Objective: To determine the effect of a 6-week concentric-eccentric strengthening programme on individuals with Chronic Ankle instability (CAI) as measured by Mean Surface Electromyography (SEMG) for Peroneus Longus (PL), Peroneus Brevis (PB) and Tibialis Anterior (TA), muscle onset times relative to a Drop Vertical Jump (DVJ) and Centre of Pressure (COP) data for static single-limb balance with eyes open/closed. To establish the effect of this rehab approach on self-reported measures of function; The Cumberland Ankle Instability Tool (CAIT) (Hiller et al., 2006) and the Foot and Ankle Ability Measure (FAAM) (Carcia et al., 2008) and whether a diagnosis of Mechanical Ankle Instability (MAI), as diagnosed by Stress Fluoroscopy and Dynamic Ultrasound, has an effect on outcomes.
Methods: Eleven adults with CAI were tested, seven of whom had a diagnosis of MAI. Baseline SEMG amplitudes were recorded from the PL, PB and TA during a series of dynamic tasks; treadmill walking, jogging, single-limb stance eyes-open/closed, wobble board stance, single-limb calf raise and DVJ. Mean SEMG were analysed from PL, PB and TA. Muscle onset times related to DVJ were analysed for each of the test muscles. COP data was analysed from single-limb stance eyes-open/closed. The participants then embarked on a progressive home based concentric-eccentric strengthening programme daily over a 6-week period. At the end of the 6-week regime the above measurements were repeated.
Results: There were statistically significant improvements in self-reported measures of function CAIT (P=.000), FAAM ADL self-rating (P=.020), FAAM Sport (P=.023) and FAAM Sport self-rating (P=.011). There was no statistically significant difference in mean SEMG, muscle onset times or COP measures following the concentric-eccentric strengthening regime. A diagnosis of MAI had no statistically significant impact on results.
Conclusions: The 6-week concentric-eccentric strengthening programme had a statistically significant effect on self-reported measures of function, but failed to influence neuromuscular or postural control regardless of the presence of MAI or not.
References:
1. Hiller, C.E., Refshaughe, K.M., Bundy, A.C., Herbert, R.D. and Kilbreath, S.L. (2006). The Cumberland Ankle Instability Tool; A report of validity and reliability testing. Archives of Physical Medicine and Rehabilitation. 87(9): 1235-41
2. Carcia, C.R., Martin, R.L. and Drouin, J.M. (2008) Validity of the Foot and Ankle Ability Measure in athletes with Chronic Ankle Instability. Journal of Athletic Training. 43(2): 179-83
Ethical Approval: This study was submitted as part of an MSC. Ethical approval was obtained from both UCD and St. Vincent’s University Hospital prior to the commencement of this study.
