The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait

Abstract Objective To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle. Methods In this case‐control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in pa...

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Main Authors: Elaheh Ziaei Ziabari, Mohammad Haghpanahi, Mohammad Razi, Bart Lubberts, Soheil Ashkani‐Esfahani, Christopher W. DiGiovanni
Format: Article
Language:English
Published: Wiley 2022-09-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.13307
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author Elaheh Ziaei Ziabari
Mohammad Haghpanahi
Mohammad Razi
Bart Lubberts
Soheil Ashkani‐Esfahani
Christopher W. DiGiovanni
author_facet Elaheh Ziaei Ziabari
Mohammad Haghpanahi
Mohammad Razi
Bart Lubberts
Soheil Ashkani‐Esfahani
Christopher W. DiGiovanni
author_sort Elaheh Ziaei Ziabari
collection DOAJ
description Abstract Objective To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle. Methods In this case‐control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo‐reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle‐toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion‐eversion at initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing phase of the gait were measured. Results In patients with CAI, the injured and uninjured ankles were significantly different regarding angle‐toe angle, inversion‐eversion RoM, dorsiplantar flexion in mid‐stance, inversion‐eversion at initial contact and terminal stance as well as the pre‐swing and swing phases (p < 0.01). The uninjured ankles of patients showed lower ankle‐toe velocity (p = 0.01) and acceleration (p = 0.01) compared to both the left and right ankles of the controls. In addition, the uninjured ankles of the patients showed decreased ankle dorsiflexion and increased inversion during initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing compared to the control group (p < 0.017). Conclusion The results suggest that unilateral CAI can affect gait biomechanics in the contralateral uninjured ankle. Left unaddressed, unilateral CAI may lead to increased morbidity to the contralateral uninjured side. When surgery is not preferred for the management of unilateral CAI, rehabilitation protocols should focus on both sides.
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spelling doaj.art-cf8a9f84c7e74fff9492f57d9d7207002022-12-22T04:30:45ZengWileyOrthopaedic Surgery1757-78531757-78612022-09-011492238224410.1111/os.13307The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During GaitElaheh Ziaei Ziabari0Mohammad Haghpanahi1Mohammad Razi2Bart Lubberts3Soheil Ashkani‐Esfahani4Christopher W. DiGiovanni5School of Mechanical Engineering Iran University of Science and Technology Tehran IranSchool of Mechanical Engineering Iran University of Science and Technology Tehran IranDepartment of Orthopedic Surgery, Rasoul Akram Hospital Iran University of Medical Sciences Tehran IranFoot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital Harvard Medical School Boston Massachusetts USAFoot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital Harvard Medical School Boston Massachusetts USAFoot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital Harvard Medical School Boston Massachusetts USAAbstract Objective To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle. Methods In this case‐control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo‐reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle‐toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion‐eversion at initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing phase of the gait were measured. Results In patients with CAI, the injured and uninjured ankles were significantly different regarding angle‐toe angle, inversion‐eversion RoM, dorsiplantar flexion in mid‐stance, inversion‐eversion at initial contact and terminal stance as well as the pre‐swing and swing phases (p < 0.01). The uninjured ankles of patients showed lower ankle‐toe velocity (p = 0.01) and acceleration (p = 0.01) compared to both the left and right ankles of the controls. In addition, the uninjured ankles of the patients showed decreased ankle dorsiflexion and increased inversion during initial contact, loading response, mid‐stance, terminal stance, pre‐swing, and swing compared to the control group (p < 0.017). Conclusion The results suggest that unilateral CAI can affect gait biomechanics in the contralateral uninjured ankle. Left unaddressed, unilateral CAI may lead to increased morbidity to the contralateral uninjured side. When surgery is not preferred for the management of unilateral CAI, rehabilitation protocols should focus on both sides.https://doi.org/10.1111/os.13307ankle sprainchronic ankle instabilitybiomechanicskinematicsgait
spellingShingle Elaheh Ziaei Ziabari
Mohammad Haghpanahi
Mohammad Razi
Bart Lubberts
Soheil Ashkani‐Esfahani
Christopher W. DiGiovanni
The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait
Orthopaedic Surgery
ankle sprain
chronic ankle instability
biomechanics
kinematics
gait
title The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait
title_full The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait
title_fullStr The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait
title_full_unstemmed The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait
title_short The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait
title_sort effects of chronic ankle instability on the biomechanics of the uninjured contralateral ankle during gait
topic ankle sprain
chronic ankle instability
biomechanics
kinematics
gait
url https://doi.org/10.1111/os.13307
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