Relationship between self-reported functional stability and peroneal muscle structure in individuals with chronic ankle instability
Öz
Purpose: Chronic ankle instability is characterized by repeated ankle sprains. Peroneal muscles are important for control of the ankle and have been evaluated using electromyographic analyses, but there has been lack of study about any relationship between the peroneal muscle structure and self-reported function after ankle sprains. Therefore, this study aimed to investigate the relationship between self-reported functional stability and peroneal muscle structure in chronic ankle instability.
Methods: Thirty subjects aged between 18-45 years and reporting chronic ankle instability were evaluated. Participants completed the Cumberland Ankle Instability Tool questionnaire to determine ankle stability experience. Structural analysis of the peroneal muscles was performed using musculoskeletal ultrasound scanning. Cross sectional area and thickness of peroneal longus and brevis were scanned.
Results: The mean Cumberland Ankle Instability Tool score of subjects was 15.40±6.23. A statistically significant positive moderate correlation was found between stability scores and total cross-sectional area of peroneal muscles (r=0.405, p=0.027). In another words; subjects with higher levels of self-reported ankle stability had larger peroneal cross-sectional area.
Conclusion: The subjects with chronic ankle instability who had larger peroneal cross-sectional area may have greater peroneal strength. Thereafter, this group may have better ankle stability than those with perceived low ankle stability. This potential for a structural relationship associated with improved stability may be relevant to physiotherapists and rehabilitation programmes. Further research may focus on other muscular structures around the ankle joint in chronic ankle instability.
Anahtar Kelimeler
Ankle Joint instability Joint instability Muscles Ultrasonography
Kaynakça
- 1. Hertel J. Functional Anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37:364-375.
- 2. Gribble PA, Delahunt E, Bleakley CM, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. J Athl Train. 2014;49:121-127.
- 3. Delahunt E, Coughlan GF, Caulfield B, et al. Inclusion criteria when investigating insufficiencies in chronic ankle instability. Med Sci Sports Exerc. 2010;42:2106-2121.
- 4. Hung YJ. Neuromuscular control and rehabilitation of the unstable ankle. World J Orthop. 2015;6:434-438.
- 5. Ryan L. Mechanical stability, muscle strength and proprioception in the functionally unstable ankle. Aust J Physiother. 1994;40:41-47.
- 6. Bullock-Saxton JE. Local sensation changes and altered hip muscle function following severe ankle sprain. Phys Ther. 1994;74:17-28.
- 7. Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med. 2008;27:353-370.
- 8. Wikstrom EA, Hubbard-Turner T, McKeon PO. Understanding and treating lateral ankle sprains and their consequences. Sports Med. 2013;43:385-393.
- 9. Nordin M, Frankel VH. Basic biomechanics of the musculoskeletal system. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001.
- 10. Lentell G, Baas B, Lopez D, et al. The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. J Orthop Sports Phys Ther. 1995;21:206-215.
- 11. De Noronha M, Refshauge KM, Kilbreath SL, et al. Loss of proprioception or motor control is not related to functional ankle instability: an observational study. Aust J Physiother. 2007;53:193-198.
- 12. Frontera WR, Ochala J. Skeletal muscle: a brief review of structure and function. Calcif Tissue Int. 2015;96:183-195.
- 13. Fukunaga T, Miyatani M, Tachi M, et al. Muscle volume is a major determinant of joint torque in humans. Acta Physiol. 2001;172:249-255.
- 14. Lieber RL. Skeletal muscle structure and function: implications for rehabilitation and sports medicine: Williams & Wilkins Baltimore; 1992.
- 15. Dupont AC, Sauerbrei EE, Fenton PV, et al. Real-time sonography to estimate muscle thickness: comparison with MRI and CT. J Clin Ultrasound. 2001;29:230-236.
- 16. Chew K, Stevens KJ, Wang TG, et al. Introduction to diagnostic musculoskeletal ultrasound: part 2: examination of the lower limb. Am J Phys Med Rehabil. 2008;87:238-248.
- 17. Abdeen R, Comfort P, Starbuck C, et al. Ultrasound characteristics of foot and ankle structures in healthy, coper, and chronically unstable ankles. J Ultrasound Med. 2018;00:1-10.
- 18. Thoirs K, English C. Ultrasound measures of muscle thickness: intra-examiner reliability and influence of body position. Clin Physiol Funct I. 2009;29:440-446.
- 19. Namavarian N, Rezasoltani A, Zavieh MK, et al. Rehabilitative Ultrasound imaging to study the gastrocnemius muscles morphology in patients with genu varum and valgum deformities. Physiother Res Int. 2017;2:21-25.
- 20. English C, Fisher L, Thoirs K. Reliability of real-time ultrasound for measuring skeletal muscle size in human limbs in vivo: a systematic review. Clin Rehabil. 2012;26:934-944.
- 21. Hiller CE, Refshauge KM, Bundy AC, et al. The cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil. 2006;87:1235-1241.
- 22. Ozgul B PM, Starbuck C, Abdeen R, et al. The inter and intraobserver reliability of musculoskeletal ultrasound assessment of anterior talofibular ligament & ankle muscles 1st International Congress on Physiotechnotherapy; May 09-13 2018; Sarajevo Bosnia and Herzegovina: J Exerc Ther Reh; 2018;13.
- 23. Girish V, Vijayalakshmi A. Affordable image analysis using NIH Image/ImageJ. Indian J Cancer. 2004;41:47.
- 24. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N.J.: L. Erlbaum Associates; 1988.
- 25. Pozzi F, Moffat M, Gutierrez G. Neuromuscular control during performance of a dynamic balance task in subjects with and without ankle instability. Int J Sports Phys Ther. 2015;10:520.
- 26. Van Cingel RE, Kleinrensink G, Uitterlinden EJ, et al. Repeated ankle sprains and delayed neuromuscular response: acceleration time parameters. The J Orthop Sports Phys Ther. 2006;36:72-79.
- 27. Vaes P, Duquet W, Van Gheluwe B. Peroneal reaction times and eversion motor response in healthy and unstable ankles. J Athl Train. 2002;37:475-480.
- 28. Ebig M, Lephart SM, Burdett RG, et al. The effect of sudden inversion stress on EMG activity of the peroneal and tibialis anterior muscles in the chronically unstable ankle. J Orthop Sports Phys Ther 1997;26:73-77.
- 29. Gross MT. Effects of recurrent lateral ankle sprains on active and passive judgements of joint position. Phys Ther. 1987;67:1505-1509.
- 30. Lobo CC, Morales CR, Sanz DR, et al. Ultrasonography comparison of peroneus muscle cross-sectional area in subjects with or without lateral ankle sprains. J Manipulative Physiol. 2016;39:635-644.
- 31. Sakai S, Urabe Y, Morikawa M, et al. Quantity and quality of the peroneus longus assessed using ultrasonography in leg with chronic ankle instability. J Phys Ther. 2018;30:1396-1400.
- 32. Fukumoto Y, Ikezoe T, Yamada Y, et al. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol. 2012;112:1519-1525.
- 33. Lieber RL, Friden J. Functional and clinical significance of skeletal muscle architecture. Muscle Nerve. 2000;23:1647-1666.
- 34. Strasser EM, Draskovits T, Praschak M, et al. Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly. Age. 2013;35:2377-2388.
- 35. David P, Halimi M, Mora I, et al. Isokinetic testing of evertor and invertor muscles in patients with chronic ankle instability. J Appl Biomech. 2013;29:696-704.
- 36. Cho BK, Park JK, Choi SM, et al. The peroneal strength deficits in patients with chronic ankle instability compared to ankle sprain copers and normal individuals. Foot Ankle Surg. 2017.
- 37. Kaminski TW, Hartsell HD. Factors contributing to chronic ankle instability: A strength perspective. J Athl Train. 2002;37:394-405.
- 38. Karlsson J, Bergsten T, Peterson L, et al. Radiographic evaluation of ankle joint stability. Clin J Sport Med. 1991;1:166-175.
- 39. Larsen E, Angermann P. Association of ankle instability and foot deformity. Acta Orthop Scand. 1990;61:136-139.
- 40. Rottigni SA, Hopper D. Peroneal muscle weakness in female basketballers following chronic ankle sprain. Aust J Physiother. 1991;37:211-217.
Kronik ayak bileği instabilitesi olan bireylerde subjektif fonksiyonel stabilite ile peroneal kas yapısı arasındaki ilişki
Öz
Amaç: Kronik ayak bileği instabilitesi tekrarlayan ayak bileği burkulmaları ile karakterize edilir. Peroneal kaslar ayak bileğinin kontrolü için önemlidir ve elektromyografik analizler kullanılarak değerlendirilir ancak peroneal kas yapısı ile ayak bileği burkulmalarından sonra bildirilen subjektif fonksiyon arasındaki ilişki hakkında yeterli çalışma bulunmamaktadır. Bu nedenle, bu çalışmanın amacı, kronik ayak bileği instabilitesinde birey tarafından beyan edilen fonksiyonel stabilite ile peroneal kas
yapısı arasındaki ilişkiyi araştırmaktı.
Yöntem: Çalışma kapsamında 18-45 yaş aralığında, kronik ayak bileği instabilitesi olan 30 birey değerlendirildi. Olgular ayak bileği stabilite deneyiminin belirlenmesi için Cumberland Ayak Bileği Instabilite Ölçeği’ni doldurdu. Peroneal kasların yapısal analizi kas iskelet sistemi ultrason görüntüleme yöntemiyle gerçekleştirildi. Peroneus longus ve brevisin kesit alanı ve kalınlığı görüntülendi.
Bulgular: Olguların Cumberland Ayak Bileği İnstabilite Ölçeği skoru ortalama 15,40±6,23 idi. Stabilite skorları ile peroneal kasların kesit alanı arasında istatistiksel olarak anlamlı pozitif ve orta düzeyde bir korelasyon saptandı (r=0,405; p=0,027). Diğer bir deyişle; subjektif ayak bileği stabilitesi yüksek olan olgular daha geniş peroneal kesit alanına sahipti.
Sonuç: Daha geniş peroneal kesit alanı olan kronik ayak bileği instabilitesi olan olgular daha yüksek peroneal kuvvete sahip olabilir. Bu durumda, bu grup düşük seviyede algılanan ayak bileği stabilitesi olan olgulardan daha iyi ayak bileği stabilitesine sahip olabilir. Geliştirilmiş stabilite ile ilgili bu yapısal ilişki potansiyeli fizyoterapistleri ve rehabilitasyon programlarını ilgilendirebilir. Daha fazla araştırma kronik ayak bileği instabilitesinde ayak bileği eklemi çevresindeki diğer kas yapılarına odaklanabilir.
Anahtar Kelimeler
Kaynakça
- 1. Hertel J. Functional Anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37:364-375.
- 2. Gribble PA, Delahunt E, Bleakley CM, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. J Athl Train. 2014;49:121-127.
- 3. Delahunt E, Coughlan GF, Caulfield B, et al. Inclusion criteria when investigating insufficiencies in chronic ankle instability. Med Sci Sports Exerc. 2010;42:2106-2121.
- 4. Hung YJ. Neuromuscular control and rehabilitation of the unstable ankle. World J Orthop. 2015;6:434-438.
- 5. Ryan L. Mechanical stability, muscle strength and proprioception in the functionally unstable ankle. Aust J Physiother. 1994;40:41-47.
- 6. Bullock-Saxton JE. Local sensation changes and altered hip muscle function following severe ankle sprain. Phys Ther. 1994;74:17-28.
- 7. Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med. 2008;27:353-370.
- 8. Wikstrom EA, Hubbard-Turner T, McKeon PO. Understanding and treating lateral ankle sprains and their consequences. Sports Med. 2013;43:385-393.
- 9. Nordin M, Frankel VH. Basic biomechanics of the musculoskeletal system. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001.
- 10. Lentell G, Baas B, Lopez D, et al. The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. J Orthop Sports Phys Ther. 1995;21:206-215.
- 11. De Noronha M, Refshauge KM, Kilbreath SL, et al. Loss of proprioception or motor control is not related to functional ankle instability: an observational study. Aust J Physiother. 2007;53:193-198.
- 12. Frontera WR, Ochala J. Skeletal muscle: a brief review of structure and function. Calcif Tissue Int. 2015;96:183-195.
- 13. Fukunaga T, Miyatani M, Tachi M, et al. Muscle volume is a major determinant of joint torque in humans. Acta Physiol. 2001;172:249-255.
- 14. Lieber RL. Skeletal muscle structure and function: implications for rehabilitation and sports medicine: Williams & Wilkins Baltimore; 1992.
- 15. Dupont AC, Sauerbrei EE, Fenton PV, et al. Real-time sonography to estimate muscle thickness: comparison with MRI and CT. J Clin Ultrasound. 2001;29:230-236.
- 16. Chew K, Stevens KJ, Wang TG, et al. Introduction to diagnostic musculoskeletal ultrasound: part 2: examination of the lower limb. Am J Phys Med Rehabil. 2008;87:238-248.
- 17. Abdeen R, Comfort P, Starbuck C, et al. Ultrasound characteristics of foot and ankle structures in healthy, coper, and chronically unstable ankles. J Ultrasound Med. 2018;00:1-10.
- 18. Thoirs K, English C. Ultrasound measures of muscle thickness: intra-examiner reliability and influence of body position. Clin Physiol Funct I. 2009;29:440-446.
- 19. Namavarian N, Rezasoltani A, Zavieh MK, et al. Rehabilitative Ultrasound imaging to study the gastrocnemius muscles morphology in patients with genu varum and valgum deformities. Physiother Res Int. 2017;2:21-25.
- 20. English C, Fisher L, Thoirs K. Reliability of real-time ultrasound for measuring skeletal muscle size in human limbs in vivo: a systematic review. Clin Rehabil. 2012;26:934-944.
- 21. Hiller CE, Refshauge KM, Bundy AC, et al. The cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil. 2006;87:1235-1241.
- 22. Ozgul B PM, Starbuck C, Abdeen R, et al. The inter and intraobserver reliability of musculoskeletal ultrasound assessment of anterior talofibular ligament & ankle muscles 1st International Congress on Physiotechnotherapy; May 09-13 2018; Sarajevo Bosnia and Herzegovina: J Exerc Ther Reh; 2018;13.
- 23. Girish V, Vijayalakshmi A. Affordable image analysis using NIH Image/ImageJ. Indian J Cancer. 2004;41:47.
- 24. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N.J.: L. Erlbaum Associates; 1988.
- 25. Pozzi F, Moffat M, Gutierrez G. Neuromuscular control during performance of a dynamic balance task in subjects with and without ankle instability. Int J Sports Phys Ther. 2015;10:520.
- 26. Van Cingel RE, Kleinrensink G, Uitterlinden EJ, et al. Repeated ankle sprains and delayed neuromuscular response: acceleration time parameters. The J Orthop Sports Phys Ther. 2006;36:72-79.
- 27. Vaes P, Duquet W, Van Gheluwe B. Peroneal reaction times and eversion motor response in healthy and unstable ankles. J Athl Train. 2002;37:475-480.
- 28. Ebig M, Lephart SM, Burdett RG, et al. The effect of sudden inversion stress on EMG activity of the peroneal and tibialis anterior muscles in the chronically unstable ankle. J Orthop Sports Phys Ther 1997;26:73-77.
- 29. Gross MT. Effects of recurrent lateral ankle sprains on active and passive judgements of joint position. Phys Ther. 1987;67:1505-1509.
- 30. Lobo CC, Morales CR, Sanz DR, et al. Ultrasonography comparison of peroneus muscle cross-sectional area in subjects with or without lateral ankle sprains. J Manipulative Physiol. 2016;39:635-644.
- 31. Sakai S, Urabe Y, Morikawa M, et al. Quantity and quality of the peroneus longus assessed using ultrasonography in leg with chronic ankle instability. J Phys Ther. 2018;30:1396-1400.
- 32. Fukumoto Y, Ikezoe T, Yamada Y, et al. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol. 2012;112:1519-1525.
- 33. Lieber RL, Friden J. Functional and clinical significance of skeletal muscle architecture. Muscle Nerve. 2000;23:1647-1666.
- 34. Strasser EM, Draskovits T, Praschak M, et al. Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly. Age. 2013;35:2377-2388.
- 35. David P, Halimi M, Mora I, et al. Isokinetic testing of evertor and invertor muscles in patients with chronic ankle instability. J Appl Biomech. 2013;29:696-704.
- 36. Cho BK, Park JK, Choi SM, et al. The peroneal strength deficits in patients with chronic ankle instability compared to ankle sprain copers and normal individuals. Foot Ankle Surg. 2017.
- 37. Kaminski TW, Hartsell HD. Factors contributing to chronic ankle instability: A strength perspective. J Athl Train. 2002;37:394-405.
- 38. Karlsson J, Bergsten T, Peterson L, et al. Radiographic evaluation of ankle joint stability. Clin J Sport Med. 1991;1:166-175.
- 39. Larsen E, Angermann P. Association of ankle instability and foot deformity. Acta Orthop Scand. 1990;61:136-139.
- 40. Rottigni SA, Hopper D. Peroneal muscle weakness in female basketballers following chronic ankle sprain. Aust J Physiother. 1991;37:211-217.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mart 2020 |
| Gönderilme Tarihi | 11 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 7 Sayı: 1 |
