High lateral plantar pressure is related to an increased tibialis anterior/fibularis longus activity ratio in patients with recurrent lateral ankle sprain

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Abstract

Introduction

Center of pressure (COP) is a sudden displacement at the time of a lateral ankle sprain (LAS). It has been suggested that the distribution of plantar pressure and the quantity of COP displacement are important for assessing the risk of LAS. Therefore, we evaluated the plantar pressure during a single-leg balance test with eyes closed (SLB-C) to identify the factors and characteristics of plantar pressure in people with repeated cases of LAS.

Methods

We recruited 22 collegiate athletes and divided them into an instability group (IG; n=11) and a control group (CG; n=11). We measured the distribution of plantar pressure and lower extremity muscle activity during a SLB-C along with static alignment and isometric ankle strength.

Results

The fibularis longus (FL) activity was significantly lower in the IG than in the CG. The lateral plantar pressure (LPP)/medial plantar pressure (MPP) ratio was also higher in the IG than in the CG. In addition, the LPP/MPP ratio was correlated with the tibialis anterior (TA)/FL ratio.

Conclusion

These results suggest that increased lateral plantar pressure is related to decreased FL activity and increased TA/FL ratio.

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Most cited references 41

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Effect size, confidence interval and statistical significance: a practical guide for biologists.

Shinichi Nakagawa, Innes Cuthill (2007)

Null hypothesis significance testing (NHST) is the dominant statistical approach in biology, although it has many, frequently unappreciated, problems. Most importantly, NHST does not provide us with two crucial pieces of information: (1) the magnitude of an effect of interest, and (2) the precision of the estimate of the magnitude of that effect. All biologists should be ultimately interested in biological importance, which may be assessed using the magnitude of an effect, but not its statistical significance. Therefore, we advocate presentation of measures of the magnitude of effects (i.e. effect size statistics) and their confidence intervals (CIs) in all biological journals. Combined use of an effect size and its CIs enables one to assess the relationships within data more effectively than the use of p values, regardless of statistical significance. In addition, routine presentation of effect sizes will encourage researchers to view their results in the context of previous research and facilitate the incorporation of results into future meta-analysis, which has been increasingly used as the standard method of quantitative review in biology. In this article, we extensively discuss two dimensionless (and thus standardised) classes of effect size statistics: d statistics (standardised mean difference) and r statistics (correlation coefficient), because these can be calculated from almost all study designs and also because their calculations are essential for meta-analysis. However, our focus on these standardised effect size statistics does not mean unstandardised effect size statistics (e.g. mean difference and regression coefficient) are less important. We provide potential solutions for four main technical problems researchers may encounter when calculating effect size and CIs: (1) when covariates exist, (2) when bias in estimating effect size is possible, (3) when data have non-normal error structure and/or variances, and (4) when data are non-independent. Although interpretations of effect sizes are often difficult, we provide some pointers to help researchers. This paper serves both as a beginner's instruction manual and a stimulus for changing statistical practice for the better in the biological sciences.

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Persistent disability associated with ankle sprains: a prospective examination of an athletic population.

Charles Scoville, D. Taylor, Jason G. Williams … (1998)

The purpose of this study was to examine a young athletic population to update the data regarding epidemiology and disability associated with ankle injuries. At the United States Military Academy, all cadets presenting with ankle injuries during a 2-month period were included in this prospective observational study. The initial evaluation included an extensive questionnaire, physical examination, and radiographs. Ankle sprain treatment included a supervised rehabilitation program. Subjects were reevaluated at 6 weeks and 6 months with subjective assessment, physical examination, and functional testing. The mean age for all subjects was 20 years (range, 17-24 years). There were 104 ankle injuries accounting for 23% of all injuries seen. There were 96 sprains, 7 fractures, and 1 contusion. Of the 96 sprains, 4 were predominately medial injuries, 76 were lateral, and 16 were syndesmosis sprains. Ninety-five percent had returned to sports activities by 6 weeks; however, 55% of these subjects reported loss of function or presence of intermittent pain, and 23% had a decrement of >20% in the lateral hop test when compared with the uninjured side. At 6 months, all subjects had returned to full activity; however, 40% reported residual symptoms and 2.5% had a decrement of >20% on the lateral hop test. Neither previous injury nor ligament laxity was predictive of chronic symptomatology. Furthermore, chronic dysfunction could not be predicted by the grade of sprain (grade I vs. II). The factor most predictive of residual symptoms was a syndesmosis sprain, regardless of grade. Syndesmosis sprains were most prevalent in collision sports. This study demonstrates that even though our knowledge and understanding of ankle sprains and rehabilitation of these injuries have progressed in the last 20 years, chronic ankle dysfunction continues to be a prevalent problem. The early return to sports occurs after almost every ankle sprain; however, dysfunction persists in 40% of patients for as long as 6 months after injury. Syndesmosis sprains are more common than previously thought, and this confirms that syndesmosis sprains are associated with prolonged disability.

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Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains

Phillip A Gribble, Chris M Bleakley, Brian M Caulfield … (2016)

Lateral ankle sprains (LASs) are the most prevalent musculoskeletal injury in physically active populations. They also have a high prevalence in the general population and pose a substantial healthcare burden. The recurrence rates of LASs are high, leading to a large percentage of patients with LAS developing chronic ankle instability. This chronicity is associated with decreased physical activity levels and quality of life and associates with increasing rates of post-traumatic ankle osteoarthritis, all of which generate financial costs that are larger than many have realised. The literature review that follows expands this paradigm and introduces emerging areas that should be prioritised for continued research, supporting a companion position statement paper that proposes recommendations for using this summary of information, and needs for specific future research.

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Author and article information

Journal

Journal ID (nlm-ta): Open Access J Sports Med

Journal ID (iso-abbrev): Open Access J Sports Med

Journal ID (publisher-id): Open Access Journal of Sports Medicine

Title: Open Access Journal of Sports Medicine

Publisher: Dove Medical Press

ISSN (Electronic): 1179-1543

Publication date Collection: 2017

Publication date (Electronic): 01 June 2017

Volume: 8

Pages: 123-131

Affiliations

[1 ]Graduate School of Sport Sciences

[2 ]Institute of Physical Education, Keio University, Hiyoshi, Yokohama

[3 ]Graduate School of Asia-Pacific Studies, Waseda University, Shinjuku, Tokyo

[4 ]Faculty of Sport Sciences, Waseda University, Higashifushimi, Nishitokyo, Japan

Author notes

Correspondence: Norikazu Hirose, No 75-2-208, Faculty of Sport Sciences, Waseda University, 2-7-5 Higashifushimi, Nishitokyo, Tokyo 202-0021, Japan, Tel +81 84 2461 1322, Email toitsu_hirose@ 123456waseda.jp

Article

Publisher ID: oajsm-8-123

DOI: 10.2147/OAJSM.S131596

PMC ID: 5460647

SO-VID: 8e8bb52d-8e8c-4198-ad47-3c3416ed86e2

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

High lateral plantar pressure is related to an increased tibialis anterior/fibularis longus activity ratio in patients with recurrent lateral ankle sprain

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Abstract

Introduction

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Most cited references 41

Effect size, confidence interval and statistical significance: a practical guide for biologists.

Persistent disability associated with ankle sprains: a prospective examination of an athletic population.

Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains

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