Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 81 leaves ; 30 cm / Damage to the proprioceptive organs, as well as lack of proprioceptive retraining, after an inversion ankle sprain, has been shown to contribute to the problem of recurring ankle joint injuries, which has the highest incidence of sports related injuries. The proprioceptive organs are important as afferent pathways in reflexes and for the adjustment of posture and muscle tone (Miller and Narson, 1995 and Jerosch and Bischof, 1996). Manipulation is thought to cause a change in the afferent pathways of the manipulated joints and it is proposed that this change may restore normal proprioceptive input, in a previously injured joint (Wyke, 1981 and Slosberg 1988). This however is unproven as indicated in a study by Lephart and Fu, (1995), where techniques to improve proprioception remain untested and according to Brynin and Farrar (1995), screening for proprioceptive and neuromuscular co-ordination should be carried out as part of a chiropractor’s physical examination and injury evaluation. This was a qualitative pre-post clinical study. Forty (40) subjects between the ages of 25 and 45, who had been diagnosed with chronic ankle instability syndrome, were recruited.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2005 221 leaves ; 30 cm / Previously the focus has been on the improvement of strength prior to proprioception (Calliet, 1997; Flemister et al. 1998 and Buhler et al. 2002). However according to Oloff (1994); Vegso (1995); Calliet (1997); Kawaguchi (1999); Buhler et al. (2002) and McGrew et al. (2003), focus should lie in obtaining a functional range of motion (increased flexibility) and proprioceptive ability and strength will follow with normalization of the relationship of the anatomical structures. All research in this regard has never assessed the assumption that the strength of the relevant musculature would return (Blokker et al.1992 and Klaue et al.1998). The objectives of this study were: to determine the relative effectiveness of Proprioceptive Neuromuscular Facilitation as compared to the Active Rocker-Board Exercises in the rehabilitation of chronic ankle sprains; as well as to determine the best sequence of applying these techniques to chronic ankle sprains in terms of objective clinical findings.

Thesis (Ph.D.)--Virginia Commonwealth University, 2010. / Prepared for: Dept. of Biomedical Engineering. Title from title-page of electronic thesis. Bibliography: leaves 149-157.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 1 v. (various pagings) ; 30 cm / Following an inversion ankle joint sprain, damage to the proprioceptive organs can occur, which is made worse by lack of proprioceptive retraining and will increase the chances of re-injury (Hoffman and Payne 1995:144 and Anderson, 2002). Pellow and Brantingham (2001) indicated that patients who received multiple manipulations improved more rapidly than patients in the placebo group. Therefore it is proposed that manipulation provokes changes in afferent input that may restore normal proprioceptive input (Slosberg, 1988). However, Pellow and Brantingham (2001) were not able to establish what effect multiple manipulations had, as opposed to a single manipulation, on the proprioception on the foot and ankle complex and how this may influence the clinical outcome of the patient’s treatment. Therefore, it was hypothesized that multiple manipulations of the foot and ankle complex would have a greater effect on chronic ankle instability syndrome than a single treatment in terms of overall improvement subjectively and objectively. In addition to this the following was also hypothesized: • That multiple manipulations of the foot and ankle complex would increase the ROM to a greater extent than single manipulations. • That multiple manipulations would decrease point tenderness more effectively than a single manipulation.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Background: Acute ankle sprains and chronic ankle instability syndrome (CAIS) may be managed effectively through conservative management approaches such as strapping. There are two main types of strapping viz. rigid tape which is used to stabilise the joint and limit joint motion and elastic tape which permits joint motion but provides dynamic support. Kinesio™ tape is becoming increasingly popular in the management of various conditions. It is reportedly beneficial in reducing pain, improving circulation, increasing proprioception and correcting muscle function. Due to claimed benefits of Kinesio™ tape, it should, in theory, be beneficial in the management of individuals with CAIS particularly in terms of reducing pain and improving proprioception. AIM: To investigate the effect of three types of strapping applied in the method described for the application of Kinesio™ tape in the management of CAIS. METHODS This study consisted of three groups of 15 participants (recruited through convenience sampling) with each group receiving a different tape (i.e. rigid, elastic or Kinesio™ tape), all three groups, however, received the same taping method which was the Kinesio™ tape functional correction application. After obtaining informed consent each participant underwent a case history, physical examination and a foot an ankle orthopaedic examination. Thereafter, baseline measurements of subjective pain rating (NRS-101), pain threshold (analogue algometer), ankle dorsiflexion, plantarflexion and inversion (analogue goniometer) and proprioception (Biodex Biosway portable balance system) were documented. Depending on the group, the particular tape was then applied and a follow up consultation was made for two to three days later where the tape was removed, measurements were reassessed and the tape was reapplied. At the final consultation three to four days later, the tape was removed and final measurements were assessed and documented. Statistical intra- (using Wilcoxon Signed Ranks Test) and inter-group (using the Mann-Whitney U-test) analyses of the data were performed due to a skewed distribution of the variables. Data was analysed using SPSS version 21.0 with the level of significance set at 0.05. RESULTS The mean (± SD) age of the participants was 24.8 (4.7) and there were 23 male participants in total. Intra-group analyses of subjective outcome measurements showed significant increases (p < 0.05) in subjective pain rating in all three groups across all consultations. Similarly, intra-group analyses of objective outcome measurements found significant increases (p < 0.05) in pain threshold and dorsiflexion range of motion in all three groups across all consultations. Plantarflexion and inversion range of motion also showed significant increases (p < 0.05) but these were not consistent across all consultations. Intra-group analyses of the sway index showed no significant improvements (p > 0.05) in Groups Two and Three across the three consultations. Only Group One showed significant increases during the eyes open foam surface (EOFoS) (p = 0.013) and eyes closed foam surface (ECFoS) (p = 0.047) test conditions between Consultations One and Two. Inter-group analyses of subjective outcome measurements showed no significant increases (p > 0.05) in subjective pain rating across each of the three consults in all three groups. Inter-group analyses of objective outcome measurements revealed a significant increase in pain threshold (p = 0.040) between Groups Two and Three at Consultation One. There was a significant increase in plantarflexion between Groups One and Three at Consultation Two (p = 0.021) and Consultation Three (p = 0.030). There were no other significant results amongst the three groups. CONCLUSION The results suggest that pain rating, pain threshold and ankle dorsiflexion would improve if taping is applied in the manner described for Kinesio™ tape irrespective of the type of taping used in the management of CAIS. The taping method did not result in a significant difference in proprioception. Further studies, with larger sample sizes are required to confirm the findings of this study and to determine the role of taping in the management of CAIS. / M

BACKGROUND: Chronic ankle instability (CAI) patients have varying levels of mechanical and sensorimotor impairments that may lead to disparate functional movement patterns. Current literature on landing biomechanics in a CAI population, however, considers all patients as a homogeneous group. In our prior work, we identified 6 subgroups of movement patterns using lower extremity kinematics during a landing/cutting task and that showed promise in furthering understanding of movement patterns in a laboratory-based environment. To increase the utility of this methodology in clinical settings, there is a need to find easily administered clinical tests that can help identify multiple subgroups of movement patterns in a CAI population. The purpose of the present study was to identify clinical tests that would help identify frontal and sagittal kinematic movement pattern subgroups during a landing/cutting task. We hypothesized that clinical tests would help predict group assignment; which CAI patient is assigned to frontal and sagittal kinematic movement pattern subgroups, respectively. METHODS: We recruited 100 CAI patients from a university population. We used three-dimensional instrumented motion analysis to capture ankle, knee and hip kinematics as subjects performed a single-leg maximal jump landing/cutting task. We used sagittal and frontal joint angle waveforms to group CAI patients. We then used 12 demographic and clinical measures to predict these subgroups of CAI. These consisted of gender, Star Excursion Balance Test-Anterior (SEBT-ANT), Biodex static balance, figure 8 hop, triple crossover hop, dorsiflexion range of motion (DFROM), number of failed trials, body mass index, a score of Foot and Ankle Ability Measure-Activities of Daily Living (FAAM-ADL), a score of FAAM-Sports, number of "yes" responses on Modified Ankle Instability Index, and number of previous ankle sprains. First, we used functional principal component analysis to create representative curves for each CAI patient and plane from the 3 lower extremity joint angles. We then used these curves as inputs to a predictor-dependent product partition model to cluster each CAI patient to unique subgroups. Finally, we used a multinomial prediction model to examine the accuracy of predicting group membership from demographic and clinical metrics. RESULTS: The predictor-dependent product partition model identified 4 frontal and 5 sagittal movement pattern subgroups. Six predictors (e.g., gender, SEBT-ANT, figure 8 hop, triple crossover hop, DFROM, and FAAM-ADL) predicted group membership with 55.7% accuracy for frontal subgroups. Ten predictors (minus Biodex static balance and number of previous ankle sprains) predicted group membership with 59% accuracy for sagittal subgroups. CONCLUSION: Novel statistical analyses allowed us to predict group membership for multiple frontal and sagittal kinematic movement patterns during landing/cutting using a series of clinical predictors. However, due to relatively lower accuracy (56–59% accuracy), the clinical utility of the current prediction model may be limited. Future work should consider including other clinical predictors to maximize prediction accuracy for identifying multiple kinematic movement patterns during a landing/cutting task.

Electrical stimulation has long been used in the treatment of a variety of ailments. Its current uses range from muscle re-education and orthotic substitute to scoliosis management and edema control. I chose to study the effect of electrode polarity in high voltage electrogalvanic stimulation in the treatment of edema for several reasons. I had access to subjects because I was the only physical therapist at the Stockton Orthopedic Medical Group. High voltage electrogalvanic stimulation is a commonly used modality in treating edema (Brown, 1981). High voltage generators have a polarity switch, and the direction manual which accompanies the Electro-Med generator used by the Stockton Orthopedic Medical Group states that the negative pole should be used for edema reduction. (Instruction manual for high voltage Electrogalvanic Stimulator, 1977). However, the effect of electrode polarity on edema reduction has not been demonstrated, nor documented in the literature.

No description available.

After investigating the injury mechanism, this dissertation aims to design an intelligent sprain-free sports shoe for the prevention of sport-related ankle sprain injury. It consists of a three-step mechanism: (1) Sensing, (2) Identification, and (3) Correction. The progress of this dissertation covers two options of sensing and identification. The first option is to monitor the ankle spraining motion with the ankle inversion angle. A method to employ two tiny inertial and magnetic sensors at the shank and foot segment is adopted as the sensing system. A laboratory study is conducted to obtain ankle inversion magnitude and velocity during various sport motions. Together with the article kinematics reported in the accidental sprain case report, a standard for identifying ankle sprain is established. The second option is to monitor the ankle spraining motion with the ankle supination torque. A feasible method to estimate the complete ground reaction forces with the information from pressure insoles is presented. Then, a tiny in-shoe three-pressure-sensor system is devised to monitor the ankle supination torque during sport motions. With the information of failure torque at the ankle joint reported by previous cadaveric study, an identification system of the ankle supination torque is devised. / Ankle sprain injury is the most common single type of sport-related musculoskeletal trauma which causes rupture and tear to the anterior talofibular ligament and ankle instability. In this dissertation, a new paradigm, "Orthopaedic Sport Biomechanics", is proposed to present the role of biomechanics in the practice of orthopaedics sports medicine, including the analysis of injury mechanism, and the design of prophylactic equipment for injury prevention. To directly investigate the injury, a case report of an accidental injury event in laboratory is presented. It was found that an internally rotated ankle orientation at foot strike may predispose the ankle joint to a supination sprain injury, by triggering lateral drift of the rearfoot and the subsequent vigorous inversion. At injury, the ankle joint reached an inversion of 48 degrees and an internal rotation of 10 degrees. / Future studies on the sensing and identification process, the correction, and the final evaluation are suggested. We hope that we could really invent the sprain-free shoe to help reducing the incidence of ankle sprain injury in sports in future. / Fong, Tik Pui Daniel. / Adviser: Kai-Ming Chan. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3635. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 102-127). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

The ankle sprain is a common injury in basketball. A mechanism for this injury occurs when landing improperly from a jump. The concept of wedge and flare designs in shoes is (1) to offer benefit in reducing the potential for an ankle sprain while (2) not hindering performance or usability concerning basketball movements that are needed for successful play. The purpose was to take conceptual designs of the wedge and flare through an iterative design process. Therefore, the objectives were to fabricate shoe prototypes with these conceptual designs, to test the performance of these prototypes, and to develop the next iteration of design based upon the results of testing. The results of this design process are discussed.