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      Lower Extremity Biomechanics During a Drop-Vertical Jump in Participants With or Without Chronic Ankle Instability

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          Abstract

          <div class="section"> <a class="named-anchor" id="st1"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e143">Context: </h5> <p id="d5434941e145">Chronic ankle instability (CAI) is a condition characterized by range-of-motion, neuromuscular, and postural-control deficits and subjective disability, reinjury, and posttraumatic osteoarthritis. Differences have been reported in kinematics, kinetics, surface electromyography (EMG), and ground reaction forces during functional tasks performed by those with CAI. These measures are often collected independently, and the research on collecting measures simultaneously during a movement task is limited. </p> </div><div class="section"> <a class="named-anchor" id="st2"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e148">Objective: </h5> <p id="d5434941e150">To assess the kinematics and kinetics of the lower extremity, vertical ground reaction force (vGRF), and EMG of 4 shank muscles during a drop–vertical-jump (DVJ) task. </p> </div><div class="section"> <a class="named-anchor" id="st3"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e153">Design: </h5> <p id="d5434941e155">Controlled laboratory study.</p> </div><div class="section"> <a class="named-anchor" id="st4"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e158">Setting: </h5> <p id="d5434941e160">Motion-capture laboratory.</p> </div><div class="section"> <a class="named-anchor" id="st5"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e163">Patients or Other Participants: </h5> <p id="d5434941e165">Forty-seven young, active adults in either the CAI (n = 24) or control (n = 23) group.</p> </div><div class="section"> <a class="named-anchor" id="st6"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e168">Intervention(s): </h5> <p id="d5434941e170">Three-dimensional motion capture was performed using an electromagnetic motion-capture system. Lower extremity kinematics, frontal- and sagittal-plane kinetics, vGRF, and EMG of the shank musculature were collected while participants performed 10 DVJs. </p> </div><div class="section"> <a class="named-anchor" id="st7"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e173">Main Outcome Measure(s): </h5> <p id="d5434941e175">Means and 90% confidence intervals were calculated for all measures from 100 milliseconds before to 200 milliseconds after force-plate contact. </p> </div><div class="section"> <a class="named-anchor" id="st8"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e178">Results: </h5> <p id="d5434941e180">Patients with CAI had greater inversion from 107 to 200 milliseconds postcontact (difference = 4.01° ± 2.55°), smaller plantar-flexion kinematics from 11 to 71 milliseconds postcontact (difference = 5.33° ± 2.02°), greater ankle sagittal-plane kinetics from 11 to 77 milliseconds postcontact (difference = 0.17 ± 0.09 Nm/kg) and from 107 to 200 milliseconds postcontact (difference = 0.23 ± 0.03 Nm/kg), and smaller knee sagittal-plane kinematics from 95 to 200 milliseconds postcontact (difference = 8.23° ± 0.97°) than control participants after landing. The patients with CAI had greater vGRF from 94 to 98 milliseconds postcontact (difference = 0.83 ± 0.03 N/kg) and peroneal activity from 17 to 128 milliseconds postcontact (difference = 10.56 ± 4.52 N/kg) than the control participants. </p> </div><div class="section"> <a class="named-anchor" id="st9"> <!-- named anchor --> </a> <h5 class="section-title" id="d5434941e183">Conclusions: </h5> <p id="d5434941e185">Patients with CAI presented with differences in their landing strategies that may be related to continued instability. Kinematic and kinetic changes after ground contact and greater vGRF may be related to a faulty landing strategy. The DVJ task should be considered for rehabilitation protocols in these individuals. </p> </div>

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          The epidemiology of ankle sprains in the United States.

          Ankle sprain has been studied in athletic cohorts, but little is known of its epidemiology in the general population. A longitudinal, prospective epidemiological database was used to determine the incidence and demographic risk factors for ankle sprains presenting to emergency departments in the United States. It was our hypothesis that ankle sprain is influenced by sex, race, age, and involvement in athletics. The National Electronic Injury Surveillance System (NEISS) was queried for all ankle sprain injuries presenting to emergency departments between 2002 and 2006. Incidence rate ratios were then calculated with respect to age, sex, and race. During the study period, an estimated 3,140,132 ankle sprains occurred among an at-risk population of 1,461,379,599 person-years for an incidence rate of 2.15 per 1000 person-years in the United States. The peak incidence of ankle sprain occurred between fifteen and nineteen years of age (7.2 per 1000 person-years). Males, compared with females, did not demonstrate an overall increased incidence rate ratio for ankle sprain (incidence rate ratio, 1.04; 95% confidence interval, 1.00 to 1.09). However, males between fifteen and twenty-four years old had a substantially higher incidence of ankle sprain than their female counterparts (incidence rate ratio, 1.53; 95% confidence interval, 1.41 to 1.66), whereas females over thirty years old had a higher incidence compared with their male counterparts (incidence rate ratio, 2.03; 95% confidence interval, 1.65 to 2.65). Compared with the Hispanic race, the black and white races were associated with substantially higher rates of ankle sprain (incidence rate ratio, 3.55 [95% confidence interval, 1.01 to 6.09] and 2.49 [95% confidence interval, 1.01 to 3.97], respectively). Nearly half of all ankle sprains (49.3%) occurred during athletic activity, with basketball (41.1%), football (9.3%), and soccer (7.9%) being associated with the highest percentage of ankle sprains during athletics. An age of ten to nineteen years old is associated with higher rates of ankle sprain. Males between fifteen and twenty-four years old have higher rates of ankle sprain than their female counterparts, whereas females over thirty years old have higher rates than their male counterparts. Half of all ankle sprains occur during athletic activity.
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            A Systematic Review on Ankle Injury and Ankle Sprain in Sports

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              Long term outcomes of inversion ankle injuries.

              Ankle sprains are common sporting injuries generally believed to be benign and self limiting. However, some studies report a significant proportion of patients with ankle sprains having persistent symptoms for months or even years. To determine the proportion of patients presenting to an Australian sports medicine clinic who had long term symptoms after a sports related inversion ankle sprain. Consecutive patients referred to the NSW Institute of Sports Medicine from August 1999 to August 2002 with inversion ankle sprain were included. Exclusion criteria were fracture, ankle surgery, or concurrent lower limb problems. A control group, matched for age and sex, was recruited from patients attending the clinic for upper limb injuries in the same time period. Current ankle symptoms, ankle related disability, and current health status were ascertained through a structured telephone interview. Nineteen patients and matched controls were recruited and interviewed. The mean age in the ankle group was 20 (range 13-28). Twelve patients (63%) were male. Average follow up was 29 months. Only five (26%) ankle injured patients had recovered fully, with no pain, swelling, giving way, or weakness at follow up. None of the control group reported these symptoms (p<0.0001). Assessments of quality of life using short form-36 questionnaires (SF36) revealed a difference in the general health subscale between the two groups, favouring the control arm (p<0.05). There were no significant differences in the other SF36 subscales between the two groups. Most patients who sustained an inversion ankle injury at sport and who were subsequently referred to a sports medicine clinic had persistent symptoms for at least two years after their injury. This reinforces the importance of prevention and early effective treatment.
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                Author and article information

                Journal
                Journal of Athletic Training
                Journal of Athletic Training
                Journal of Athletic Training/NATA
                1062-6050
                April 2018
                April 2018
                : 53
                : 4
                : 364-371
                Affiliations
                [1 ]Athletic Training &amp; Nutrition Department, Weber State University, Ogden, UT;
                [2 ]Exercise &amp; Sport Injury Laboratory, University of Virginia, Charlottesville;
                [3 ]School of Medicine, Virginia Commonwealth University, Richmond;
                [4 ]Department of Kinesiology, University of North Carolina at Charlotte
                Article
                10.4085/1062-6050-481-15
                5967278
                29667844
                89b01c5e-5f09-497c-a8d7-f8680012bcf8
                © 2018
                History

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