Context: A dynamic postural-control task that has gained notoriety in the clinical and research settings is the Star Excursion Balance Test (SEBT). Researchers have suggested that, with appropriate instruction and practice by the individual and normalization of the reaching distances, the SEBT can be used to provide objective measures to differentiate deficits and improvements in dynamic postural-control related to lower extremity injury and induced fatigue, and it has the potential to predict lower extremity injury. However, no one has reviewed this body of literature to determine the usefulness of the SEBT in clinical applications. Objective: To provide a narrative review of the SEBT and its implementation and the known contributions to task performance and to systematically review the associated literature to address the SEBT's usefulness as a clinical tool for the quantification of dynamic postural-control deficits from lower extremity impairment. Data Sources: Databases used to locate peer-reviewed a...

/pdf/using-the-star-excursion-balance-test-to-assess-dynamic-504v3a7uet.pdf

Using the Star Excursion Balance Test to Assess Dynamic Postural-Control Deficits and Outcomes in Lower Extremity Injury: A Literature and Systematic Review

While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant/patient selection criteria across studies presents a potential obstacle to addressing the problem properly. This major gap within the literature limits the ability to generalise this evidence to the target patient population. Therefore, there is a need to provide standards for patient/participant selection criteria in research focused on CAI with justifications using the best available evidence. The International Ankle Consortium provides this position paper to present and discuss an endorsed set of selection criteria for patients with CAI based on the best available evidence to be used in future research and study designs. These recommendations will enhance the validity of research conducted in this clinical population with the end goal of bringing the research evidence to the clinician and patient.

/pdf/selection-criteria-for-patients-with-chronic-ankle-1w1ohnft89.pdf

Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the international ankle consortium

Sensorimotor deficits with ankle sprains and chronic ankle instability.

DELAHUNT, E., G. F. COUGHLAN, B. CAULFIELD, E. J. NIGHTINGALE, C.-W. C. LIN, and C. E. HILLER. Inclusion CriteriaWhen Investigating Insufficiencies in Chronic Ankle Instability. Med. Sci. Sports Exerc., Vol. 42, No. 11, pp. 2106–2121, 2010.Introduction: The development of chronic ankle instability (CAI) is the primary residual deficit after ankle joint sprain. It has beenproposed that CAI is characterized by two entities, namely, mechanical instability and functional instability. Each of these entities inturn is composed of various insufficiencies. Research of functional insufficiencies to date has shown large variances in results. Oneparticular reason for this could be discrepancies in inclusion criteria and definitions between CAI, mechanical instability, and functionalinstability used in the literature. Thus, we endeavored to undertake a systematic investigation of those studies published in the area ofCAI to identify if there is a large discrepancy in inclusion criteria across studies. Methods: A systematic search of the followingdatabases was undertaken to identify relevant studies: Cochrane Central Register of Controlled Trials, PubMed, CINAHL, SportDiscus,PEDro, and AMED. Results: The results of this study indicate that there is a lack of consensus across studies regarding what actuallyconstitutes ankle instability. Furthermore, it is evident that the majority of studies use very different inclusion criteria, which leads to anonhomogenous population and to difficulties when comparing results across studies. Conclusions: Future studies should endeavor tobe specific with regard to the exact inclusion criteria being used. Particular emphasis should be given to issues such as the number ofprevious ankle sprains reported by each subject and how often and during which activities episodes of ‘‘giving way’’ occur as well asthe presence of concomitant symptoms such as pain and weakness. We recommend that authors use one of the validated tools fordiscriminating the severity of CAI. Furthermore, we have provided a list of operational definitions and key criteria to be specified whenreporting on studies with CAI subjects. Key Words: ANKLE SPRAIN, INJURY, SYSTEMATIC INVESTIGATION, FUNCTIONALINSTABILITY, MECHANICAL INSTABILITY

Inclusion criteria when investigating insufficiencies in chronic ankle instability.

Lateral ankle sprains (LASs) are the most prevalent musculoskeletal injury in physically active populations. They also have a high prevalence in the general population and pose a substantial healthcare burden. The recurrence rates of LASs are high, leading to a large percentage of patients with LAS developing chronic ankle instability. This chronicity is associated with decreased physical activity levels and quality of life and associates with increasing rates of post-traumatic ankle osteoarthritis, all of which generate financial costs that are larger than many have realised. The literature review that follows expands this paradigm and introduces emerging areas that should be prioritised for continued research, supporting a companion position statement paper that proposes recommendations for using this summary of information, and needs for specific future research.

/pdf/evidence-review-for-the-2016-international-ankle-consortium-d3scpa5ig9.pdf

Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains.

Background: The development of repetitive ankle sprains and persistent symptoms after initial ankle sprain has been termed chronic ankle instability (CAI). There is no clear indication of which mea...

https://etda.libraries.psu.edu/files/final_submissions/6180

Contributing factors to chronic ankle instability.

Context: Although dozens of individual mechanical and functional insufficiencies have been reported in those with chronic ankle instability (CAI), no authors to date have examined the relationship of the insufficiencies to each other. Therefore, studying both the functional and mechanical insufficiencies in the same experimental design will provide valuable information. Objective: To determine the relationships among the numerous functional and mechanical insufficiencies purported to cause CAI. Design: Descriptive study with a correlational design. Setting: Medical center and research laboratory. Patients or Other Participants: Thirty subjects with unilateral CAI (15 males and 15 females: age 20.3 1.3 years; height 172.5 10.7 cm; mass 72.9 15.8 kg). Main Outcome Measure(s): Twenty-six measures of mechanical insufficiencies (ankle laxity and hypomobility) and functional insufficiencies (subjective level of function, static and dynamic balance, ankle and hip strength) were taken on both limbs of all subjects. Bivariate correlations using Pearson product moment coefficients were calculated between all dependent variables measured in the unstable ankles. The level of significance was set a priori at P .05 for all analyses. Results: A number (35) of significant bivariate correlations were identified. Most (32) of these significant relationships were found between functional instability measures (r .38 to .96). Three significant relationships were noted between measures of functional (balance, strength) and mechanical (laxity, hypomobility) instability (r .47 to .52). No significant relationships were found between the different mechanical instability measures. Conclusions: Certain measures of functional instability were significantly correlated and may be redundant. Additionally, the significant correlations between measures of functional (balance, strength) and mechanical instability (laxity, hypomobility) demonstrate that the 2 factors are not completely dichotomous and need to be examined together.

Correlations among multiple measures of functional and mechanical instability in subjects with chronic ankle instability.

AIM: Little is known about the association of lower extremity structural malalignments, flexibility patterns, generalized laxity, postural control, previous ankle sprain history and the increased risk of anterior cruciate ligament (ACL) injuries in females We hypothesized that females with a history of ACL injury would be more likely to have a history of prior ankle sprain and different structural alignments than females without a history of ACL injury METHODS: It is a case control study: 33 young adult females with a history of an ACL injury and 33 controls with no history of knee injury provided their knee and ankle injury history and had 16 lower extremity measures taken RESULTS: The factors most associated with ACL injury history were greater generalized laxity (r(2) change: 0073), greater genu recurvatum (r(2) change: 0069), and decreased iliotibial band (ITB) flexibility (r(2) change: 0069) There was also a significant association between ACL injury history and previous ankle sprain injury history (chi squared=527; P=002) Those with a history of ACL injury were more likely to have had a prior ipsilateral ankle sprain CONCLUSION: Increased generalized laxity, greater genu recurvatum, and decreased ITB flexibility discriminated between females with and without history of ACL injury A relationship linking previous ankle injury and ACL injury risk was found Taking a thorough medical history and screening for generalized laxity, genu recurvatum, and a tight ITB in those with a history of LAS, may help identify those at risk for an ACL injury and who may benefit most from preventive measures Language: en

Lauren C. Kramer

Papers

Contributing factors to chronic ankle instability.

Correlations among multiple measures of functional and mechanical instability in subjects with chronic ankle instability.

Factors associated with anterior cruciate ligament injury: history in female athletes.