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Proximal Adaptations in Chronic Ankle Instability: Systematic Review and Meta-analysis
Alexandra F Dejong1, Rachel M Koldenhoven2, Jay Hertel1
1University of Virginia Exercise and Sports Injury Laboratory, Charlottesville, VA.
Medicine and Science in Sports and Exercise
|January 25, 2020
Summary
Chronic ankle instability (CAI) leads to hip strength deficits and altered knee movement during jumping. These findings suggest clinicians should assess and treat proximal areas in CAI patients.
Area of Science:
- Biomechanics
- Neuromuscular control
- Sports medicine
Background:
- Chronic ankle instability (CAI) impacts the entire lower kinetic chain.
- Proximal adaptations in the trunk, hip, thigh, and knee are not well-synthesized.
- Understanding these adaptations is crucial for effective CAI management.
Purpose of the Study:
- To systematically review and meta-analyze neuromuscular and biomechanical outcomes in the trunk, hip, thigh, and knee of CAI patients.
- To compare these outcomes during functional assessments against healthy individuals.
- To synthesize existing data on proximal adaptations in CAI.
Main Methods:
- Searched CINAHL and MEDLINE/PubMed databases up to June 3, 2019.
- Included studies comparing trunk, hip, thigh, or knee outcomes in CAI vs. healthy groups.
- Conducted random effects meta-analyses for consistent outcome measures.
Main Results:
- CAI patients exhibited significantly decreased triplanar isometric hip strength (P < 0.001).
- No significant differences in knee kinematics were found during dynamic balance tests (P = 0.26).
- Limited evidence suggested altered knee kinematics during jumping tasks in CAI.
Conclusions:
- CAI is associated with triplanar hip strength deficits.
- Altered knee flexion angles during jumping were observed in CAI groups.
- Clinicians should consider proximal assessments and interventions for CAI management.
