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Predicting balance improvements following STARS treatments in chronic ankle instability participants.

ABSTRACT: OBJECTIVES:Sensory Targeted Ankle Rehabilitation Strategies that stimulate sensory receptors improve postural control in chronic ankle instability participants. However, not all participants have equal responses. Therefore, identifying predictors of treatment success is needed to improve clinician efficiency when treating chronic ankle instability. Therefore, the purpose was to identify predictors of successfully improving postural control in chronic ankle instability participants. DESIGN:Secondary data analysis. METHODS:Fifty-nine participants with self-reported chronic ankle instability participated. The condition was defined as a history of at least two episodes of "giving way" within the past 6 months; and limitations in self-reported function as measured by the Foot and Ankle Ability Measure. Participants were randomized into three treatment groups (plantar massage, ankle joint mobilization, calf stretching) that received 6, 5-min treatment sessions over a 2-week period. The main outcome measure was treatment success, defined as a participant exceeding the minimal detectable change score for a clinician-oriented single limb balance test. RESULTS:Participants with ?3 balance test errors had a 73% probability of treatment success following ankle joint mobilizations. Participants with a self-reported function between limb difference <16.07% and who made >2.5 errors had a 99% probability of treatment success following plantar massage. Those who sustained ?11 ankle sprains had a 94% treatment success probability following calf stretching. CONCLUSIONS:Self-reported functional deficits, worse single limb balance, and number of previous ankle sprains are important characteristics when determining if chronic ankle instability participants will have an increased probability of treatment success.

SUBMITTER: Wikstrom EA

PROVIDER: S-EPMC5359082 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Predicting balance improvements following STARS treatments in chronic ankle instability participants.

Wikstrom Erik A EA McKeon Patrick O PO

Journal of science and medicine in sport 20160920 4

<h4>Objectives</h4>Sensory Targeted Ankle Rehabilitation Strategies that stimulate sensory receptors improve postural control in chronic ankle instability participants. However, not all participants have equal responses. Therefore, identifying predictors of treatment success is needed to improve clinician efficiency when treating chronic ankle instability. Therefore, the purpose was to identify predictors of successfully improving postural control in chronic ankle instability participants.<h4>De ...[more]

PMID: 27840034

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Project description:ContextChronic ankle instability (CAI) is characterized by multiple sensorimotor deficits, affecting strength, postural control, motion, and movement. Identifying specific deficits is the key to developing appropriate interventions for this patient population; however, multiple movement strategies within this population may limit the ability to identify specific movement deficits.ObjectiveTo identify specific movement strategies in a large sample of participants with CAI and to characterize each strategy relative to a sample of uninjured control participants.DesignDescriptive laboratory study.SettingBiomechanics laboratory.Patients or other participantsA total of 200 individuals with CAI (104 men, 96 women; age = 22.3 ± 2.2 years, height = 174.2 ± 9.5 cm, mass = 72.0 ± 14.0 kg) were selected according to the inclusion criteria established by the International Ankle Consortium and were fit into clusters based on movement strategy. A total of 100 healthy individuals serving as controls (54 men, 46 women; age = 22.2 ± 3.0 years, height = 173.2 ± 9.2 cm, mass = 70.7 ± 13.4 kg) were compared with each cluster.Main outcome measure(s)Lower extremity joint biomechanics and ground reaction forces were collected during a maximal vertical jump landing, followed immediately by a side cut. Data were reduced to functional output or curves, kinematic data from the frontal and sagittal planes were reduced to a single representative curve for each plane, and representative curves were clustered using a Bayesian clustering technique. Estimated functions for each dependent variable were compared with estimated functions from the control group to describe each cluster.ResultsSix distinct clusters were identified from the frontal-plane and sagittal-plane data. Differences in joint angles, joint moments, and ground reaction forces between clusters and the control group were also identified.ConclusionsThe participants with CAI demonstrated 6 distinct movement strategies, indicating that CAI could be characterized by multiple distinct movement alterations. Clinicians should carefully evaluate patients with CAI for sensorimotor deficits and quality of movement to determine the appropriate interventions for treatment.

Project description:Context Therapeutic modalities that stimulate sensory receptors around the foot-ankle complex improve chronic ankle instability (CAI)-associated impairments. However, not all patients have equal responses to these modalities. Identifying predictors of treatment success could improve clinician efficiency when treating patients with CAI.Objective To conduct a response analysis on existing data to identify predictors of improved self-reported function in patients with CAI.Design Secondary analysis of a randomized controlled clinical trial.Setting Sports medicine research laboratories.Patients or other participants Fifty-nine patients with CAI, which was defined in accordance with the International Ankle Consortium recommendations.Intervention(s) Participants were randomized into 3 treatment groups (plantar massage [PM], ankle-joint mobilization [AJM], or calf stretching [CS]) that received six 5-minute treatments over 2 weeks.Main outcome measure(s) Treatment success, defined as a patient exceeding the minimally clinically important difference of the Foot and Ankle Ability Measure-Sport (FAAM-S).Results Patients with ≤5 recurrent sprains and ≤82.73% on the Foot and Ankle Ability Measure had a 98% probability of having a meaningful FAAM-S improvement after AJM. As well, ≥5 balance errors demonstrated 98% probability of meaningful FAAM-S improvements from AJM. Patients <22 years old and with ≤9.9 cm of dorsiflexion had a 99% probability of a meaningful FAAM-S improvement after PM. Also, those who made ≥2 single-limb-stance errors had a 98% probability of a meaningful FAAM-S improvement from PM. Patients with ≤53.1% on the FAAM-S had an 83% probability of a meaningful FAAM-S improvement after CS.Conclusions Each sensory-targeted ankle-rehabilitation strategy resulted in a unique combination of predictors of success for patients with CAI. Specific indicators of success with AJM were deficits in self-reported function, single-limb balance, and <5 previous sprains. Age, weight-bearing-dorsiflexion restrictions, and single-limb balance deficits identified patients with CAI who will respond well to PM. Assessing self-reported sport-related function can identify CAI patients who will respond positively to CS.

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Predicting balance improvements following STARS treatments in chronic ankle instability participants.

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Predicting balance improvements following STARS treatments in chronic ankle instability participants.

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