Thesis (M.Tech.: Chiropractic)-Dept of Chiropractic, Durban Institute of Technology, 2005 x, 58, Annextures A-L, 20 leaves / An inversion ankle sprain can be defined as an injury caused by landing forcefully on an inverted, plantarflexed and internally rotated foot. This results in the fibres of the surrounding ligaments to become ruptured without disturbing the continuity of the ligament. Chronic stable ankle sprains was defined as the recurrent giving way of the ankle and there may be residual pain and swelling with no mechanical instability. According to literature, mechanisms involved in the development of chronic ankle sprains are: the lack of appropriate and early immobilization in severe cases, the development of scar tissue, lack of strengthening exercises or the development of hypermobility. Many treatments have been suggested to address these factors and would include: peripheral manipulation of the ankle joint, Muscle Energy Technique, muscle strengthening and stretching, proprioceptive training and deep transverse friction massage. Of the above mentioned treatments, Muscle Energy Technique has not been researched in a clinical setting for the treatment of chronic stable ankle inversion sprains. Therefore the purpose of this study was to investigate the relative effectiveness of Muscle Energy Technique compared to Manipulation in the treatment of chronic stable ankle inversion sprains.

Ankle sprains are among the most common injuries sustained by physically active individuals. Although ankle sprains are often considered innocuous in nature, a large percentage of individuals experience repetitive sprains, residual symptoms, and recurrent ankle instability following a single acute sprain; otherwise known as chronic ankle instability (CAI). In addition to repetitive ankle trauma, those with CAI experience reductions in functional capacity over the life span. This indicates that current intervention strategies for CAI are inadequate and require further investigation. The objective of this dissertation was to explore differences in walking and running gait parameters between individuals with and without CAI; as well as, examine the effects of a 2-week Maitland Grade III anterior-to-posterior talocrural joint mobilization intervention on self-reported function, ankle mechanics, postural control, and walking and running gait parameters in a cohort of individuals with CAI. It was hypothesized that individuals with CAI would exhibit different gait kinematics and joint coupling variability patterns compared to healthy individuals and the joint mobilization intervention would improve patient-oriented, clinician-oriented, and laboratory-oriented measures of function in those with CAI. Several observations were made from the results. In the first study, alterations in single joint kinematics and joint coupling variability were found between those with CAI and healthy individuals. In the second study, it was determined that the joint mobilization intervention improved patient-oriented and clinician-oriented measures of function as indicated by improved Foot and Ankle Ability Measure scores, increased weight-bearing dorsiflexion range of motion, and increased reach distances on the Star Excursion Balance Test. However, there were no changes in measures of instrumented ankle arthrometry or laboratory measures of postural control. In the third study, there were no changes in single joint kinematics or joint coupling variability during walking and running associated with the joint mobilization intervention. It can be concluded that joint mobilizations had a significant positive impact on patient-, and clinician-oriented measures of function. Though the laboratory measures did not detect any improvements, joint mobilizations did not produce deleterious effects on function. Therefore, future investigation on the effects of joint mobilization in conjunction with other, more active, rehabilitation strategies is warranted.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / An inversion ankle sprain can be defined as an injury caused by landing forcefully on an inverted, plantarflexed and internally rotated foot. This results in the fibres of the surrounding ligaments to become ruptured without disturbing the continuity of the ligament. Chronic stable ankle sprains was defined as the recurrent giving way of the ankle and there may be residual pain and swelling with no mechanical instability. According to literature, mechanisms involved in the development of chronic ankle sprains are: the lack of appropriate and early immobilization in severe cases, the development of scar tissue, lack of strengthening exercises or the development of hypermobility. Many treatments have been suggested to address these factors and would include: peripheral manipulation of the ankle joint, Muscle Energy Technique, muscle strengthening and stretching, proprioceptive training and deep transverse friction massage. Of the above mentioned treatments, Muscle Energy Technique has not been researched in a clinical setting for the treatment of chronic stable ankle inversion sprains. Therefore the purpose of this study was to investigate the relative effectiveness of Muscle Energy Technique compared to Manipulation in the treatment of chronic stable ankle inversion sprains. / M

No description available.

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

Thesis (Ph. D.)--Hong Kong Polytechnic University, 2003. / Includes bibliographical references (leaves 199-216). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (Ph. D.)--Hong Kong Polytechnic University, 2003. / Includes bibliographical references (leaves 199-216).

Submitted in partial fulfillment of the requirements for Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Background: Ankle sprains are a frequently occurring injury sustained by sports individuals accounting for approximately 20% to 40% of all sports injuries (DiStefano et al. 2008; LeBrun and Krause, 2005). Ankle sprains are mainly caused by excessive inversion (Takao et al., 2005; Andersen et al., 2004), when the foot is twisted inwards and lands at a high velocity damaging the lateral capsule-ligamentous complex (Beynnon et al., 2005). According to Naqvi, Cunningham and Lynch (2012) untreated or inappropriately managed ankle sprains can lead to a cascade of negative alteration to both the joint structures and the individual’s lifestyle. According to Hale, Hertel and Olmsted-Kramer (2007) 30% of ankle sprains result in chronic ankle instability (CAI) and 78% of the CAI cases develop into post-traumatic ankle osteoarthritis. This poses a negative impact on an individual’s athletic performance. Ankle sprains can be managed conservatively with the utilization of the PRICE protocol during the acute stage, cross friction massage or instrument assisted soft tissue mobilization techniques (for example Graston®, FAKTR© Concept) for both acute and subacute ankle sprains (Bleakley, 2010). Aim: The purpose of this study was to determine the effectiveness of a myofascial treatment protocol (FAKTR© Concept) combined with cryotherapy compared to cryotherapy and sham laser in the treatment of sub-acute and acute ankle inversion sprains. Objectives: 1. To determine the effectiveness of a myofascial treatment protocol combined with cryotherapy in terms of subjective (numerical pain rating scale [NRS] and foot function index [FFI]) and objective (oedema measurements [EDM], digital inclinometer readings [DIR], algometer readings [AR] and stork balance stand test score [STR]) measurements in the treatment of acute and sub-acute ankle sprains. 2. To determine the effectiveness of sham laser combined with cryotherapy in terms of subjective (NRS and FFI) and objective (EDM, DIR, AR and STR) measurements in the treatment of acute and sub-acute ankle sprains. 3. To compare the relative improvement between the two groups in terms of subjective (NRS and FFI) and objective measurement (EDM, DIR, AR and STR). Study design: This was a quantitative randomised controlled clinical trial. Methods: Forty participants with sub-acute or acute ankle sprains of not more than three weeks were recruited into the study. All participants had a full case history, physical, and foot and ankle regional examination to assess for their eligibility for entry into the study in terms of inclusion and exclusion criteria. These participants were randomly allocated using the hat method into one of two study groups, Group A (treatment group) or Group B. Participants in Group A received a myofascial treatment protocol (FAKTR© Concept) combined with cryotherapy and Group B received cryotherapy and sham laser. These participants had four treatments in two weeks where the appropriate treatment was administered. Pre-treatment subjective (NRS and FFI) and objective (EDM, DIR, AR and STR) measurements were taken at each consultation. This data was analysed using SPSS software version 24.0. Results: The General Linear Model for repeated measures was used for the intra- group and inter-group analysis of the data. Intra-group analysis of the FAKTR© treatment group showed that the group had statistically significant improvements in terms of the subjective and objective measurements of the study with the p-value < 0.05 between all treatment periods. Intra-group analysis of the control group showed no statistically significant improvements in terms of subjective and objective measurements of the study. Inter-group analysis showed no statistically significant difference in terms of the DIR and EDM. The NRS, AR, STR and FFI readings showed statistically significant differences between the two groups with a p-value of < 0.05 mainly on the last two consultations. Conclusion: This study concluded that the myofascial treatment protocol (FAKTR© Concept) combined with cryotherapy was more effective than cryotherapy and sham laser in the treatment of sub-acute and acute inversion ankle sprains. The FAKTR© Concept treatment group appeared to show statistically significant improvements compared to the control group.

O entorse de tornozelo está entre as lesões mais comuns durante as atividades esportivas. Apesar de extensas pesquisas clínicas e experimentais, a recorrência da lesão permanece alta. A prevenção do entorse de tornozelo só é possível uma vez que os fatores de risco forem identificados. Alterações no posicionamento do pé, déficits proprioceptivos, frouxidão mecânica lateral do tornozelo e déficits de força muscular são os possíveis fatores de risco para o entorse de tornozelo, mas os seus verdadeiros mecanismos ainda não estão esclarecidos. O entendimento desses mecanismos pode auxiliar os profissionais de saúde, principalmente os fisioterapeutas, a elaborar um programa de tratamento mais direcionado, levando a uma reabilitação mais eficaz. O objetivo deste estudo foi avaliar os fatores mecânicos e eletromiográficos associados ao entorse de tornozelo. Trinta e duas atletas de basquetebol e voleibol do gênero feminino (16.06±0.8 anos; 67.63±8.17 kg; 177.8±6.47 cm) participaram do estudo. As atletas foram separadas em dois grupos: um grupo controle, sem sintomas (29 tornozelos), e atletas que tinham sofrido entorse de tornozelo (29 tornozelos). A avaliação do alinhamento do retropé foi realizada por meio de fotogrametria, pelo programa SAPO® v.0.63, com as atletas em pé. A propriocepção, o torque passivo gerado pela resistência do movimento do tornozelo e a força muscular foram avaliados no dinamômetro isocinético Biodex®, e a atividade eletromiográfica de superfície pelo sistema Noraxon®. O senso de posição articular (15° inversão, 0°, 15° eversão), a cinestesia (2°/s, 4°/s, 10º/s) e o torque passivo (5°/s, 10º/s, 20°/s) foram avaliados durante os movimentos passivos de eversão e inversão. O torque eversor e inversor foi testado isometricamente (15° inversão, 0°, 15° eversão), concentricamente e excentricamente (60°/s, 180°/s, 300°/s), simultaneamente à medida do sinal eletromiográfico dos músculos fibular longo e tibial anterior. Os dados foram analisados pela ANOVA de dois e três fatores e teste post hoc Tukey. Os resultados mostraram que o alinhamento do retropé e o senso de posição não estão associados ao entorse de tornozelo em atletas do gênero feminino. Os resultados do grupo com entorse do tornozelo que indicaram diferenças significativas em relação ao grupo controle foram: atraso no tempo de percepção do movimento, menor torque passivo e menor torque isométrico e isocinético concêntrico. Além disso, a atividade eletromiográfica do músculo fibular longo e tibial anterior, durante o teste isocinético concêntrico, foi menor no grupo com entorse do tornozelo. Baseado nesses resultados, as atletas que tiveram entorse de tornozelo apresentaram déficits proprioceptivos, frouxidão mecânica e fraqueza muscular. / Ankle sprain are among the most common injuries during athletic activities. Despite extensive clinical and basic science research, the recurrence rate remains high. Prevention of ankle sprain is only possible once risk factors had been identified. Changes in foot positioning, impaired proprioception, mechanical lateral ankle laxity and muscle strength deficits are possible ankle sprain risk factors, but its real mechanisms remain unclear. Understanding such mechanisms will help health professionals, mainly physiotherapists, identify where to focus treatment efforts, leading to more effective rehabilitation. The aim of this study was to evaluate mechanical and electromyographic factors associated with ankle sprain. Thirty-two basketball and volleyball female athletes (16.06±0.8 years; 67.63±8.17 kg; 177.8±6.47 cm) participated in this study. Their ankles were divided into two groups: a symptom-free control group (29) and athletes who had suffered ankle sprain (29). Assessment of hindfoot alignment was performed by means of photogrammetry SAPO® v.0.63 software, with the athletes standing up. The proprioception, resistive torque at maximum passive ankle movement and muscle strength were assessed on the Biodex® isokinetic dynamometer and the surface electromyographic activity through the Noraxon® system. The joint position sense (15° inversion, 0°, 15° eversion), kinesthesia (2°/s, 4°/s, 10°/s) and resistive torque (5°/s, 10°/s, 20°/s), were evaluated during passive ankle inversion and eversion movements. Evertor and invertor torques were assessed isometrically (15° inversion, 0°, 15° eversion), concentrically and eccentrically (60°/s, 180°/s, 300°/s) measured simultaneously with electromyographic signal of peroneus longus and tibialis anterior muscles. The data were analyzed using 2 and 3-way ANOVA with Tukeys test for post hoc analysis. The results showed that the hindfoot alignment and the joint position sense were not associated with the ankle sprain in female athletes. The results of the ankle sprain group showed significant differences from the control group: delay in the time to detection passive motion, lower resistive torque and lower isometric and concentric torque. In addition, the electromyographic activity of peroneus longus and tibialis anterior muscles during isokinetic concentric test was lower in the ankle sprain group. Based on these results, the athletes who had ankle sprain have proprioceptives deficits, mechanical laxity and muscle weakness.

O entorse de tornozelo está entre as lesões mais comuns durante as atividades esportivas. Apesar de extensas pesquisas clínicas e experimentais, a recorrência da lesão permanece alta. A prevenção do entorse de tornozelo só é possível uma vez que os fatores de risco forem identificados. Alterações no posicionamento do pé, déficits proprioceptivos, frouxidão mecânica lateral do tornozelo e déficits de força muscular são os possíveis fatores de risco para o entorse de tornozelo, mas os seus verdadeiros mecanismos ainda não estão esclarecidos. O entendimento desses mecanismos pode auxiliar os profissionais de saúde, principalmente os fisioterapeutas, a elaborar um programa de tratamento mais direcionado, levando a uma reabilitação mais eficaz. O objetivo deste estudo foi avaliar os fatores mecânicos e eletromiográficos associados ao entorse de tornozelo. Trinta e duas atletas de basquetebol e voleibol do gênero feminino (16.06±0.8 anos; 67.63±8.17 kg; 177.8±6.47 cm) participaram do estudo. As atletas foram separadas em dois grupos: um grupo controle, sem sintomas (29 tornozelos), e atletas que tinham sofrido entorse de tornozelo (29 tornozelos). A avaliação do alinhamento do retropé foi realizada por meio de fotogrametria, pelo programa SAPO® v.0.63, com as atletas em pé. A propriocepção, o torque passivo gerado pela resistência do movimento do tornozelo e a força muscular foram avaliados no dinamômetro isocinético Biodex®, e a atividade eletromiográfica de superfície pelo sistema Noraxon®. O senso de posição articular (15° inversão, 0°, 15° eversão), a cinestesia (2°/s, 4°/s, 10º/s) e o torque passivo (5°/s, 10º/s, 20°/s) foram avaliados durante os movimentos passivos de eversão e inversão. O torque eversor e inversor foi testado isometricamente (15° inversão, 0°, 15° eversão), concentricamente e excentricamente (60°/s, 180°/s, 300°/s), simultaneamente à medida do sinal eletromiográfico dos músculos fibular longo e tibial anterior. Os dados foram analisados pela ANOVA de dois e três fatores e teste post hoc Tukey. Os resultados mostraram que o alinhamento do retropé e o senso de posição não estão associados ao entorse de tornozelo em atletas do gênero feminino. Os resultados do grupo com entorse do tornozelo que indicaram diferenças significativas em relação ao grupo controle foram: atraso no tempo de percepção do movimento, menor torque passivo e menor torque isométrico e isocinético concêntrico. Além disso, a atividade eletromiográfica do músculo fibular longo e tibial anterior, durante o teste isocinético concêntrico, foi menor no grupo com entorse do tornozelo. Baseado nesses resultados, as atletas que tiveram entorse de tornozelo apresentaram déficits proprioceptivos, frouxidão mecânica e fraqueza muscular. / Ankle sprain are among the most common injuries during athletic activities. Despite extensive clinical and basic science research, the recurrence rate remains high. Prevention of ankle sprain is only possible once risk factors had been identified. Changes in foot positioning, impaired proprioception, mechanical lateral ankle laxity and muscle strength deficits are possible ankle sprain risk factors, but its real mechanisms remain unclear. Understanding such mechanisms will help health professionals, mainly physiotherapists, identify where to focus treatment efforts, leading to more effective rehabilitation. The aim of this study was to evaluate mechanical and electromyographic factors associated with ankle sprain. Thirty-two basketball and volleyball female athletes (16.06±0.8 years; 67.63±8.17 kg; 177.8±6.47 cm) participated in this study. Their ankles were divided into two groups: a symptom-free control group (29) and athletes who had suffered ankle sprain (29). Assessment of hindfoot alignment was performed by means of photogrammetry SAPO® v.0.63 software, with the athletes standing up. The proprioception, resistive torque at maximum passive ankle movement and muscle strength were assessed on the Biodex® isokinetic dynamometer and the surface electromyographic activity through the Noraxon® system. The joint position sense (15° inversion, 0°, 15° eversion), kinesthesia (2°/s, 4°/s, 10°/s) and resistive torque (5°/s, 10°/s, 20°/s), were evaluated during passive ankle inversion and eversion movements. Evertor and invertor torques were assessed isometrically (15° inversion, 0°, 15° eversion), concentrically and eccentrically (60°/s, 180°/s, 300°/s) measured simultaneously with electromyographic signal of peroneus longus and tibialis anterior muscles. The data were analyzed using 2 and 3-way ANOVA with Tukeys test for post hoc analysis. The results showed that the hindfoot alignment and the joint position sense were not associated with the ankle sprain in female athletes. The results of the ankle sprain group showed significant differences from the control group: delay in the time to detection passive motion, lower resistive torque and lower isometric and concentric torque. In addition, the electromyographic activity of peroneus longus and tibialis anterior muscles during isokinetic concentric test was lower in the ankle sprain group. Based on these results, the athletes who had ankle sprain have proprioceptives deficits, mechanical laxity and muscle weakness.