Int J Sports Med 2015; 36(12): 1027-1032
DOI: 10.1055/s-0035-1550046
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

The Effect of Lateral Ankle Ligament Repair in Muscle Reaction Time in Patients with Mechanical Ankle Instability

H.-Y. Li
1   Department of Sports Medicine and Arthroscopy Surgery, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
,
J.-J. Zheng
2   Department of Rehabilitation Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, China
,
J. Zhang
1   Department of Sports Medicine and Arthroscopy Surgery, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
,
Y.-H. Hua
3   Department of Sports Medicine, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
,
S.-Y. Chen
1   Department of Sports Medicine and Arthroscopy Surgery, Sports Medicine Center of Fudan University, Huashan Hospital, Shanghai, China
› Author Affiliations
Further Information

Publication History



accepted after revision 20 April 2015

Publication Date:
24 July 2015 (online)

Abstract

Studies have shown that functional ankle instability can result in prolonged muscle reaction time. However, the deficit in muscle reaction time in patients with mechanical ankle instability (MAI) and the effect of lateral ankle ligament repair on muscle reaction time are unclear. The purpose of this study was to identify the deficit in muscle reaction time, and to evaluate the role of lateral ligament repair in improving muscle reaction time in MAI patients. Sixteen MAI patients diagnosed with lateral ankle ligament tears by ultrasonography and magnetic resonance imaging underwent arthroscopic debridement and open lateral ankle ligament repair with a modified Broström procedure. One day before the operation, reaction times of the tibialis anterior and peroneus longus muscles were recorded following sudden inversion perturbation while walking on a custom walkway, and anterior drawer test (ADT) and American Orthopaedic Foot and Ankle Society (AOFAS) scale score were evaluated. Six months postoperatively, muscle reaction time, ADT and AOFAS scale score were reevaluated, and muscle reaction times in 15 healthy controls were also recorded. Preoperatively, the affected ankles in the MAI group had significantly delayed tibialis anterior and peroneus longus muscles reaction times compared with controls. Six months after the operation, median AOFAS scale scores were significantly greater than preoperatively, and ADT was negative in the MAI group. However, the affected ankles in the MAI group showed no difference in muscle reaction time compared with preoperative values. MAI patients had prolonged muscle reaction time. The modified Broström procedure produced satisfactory clinical outcomes in MAI patients, but did not shorten reaction times of the tibialis anterior and peroneus longus muscles.

 
  • References

  • 1 Chen H, Li HY, Zhang J, Hua YH, Chen SY. Difference in postural control between patients with functional and mechanical ankle instability. Foot Ankle Int 2014; 35: 1068-1074
  • 2 Cordova ML, Cardona CV, Ingersoll CD, Sandrey MA. Long-term ankle brace use does not affect peroneus longus muscle latency during sudden inversion in normal subjects. J Athl Train 2000; 35: 407-411
  • 3 Delahunt E, Coughlan GF, Caulfield B, Nightingale EJ, Lin CW, Hiller CE. Inclusion criteria when investigating insufficiencies in chronic ankle instability. Med Sci Sports Exerc 2010; 42: 2106-2121
  • 4 Fernandes N, Allison GT, Hopper D. Peroneal latency in normal and injured ankles at varying angles of perturbation. Clin Orthop Relat Res 2000; 375: 193-201
  • 5 Gehring D, Faschian K, Lauber B, Lohrer H, Nauck T, Gollhofer A. Mechanical instability destabilises the ankle joint directly in the ankle-sprain mechanism. Br J Sports Med 2014; 48: 377-382
  • 6 Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F, Fong DT, Hertel J, Hiller C, Kaminski T, McKeon P, Refshauge K, van der Wees P, Vincenzino B, Wikstrom E. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med 2014; 48: 1014-1018
  • 7 Halasi T, Kynsburg A, Tállay A, Berkes I. Changes in joint position sense after surgically treated chronic lateral ankle instability. Br J Sports Med 2005; 39: 818-824
  • 8 Harriss DJ, Atkinson G. Ethical standards in sports and exercise science research: 2014 update. Int J Sports Med 2013; 34: 1025-1028
  • 9 Hertel J. Functional instability following lateral ankle sprain. Sports Med 2000; 29: 361-371
  • 10 Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 2002; 37: 364-375
  • 11 Hoch MC, McKeon PO. Peroneal reaction time after ankle sprain: a systematic review and meta-analysis. Med Sci Sports Exerc 2014; 46: 546-556
  • 12 Hopkins JT, Brown TN, Christensen L, Palmieri-Smith RM. Deficits in peroneal latency and electromechanical delay in patients with functional ankle instability. J Orthop Res 2009; 27: 1541-1546
  • 13 Hopper D, Allison G, Fernandes N, O’Sullivan L, Wharton A. Reliability of the peroneal latency in normal ankles. Clin Orthop Relat Res 1998; 350: 159-165
  • 14 Hua Y, Chen S, Li Y, Chen J, Li H. Combination of modified Broström procedure with ankle arthroscopy for chronic ankle instability accompanied by intra-articular symptoms. Arthroscopy 2010; 26: 524-528
  • 15 Hua Y, Yang Y, Chen S, Cai Y. Ultrasonography examination for the diagnosis of chronic anterior talofibular ligament injury. Acta Radiol 2012; 53: 1142-1145
  • 16 Hubbard TJ, Hertel J. Mechanical contributions to chronic lateral ankle instability. Sports Med 2006; 36: 263-277
  • 17 Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. J Foot Ankle Surg 2007; 46: 65-74
  • 18 Johnson MB, Johnson CL. Electromyographic response of peroneal muscles in surgical and nonsurgical injured ankles during sudden inversion. J Orthop Sports Phys Ther 1993; 18: 497-501
  • 19 Keles SB, Sekir U, Gur H, Akova B. Eccentric/concentric training of ankle evertor and dorsiflexors in recreational athletes: Muscle latency and strength. Scand J Med Sci Sports 2014; 24: e29-e38
  • 20 Kernozek T, Durall CJ, Friske A, Mussallem M. Ankle bracing, plantar-flexion angle, and ankle muscle latencies during inversion stress in healthy participants. J Athl Train 2008; 43: 37-43
  • 21 Knight AC, Weimar WH. Difference in response latency of the peroneus longus between the dominant and nondominant legs. J Sport Rehabil 2011; 20: 321-332
  • 22 Konradsen L, Olesen S, Hansen HM. Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. Am J Sports Med 1998; 26: 72-77
  • 23 Konradsen L, Ravn JB, Sørensen AI. Proprioception at the ankle: The effect of anaesthetic blockade of ligament receptors. J Bone Joint Surg Br 1993; 75: 433-436
  • 24 Konradsen L, Voigt M, Højsgaard C. Ankle inversion injuries. The role of the dynamic defense mechanism. Am J Sports Med 1997; 25: 54-58
  • 25 Linford CW, Hopkins JT, Schulthies SS, Freland B, Draper DO, Hunter I. Effects of neuromuscular training on the reaction time and electromechanical delay of the peroneus longus muscle. Arch Phys Med Rehabil 2006; 87: 395-401
  • 26 Midgley W, Hopkins JT, Feland B, Kaiser D, Merrill G, Hunter I. The effects of external ankle support on dynamic restraint characteristics of the ankle in volleyball players. Clin J Sport Med 2007; 17: 343-348
  • 27 Mitchell A, Dyson R, Hale T, Abraham C. Biomechanics of ankle instability. Part 1: Reaction time to simulated ankle sprain. Med Sci Sports Exerc 2008; 40: 1515-1521
  • 28 Mitchell A, Dyson R, Hale T, Abraham C. Biomechanics of ankle instability. Part 2: Postural sway-reaction time relationship. Med Sci Sports Exerc 2008; 40: 1522-1528
  • 29 Myers JB, Riemann BL, Hwang JH, Fu FH, Lephart SM. Effect of peripheral afferent alteration of the lateral ankle ligaments on dynamic stability. Am J Sports Med 2003; 31: 498-506
  • 30 Nakazawa K, Kawashima N, Akai M, Yano H. On the reflex coactivation of ankle flexor and extensor muscles induced by a sudden drop of support surface during walking in humans. J Appl Physiol 2004; 96: 604-611
  • 31 Oae K, Takao M, Uchio Y, Ochi M. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging. Skeletal Radiol 2010; 39: 41-47
  • 32 O’Loughlin PF, Murawski CD, Egan C, Kennedy JG. Ankle instability in sports. Phys Sportsmed 2009; 37: 93-103
  • 33 Osborne MD, Chou LS, Laskowski ER, Smith J, Kaufman KR. The effect of ankle disk training on muscle reaction time in subjects with a history of ankle sprain. Am J Sports Med 2001; 29: 627-632
  • 34 Palmieri-Smith RM, Hopkins JT, Brown TN. Peroneal activation deficits in persons with functional ankle instability. Am J Sports Med 2009; 37: 982-988
  • 35 Petrera M, Dwyer T, Theodoropoulos JS, Ogilvie-Harris DJ. Short- to medium-term outcomes after a modified Broström repair for lateral ankle instability with immediate postoperative weightbearing. Am J Sports Med 2014; 42: 1542-1548
  • 36 Santos MJ, Liu H, Liu W. Unloading reactions in functional ankle instability. Gait Posture 2008; 27: 589-594
  • 37 Sheth P, Yu B, Laskowski ER, An KN. Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med 1997; 25: 538-543
  • 38 Sinkjaer T, Andersen JB, Ladouceur M, Christensen LO, Nielsen JB. Major role for sensory feedback in soleus EMG activity in the stance phase of walking in man. J Physiol 2000; 523 pt3: 817-827
  • 39 Ty Hopkins J, McLoda T, McCaw S. Muscle activation following sudden ankle inversion during standing and walking. Eur J Appl Physiol 2007; 99: 371-378
  • 40 Vaes P, Duquet W, Van Gheluwe B. Peroneal reaction times and eversion motor response in healthy and unstable ankles. J Athl Train 2002; 37: 475-480
  • 41 van Dijk CN, Mol BW, Lim LS, Marti RK, Bossuyt PM. Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma. Acta Orthop Scand 1996; 67: 566-570
  • 42 Wainright WB, Spritzer CE, Lee JY, Easley ME, DeOrio JK, Nunley JA, DeFrate LE. The effect of modified Broström-Gould repair for lateral ankle instability on in vivo tibiotalar kinematics. Am J Sports Med 2012; 40: 2099-2104
  • 43 Witchalls J, Blanch P, Waddington G, Adams R. Intrinsic functional deficits associated with increased risk of ankle injuries: a systematic review with meta-analysis. Br J Sports Med 2012; 46: 515-523