a History of Sports-Related Concussion." Journal of Applied Biomechanics 36, no. 5 (October 1, 2020): 313–18. http://dx.doi.org/10.1123/jab.2020-0034.
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Recent evidence suggests previously concussed athletes are at greater risk for lower-extremity (LE) injuries than are controls. However, little is known regarding the influence of sports-related concussion (SRC) on landing biomechanics that may provide a mechanistic rationale for LE injury risk. The purpose of this investigation was to examine LE drop-landing biomechanics in adolescent athletes with and without a previous SRC history. Participants included 10 adolescent athletes with an SRC history and 11 controls from multiple sports. Three-dimensional kinematic and kinetic data associated with LE injury risk were analyzed across 5 trials for 30- and 60-cm landing heights. Multivariate analyses indicated group differences in landing patterns from the 30- (P = .041) and 60-cm (P = .015) landing heights. Follow-up analyses indicated that concussed adolescent athletes demonstrated significantly less ankle dorsiflexion and knee flexion versus controls when performing drop landings. Our findings suggest that previously concussed adolescent athletes complete drop-landing maneuvers with ankle and knee joint kinematic patterns that suggest greater risk for LE injury. While limitations such as sport variety and explicit LE injury history are present, the results of this study provide a possible biomechanical rationale for the association between SRC and LE injury risk.
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Newman, Thomas M., Giampietro L. Vairo, and William E. Buckley. "The Comparative Effects of Ankle Bracing on Functional Performance." Journal of Sport Rehabilitation 27, no. 5 (September 1, 2018): 491–502. http://dx.doi.org/10.1123/jsr.2016-0136.
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Ankle sprains represent a common musculoskeletal injury that clinicians are tasked with preventing and treating. Because of the prevalence of this injury, ankle braces have been designed to prophylactically protect the joint and reduce the incidence of repetitive sprains. Although an abundance of literature exists focusing on the efficacy of braces in preventing ankle sprains in young, healthy, and physically active populations, there is a scarcity of evidence specific to the impact of these apparatuses on functional performance; therefore, the purpose of this critically appraised topic (CAT) is to investigate the effects of ankle braces on functional performance measures in such individuals. The outcomes of this CAT will assist sport rehabilitation specialists with informed clinical decision making in managing young, healthy, and physically active populations using ankle braces. Do ankle braces hinder functional performance measures when compared with an unbraced condition in a young, healthy, and physically active population? A minimum of level II evidence research studies were surveyed for this CAT. For this CAT, 1 randomized controlled trial and 3 prospective cohort studies were selected. One study found a statistically significant main effect of increased agility run times while participants wore ankle braces. Another study demonstrated a statistically significant decrease in vertical jump height and ankle range of motion while wearing braces. No other statistically significant findings were reported among studies comparing unbraced with braced conditions. Current data indicate that young, healthy, and physically active individuals may experience varied performance effects when executing specific functional performance tasks while wearing ankle braces. In general, bracing does not appear to significantly impair performance on most functional tasks; however, decrements were noted to increases in agility run time and decreases in vertical jump height. Subsequent analysis indicated that a brace may result in decreased ankle plantarflexion, dorsiflexion, eversion, and inversion range of motion, which may underpin noted performance deficits.
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Caliskan, Pinar Melodi, Anne Benjaminse, and Alli Gokeler. "Development of an on-field injury screening test using wearable sensor technology." Orthopaedic Journal of Sports Medicine 8, no. 9_suppl7 (September 1, 2020): 2325967120S0051. http://dx.doi.org/10.1177/2325967120s00513.
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Introduction: Injuries of the anterior cruciate ligament (ACL) commonly occur during complex game situations when the athlete encounters multiple factors such as ball, opponent, field position, and game strategy (Grooms et al., 2018). Many of the current traditional injury screening programs are performed within a predictable, fixed or ‘closed’ environment which do not represent real game situations that require high neurocognitive demands (Dingenen & Gokeler, 2017; Grooms et al., 2018). A complementary approach to lab-based settings is necessary to incorporate the demands of the complex athletic environments. By using wearable sensor technology, we aim to develop an on-field injury screening test in elite youth male soccer players. Investigating the individual differences in motor coordination patterns of the players during sport-specific tasks might enhance our understanding of how ACL injuries occur. Hypotheses: We hypothesized that the motor coordination patterns of the players would be affected when they perform under different conditions manipulated with constraints (task and environmental). Methods: A football-specific test setup was created to analyse the kinematic and performance measures of a group of 17 male youth elite football players aged 15 years (height = 164 ± 9 cm, mass = 50.9± 7.4 kg). The players were grouped into two and measured on two consecutive days. All the players were instructed to complete the test setup (4 conditions, 5 trials) as fast as possible. Condition 1 includes no constraint, condition 2 includes a task constraint (football dummies), condition 3 includes an environmental constraint (stroboscopic glasses) (SENAPTEC, Beaverton, Oregon) and condition 4 includes both task and environmental constraints. 3-D kinematics of the hip, knee, ankle joints were captured using Xsens wearable full-body sensor suits (Xsens, MVN Link version, Enschede, The Netherlands). MATLAB (MATLAB R2019a, The MathWorks Inc., Massachusetts) was used to process and analyse the kinematic data. Data from condition 1 was determined as reference behavior/condition to be compared to other conditions. Kinematic data are presented in attitude vectors (ATV). Results: In total, 81% of the players demonstrated a significant difference (P < 0.05) in angles of hip, knee and ankle joints when performing under different conditions. The percentage of players with increased comparison-based joint movements as follows; condition 1 to condition 2 comparison; 41% hip flexion, 59% hip extension, 53% hip abduction, 47% hip adduction, 62% knee flexion, 38% knee extension, 59% knee abduction, 41% knee adduction, 47% ankle dorsiflexion, 53% ankle plantarflexion, condition 1 to condition 3 comparison; 35% hip flexion, 65% hip extension, 47% hip abduction, 53% hip adduction, 50% knee flexion, 50% knee extension, 41% knee abduction, 59% knee adduction, 59% ankle dorsiflexion, 41% ankle plantarflexion and condition 1 to condition 4 comparison; 31% hip flexion, 69% hip extension, 38% hip abduction, 62% hip adduction, 60% knee flexion, 40% knee extension, 44% knee abduction, 56% knee adduction, 69% ankle dorsiflexion, 31% ankle plantarflexion. Conclusion: The result of this pilot study demonstrated that manipulating task with different constraints caused significant changes in players’ motor coordination patterns which supported the hypothesis of our study. Our findings suggest to develop ACL injury screening tests in a sport-specific setting.
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Larwa, Joseph, Conrad Stoy, Ross S. Chafetz, Michael Boniello, and Corinna Franklin. "Stiff Landings, Core Stability, and Dynamic Knee Valgus: A Systematic Review on Documented Anterior Cruciate Ligament Ruptures in Male and Female Athletes." International Journal of Environmental Research and Public Health 18, no. 7 (April 6, 2021): 3826. http://dx.doi.org/10.3390/ijerph18073826.
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Anterior cruciate ligament (ACL) injuries are the most common ligament injury of the knee, accounting for between 100,000 and 200,000 injuries among athletes per year. ACL injuries occur via contact and non-contact mechanisms, with the former being more common in males and the later being more common in females. These injuries typically require surgical repair and have relatively high re-rupture rates, resulting in a significant psychological burden for these individuals and long rehabilitation times. Numerous studies have attempted to determine risk factors for ACL rupture, including hormonal, biomechanical, and sport- and gender-specific factors. However, the incidence of ACL injuries continues to rise. Therefore, we performed a systematic review analyzing both ACL injury video analysis studies and studies on athletes who were pre-screened with eventual ACL injury. We investigated biomechanical mechanisms contributing to ACL injury and considered male and female differences. Factors such as hip angle and strength, knee movement, trunk stability, and ankle motion were considered to give a comprehensive, joint by joint analysis of injury risk and possible roles of prevention. Our review demonstrated that poor core stability, landing with heel strike, weak hip abduction strength, and increased knee valgus may contribute to increased ACL injury risk in young athletes.
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Mocanu, Mircea Dan, Claudiu Mereuță, and Daniel Andrei Iordan. "Injuries resulting from practicing performance sports in table tennis and tennis." Annals of "Dunarea de Jos" University of Galati Fascicle XV Physical Education and Sport Management 2 (December 24, 2020): 12–23. http://dx.doi.org/10.35219/efms.2020.2.02.
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Performance sport as an area of human excellence requires, besides an over-average genetic endowment of motor skills, a huge workload of high intensity, which causes the wear of the body systems of the athletes, especially the osteo-musculo-articular. The high ball movement speed for rocket and paddle sports disciplines such as table tennis and field tennis, intensively demands the performance of the body of practitioners when performing specific technical tactics, especially the technical elements of the attack, such as topspin or smash. Based on the theoretical documentation, I noticed an acute condition in the scapulo-humeral joint 21.05%, at the lumbar level 15.79% and 13.16% in the ankle joint in the table tennis and in the field tennis as percentages at scapulo-humeral joint 13.85%, lumbar 15.38% and 20.00% ankle joint, aspects that validate our desire to improve the quality of life of practicing athletes of the two disciplines through a program of amelioration of compensatory nature.The objective of this theoretical research is to identify the areas subject to mechanical stress with high risk of wearor injury from the two "sister" sports disciplines.Tasks: Critical analysis of a larger volume of studies conducted on the direction of our research interest.Purpose: obtaining the information necessary which would highlight the risks the performance athletes, practitioners of the two disciplines, are subjected to, as well as gaining knowledge on tennis and table tennis.