Acute Lateral Ankle Sprain: A Laboratory Analysis

Lateral Ankle Sprain
September 24, 2015
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Evidence-Based Practice – Issue 8-2015

Dynamic Balance Deficits 6 Months Following First-Time Acute Lateral Ankle Sprain: A Laboratory Analysis

Article.  Doherty C, et al. Dynamic Balance Deficits 6 Months Following First-Time Acute Lateral Ankle Sprain: A Laboratory analysis.  Journal of Orthopaedic and Sports Physical Therapy 2015; 45(8):  626-633.

Purpose.  The purpose of this study was to compare kinematic and stabilometric measures during the star excursion balance test among patients 6 months after sustaining a first-time acute lateral ankle sprain versus healthy controls.

Study Design.  Descriptive laboratory study.

Methods

  • Subjects
    • 69 participants 6 months following an acute lateral ankle sprain
    • 20 healthy non-injured controls
      • No statistical difference in age, height, or weight of the two groups
  • Data Collection
    • Cumberland Ankle Instability Tool
    • Foot and Ankle Ability Measure
    • Range of Motion
      • Dorsiflexion (knee to wall test- angle of tibia at maximum closed chain dorsiflexion)
    • Star Excursion Balance Test Reach Distances
      • Anterior
      • Posterolateral
      • Posteromedial
    • Kinematics
      • Sagittal Plane hip, knee, and ankle position during Start Excursion Balance Test
    • Kinetics
      • Center of Pressure with platform stabilometry during Star Excursion Balance Test
Star Excursion Balance Test

Figure 1.  Lab set up for the star excursion balance test

Results

  • No difference in ankle dorsiflexion between groups
  • Participants with previous ankle sprain have lower scores on all 3 reach distances

Balance Excursion Test Results

  • The lateral ankle sprain group exhibited less knee and hip flexion during all three reach directions.  

Balance Excursion Results 2

  • The lateral ankle sprain group exhibited lower fractal dimension of the center of pressure

Clinical Relevance

  • The fractal dimension of the center of gravity suggests that patients following lateral ankle sprains are less effective in establishing base of support for all reach directions.  
  • Participants 6 months after an acute lateral sprain demonstrate dynamic balance deficits on their injured and uninjured limbs on the star excursion balance test.  
  • Clinicians should implement treatment programs to improve and normalize balance deficits following an ankle sprain.
  • Balance impairments may contribute to chronicity of ankle instability.