|
PRACTICAL
SIGNIFICANCE
The
results
of this
study
demonstrate
that
chronic
ankle
instability
disrupts
dynamic
postural
control
most
noticeably
by
altering
neuromuscular
control
proximal
to the
knee.
This
effect
is
magnified
with the
presence
of
fatigue.
STUDY
BACKGROUND
There
has been
extensive
sports
medicine
research
investigating
the
residual
effects
of
lateral
ankle
sprains
and
chronic
ankle
instability
(CAI).
While
there
are a
plethora
of
studies
of
neuromuscular
control
in CAI
subjects
using
instrumented
methods,
there is
a clear
lack of
non-instrumented
clinically
applicable
tests to
assess
neuromuscular
and
functional
deficits
in
patients
with CAI.
There
also
appears
to be a
relationship
between
altered
neuromuscular
control
and
muscle
fatigue.
Deficits
in
static
postural
control
related
to CAI
and
fatigue
have
been
investigated
separately,
but
there is
little
evidence
to link
these
factors
to
performance
measures
of
dynamic
postural
control.
OBJECTIVE
To
investigate
the
effects
of
fatigue
and CAI
on
performance
measures
of the
Star
Excursion
Balance
Test (SEBT),
a
measure
of
dynamic
postural
control.
DESIGN
AND
SETTING
For each
of the
three
designated
reaching
directions,
four
separate
5 [Day]
x2
[Side]
x2
[Time]
ANOVA’s
with a
between
factor
of Group
were
performed
for
normalized
reach
distance,
maximal
ankle
dorsiflexion,
knee
flexion,
and hip
flexion
angles.
All data
were
collected
in a
research
laboratory.
SUBJECTS
Thirty
subjects
(16
Healthy,
14 CAI)
participated.
MEASUREMENTS
All
subjects
completed
5
testing
sessions
during
which
sagittal
plane
kinematics
and
reaching
distances
were
recorded
while
performing
3
reaching
directions
(anterior,
medial,
and
posterior)
of the
SEBT
(Figure
1) with
the same
stance
leg
before
and
after
different
fatiguing
conditions.
The
procedure
was
repeated
for both
legs
during
each
session.
RESULTS
The
involved
side of
the CAI
subjects
displayed
smaller
reach
distance
values
for all
three
reaching
directions
compared
to the
non-injured
side and
the
Healthy
group.
(Table
1).
The
effects
of
fatigue
amplified
this
trend.
CONCLUSIONS
The
results
demonstrate
that CAI
and
fatigue
disrupted
SEBT
performance
(MAXD)
most
noticeably
by
altering
control
of
sagittal
plane
joint
angles
proximal
to the
ankle.
Table 1:
Group by
Side
Interaction:
MAXD
[reach
distance
(cm)/leg
length
(cm)] ±
standard
error
![Table 1: Group by Side Interaction: MAXD [reach distance (cm)/leg length (cm)] ± standard error](GribbleTable1.gif)
Figure
1: Star
Excursion
Balance
Test
|
Publication
&
Presentation
List:
-
Gribble
PA,
Hertel
J,
Denegar
CR,
Buckley,
WE.
The
effects
of
fatigue
and
chronic
ankle
instability
on
dynamic
postural
control.
2004
NATA
Annual
Meeting
and
Clinical
Symposia
–
Free
Communications:
Oral
presentation.
Baltimore,
MD.
Reprinted
in:
Journal
of
Athletic
Training.
39
(2-S),
p
38,2004.
|
|
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|
Phillip A. Gribble, PhD, ATC
Principal Investigator |
Phillip A. Gribble, BA, University of North Carolina at Chapel Hill; MA, University of North Carolina at Chapel Hill; PhD Kinesiology, Pennsylvania State University, 2003.
Phillip A. Gribble, PhD, ATC
Assistant Professor, Department of Kinesiology
Director, Graduate Athletic Training Program
Director, Athletic Training Research Laboratory
The University of Toledo
2801 Bancroft
Toledo, Ohio 43606-3390
Phone: ext. 2691
Office: HHS-2505H
phillip.gribble@utoledo.edu |
|
|
This
Grant
Information
Summary
may be
downloaded
in a
2-page
pdf file
from
http://www.natafoundation.org/PDF/Gribble.pdf. |
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