Factors associated with persistent pain in college athletes with a history of lateral ankle sprain.

OBJECTIVES: To determine the factors associated with and prevalence of persistent pain in college athletes with chronic ankle instability (CAI) and with previous lateral ankle sprain (LAS) without CAI. DESIGN: Cross-Sectional Study. SETTING: Online survey at one university. PARTICIPANTS: Of the 385 respondents surveyed online, 140 were identified as having experienced at least one LAS (CAI group: 69, coper group: 24, LAS group not classified as either: 47). MAIN OUTCOME MEASURES: Factors associated with the presence of pain during activities of daily living (ADL) and sports were identified using multivariate logistic regression analyses. Independent variables were demographics, injury characteristics, the Identification of Functional Ankle Instability (IdFAI) score, the Foot and Ankle Ability Measure Sports (FAAM-Sports) and ADL subscales, and the Tampa Scale for Kinesiophobia-11 score. RESULTS: The prevalence of pain during ADL and sports in the three groups was 16.7%-42.0% and 33.3%-56.5%, respectively. FAAM-Sports and IdFAI score were significantly associated with pain during ADL and sports in the CAI group (odd ratio: 0.923 and 1.145), respectively. No significant pain-related factors were found in the coper and LAS groups. CONCLUSIONS: Lower self-reported function and greater perceived ankle instability may be important factors in pain management in athletes with CAI.

Inertial Sensor-Based Assessment of Static Balance in Athletes with Chronic Ankle Instability.

The Balance Error Scoring System (BESS), a subjective examiner-based assessment, is often employed to assess postural balance in individuals with chronic ankle instability (CAI); however, inertial sensors may enhance the detection of balance deficits. This study aimed to compare the BESS results between the CAI and healthy groups using conventional BESS scores and inertial sensor data. The BESS test (six conditions: double-leg, single-leg, and tandem stances on firm and foam surfaces, respectively) was performed for the CAI (n = 16) and healthy control (n = 16) groups with inertial sensors mounted on the sacrum and anterior shank. The BESS score was calculated visually by the examiner by counting postural sway as an error based on the recorded video. The root mean square for resultant acceleration (RMSacc) in the anteroposterior, mediolateral, and vertical directions was calculated from each inertial sensor affixed to the sacral and shank surfaces during the BESS test. The mixed-effects analysis of variance and unpaired t-test were used to assess the effects of group and condition on the BESS scores and RMSacc. No significant between-group differences were found in the RMSacc of the sacral and shank surfaces, and the BESS scores (P > 0.05), except for the total BESS score in the foam condition (CAI: 14.4 ± 3.7, control: 11.7 ± 3.4; P = 0.039). Significant main effects of the conditions were found with respect to the BESS scores and RMSacc for the sacral and anterior shank (P < 0.05). The BESS test with inertial sensors can detect differences in the BESS conditions for athletes with CAI. However, our method could not detect any differences between the CAI and healthy groups.

Kinesiophobia, self-reported ankle function, and sex are associated with perceived ankle instability in college club sports athletes with chronic ankle instability.

OBJECTIVE: To investigate the association between sex, self-reported ankle function, pain intensity, kinesiophobia, and perceived ankle instability in athletes with chronic ankle instability (CAI). DESIGN: Cross-Sectional Study. SETTING: University. PARTICIPANTS: College club sports athletes with CAI (n = 42). MAIN OUTCOME MEASURES: Relationships with the Cumberland Ankle Instability Tool (CAIT) score and the Tampa Scale for Kinesiophobia-11 (TSK-11), the Foot and Ankle Ability Measure (FAAM), sex (0: male, 1: female), and ankle pain intensity by the Numeric Rating Scale were explored with multiple regression analysis. RESULTS: The regression model explained 50.3% of the variance of the CAIT score (P < 0.001), and the TSK-11 score (B = -0.382, P = 0.002), the FAAM sports subscale score (B = 0.122, P = 0.038), and sex (B = -2.646, P = 0.031) were significant independent variables for the CAIT score (P < 0.001), while pain intensity was not significant (B = -0.182, P = 0.504). These results indicated that higher TSK-11 score, lower FAAM sports subscale score, and being female were related to lower CAIT score. CONCLUSIONS: Kinesiophobia related to perceived instability along with self-reported function and sex in athletes with CAI. Clinicians should assess the psychological aspects of athletes with CAI.

Lower limb kinematics during single leg landing in three directions in individuals with chronic ankle instability.

OBJECTIVES: To compare the lower limb kinematics of participants with chronic ankle instability (CAI) and healthy participants during forward, lateral, and medial landings. DESIGN: Cross-sectional study. SETTING: Laboratory. PARTICIPANTS: Eighteen athletes with CAI and 18 control athletes. MAIN OUTCOME MEASURES: Hip, knee, and ankle joint kinematics during forward, lateral, and medial single-leg landings were compared between the groups using two-way ANOVA for discrete values and statistical parametric mapping two-sample t-tests for time-series data. RESULTS: The CAI group had significantly greater ankle dorsiflexion than the control group (P ≤ 0.013), which was observed from the pre-initial contact (IC) for lateral and medial landings and post-IC for forward landing. The CAI group showed greater knee flexion than the control group from the IC for lateral landing and post-IC for forward landing (P ≤ 0.014). No significant differences in ankle inversion kinematics were found between the CAI and control groups. Lateral landing had a greater peak inversion angle and velocity than forward and medial landings (P < 0.001). Medial landing had a greater inversion velocity than forward landing (P < 0.001). CONCLUSIONS: This study suggests that individuals with CAI show feedforward protective adaptations in the pre-landing phase for lateral and medial landings.