Amy Donohoe sPT, William Fogarty sPT, Maddison Grogan sPT ...
Undergraduate Category: Health Sciences Degree Level: BS Rehab Science/Doctor of Physical Therapy Abstract ID#648
An Approach to Intervene Chronic Ankle Instability through Error Augmenta9on Amy Donohoe sPT, William Fogarty sPT, Maddison Grogan sPT, Benjamin Rose sPT, KrisOna Simberg BS sPT Mentor: Sheng-‐Che Yen, PT, PhD Results: Subjects showed a significant increase in ankle eversion during walking. This Mo9va9on: Ankle sprains are one of the most common orthopedic injuries, 1 with 1 in 10,000 people suffering an ankle sprain daily . This equates to roughly increase persisted even aVer the weight was removed. There were no significant 23,000 ankle sprains per day, 85% of which are lateral ankle sprains2. Up to 70% findings in dorsiflexion. of individuals who have an ankle sprain report developing chronic ankle 1 instability or CAI. A significant problem in paOents with CAI is recurrent ankle sprains due to acquired motor control deficits.
A
Pre-‐Landing
* * * *
3
Inversion
Eversion
-‐2
2
-‐4
Dorsiflexion
1 0 -‐1
Plantarflexion
-‐2 -‐3 -‐4 -‐5
-‐6 Baseline
Early AdaptaOon
Late AdaptaOon
Early Post AdaptaOon
Late Post AdaptaOon
-‐6 Baseline
B
Early AdaptaOon
Late AdaptaOon
Post-‐Landing
Early Post AdaptaOon
8
6
* * * *
4 2 0 -‐2
4
Inversion
Eversion
Sagical Plane Angle (deg)
6
-‐4
Dorsiflexion
2
0
Plantarflexion
-‐2
-‐4
-‐6 Baseline
C
Early AdaptaOon
Late AdaptaOon
Early Post AdaptaOon
-‐6
Late Post AdaptaOon
Baseline
Late AdaptaOon
Early Post AdaptaOon
Late Post AdaptaOon
Pre-‐landing
20
4
Inversion
2 0 -‐2
Eversion
-‐4 -‐6 -‐8
Stance
15 10
0
Plantarflexion
-‐5 -‐10
-‐14
Dorsiflexion
5
Swing
-‐12
Baseline
Early AdaptaOon
Post-‐landing
Pre-‐landing
Post-‐landing
-‐10
Stance
Swing
-‐15 Early AdaptaOon
Late AdaptaOon
Early Post AdaptaOon
Late Post AdaptaOon
Baseline
Early AdaptaOon
Late AdaptaOon
Conclusions: The results provide evidence to support that our error driven approach is feasible to correct abnormal ankle posiOoning during walking. This approach can induce both feed forward and backward control, which directly addresses the deficits shown in the CAI populaOon(3). We believe that there was no change in dorsiflexion angles as a result of increased isometric firing of the preObials. The primary limitaOon for this study is the placing of the weight on the foot, as the opOmal placement is unknown. Further studies need to be performed to analyze whether or not this approach is effecOve on subjects who have CAI. References: 1. McKeon PO, Macacola CG. IntervenOons for the PrevenOon of First Time and Recurrent Ankle Sprains. Clinics in Sports Medicine. 2008; 27: 371-‐382. 2. Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. American Journal of Sports Medicine. 1977; 5: 241-‐2. 3. Delahunt E, Monaghan K, Caulfield B. Altered neuromuscular control and ankle joint kinemaOcs during walking in subjects with funcOonal instability of the ankle joint. American Journal of Sports Medicine. 2006; 34:1970-‐1976.
Late Post AdaptaOon
Post-‐Landing
Sagical Plane Angle (deg)
1-‐lb sandbag
0
Frontal Plane Angle (deg)
Approach: Healthy subjects were included in this study. A one-‐pound sandbag was placed on the lateral side of the right foot to amplify error signal while they walked on a treadmill. The ankle kinemaOcs before, during, and aVer walking with the weight was recorded and analyzed using a 3D moOon capture system.
2
Frontal Plane Angle (deg)
Problem statement: The purpose of this study was to examine the feasibility of an error-‐driven approach to reduce the risk of recurrent ankle sprains through correcOon of abnormal ankle posiOoning during ambulaOon. Specifically, we tested if an inversion directed force could induce a detectable error causing healthy individuals to reposiOon their ankle. We hypothesized that success with healthy individuals may indicate further invesOgaOon for an inversion force perturbaOon as an appropriate intervenOon for individuals with CAI.
Frontal Plane Angle (deg)
4
4
Sagical Plane Angle (deg)
6
Pre-‐Landing
Early Post AdaptaOon
Late Post AdaptaOon
An Approach to Intervene Chronic Ankle Instability through Error Augmenta9on Amy Donohoe sPT, William Fogarty sPT, Maddison Grogan sPT, Benjamin Rose sPT, KrisOna Simberg BS sPT Mentor: Sheng-‐Che Yen, PT, PhD Results: Subjects showed a significant increase in ankle eversion during walking. This Mo9va9on: Ankle sprains are one of the most common orthopedic injuries, 1 with 1 in 10,000 people suffering an ankle sprain daily . This equates to roughly increase persisted even aVer the weight was removed. There were no significant 23,000 ankle sprains per day, 85% of which are lateral ankle sprains2. Up to 70% findings in dorsiflexion. of individuals who have an ankle sprain report developing chronic ankle 1 instability or CAI. A significant problem in paOents with CAI is recurrent ankle sprains due to acquired motor control deficits.
A
Pre-‐Landing
* * * *
3
Inversion
Eversion
-‐2
2
-‐4
Dorsiflexion
1 0 -‐1
Plantarflexion
-‐2 -‐3 -‐4 -‐5
-‐6 Baseline
Early AdaptaOon
Late AdaptaOon
Early Post AdaptaOon
Late Post AdaptaOon
-‐6 Baseline
B
Early AdaptaOon
Late AdaptaOon
Post-‐Landing
Early Post AdaptaOon
8
6
* * * *
4 2 0 -‐2
4
Inversion
Eversion
Sagical Plane Angle (deg)
6
-‐4
Dorsiflexion
2
0
Plantarflexion
-‐2
-‐4
-‐6 Baseline
C
Early AdaptaOon
Late AdaptaOon
Early Post AdaptaOon
-‐6
Late Post AdaptaOon
Baseline
Late AdaptaOon
Early Post AdaptaOon
Late Post AdaptaOon
Pre-‐landing
20
4
Inversion
2 0 -‐2
Eversion
-‐4 -‐6 -‐8
Stance
15 10
0
Plantarflexion
-‐5 -‐10
-‐14
Dorsiflexion
5
Swing
-‐12
Baseline
Early AdaptaOon
Post-‐landing
Pre-‐landing
Post-‐landing
-‐10
Stance
Swing
-‐15 Early AdaptaOon
Late AdaptaOon
Early Post AdaptaOon
Late Post AdaptaOon
Baseline
Early AdaptaOon
Late AdaptaOon
Conclusions: The results provide evidence to support that our error driven approach is feasible to correct abnormal ankle posiOoning during walking. This approach can induce both feed forward and backward control, which directly addresses the deficits shown in the CAI populaOon(3). We believe that there was no change in dorsiflexion angles as a result of increased isometric firing of the preObials. The primary limitaOon for this study is the placing of the weight on the foot, as the opOmal placement is unknown. Further studies need to be performed to analyze whether or not this approach is effecOve on subjects who have CAI. References: 1. McKeon PO, Macacola CG. IntervenOons for the PrevenOon of First Time and Recurrent Ankle Sprains. Clinics in Sports Medicine. 2008; 27: 371-‐382. 2. Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. American Journal of Sports Medicine. 1977; 5: 241-‐2. 3. Delahunt E, Monaghan K, Caulfield B. Altered neuromuscular control and ankle joint kinemaOcs during walking in subjects with funcOonal instability of the ankle joint. American Journal of Sports Medicine. 2006; 34:1970-‐1976.
Late Post AdaptaOon
Post-‐Landing
Sagical Plane Angle (deg)
1-‐lb sandbag
0
Frontal Plane Angle (deg)
Approach: Healthy subjects were included in this study. A one-‐pound sandbag was placed on the lateral side of the right foot to amplify error signal while they walked on a treadmill. The ankle kinemaOcs before, during, and aVer walking with the weight was recorded and analyzed using a 3D moOon capture system.
2
Frontal Plane Angle (deg)
Problem statement: The purpose of this study was to examine the feasibility of an error-‐driven approach to reduce the risk of recurrent ankle sprains through correcOon of abnormal ankle posiOoning during ambulaOon. Specifically, we tested if an inversion directed force could induce a detectable error causing healthy individuals to reposiOon their ankle. We hypothesized that success with healthy individuals may indicate further invesOgaOon for an inversion force perturbaOon as an appropriate intervenOon for individuals with CAI.
Frontal Plane Angle (deg)
4
4
Sagical Plane Angle (deg)
6
Pre-‐Landing
Early Post AdaptaOon
Late Post AdaptaOon
