Search Results (19)

This study aimed to investigate the significance of baseline measurements for amateur team athletes playing contact and collision team sports with a specific focus on the Sports Concussion Assessment Tool (SCAT) to improve concussion management. Symptoms of sports-related concussions (SRCs) can be diverse and long-lasting and include cognitive impairment, sleep disturbances, and vestibular dysfunction. Therefore, comprehensive baseline data are essential to preventing recurrent concussions and secondary injuries. This study was conducted during the 2023 off-season and evaluated the baseline condition of 65 male university rugby players using the SCAT5, which includes self-reported symptoms, and the modified Balance Error Scoring System (mBESS). The athletes were assessed for the presence or absence of SRC, and the mean values were compared using the Mann–Whitney U test. Among the participants, 35.38% (23/65) reported symptoms, with an average of 1.5 ± 2.8 symptoms per player and an average symptom score of 2.66 ± 5.93. In the mBESS, no errors were observed in the tandem stance test; however, 72.31% (47/65) made errors in the single-leg stance test on the non-dominant foot, with an average of 1.7 ± 1.5 errors. Many athletes self-reported symptoms and balance errors, even during asymptomatic periods before experiencing concussion, indicating unresolved issues. In the injury history survey, the baseline evaluations and injury histories of the participants classified into the SRC and non-SRC groups were compared. In the mBESS single-leg stance test (non-dominant foot), 84.21% (32/38) of the SRC group participants made errors, with an average score of 2.13 ± 1.52, whereas 55.55% (15/27) of the non-SRC group participants made errors, with an average score of 1.15 ± 1.35, showing a significant difference (p = 0.007). Additionally, significant differences were observed in the average number of ankle sprains (p = 0.027) and fractures (p = 0.048) between patients with and without a history of SRC. These findings indicate that athletes may have underlying issues even during normal periods before concussion. Moreover, the results highlighted the impact of previous concussions on motor control and injury risk. This underscores the importance of preseason baseline measurements using the SCAT to identify at-risk athletes and implement preventive measures. These findings align with the recommendations of the 6th International Conference on Concussion in Sport and suggest further refinement of concussion assessment tools. Full article

The platelet-rich plasma (PRP) approach may be an effective treatment for joint and cartilage pathologies. However, the rationale for its effectiveness on joint instability is limited. This study aimed to assess the safety and effectiveness of PRP injections in patients with chronic lateral ankle instability (CLAI). This retrospective study was performed at a single-center outpatient clinic between January 2015 and February 2023 and included pre-intervention assessment and short-term follow-up. Patients were excluded if they had received previous surgical treatment or had constitutional hyperlaxity, systemic diseases, or grade II or III osteoarthritis. The clinical and functional evaluation consisted of the Karlsson score, the Cumberland Ankle Instability Tool (CAIT), Good’s grading system, the patient’s subjective satisfaction level, and the time required to return to exercise. The entire PRP therapy regime consisted of three PRP administrations at 7-day intervals and follow-up appointments. PRP was administered both intraarticularly and into talofibular ligaments. A total of 47 consecutive patients with CLAI were included, 11 were female (23.4%), with a mean age at intervention of 31.19 ± 9.74 years. A statistically significant improvement was found in the CAIT and Karlsson scores at 3 months (27.74 ± 1.68 and 96.45 ± 4.28, respectively) relative to the pre-intervention status (10.26 ± 4.33 and 42.26 ± 14.9, respectively, p < 0.000). The mean follow-up of patients with CLAI was 17.94 ± 3.25 weeks. This study represents successful short-term functional and clinical outcomes in patients with CLAI after PRP treatment, with no adverse effects. It demonstrates the feasibility of a randomized controlled trial to further assess this therapy. Full article

Functional ankle instability (FAI), which is characterized by recurrent ankle sprains and perceived joint instability, arises from various factors contributing to compromised biomechanical control during activities, particularly those involving landing tasks. While current research predominantly addresses lower-extremity and core stabilization interventions for FAI, the contribution of upper body control to landing biomechanics in this population remains insufficiently explored. In this study, 42 participants (19 males, 23 females) with FAI were randomly assigned to either the upper-body control training group (UBCTG) or the core muscle stabilization training group (CMSTG). The groups underwent six-week interventions, with the UBCTG receiving a dynamic core exercise program including upper body control and the CMSTG receiving static core muscle training. Pre- and post-intervention assessments encompassed electromyography of the gastrocnemius, tibialis anterior, and peroneus longus, motion analysis of the lower extremities, and ground reaction force (GRF) readings during a single-leg-jump task. Additionally, dynamic balance was assessed using the Y balance test and self-reported measurements of ankle instability were performed. The results showed similar increases in muscle activation, joint movement, and self-reported ankle instability scores within both groups. However, significant between-group differences were observed in terms of knee flexion angle, dynamic balance, and ankle instability scores, favoring the UBCTG. Although the peak vertical GRF significantly decreased and the time to peak vertical GRF increased in both groups, more changes were noted in the UBCTG. Our results demonstrated that dynamic core exercises with additional upper body control training enhance landing biomechanics, dynamic balance, and stability in individuals with FAI. Consequently, we recommend incorporating shoulder girdle exercises, proprioceptive drills, and balance exercises into dynamic core training. 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

Background (1): Men’s football is a physically demanding contact sport that involves intermittent bouts of sprinting, jogging, walking, jumping and changes of direction. The physical demands of the game vary by level of play (amateur club, sub-elite and open club or international), but injury rates at all levels of the men’s football game remain the highest of all sports. Objective: The aim of this study is to conduct a systematic review of data from the epidemiological literature regarding the profile, severity and mechanisms of injuries and the frequency of recurrent injuries in professional and amateur football players. Methods (2): A systematic review, according to PRISMA guidelines, was performed up to June 2023 in the databases of PubMed, Web of Science, Google academic, Google scholar and the Diva portal. Twenty-seven studies that reported data on the type, severity, recurrence and mechanisms of injury in professional and amateur men’s football were selected and analyzed. Two reviewers independently audited data and assessed the study quality using the additional and adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): In professional male football players, the mean prevalence of muscle/tendon injuries was 39.78%, followed by joint and ligament injuries—21.13%, contusions—17.86%, and fractures—3.27%, and for amateur football players, the prevalence’s were 44.56% (muscle/tendon injuries), 27.62% (joint and ligament injuries), 15.0% (contusions) and 3.05% (fracture), respectively. The frequency of traumatic injuries was higher in amateur football players (76.88%) compared to professional football players (64.16%), the situation being reversed in the case of overuse injuries: 27.62% in professional football players and 21.13% in amateur football players. Most contact injuries were found in professional footballers (50.70%), with non-contact injuries predominating in amateur footballers (54.04%). The analysis of the severity of injuries showed that moderate injuries dominated in the two categories of footballers; the severe injuries in amateur footballers exceeded the severe injuries recorded in professional footballers by 9.60%. Recurrence proportions showed an inverse relationship with the level of play, being higher in amateur footballers (16.66%) compared to professional footballers (15.25%). Conclusions (4): Football-related injuries have a significant impact on professional and amateur football players and their short- and long-term health status. Knowing the frequency of severe diagnoses, such as strains, tears and cramps of the thigh muscles, ankle ligament sprains and hip/groin muscle strain requires the establishment of adequate programs to prevent them, especially in amateur football players, who are more prone to serious injuries. Full article

Background: Chronic ankle instability is a common condition that develops after lateral ankle sprains. Many surgical techniques have been described in case of failure of conservative treatment. The purpose of this paper is to present the results in terms of clinical outcomes, return to sport and recurrence rate after reconstruction of the lateral ligament complex of the ankle with a minimally invasive approach at a minimum follow up of five years. Methods: This retrospective study involved forty-seven patients treated for chronic ankle instability from January 2013 to November 2017. The clinical outcomes were evaluated with the American Orthopedic Foot and Ankle Society ankle and hindfoot score (AOFAS score), the University of California–Los Angeles Rating Scale (UCLA Rating Scale), the Karlsson–Peterson ankle instability score and the Halasi scale at a mean follow up time of 80 months. Results: The mean age of the patients was 42 years (23–63). The mean VAS pain score decreased from 5.6 (2–9) pre-operatively to 0.7 (0–7) post-operatively. The mean UCLA Rating Scale score improved from 7.7 (4–8) before surgical treatment to 9.2 (6–10) afterwards. The AOFAS score increased from a pre-operative mean value of 66.5 (40–95) to a post-operative mean value of 94 (88–100) and the Halasi scale from a pre-injury mean value of 4.3 (2–8) to 4.5 post-operatively (2–8). The mean Karlsson–Peterson ankle instability score increased from 71 (40–90) pre-operatively to 87.9 (70–90) post-operatively. During this period of follow up, the procedure survival rate was 95.7%, with two cases of recurrence of ankle sprain post-operatively after twelve months in one case and forty months in the other case. Conclusions: The described technique of reconstruction of the anterior talofibular and calcaneofibular ligament with a minimally invasive approach with a semitendinosus autograft is a viable treatment option for chronic ankle instability and enables the majority of patients to regain their activity and sport level with a low recurrence rate at a mid-term follow up. Full article

Center of pressure (COP) tracking during posture transition is an ideal scale for determining the recurrence of an ankle injury, thereby preventing chronic ankle instability (CAI). However, the same is difficult to determine because the reduced ability of certain patients (who experienced sprain) to control posture at the ankle joint is masked by the chain of hip and ankle joint motion. Thus, we observed the effects of knee joint immobilization/non-immobilization on postural control strategies during the posture transition task and attempted to evaluate the detailed pathophysiology of CAI. Ten athletes with unilateral CAI were selected. To examine differences in COP trajectories in the CAI side and non-CAI legs, patients stood on both legs for 10 s and one leg for 20 s with/without knee braces. COP acceleration during the transition was significantly higher in the CAI group with a knee brace. The COP transition from the double- to single-leg stance phase was significantly longer in the CAI foot. In the CAI group, the fixation of the knee joint increased COP acceleration during postural deviation. This suggests that there is likely an ankle joint dysfunction in the CAI group that is masked by the hip strategy. Full article

Lateral ankle sprain (LAS) is a common sports injury that frequently occurs in active individuals. LAS is characterized by a high recurrence rate, with a large proportion of patients progressing to chronic ankle instability (CAI). Pilates exercises have provided positive results in health care and in rehabilitation. This study compared Pilates training (PT) with traditional balance training (BT) in patients with CAI. Fifty-one college football players with CAI, divided into PT (n = 26) and BT (n = 25) groups, were included in the study. The groups performed PT or BT training as assigned, three times per week for 6 weeks. Isokinetic ankle strength, one-leg hop tests, Y-balance test (YBT), and foot and ankle outcome score (FAOS) were evaluated before and after training. There were considerable improvements in both the PT and BT groups after training. Group and time comparisons revealed that the PT group achieved better triple hop test results than the BT group, whereas the BT group exhibited a greater improvement in YBT posteromedial and posterolateral reach distances. In athletes with CAI, both PT and BT effectively improved symptoms and function. These findings suggest that ankle strength, balance, and core stability should be comprehensively evaluated and targeted in CAI rehabilitation programs. Full article

(1) Background: Chronic ankle instability (CAI) is a complex condition that includes limited mobility, perceived instability, and recurrent ankle sprains are common characteristics that reduce the quality of life in subjects who suffer from CAI. Neuromuscular training and strength training have been recommended in CAI management interventions. However, there are contradictory findings on results when comparing neuromuscular training, strength training, and the control group. The objective of this study was to compare the effectiveness of 8 weeks of neuromuscular intervention training, strength training, and no intervention in a sporting population with reported CAI. (2) Methods: Sixty-seven athletes with CAI were randomly assigned to a neuromuscular training group (NG), strength training group (SG), or control group (CG). Participants completed 8 weeks of neuromuscular training (a combination of static and dynamic exercises), strength training (resistance band exercises), or no training. Outcome measures were assessed at baseline and after 8 weeks and included selfs-reported instability feeling (CAIT), dynamic balance (SEBT), ankle dorsiflexion range of motion (WBLT), and functional status (FAAM and FAAM-SPORT). (3) Results: There were significant differences between strength and control groups in the posteromedial direction of SEBT, FAAM, and FAAM-SPORT after 8 weeks of intervention. (4) Conclusions: Neuromuscular training and strength training based on resistance bands exercises showed significant improvements in ankle dorsiflexion, subjective feeling of instability, functional status, and dynamic balance in patients with CAI. Full article

Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. Materials and Methods: This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: (“kinesiology tape” OR “tape” OR “taping” OR “elastic taping” OR “kinesio taping” OR “neuro taping”) AND (unstable OR instability) AND (ankle OR (ankle OR “ankle sprain” OR “injured ankle” OR “ankle injury”)). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. Results: In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. Conclusions: The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI. Full article

Football is a sport involving dynamic movements, and ankle sprains are common sports injuries experienced by football players. Ankle sprains exhibit a high recurrence rate, and rehabilitation training is effective; however, expert-supervised rehabilitation (SVR) at training centers is difficult due to the recent COVID-19 pandemic. This study investigated the effects of mobile-based rehabilitation (MBR) performed at home by high school football players. Sixty players (SVR: 30 and MBR: 30) with recurrent ankle sprains were analyzed. The rehabilitation program consisted of strength and balance training, and the training intensity was gradually increased from week 1 to week 8. The SVR group underwent training at the center with experts, and the BMR group were provided with programs and feedback using mobile devices. Ankle muscle strength was evaluated by measuring isometric eversion, inversion, plantarflexion, and dorsiflexion contraction using a hand-held dynamometer, and dynamic balance was assessed using the Y-balance test (YBT; anterior, posteromedial, and posterolateral); the Foot and Ankle Outcome Score (FAOS) was used for the subjective evaluation. Measurements were conducted at weeks 1, 4, and 8. The patients visited the clinic within 1 week after the injury, and the first test was conducted after consent to participate in the research. Patients underwent the second test at an average of 3.2 weeks after the first test, and the last test at an average of 4.4 weeks after the second test. Although only the SVR group exhibited improvement in strength (eversion and dorsiflexion), YBT and subjective satisfaction at week 4, these measurements improved in both the SVR and MBR groups at week 8. Therefore, mobile–based rehabilitation could be a suitable alternative for high school athletes with ankle sprains who cannot undergo supervised rehabilitation. Full article

We aimed to investigate the preoperative history, clinical manifestations, imaging findings, and postoperative clinical outcomes for patients with surgically confirmed synovial fistula around the ankle joint. 19 consecutive patients who were confirmed to have synovial fistula in the surgical field were enrolled in this study. Medical records of all patients in terms of preoperative details, operative findings, and postoperative outcomes at 1 year after the surgery were retrieved. As a diagnostic modality, the normal saline test or MRI was used. Intraoperatively, the synovial fistula was repaired with the capsuloligamentous repair or additional periosteal augmentation. All patients had a history of ankle sprain prior to symptoms and showed positive results in the saline load test. One patient had recurred symptom after the surgery, so needed a revisional periosteal augmentation. At 1 year follow-up period, the average Foot ankle outcome score was 87.65 and no surgery-related complication was detected. Synovial fistula of the ankle joint needs to be taken into consideration as a possible complication in patients with ankle sprain history and recurrent joint swelling. The saline load test would be useful for its diagnosis, and treatment should be focused on the complete closure of capsular opening along with restoration of its surrounding pathologic conditions. Full article

Ankle sprain is a common musculoskeletal injury, and recurrent ankle sprains often lead to ankle instability. This study aimed to examine whether a 6-week balance training on a wobble board (WB) combined with kinesio taping (KT) is effective in improving balance, postural stability, and ankle stability among female athletes with functional ankle instability (FAI). Twenty-four female athletes with FAI were randomly assigned to study (SG) or control groups (CG). SG attended a 6-week training protocol of combined balance training on the wobble board with KT applied to ankles during exercise. CG only went through a 6-week balance training procedure that was the same as the SG. Before and after the training program, balance and postural stability and the severity of ankle instability were assessed by single-leg Biodex Balance system and Cumberland Ankle Instability Tool (CAIT), respectively. The analysis revealed that the scores of balance and postural stability decreased after the 6-week training for CG (p = 0.002) and SG (p = 0.001), which indicates an improvement for these variables, and the score of CAIT increased, which means the severity of instability reduced (p = 0.001 for both groups). Significant between-group differences were found for balance and postural stability (t = 2.79, p = 0.011, g = −1.99) and the severity of instability (t = 2.082, p = 0.049, g = 1.36), favoring SG compared with CG. This study showed that the addition of KT to balance training is more effective than balance training alone in improving balance, postural stability, and severity of ankle instability in female athletes with FAI. Our findings could provide a preliminary reference for designing combined balance and KT programs for delivering health benefits to females with FAI. Full article

Tarsal coalition is defined as an abnormal bony, cartilaginous, or fibrous union of two or more tarsal bones. The incidence of tarsal coalition is approximately 2% in the general population. Talocalcaneal and calcaneonavicular coalitions are the most common. The talonavicular coalition is a rare entity with an incidence of approximately 1.3% among patients with tarsal coalitions. We present a case of a 12-year-old girl who had talonavicular and talocalcaneal coalitions associated with a recurrent ankle sprain. The talonavicular coalition was asymptomatic, and the talocalcaneal coalition was the cause of ankle pain and recurrent sprain. Surgical resection of the talocalcaneal coalition led to successful clinical and functional outcomes. In conclusion, the possibility of multiple tarsal coalitions should be considered in tarsal coalition patients, and the talocalcaneal coalition should be considered as a differential diagnosis in an adolescent patient with a recurrent ankle sprain. Full article

The prevention of recurrent ankle sprain and functional ankle instability in soccer players is essential. This study clarified hip joint mobility and dynamic balance ability in soccer players with functional ankle instability. This case–control study included 17 male college soccer players. All participants were assessed using the Cumberland Ankle Instability Tool and were divided into chronic ankle instability (CAI) and non-CAI groups for each of their dominant and nondominant legs. Bilateral passive hip range of motion (ROM) was assessed and the modified Star Excursion Balance Test (mSEBT) was measured for each leg. In the dominant leg, the reach in the posterolateral direction in the CAI group was significantly less than that in the non-CAI group. Hip internal rotation angles in the dominant leg in the CAI group were greater than those in the non-CAI group; however, no significant correlations with the three directions of mSEBT were observed. In the nondominant leg, mSEBT and hip ROMs did not show any significant differences between groups. The dominant leg in soccer players with CAI had poor dynamic balance ability while reaching posterolaterally. However, acquiring hip flexibility may not be necessary to improve the dynamic balance ability. These findings may help develop future research. Full article