Search Results (25)

Background/Objectives: The simulation of human movement offers transformative potential for the design of medical devices, particularly in understanding the cause–effect dynamics in individuals with neurological or musculoskeletal impairments. This study presents a simulation-driven framework to determine the optimal ankle–foot orthosis (AFO) stiffness for mitigating the risk of ankle sprains due to excessive subtalar inversion during high-impact activities, such as landing from a free fall. Methods: We employed biomechanical simulations to assess the influence of translational stiffness on subtalar inversion control, given that inversion angles exceeding 25 degrees are strongly correlated with injury risk. Simulations were conducted using a musculoskeletal model with and without a passive AFO; the stiffness varied in three anatomical directions. A Design of Experiments (DoE) approach was utilized to capture nonlinear interactions among stiffness parameters. Results: The results indicated that increased translational stiffness significantly reduced inversion angles to safer levels, though direction–dependent effects were noted. Based on these insights, we developed a 4D visualization tool that integrates simulation data with an interactive color–coded interface to depict ”safe design” zones for various AFO stiffness configurations. This tool supports clinicians in selecting stiffness values that optimize both safety and functional performance. Conclusions: The proposed framework enhances clinical decision-making and engineering processes by enabling more accurate and individualized AFO designs. Full article

Introduction: Rotational ankle instability (RAI), involving combined medial and lateral ligament insufficiency, is an increasingly recognized clinical entity. While open surgery has traditionally been the mainstay for treating deltoid ligament injuries, recent developments in arthroscopic techniques offer a minimally invasive alternative. This systematic review aimed to evaluate the current evidence on the arthroscopic management of medial and rotational ankle instability, focusing on surgical techniques, clinical outcomes, and complications. Methods: A systematic literature search was conducted following PRISMA guidelines using the PubMed, Scopus, and Web of Science databases. The search strategy included the following terms: ((rotation instability) OR (deltoid) OR (medial ankle instability)) AND (ankle arthrosc*). Eligible studies included adult patients undergoing arthroscopic repair of medial ankle instability with a mean 26.4 months follow-up and reported clinical outcomes. Ten studies met the inclusion criteria, encompassing 336 patients and 346 ankles. Results: The mean patient age was 32.6 ± 5.0 years, with 80.6% being male. MRI was the primary diagnostic tool across most studies. Ankle sprains were the most common cause of instability. Lateral ligament insufficiency was frequently associated with medial injuries, reported in all studies evaluating this parameter. All patients underwent prior conservative treatment (mean duration: 5.6 months). Surgical management involved all-inside arthroscopic repair using knotless suture anchors. Additional procedures were performed in 90% of studies, including osteophyte resection (33.3%) and microfracture (22.2%). The mean follow-up period was 26.4 months. The mean postoperative AOFAS score was 95.3, with return to sport generally achieved between 3 and 5 months. Complications were minimal, primarily consisting of superficial wound issues and transient nerve irritation; no major complications or revision surgeries were reported. Discussion: Arthroscopic management of medial and rotational ankle instability is associated with excellent functional outcomes, low complication rates, and early return to sport. Compared to open procedures, arthroscopic techniques offer advantages including reduced soft tissue trauma, fewer wound complications, and the ability to address concomitant intra-articular lesions in a single session. Although technically demanding, this approach is particularly beneficial in athletic populations. However, high-quality prospective studies are still needed to validate these findings and establish long-term comparative outcomes with open reconstruction techniques. Full article

This study aims to identify the prevalence and patterns of sports injuries in recreational sports activities in South Korea. This study utilized data from the “survey of safety accidents” conducted by the Korea Sports Safety Foundation and finally, 3182 recreational sports participants who experienced injuries were selected for the study. For data processing, data related to recreational sports injuries were first collected and organized using Excel 2015, and frequency analysis was conducted using the SPSS 25.0 program. Furthermore, the association rule method was applied via Python 3.13.3 to analyze the patterns of injury sites and types. First, by investigating the prevalence of injuries in recreational sports, it was found that the injury frequency was highest in soccer, followed by cycling, hiking, and badminton. Second, in soccer, it was found that when ankle injuries, which have a high injury frequency, occur, knee, toe, and sprain injuries also occur together (Lift: 1.843). Additionally, in cycling, when knee injuries occur, toe, sprain, and strain (bruise) injuries also occur together (Lift: 2.420). In mountain biking, when ankle injuries, which have a high injury frequency, occur, cuts, sprains, stab wounds (cuts), sprains, and strains (bruises) also occur together (Lift: 1.808). The current survey on recreational sports injuries is expected to be used as basic data to prevent injuries in advance for participants in recreational sports, and it is expected that this will allow them to participate in sports by recognizing common injury sites before participating in sports. Full article

The ankle, a pivotal and intricate joint within human anatomy, is particularly susceptible to injuries, notably sprains, due to its complex structural composition and the substantial load it endures, especially among high-performance athletes, thereby necessitating the development of innovative, patient-specific rehabilitation solutions to address the challenges presented during the recovery process. In response to this, a non-surgical approach is proposed, involving the meticulous design and implementation of a personalized orthosis. It will be designed employing additive manufacturing with polyethylene terephthalate glycol (PETG), which facilitates immobilization while also enhancing breathability and comfort through the strategic incorporation of hexagonal holes. It demonstrates significant promise in its innovative design, customizability, and potential applicability, contributing to the broader field of biomechanics and orthopedic rehabilitation. Full article

Ultrasound has emerged as a valuable imaging modality for evaluating ligamentous injuries around the ankle joint, offering several advantages over traditional imaging techniques. It is more cost-effective and widely available than MRI, and it avoids the ionizing radiation exposure associated with X-rays, making it a safer option, particularly for pediatric and adolescent populations. In cases of inversion ankle sprains, ultrasound allows for more accurate assessment of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) compared to X-rays and manual examination and yields diagnostic results comparable to MRI. For high ankle sprains involving syndesmosis injuries, ultrasound—especially stress ultrasound—has shown high diagnostic accuracy. Additionally, ultrasound evaluation of the deltoid ligament (DL) in cases of ankle fractures can aid surgeons in determining the need for ligament repair in conjunction with fracture management. This review explores recent developments in ultrasound imaging of the lateral, medial, and syndesmotic ligaments of the ankle joint and discusses its potential applications for evaluating the spring and posterior ligaments. The review provides a comprehensive overview of the ever-expanding role of ultrasound in the management of ankle ligamentous injuries. Full article

Ankle sprains are considered to be the most common musculoskeletal lower limb injury, accounting for a high percentage of all sport injuries in football. Motor imagery (MI) has been widely used for sports performance optimization purposes, suggesting that athletes’ ability to reenact a motor action can improve sports performance and rehabilitation. The aim of the present study was to explore the role of MI as an adjunct intervention in VO2max and lactate in football players with Grade II ankle sprains during the return-to-play period. Fifty-eight professional football players were randomly divided into two groups: first, the MI (n = 29) and second, the placebo (n = 29). The MI group received recorded MI instructions, whereas the placebo group received only relaxation instructions. A one-way ANOVA revealed statistically significant results within the first 4 weeks following the interventions in both groups. Additionally, a t-test showed statistically significant differences between the two groups in VO2max (t = −6.04, p = 0.000, two-tailed, p < 0.05) and lactate (t = 4.33, p = 0.000, two-tailed, p < 0.05). Further research across various sports is needed to better understand the role of MI in the return-to-play period, particularly regarding injury management and sports performance. Full article

Background: Basketball is a high-intensity sport, which includes actions such as jumping, changes of direction, accelerations, and decelerations, which generates fatigue situations that may increase the risk of injury. Specifically, the joints at greatest risk are the ankle and knee, with ankle sprains and anterior cruciate ligament (ACL) tears being the most prevalent injuries. There are several strategies aimed at reducing the incidence, based on training methods or other prophylactic measures. Therefore, the purpose of the study is to perform a systematic review of the different injury prevention strategies in competitive-level basketball players with respect to general injuries, ankle sprains, and ACL injuries. Methods: For this purpose, the PRISMA methodology was applied, performing a search in three databases (PubMed, SPORTDiscus, and Cochrane) between 25 September 2023 and 8 October 2023. Results: A total of 964 articles were identified, out of which 283 were duplicates and 644 were discarded. Out of the remaining 37, 23 were excluded because they did not meet the inclusion criteria; therefore, 14 articles were finally included. With respect to general injuries, 8 out of 14 studies reviewed them. Concerning ankle sprains, 7 studies specifically analyzed them. Finally, 3 studies focused on ACL injuries. Conclusions: Training programs that combine different contents, known as neuromuscular training, including strength work, stabilization or core, mobility, and agility are the most effective for both general injuries and ACL injuries. For ankle sprains, the most effective measures are training programs based on analytical ankle stability exercises and the use of ankle braces. Adherence to prevention programs is essential, so they can be included as part of the warm-up. Other strategies such as training load control, functional assessment, or rule modification are not used in the included articles, so their effectiveness as prophylactic methods could not be justified. Full article

Recurrent peroneal tendon dislocation is a rare and often underrecognized condition. It may result from acute injuries, more commonly seen in athletes, or from untreated ankle sprains leading to chronic ankle instability. The aim of this study is to retrospectively evaluate short- and medium-term functional outcomes of the surgical technique involving deepening of the retromalleolar groove for the management of recurrent peroneal tendon dislocation. Nine patients, one of whom had bilateral dislocation, were enrolled in this study. The study group consisted of six males and three females, with a mean age of 31.2 years. CT scans were used to measure the depth of the neo-grooves, while the EFAS score (European Foot and Ankle Society Score) and AOFAS score (American Orthopedic Foot and Ankle Score) were used to assess functional results. The medium follow-up period was 4.8 years. CT scan data revealed a mean increase of 4.69 mm in the depth of the neo-retromalleolar groove. AOFAS scores improved from a mean preoperative value of 74.4 to 86.9 after surgery, and EFAS scores increased from a mean preoperative score of 19.7 to 31. Statistical analysis of clinical scores yielded significant results with a p-value < 0.005. All patients returned to their previous sports activities within an average time of 7.7 months, reporting no pain or limitations. There were no recurrences observed. The retromalleolar groove deepening technique demonstrated excellent results in the treatment of recurrent peroneal tendon dislocation, evidenced by significant improvements in clinical scores, functional recovery, successful return to sports, and high patient satisfaction. Full article

Capoeira involves fighting movements, turns, acrobatic jumps, and repeated movements, which can lead to injury. This study determined the incidence of injuries in capoeira athletes and analyzed the associated factors. The sample included 157 capoeira athletes, 94 (59.9%) of which were males aged 8–67 years. A questionnaire was administered; in the results, 95 (60.5%) athletes suffered injury during their entire capoeira practice, totaling 218 injuries, and 48 (30.6%) athletes had incurred an injury in the previous year, totaling 81 injuries. There were 0.85 injuries per 1000 h of capoeira training. The most common injuries were sprains (19.23%) and muscle bruises (14.10%), which were located in the ankles (20.51%) and knees (16.67%). Falls (24.36%) and repetitive movements (15.38%) were the most prevalent injury mechanisms. Male athletes presented a higher risk of sustaining capoeira-related injuries than women (odds ratio = 2.19; 95% CI: 1.05–4.61; p = 0.037). Individuals who trained equal to or more than three times per week were more at risk by 0.44 (p ≤ 0.001) than those who trained up to two times per week. This study showed a high prevalence of injuries in this sample. Sex (male) and a training frequency that was equal to or greater than three times per week were the associated risk factors. The data obtained can be used to create specific training programs for preventing injuries. Full article

High-collar shoes are a biomimetic approach to preventing lateral ankle injuries during high-demand activities; however, the influence of collar stiffness (CS) on parameters related to lateral ankle sprain prevention during running remains unclear. In this study, we investigated the effects of a custom-designed shoe CS on muscular activity, dynamic stability, and leg stiffness (K_leg) during running using a biomimetic design approach inspired by the mechanisms of ankle sprain prevention. Sixteen healthy male participants ran on a treadmill while wearing a custom-designed high-collar shoe with low, medium, and high CS conditions, measured using circumferential ankle pressure (CAP). Lower extremity kinematics and electromyography (EMG) data were recorded simultaneously. One-way repeated-measures ANOVA was conducted to compare the CS conditions. Results indicate that high and medium CS conditions significantly reduce sagittal and frontal ankle ranges of motion (ROMs) compared to the low CS condition, providing improved stability and support against lateral ankle sprain; moreover, there was a trend towards higher dynamic stability and K_leg with increasing CS. Our study highlights the importance of considering the CAP in regulating high-collar stiffness properties and how higher CS may provide better support for the ankle during running. Nevertheless, additional research is necessary to validate the efficacy of the current design in preventing ankle sprains during high-demand activities. Full article

The ankle joint (AJ) is a crucial joint in daily life, responsible for providing stability, mobility, and support to the lower limbs during routine activities such as walking, jumping, and running. Ankle joint injuries can occur due to sudden twists or turns, leading to ligament sprains, strains, fractures, and dislocations that can cause pain, swelling, and limited mobility. When AJ trauma occurs, joint instability happens, causing mobility limitations or even a loss of joint mobility, and rehabilitation therapy is necessary. AJ rehabilitation is critical for those recovering from ankle injuries to regain strength, stability, and function. Common rehabilitation methods include rest, ice, compression, and elevation (RICE), physical therapy, ankle braces, and exercises to strengthen the surrounding muscles. Traditional rehabilitation therapies are limited and require constant presence from a therapist, but technological advancements offer new ways to fully recover from an injury. In recent decades there has been an upswing in research on robotics, specifically regarding rehabilitation. Robotic platforms (RbPs) offer several advantages for AJ rehabilitation assistance, including customized training programs, real-time feedback, improved performance monitoring, and increased patient engagement. These platforms use advanced technologies such as sensors, actuators, and virtual reality to help patients recover quicker and more efficiently. Furthermore, RbPs can provide a safe and controlled environment for patients who need to rebuild their strength and mobility. They can enable patients to focus on specific areas of weakness or instability and provide targeted training for faster recovery and reduced risk of re-injury. Unfortunately, high costs make it difficult to implement these systems in recuperative institutions, and the need for low-cost platforms is apparent. While different systems are currently being used, none of them fully satisfy patient needs or they lack technical problems. This paper addresses the conception, development, and implementation of rehabilitation platforms (RPs) that are adaptable to patients’ needs by presenting different design solutions (DSs) of ankle RPs, mathematical modeling, and simulations of a selected rehabilitation platform (RP) currently under development. In addition, some results from practical tests of the first prototype of this RP are presented. One patient voluntarily agreed to use this platform for more rehabilitation sessions on her AJ (right leg). To counteract some drawbacks of the first prototype, some improvements in the RP design have been proposed. The results on testing the improved prototype will be the subject of future work. Full article

Chronic lateral ankle instability (CLAI) is commonly secondary to prior lateral ankle ligament injury, and the concomitant latent syndesmosis injury would prolong recovery time and increase the risk of substantial traumatic arthritis. However, differentiating syndesmotic injury from isolated lateral ankle ligament injury in CLAI cases is difficult by conventional physical and radiological examinations. To improve the accuracy of syndesmotic injury diagnosis, a shoe-integrated sensor system (SISS) is proposed. This system measures plantar pressure during walking to detect the presence of syndesmotic injury. The study included 27 participants who had ankle sprains and underwent an examination. Plantar pressure in eight regions of interest was measured for both limbs, and syndesmotic injuries were examined using arthroscopy. The width of the syndesmosis was measured to evaluate its severity. The characteristics of plantar pressure were compared between patients with normal and injured syndesmosis. The results indicated that peak plantar pressure ratios with logistic regression predicted value > 0.51 accurately distinguished concomitant syndesmotic injury during walking, with high sensitivity (80%) and specificity (75%). The post-test probability of having a syndesmotic injury was positively 80% and negatively 25%. These findings demonstrate the effectiveness of cost-effective wearable sensors in objectively diagnosing concomitant syndesmotic injuries in cases of CLAI. Full article

There is limited literature analyzing pediatric hurdle injuries based on sex and age. This study compares hurdle-related injury types, injured body parts, and injury mechanisms by age and sex in pediatrics. Hurdle-related injury data from the National Electronic Injury Surveillance System were used to retrospectively review the injuries of hurdlers 18 years and under. Differences in injured body parts, injury types, and mechanisms were analyzed by age (pre-high school vs. high school) and sex (male vs. female). A total of 749 cases were extracted. Fractures were more common in pre-high schoolers (34.1% vs. 21.5%, p = 0.001), while more sprains were identified in high schoolers (29.6%) than pre-high schoolers (22.8%, p = 0.036). Males suffered more fractures than females (35.1% vs. 24.3%, p = 0.001). Females sustained more joint sprains (29.1% vs. 21.0%, p = 0.012) and contusions/hematomas (12.7% vs. 7.5%, p = 0.020). Ankle injuries were more common in females (24.0%) than males (12.0%, p = 0.001), while wrist injuries were more prevalent in males (11.7% vs. 7.2%, p = 0.034). The most common injury mechanism was apparatus-related, with no differences based on age or sex. Injury types and injured body parts differed depending on age and sex in pediatric hurdle injuries seen in emergency departments. These findings may be helpful for injury prevention and medical care for pediatric hurdlers. Full article

Gymnastics has a history of high injury incidence rates. However, little is known about the injury pathology in young gymnasts. The purpose of this study was to fill gaps in the literature by providing insight into the injury pathology in gymnasts aged 6 to 17 years. This study was retrospective in design, where injury data were collected using a Qualtrics questionnaire and distributed via social media. The findings revealed that the most common injury site was the lower limb (60.5%), in particular, the ankle/foot (49%) and knee (27%). Overuse injuries and sprains were most prevalent among the lower limb (25% and 18.4%, respectively), and gymnasts seemed to have a tendency to train through injury with modifications to training. In conclusion, lower limb joint sprain and overuse injuries accounted for the majority of injuries in youth gymnasts. These injuries were more frequently reported in girls in the years associated with peak height velocity and beyond. Full article

This review evaluated the efficacy of Motor Imagery intervention in athletes with lower limb sports injuries that could affect their pain levels during rehabilitation. We carried out a thorough research of the scientific literature for RCT studies in athletes with lower limb musculoskeletal sports injuries including search terms Motor Imagery AND pain, Motor Imagery AND sport injuries, Motor Imagery AND lower limb. We searched 3 major databases, PubMed, Scopus, and ScienceDirect, with the search period ranging from their inception until May 2022. We assessed the quality of the studies using the PEDro Scale and the data was recorded and extracted with the use of Mendeley software. The search criteria resulted in a pool of 10.107 possible articles. Upon completion of the selection procedure, only 3 RCT studies met the inclusion criteria with a total of 60 injured athletes (n = 18 with ankle sprain and n = 42 with ACL injuries). The meta-analysis showed no statistically significant positive effects of MI intervention on pain intensity after lower limb sports injuries (n = 60; MD = −1.57; 95% CI: −3.60 to 0.46; I² = 50%; p = 0.13). The limited number of studies could justify the statistically insignificant effect of MI, but although the methodological quality of the studies was moderate to high, the heterogeneity of them was also relatively high. More RCT’s are required to explore the effect of MI on pain in athletes with lower limb injuries in order to address psychophysiological processes during rehabilitation. Full article