Skip to main content
  • Original article
  • Open access
  • Published:

Assessment of lumbar proprioception in participants with functional ankle instability: a cross-sectional study

Abstract

Background

Functional ankle instability (FAI) represents 40–75% of residual disability after acute lateral ankle sprain. FAI has been associated with impaired muscle strength and postural and neuromuscular control.

Purpose

The aim of this study was to investigate the association between FAI and lumbar proprioception.

Patients and methods

Thirty individuals of both sexes (17 female and 13 male) were selected. The FAI group included 15 participants (nine female and six male) and the control group included 15 normal individuals (eight female and seven male). Lumbar proprioception was assessed using the Biodex system 3 pro isokinetic dynamometer.

Results

There was a significant increase in repositioning error in the FAI group compared with the control group (P<0.001).

Conclusion

There was an association between FAI and an increase in lumbar reposition error compared with healthy individuals. This effect should be considered in the rehabilitation protocol of patients with FAI.

References

  1. Parkhurst TM, Burnett CN. Injury and proprioception in the lower back. JOSPT 1994; 19:282–295.

    Article  CAS  Google Scholar 

  2. Newcomer K, Laskowski ER, Yu B, Larson DR, An KN. Repositioning error in low back pain: comparing trunk repositioning error in subjects with chronic low back pain and control subjects. Spine (Phila Pa 1976) 2000; 25:245–250.

    Article  CAS  Google Scholar 

  3. Lee AS, Cholewicki J, Reeves NP, Zazulak BT, Mysliwiec LW. Comparison of trunk proprioception between patients with low back pain and healthy controls. Arch Phys Med Rehabil 2010; 91:1327–1331.

    Article  Google Scholar 

  4. Georgy EE. Lumbar repositioning accuracy as a measure of proprioception in patients with back dysfunction and healthy controls. J Asian Spine 2011; 5:201–207.

    Article  Google Scholar 

  5. Amanda SB, Carrie LD, John S. Functional performance testing in participants with functional ankle instability and in a healthy control group. J Athel Train 2008; 43: 342–346.

    Article  Google Scholar 

  6. Lee AJ, Lin WH. Twelve-week biomechanical ankle platform system training on postural stability and ankle proprioception in subjects with unilateral functional ankle instability. Clin Biomechics (Bristol, Avon) 2008; 23:1065–1072.

    Article  Google Scholar 

  7. Willems T, Witvrouw E, Verstuyft J, Vaes P, De Clercq D. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 2002; 37:487–493.

    PubMed  PubMed Central  Google Scholar 

  8. Hintermann B, Boss A, Schafer D. Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med 2002; 30:402–409.

    Article  Google Scholar 

  9. Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med 2008; 27:353–370.

    Article  Google Scholar 

  10. Homle E, Magnusson SP, Becher K, Bieler T, Agaard P, Kjaer M. The effect of supervised rehabilitation on strength, postural sway, position sense and re-injury risk after acute ankle ligament sprain. Scand J Med Sci Sports 1999; 9:104–109.

    Google Scholar 

  11. Docherty CL, Valovich MT, Shultz SJ. Postural control deficits in participants with functional ankle instability as measured by the balance error scoring system. Clin J Sport Med 2006; 16:203–208.

    Article  Google Scholar 

  12. Hubbard TJ, Kramer LC, Denegar CR, Hertel J. Contributing factors to chronic ankle instability. Foot Ankle Int 2007; 28:343–354.

    Article  Google Scholar 

  13. Terada M, Brian G, Gribble PA. Alterations in neuromuscular control at the knee in individuals with chronic ankle instability. J Athl Train 2014; 49: 599–607.

    Article  Google Scholar 

  14. Martin RL, Davenport TE, Paulseth S, Wukich DK, Godges JJ. Ankle stability and movement coordination impairments: ankle ligament sprains. J Orthop Sports Phys Ther 2013; 43: A1–A40.

    Article  Google Scholar 

  15. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 2002; 37:364–375.

    PubMed  PubMed Central  Google Scholar 

  16. Hale SA, Hertel J. Reliability and sensitivity of the foot and ankle disability index in subjects with chronic ankle instability. J Athl Train 2005; 40:35–40.

    PubMed  PubMed Central  Google Scholar 

  17. Feiring DC, Ellenbecker TS, Dersheid GL. Test retest reliability of Biodex isokinetic dynamometer. JOSPT 1990; 11:298–300.

    Article  CAS  Google Scholar 

  18. Drouin JM, Valovich-mcleod TC, Shultz SJ, Gansneder BM, Perrin DH. Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J App Physio 2004; 91:22–29.

    Article  Google Scholar 

  19. Maffey-Ward L, Jull G, Wellington L. Toward a clinical test of lumber spine kinesthesia. JOSPT 1996; 24:354–358.

    Article  CAS  Google Scholar 

  20. Wilson S, Granata K. Reposition sense of lumbar curvature with flexed and asymmetric lifting postures. Spine 2003; 28:513–518.

    PubMed  PubMed Central  Google Scholar 

  21. O’Sullivan P, Burnett A, Floyd A, Gadsdon K, Logiudice J, Miller D, Quirke H. Lumbar repositioning deficit in a specific low back pain population. Spine 2003; 28:1074–1079.

    Article  Google Scholar 

  22. Brumagne S, Lyscns R, Spaepen A. Lumbosacral position sense during pelvic tilting in men and women without low back pain: test development and reliability assessment. J Orthop Sports Phys Ther 1999; 29:345–351.

    Article  CAS  Google Scholar 

  23. Monaghan K, Delahunt E, Caulfield B. Ankle function during gait in patients with chronic ankle instability compared to controls. Clin Biomech 2006; 21:168–174.

    Article  Google Scholar 

  24. Evans T, Hertel, Sebastianelli W. Bilateral deficits in postural control following lateral ankle sprain. Foot Ankle Int 2004; 25:833–839.

    Article  Google Scholar 

  25. Mckeon PO, Paolini G, Ingersoll CD, Kerrigan DC, Saliba EN, Bennet BC, Hertel J. Effects of balance training on gait parameters in patients with chronic ankle instability: randomized controlled trial. Chin Rehabil 2009; 23:609–621.

    Article  Google Scholar 

  26. Kenney ME, Maclaughin P, Cameron M. Functional instability of the ankle and its relationship to the Q angle. (master thesis) Victoria University 2003.

  27. Beckman SM, Buchanan TS. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. Arch Phys Med Rehabil 1995; 76:1138–1143.

    Article  CAS  Google Scholar 

  28. Friel K, McLean N, Myers C, Caceres M. Ipsilateral hip abductor weakness after inversion ankle sprain. J Athl Train 2006; 41:74–78.

    PubMed  PubMed Central  Google Scholar 

  29. Van Deun S, Staes FF, Stappaerts KH, Janssens L, Levin O, Peers KK. Relationship of chronic ankle instability to muscle activation patterns during the transition from double-leg to single-leg stance. Am J Sports Med 2007; 35:274–281.

    Article  Google Scholar 

  30. Bullock-Saxton JE, Janda V, Bullock MI. The influence of ankle sprain injury on muscle activation during hip extension. Int J Sports Med 1994; 15:330–334.

    Article  CAS  Google Scholar 

  31. Van der Esch M, Steultjens M, Harlaar J, Knol D, Lems W, Dekker J. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis Rheum 2007; 57:787–793.

    Article  Google Scholar 

  32. MacKinnon CD, Winter DA. Control of whole body balance in the frontal plane during human walking. Biomech 1993; 26:633–644.

    Article  CAS  Google Scholar 

  33. Lentell G, Baas B, Lopez D, McGuire L, Sarrels M, Snyder P. The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. J Orthop Sports Phys Ther 1995; 21:206–215.

    Article  CAS  Google Scholar 

  34. Marshall PW, McKee AD, Murphy BA. Impaired trunk and ankle stability in subjects with functional ankle instability. Med Sci Sports Exer 2009; 41:1549–1557.

    Article  Google Scholar 

  35. Gribble PA, Robinson R. Alterations in knee kinematics and dynamic stability associated with chronic ankle instability. J Athl Train 2009; 44:350–355.

    Article  Google Scholar 

  36. Gribble P, Robinson R. Differences in spatiotemporal landing variables during a dynamic stability task in subjects with CAI. Scand J Med Sci Sports 2010; 20: e63–e71.

    Article  CAS  Google Scholar 

  37. Caulfield BM, Garrett M. Functional instability of the ankle: differences in patterns of ankle and knee movement prior to and post landing in a single leg jump. Int J Sports Med 2002; 23:64–68.

    Article  CAS  Google Scholar 

  38. Delahunt E, Monaghan K, Caulfield B. Ankle function during hopping in subjects with functional instability of the ankle joint. Scand J Med Sci Sports 2007; 17:641–648.

    Article  CAS  Google Scholar 

  39. Noronha M, Refshauge KM, Kilbreath SL, Crosbie J. Loss of proprioception or motor control is not related to functional ankle instability: an observational study. Aust J Physiother 2007; 53:193–198.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Olfat Ibrahim Ali PhD.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ali, O.I., Alasar, S.A. Assessment of lumbar proprioception in participants with functional ankle instability: a cross-sectional study. Bull Fac Phys Ther 21, 74–79 (2016). https://doi.org/10.4103/1110-6611.196780

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1110-6611.196780

Keywords