Ankle Joint

ObjectiveThis study conducts a rigorous meta-analysis of existing literature to rigorously examine the efficacy of Proprioceptive Neuromuscular Facilitation (PNF) in ameliorating functional deficits associated with Chronic Ankle Instability (CAI).MethodsLiterature searches were conducted in multiple databases including China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biology Medicine disc (CBM), PubMed, EBSCO (Medline, CINAHL, SPORTDiscus, and Rehabilitation & Sports Medicine Source), Embase, ScienceDirect, ProQuest, Cochrane Library, and Web of Science for randomized controlled trials assessing the effects of Proprioceptive Neuromuscular Facilitation interventions on patients with Chronic Ankle Instability. The publication timeframe spanned from the inception of each database until April 10, 2024. Meta-analysis was performed using STATA 12 software on the included studies.Results① A total of 12 randomized controlled trials were included, encompassing 405 patients with Chronic Ankle Instability, demonstrating a generally high methodological quality of the literature.② Meta-analysis results indicate that compared to the control group, Proprioceptive Neuromuscular Facilitation (PNF) significantly enhanced the balance ability of patients with Chronic Ankle Instability as measured by the Y Balance Test (YBT) (Weighted Mean Difference (WMD) = 3.61, 95% CI [2.65, 4.56], z = 7.42, P0.05), however, the effects of PNF training persisted for a certain period even after cessation of treatment.ConclusionProprioceptive Neuromuscular Facilitation (PNF) can significantly improve balance, muscle strength, and pain in patients with Chronic Ankle Instability (CAI). While PNF has shown improvements in joint position sense and dorsiflexion range of motion for CAI patients, with effects that remain for a period thereafter, these improvements were not significantly different when compared to the control group. Further research is required to substantiate these specific effects.

Lateral ankle sprains are one of the most common musculoskeletal injuries. Up to 70% of individuals who sustain lateral ankle sprains develop chronic ankle instability (CAI). Exercise therapy is considered an effective treatment for patients with CAI. This meta-analysis investigated the efficacy of exercise therapy in CAI patients by reviewing 15 randomized controlled trials (RCTs) involving 586 participants. Databases including PubMed, EMBASE, Cochrane Library, and Web of Science were searched from inception to September 13, 2024. The Cochrane Risk of Bias Tool was used to assess study quality. Meta-analysis, sensitivity analysis, and publication bias analysis were conducted using RevMan 5.3.0 and Stata 18.0 software. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was applied to evaluate the quality of evidence. Main outcomes were assessed using the Foot and Ankle Ability Measure (FAAM) and the Star Excursion Balance Test (SEBT). The results demonstrated that exercise therapy significantly improved FAAM-S (MD = 7.98, CI: 4.11 to 11.86, p < 0.0001, I² = 30%). Long-term exercise therapy (over 4 weeks) significantly enhanced FAAM-A (MD = 10.95, CI: 6.60 to 15.29, p < 0.00001, I² = 0%) and dynamic balance ability of ankle joint (SBET-A: MD = 4.83, CI: 1.04 to 8.63, p = 0.01, I² = 62%; SEBT-PM: MD = 6.93, CI: 2.37 to 11.48, p = 0.003, I² = 69%; and SEBT-PL: MD = 8.98, CI: 2.66 to 15.29, p = 0.005, I² = 86%). After categorizing by exercise type, the results indicated that strength training was more effective in improving SEBT-PL (MD = 8.15, CI: 6.09 to 10.21, p < 0.00001, I² = 0%), joint mobilization was more effective in improving SEBT-A (MD = 7.65, CI: 4.93 to 10.37, p < 0.00001, I² = 0%), and proprioceptive training was more effective in improving SEBT-PM (MD = 10.46, CI: 5.27 to 15.65, p < 0.0001, I² = 33%). In conclusion, long-term, multifaceted exercise therapy demonstrates superior rehabilitation efficacy for patients with CAI. Personalized treatment plans, informed by SEBT assessment results, should prioritize targeted interventions such as joint mobilization, strength training, or proprioceptive training. This approach holds significant theoretical and practical value for optimizing CAI treatment strategies and enhancing patient outcomes.

During fatigued conditions, badminton players may experience adverse effects on their ankle joints during smash landings. In addition, the risk of ankle injury may vary with different landing strategies. This study aimed to investigate the influence of sport-specific fatigue factors and two backhand smash actions on ankle biomechanical indices. Thirteen female badminton players (age: 21.2 ± 1.9 years; height: 167.1 ± 4.1 cm; weight: 57.3 ± 5.1 kg; BMI: 20.54 ± 1.57 kg/m2) participated in this study. An 8-camera Vicon motion capture system and three Kistler force platforms were used to collect kinematic and kinetic data before and after fatigue for backhand rear-court jump smash (BRJS) and backhand lateral jump smash (BLJS). A 2 × 2 repeated measures analysis of variance was employed to analyze the effects of these smash landing actions and fatigue factors on ankle biomechanical parameters. Fatigue significantly affected the ankle-joint plantarflexion and inversion angles at the initial contact (IC) phase (p < 0.05), with both angles increasing substantially post-fatigue. From a kinetic perspective, fatigue considerably influenced the peak plantarflexion and peak inversion moments at the ankle joint, which resulted in a decrease the former and an increase in the latter after fatigue. The two smash landing actions demonstrated different landing strategies, and significant main effects were observed on the ankle plantarflexion angle, inversion angle, peak dorsiflexion/plantarflexion moment, peak inversion/eversion moment, and peak internal rotation moment (p < 0.05). The BLJS landing had a much greater landing inversion angle, peak inversion moment, and peak internal rotation moment compared with BRJS landing. The interaction effects of fatigue and smash actions significantly affected the muscle force of the peroneus longus (PL), with a more pronounced decrease in the force of the PL muscle post-fatigue in the BLJS action(post-hoc < 0.05). This study demonstrated that fatigue and smash actions, specifically BRJS and BLJS, significantly affect ankle biomechanical parameters. After fatigue, both actions showed a notable increase in IC plantarflexion and inversion angles and peak inversion moments, which may elevate the risk of lateral ankle sprains. Compared with BRJS, BLJS poses a higher risk of lateral ankle sprains after fatigue.

BackgroundChronic ankle instability (CAI) is linked to impaired dynamic balance and psychological deficits, potentially hindering optimal rehabilitation outcomes. However, the impact of psychological deficits on dynamic balance has not been explored before. Therefore, the aim of this study is to determine whether mental health factors predict dynamic balance performance in individuals with CAI using the Star Excursion Balance Test (SEBT).MethodsThis is a cross-sectional observational study performed in a university setting. Forty individuals with CAI (17 men, 23 women) participated in this study. Assessments included psychological profiles (kinesiophobia, self-reported mental health, self-efficacy, global mental health, and functional status via FAAM-Sport). Dynamic balance was evaluated using the SEBT composite and directional scores.ResultsMultiple linear regression analyses indicated that the SEBT composite score was significantly predicted by self-efficacy, global mental health and TSK-11, explaining 40% of the variance (F-value = 7.82, p ConclusionsThe findings underscore the importance of psychological factors as key predictors of dynamic balance in CAI. Incorporating mental health assessments into physical rehabilitation may enhance treatment outcomes for individuals with CAI.