RESUMEN
BACKGROUND: Lateral ankle sprain is one of the most common musculoskeletal issues during sports and activities of daily living. This study investigated the effect of combined neuromuscular training and conventional training (including strengthening, range of motion, and balance exercises) on muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with chronic ankle instability (CAI). HYPOTHESIS: The combination of neuromuscular and conventional training programs might result in additional benefits on the morphology of muscle, dynamic balance, and functional capacity in subjects with CAI. STUDY DESIGN: A single-blind parallel-arm randomized controlled trial. LEVEL OF EVIDENCE: Level 2. METHODS: A total of 34 participants with CAI were divided randomly into experimental (EG) and control groups (CG). The EG received conventional and neuromuscular training, while the CG underwent conventional training. Cross-sectional areas of the peroneus longus and tibialis anterior muscles were measured using ultrasonography. Measurements included reaching direction distance, ankle instability, and the foot and ankle outcome score, all evaluated before and immediately after 12 intervention sessions and 4 weeks later in the follow-up phase. RESULTS: Repeated-measures analysis of variance (ANOVA) revealed significant improvement in the EG, particularly in the cross-sectional area of the tibialis anterior muscle on the injured side and the posteromedial reaching direction displacement of the Y balance test. Moreover, the EG's foot and ankle outcome scores increased significantly compared with the CG (P < 0.05). However, the group effect size ranged from minor to moderate (Hedges g, 0.40-0.73). CONCLUSION: Combining neuromuscular and conventional training programs yields greater benefits than conventional training alone regarding tibialis anterior muscle morphology, posteromedial dynamic balance, and functional capacity in persons with CAI. CLINICAL RELEVANCE: The combination of neuromuscular and conventional training programs could enhance muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with CAI.
RESUMEN
BACKGROUND: Ankle sprain is a common problem among active people and athletes. It causes reduces their activity of daily living and quality of life. Because of the impaired muscle strength and neuromuscular and postural control, it seems that the morphological criteria of peri-ankle muscles are changed. OBJECTIVE: This study aimed to develop a reliable method for measuring tibialis anterior (TA) and peroneus longus (PL) muscles in the injured and intact side of lower limbs in people with unilateral chronic ankle instability (CAI). STUDY DESIGN: Cross-sectional study. METHOD: This study was intra-tester reliability by ultrasound imaging to measure ultrasonography characteristics contains thickness, width, fiber length, pennation angle, and cross-sectional area (CSA) of TA, and PL in both limbs of 25 subjects at three separate times. Intra-class correlation coefficients (ICC), limits of agreement (LOA), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated to analyzed relative and absolute intra-tester reliability, respectively. RESULTS: The present study showed good to excellent relative reliability for both injured and intact sides (ICC 0.88-0.98), less proportional measurement error (ß coefficient of LOA≈ 0), and suitable absolute reliability. CONCLUSION: Musculoskeletal ultrasonography is a reliable method for the measurement of peri-ankle muscle morphology such as thickness, width, CSA, fiber length, and pennation angle.
