Purpose: Ankle sprain is one of the most commonly damaged lower extremities. More than 70% of people with ankle sprain experience chronic ankle instability. However, some people are well adapted to this damage (Coper people) and do not suffer from chronic ankle instability. The aim of this study was to compare the balance in healthy athletes with chronic ankle instability and coper during one leg standing. Methods: 13 athletes with chronic ankle instability with mean age of 22.3 ± 2.21 years, weight 57.07 ± 7.48 kg and height 166.76 ± 5.8 cm, 10 Cooper athletes with an average age of 1.37 ± 21.9 years, weigh 56.5 ± 5.78 kg and height 165.9 ± 7.4 cm and 11 healthy athletes with an average age of 24.44 ± 4.3 years, weight 57 kg ± 97.7 kg, and The height of 165.72 ± 27.57 cm was participated in this study. Each participant for 20 seconds maintained their single-foot balance on the 3rd and 12th balance points of Biodex. The results of the study were analyzed using MANOVA at a significant level of 95% and alpha less than or equal to 0.05. Results: The results showed that the balance index did not differ significantly between healthy and Coper Groups However, in the group of chronic ankle instability, the internal-external balance index and the overall index were significantly higher than the healthy group (p≤0/05). Conclusions: The chronic ankle instability group has poor balance, especially in the internal-external direction, which can be due to damage to the ankle ligament and some deep receptors located on the ankle ligament of the ankle.
Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont Jr PJ. The epidemiology of ankle sprains in the United States. JBJS 2010; 92(13): 2279-2284.
Baumhauer JF, Nawoczenski DA, DiGiovanni BF, Flemister AS. Ankle pain and peroneal tendon pathology. Clinics in sports medicine 2004; 23(1): 21-34.
Wikstrom EA, Bishop MD, Inamdar AD, Hass CJ. Gait termination control strategies are altered in chronic ankle instability subjects. Med Sci Sports Exerc 2010; 42(1): 197-205.
Doherty C, Delahunt E, Caulfield B, Hertel J, et al. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports medicine 2014; 44(1): 123-140.
Anandacoomarasamy A, Barnsley L. Long term outcomes of inversion ankle injuries. British Journal of Sports Medicine 2005; 39(3): e14-e14.
Brown C, Padua D, Marshall SW, Guskiewicz K. Individuals with mechanical ankle instability exhibit different motion patterns than those with functional ankle instability and ankle sprain copers. Clinical biomechanics 2008; 23(6): 822-831.
Gribble PA, Delahunt E, Bleakley C, Caulfield B, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. British journal of sports medicine 2013; bjsports-2013: 585-591
Wikstrom EA, Brown CN. Minimum reporting standards for copers in chronic ankle instability research. Sports Medicine 2014; 44(2): 251-268.
Liu K, Dierkes C, Blair L. A new jump-landing protocol identifies differences in healthy, coper, and unstable ankles in collegiate athletes. Sports biomechanics 2016; 15(3): 245-254.
Terada M, Pfile KR, Pietrosimone BG, Gribble PA. Effects of chronic ankle instability on energy dissipation in the lower extremity. Medicine and science in sports and exercise 2013; 45(11): 2120-2128.
Terada M, Bowker S, Hiller C, Thomas A, , et al. Quantifying levels of function between different subgroups of chronic ankle instability. Scandinavian journal of medicine & science in sports 2017; 27(6): 650-660.
Nakagawa L, Hoffman M. Performance in static, dynamic, and clinical tests of postural control in individuals with recurrent ankle sprains. Journal of Sport Rehabilitation 2004; 13(3): 255-268.
Ross SE, Guskiewicz KM, Yu B. Single-leg jump-landing stabilization times in subjects with functionally unstable ankles. Journal of athletic training 2005; 40(4): 298.
Guskiewicz KM, Perrin DH. Research and clinical applications of assessing balance. Journal of Sport Rehabilitation 1996; 5(1): 45-63.
Brown CN, Mynark R. Balance deficits in recreational athletes with chronic ankle instability. Journal of athletic training 2007; 42(3): 367.
Emery C. Is there a clinical standing balance measurement appropriate for use in sports medicine? A review of the literature. Journal of Science and Medicine in Sport 2003; 6(4): 492-504.
Arnold BL, De La Motte S, Linens S, Ross SE. Ankle instability is associated with balance impairments: a meta-analysis. Med Sci Sports Exerc 2009; 41(5): 1048-1062.
Fitzpatrick R, Rogers DK, McCloskey D. Stable human standing with lower‐limb muscle afferents providing the only sensory input. The Journal of physiology 1994; 480(2): 395-403
Di Giulio I, Maganaris CN, Baltzopoulos V, Loram ID. The proprioceptive and agonist roles of gastrocnemius, soleus and tibialis anterior muscles in maintaining human upright posture. The Journal of physiology 2009; 587(10): 2399-2416.
Loram ID, Maganaris CN, Lakie M. Active, non‐spring‐like muscle movements in human postural sway: how might paradoxical changes in muscle length be produced? The Journal of physiology 2005; 564(1): 281-293.
Freeman M, Dean M, Hanham I. The etiology and prevention of functional instability of the foot. Bone & Joint Journal 1965; 47(4): 678-685.
Tropp H, Odenrick P. Postural control in single‐limb stance. Journal of orthopaedic research 1988; 6(6): 833-839.
Riemann BL. Is there a link between chronic ankle instability and postural instability? Journal of athletic training 2002; 37(4): 386.
Cug M, Wikstrom EA. Learning effects associated with the least stable level of the biodex® stability system during dual and single limb stance. Journal of sports science & medicine 2014; 13(2): 387.
Hung Y-j, Miller J. Extrinsic visual feedback and additional cognitive/physical demands affect single-limb balance control in individuals with ankle instability. World journal of orthopedics 2016; 7(12): 801.
Parraca JA, Olivares PR, Carbonell-Baeza A, Aparicio VA, et al. Test-Retest reliability of Biodex Balance SD on physically active old people. Journal of human sport and exercise. 2011.
Doherty C, Bleakley C, Hertel J, et al. Lower limb interjoint postural coordination one year after first-time ankle sprain. Med Sci Sports Exerc 2015; 47(11): 2398-2405
Wikstrom EA, Fournier KA, McKeon PO. Postural control differs between those with and without chronic ankle instability. Gait & posture 2010; 32(1): 82-86.
Shields CA, Needle AR, Rose WC, Swanik CB, et al. Effect of elastic taping on postural control deficits in subjects with healthy ankles, copers, and individuals with functional ankle instability. Foot & ankle international. 2013;34(10):1427-1435
Ageberg E, Roberts D, Holmström E, Fridén T. Balance in single-limb stance in healthy subjects–reliability of testing procedure and the effect of short-duration sub-maximal cycling. BMC Musculoskeletal disorders 2003; 4(1): 14.
Wang H-K, Chen C-H, Shiang T-Y, Jan M-H, Lin K-H. Risk-factor analysis of high school basketball–player ankle injuries: a prospective controlled cohort study evaluating postural sway, ankle strength, and flexibility. Archives of physical medicine and rehabilitation 2006; 87(6): 821-825.
Pozzi F, Moffat M, Gutierrez G. Neuromuscular control during performance of a dynamic balance task in subjects with and without ankle instability. International journal of sports physical therapy. 2015; 10(4):52.
Wright CJ, Arnold BL, Ross SE, Linens SW. Recalibration and validation of the cumberland ankle instability tool cutoff score for individuals with chronic ankle instability. Archives of physical medicine and rehabilitation 2014; 95(10): 1853-1859.
Hadadi M, Ebrahimi Takamjani I, Ebrahim Mosavi M, Aminian G, et al. Cross-cultural adaptation, reliability, and validity of the Persian version of the Cumberland Ankle Instability Tool. Disability and rehabilitation. 2017; 39(16): 1644-1649
Springer S, Gottlieb U, Moran U, Verhovsky G, Yanovich R. The correlation between postural control and upper limb position sense in people with chronic ankle instability. Journal of foot and ankle research 2015; 8(1): 23.
Hinman MR. Factors affecting reliability of the Biodex Balance System: a summary of four studies. Journal of sport rehabilitation 2000; 9(3): 240-252.
Kunugi S, Masunari A, Yoshida N, Miyakawa S. Postural stability and lower leg muscle activity during a diagonal single-leg landing differs in male collegiate soccer players with and without functional ankle instability. The Journal of Physical Fitness and Sports Medicine 2017; 6(4): 257-265.
Wright CJ, Arnold BL, Ross SE. Altered kinematics and time to stabilization during drop-jump landings in individuals with or without functional ankle instability. Journal of athletic training 2016; 51(1): 5-15.
Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. Journal of athletic training 2002; 37(4): 364 .
Wu X, Song W, Zheng C, Zhou S, Bai S. Morphological study of mechanoreceptors in collateral ligaments of the ankle joint. Journal of orthopaedic surgery and research 2015; 10(1): 92.
Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice, Lippincott Williams & Wilkins; 2007.
Rankin BL, Buffo SK, Dean JC. A neuromechanical strategy for mediolateral foot placement in walking humans. Journal of neurophysiology 2014; 112(2): 374-383.
Kuo AD. Stabilization of lateral motion in passive dynamic walking. The International journal of robotics research 1999; 18(9): 917-930.
Wilkerson GB, Pinerola JJ, Caturano RW. Invertor vs. evertor peak torque and power deficiencies associated with lateral ankle ligament injury. Journal of Orthopaedic & Sports Physical Therapy 1997; 26(2): 78-86.
Levangie PK, Norkin CC. Joint structure and function: a comprehensive analysis, FA Davis; 2011.
Friel K, McLean N, Myers C, Caceres M. Ipsilateral hip abductor weakness after inversion ankle sprain. Journal of athletic training 2006; 41(1): 74.
Cerny K. Pathomechanics of stance: clinical concepts for analysis. Physical therapy 1984; 64(12): 1851-1859.
Imagawa H, Hagio S, Kouzaki M. Synergistic co-activation in multi-directional postural control in humans. Journal of Electromyography and Kinesiology 2013; 23(2): 430-437.
Kutch JJ, Kuo AD, Bloch AM, Rymer WZ. Endpoint force fluctuations reveal flexible rather than synergistic patterns of muscle cooperation. Journal of neurophysiology 2008; 100(5): 2455-2471.
Feger MA, Donovan L, Hart JM, Hertel J. Lower extremity muscle activation during functional exercises in patients with and without chronic ankle instability. PM&R 2014; 6(7): 602-611.
Gutierrez GM, Knight CA, Swanik CB, et al. Examining neuromuscular control during landings on a supinating platform in persons with and without ankle instability. The American journal of sports medicine 2012; 40(1): 193-201.
Karbalaeimahdi, M., Alizadeh, M., & Minoonejad, H. (2020). Comparison of Single-Leg Balance Test in Healthy Athletes with Chronic Ankle Instability (Noncoper) and Coper . Journal of Paramedical Sciences & Rehabilitation, 9(3), 51-61. doi: 10.22038/jpsr.2020.39003.1925
MLA
M Karbalaeimahdi; M.H Alizadeh; H Minoonejad. "Comparison of Single-Leg Balance Test in Healthy Athletes with Chronic Ankle Instability (Noncoper) and Coper ", Journal of Paramedical Sciences & Rehabilitation, 9, 3, 2020, 51-61. doi: 10.22038/jpsr.2020.39003.1925
HARVARD
Karbalaeimahdi, M., Alizadeh, M., Minoonejad, H. (2020). 'Comparison of Single-Leg Balance Test in Healthy Athletes with Chronic Ankle Instability (Noncoper) and Coper ', Journal of Paramedical Sciences & Rehabilitation, 9(3), pp. 51-61. doi: 10.22038/jpsr.2020.39003.1925
VANCOUVER
Karbalaeimahdi, M., Alizadeh, M., Minoonejad, H. Comparison of Single-Leg Balance Test in Healthy Athletes with Chronic Ankle Instability (Noncoper) and Coper . Journal of Paramedical Sciences & Rehabilitation, 2020; 9(3): 51-61. doi: 10.22038/jpsr.2020.39003.1925