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Recorded by Eugene Barsky, Physiotherapy Outreach Librarian, UBC / This is a Systematic Review Presentation titled - "Effect of Manual Therapy on ROM Following Lateral Ankle Sprains: A Systematic Review", created by Master of Physical Therapy Graduating Students, University of British Columbia - 2006, Presented on September 14-15, 2006 , Vancouver, BC, Canada

The restoration of arm-free standing in paraplegic individuals can be accomplished with the help of functional electrical stimulation (FES). The key component of such a system is a controller that can modulate FES induced muscle contractions in real-time, such that artificially produced forces in the legs and abdominal muscles are able to generate stable standing posture. A 57 year-old individual with chronic ASIA-A (American Spinal Injury Association), T3/4 level spinal cord injury (SCI) participated in this study. The objective was to determine if a proportional-derivative (PD) or proportional-integral-derivative (PID) controller could be used to regulate FES induced muscle contractions in the ankle joint to allow it to maintain balance of the entire body during quiet standing, while exhibiting physiological dynamics seen in able-bodied individuals while doing so.

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Tyrimo objektai: čiurnos ir blauzdos apimtys, pėdos judesių amplitudės, skausmas, pėdos ir kulkšnies funkcija, dinaminė pusiausvyra. Čiurnos lūžis yra antras pagal dažnumą pasitaikanti čiurnos pažeidimas po patempimo (Fong et al., 2007 iš Beckenkamp et al., 2011). Švedijoje čiurnos lūžis pasitaiko 71 asmenims iš 10,000 ir kiekvienais metais daugėja 0,2 proc. Dažniausia lūžio priežastis, nukritimas lygioje vietoje (Thur et al., 2012). Dažniausiai čiurnos lūžis yra gydomas imobilizauojant galūnę 6 sav., o tai lemia judesio funkcijos sutrikimą, kuris pasireiškia tinimu, sustingimu ir raumenų silpnumu. Reabilitacija yra pradedama iš karto, kai tik lūžis būna stabilizuotas arba tik nuėmus įtvarą (Lin et al., 2010). Dviem trečdaliams pacientų, po čiurnos lūžio, funkcinis aktyvumas atsigauna gerai arba puikiai, tačiau likusiam trečdaliui — priimtinai arba blogai (Nilsson et al., 2003). Reabilitacijos tikslas — kuo greičiau atstatyti sutrikusią funkciją ir grįžti į kasdieninę veiklą. Norint sudaryti tinkamą kineziterapijos programą, reikia žinoti koks buvo pažeidimo mechanizmas ir pritaikant anatomijos ir kineziologijos žinias taikyti efektyviausią gydymo metodiką (Birrer and O‘Connor, 2004). Kineziterapijos tikslas yra pagerinti pacientų gyvenimo kokybę ir skatinti aktyvumą kasdieninėje veikloje (Harvey, 2008 iš Pääbo and Pill, 2012), nepaisant senėjimo, patirtos traumos ar ligos, arba aplinkos poveikio (Giura and Nagel, 2010). Kineziterapija, kitaip negu operacijos ir injekcijos... [toliau žr. visą tekstą] / Research objects: ankle’s and calf’s size, foot’s range of motion, pain, foot‘s and ankle‘s function, dynamic balance. Ankle fracture is the second most common ankle injury after the ankle sprain (Fong et al., 2007 from Beckenkamp et al., 2011). In Sweden ankle fracture occurs in 71 of 10,000 people and every year it increases by 0.2 percent. The most common reason for ankle fracture is falling of the flat surface (Thur et al., 2012). Usually ankle fracture is treated by immobilizing it for 6 weeks therefore, there is a loss of movement function that is shown in swelling, stiffness and the lack of muscle strength. Rehabilitation starts immediately after fracture stabilization or after when the cast is removed (Lin et al., 2010). After ankle fracture two thirds of patients recovers good or excellent function, but the one third has the acceptable or poor results (Nilsson et al., 2003). The aim of rehabilitation is to restore function and come back to work as soon as possible. To make proper physiotherapy program you need to know the mechanism of injury and applying anatomy and kinesiology knowledge apply the most effective treatment method (Birrer and O‘Connor, 2004). The aim of physiotherapy is to improve patients’ quality of life and daily activity (Harvey, 2008 from Pääbo and Pill, 2012), despite aging, injury or disease, or environmental effect (Giura and Nagel, 2010). Physiotherapy as distinct from operation or injection, is less risky, cheaper and after it patient can go... [to full text]

Chronic lateral instability of the ankle (CLI), defined as frequent sprains and recurrent giving way, difficulty in walking and running on uneven surface, is often connected with pain and swollen ankles. It occurs in 10 to 20 percent after acute ankle injuries. Mechanical instability of the talocrural and subtalar joint, peroneal weakness and impaired proprioception has been suggested as etiological factors. Aim. To investigate the natural course in conservatively treated patients with CLI. To assess the mechanical stability in patients with CLI by measuring the three dimensional motions in the talus, the fibula and the calcaneus in relation to the tibia during different testing procedures pre- and postoperatively. To determine if CLI is associated with proprioceptive deficiency. Patients and Methods. This Thesis includes 127 ankles in 78 patients (30 women, 48 men) with CLI. Thirty-seven patients were followed up 20 years after their first contact with the orthopaedic department because of CLI. Forty-six ankles were evaluated radiographically and the result was compared with a gender- and age - matched control-material. The neuromuscular response to a sudden angular displacement of the ankles was studied in 15 ankles in 13 patients using EMG. Thirty-six patients entered a prospective study using roentgen stereophotogrammetric analysis (RSA) in which the ankles were tested at manual adduction, adduction with predetermined torque, with and without external support and at drawer tests (40 N and 160N). Twenty-seven patients were followed five years postoperatively. Result. After 20 years 22 patients, conservatively treated still suffered from instability of the ankle and ten had recurrent giving way symptoms even on plane surface. Six ankles in the patient group and four in the control group displayed osteoarthritic changes Prolonged ipsilateral reaction time (m. per. long, and m. tib. ant.) was found in patients with CLI indicating proprioceptive insufficiency. Increased talar adduction and a tendency toward increased total translation of the talar center was found in ankles with CLI. Concomitant fibular rotations and translations were found but with no conclusive deviation in the ankles with symptoms. The talo-calcaneal adduction reached the same level in the patient and control groups regardless of symptoms. External support (ankle brace) increased the talar stability. The use of predetermined torque and constrained testing procedure did not add information compared with the manual test Twenty-five patients graded the result as excellent or good five years after lateral ligament reconstruction. Talar stability (decreased adduction and translation) was increased two years postoperatively and was improved or remained the same at five years without comprising the range of motion. Conclusion. In more than half the cases symptoms of CLI did not resolve spontaneously. Minor degenerative changes was found after twenty years, but not to a greater extent than in a control group. CLI was associated with proprioceptive insufficiency and talocrural but not subtalar instability. Increased ankle stability can be obtained by the use of an ankle brace and by an anatomical ligament reconstruction. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1994</p> / digitalisering@umu

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The purpose of this study was to determine the jump landing impact absorption kinematic and kinetic characteristics of the four subject groups: a) male high school athletes, b) female high school seasonal athletes, c) female high school year-round athletes, and d) female college athletes who train year-round. Subjects dropped onto a force platform from a height of 40 centimeters. Variables analyzed were flexibility, strength, Fz, Fy, and Fx force, free moment, range of motion, contact and maximum angles, time to maximum angle, contact and maximum angular velocities, and time to maximum angular velocity. Significant differences among subject groups were determined through use of a factorial analysis of variance and Scheffe' post hoc test.A difference was noted in the landing patterns of males and females. Male subjects exhibited a significantly longer time to first vertical peak force. This longer time may allow for greater initial force attenuation; however, the male athletes had a significantfy greater second peak force. Males also differed significantly from females in anteroposterior and mediolateral force.The differences in method of force attenuation may be due to significantly greater ankle eversion shown by the males and greater knee flexion used by the females. Additionally, the males had significantly greater leg strength, which may have allowed them to increase the time to first peak.The year round female high school athletes were found to use the best biomechanical landing method. They had a greater range of motion in the knee and ankle, and subsequently produced the lowest amount of vertical and anterio-posterior force. / School of Physical Education

The purpose of this study was to compare the protective characteristics of four different ankle braces and one form of ankle taping. An inversion and plantar flexion platform was used to induce ankle movements. The subjects used in this study consisted of 10 volunteer male students. The subjects had no sprains five months prior to testing. All subjects were tested in the same size 10 shoes, high tops and low tops. A Certified Athletic Trainer applied all ankle braces and ankle tapings. A closed basketweave with heel locks, adherent spray, and pre-wrap was used for all taping conditions.After the application of the ankle braces or taping, each subject performed two tests on the inversion and plantar flexion platform. A random order was used among the subjects. An ankle inversion platform was modified to induce 30 degrees of inversion and 35 degrees of plantar flexion simultaneously. The subjects will be filmed using a Locam 16mm at 200 frame/second. All subjects were filmed from the posterior plane with markings on the posterior aspect of the lower leg to help analyze the movement at the subtalar joint. A Calcomp 9100 series digitizer that was interfaced with a VAX computer was used to analyze the data and calculate the amount of angular displacement at the subtalar joint. An ANOVA with repeated measures was used to determine significant differences between support techniques. University procedures for the protection of human subjects was followed. ANOVA procedures indicated no significant difference in angular displacement between braces. A statistical analysis indicated that low top shoes provided significantly more support than high top shoes in braced ankles. / School of Physical Education