Journal of Orthopaedic & Sports Physical Therapy - Kathryn M. Refshauge, PT, PhD

Fourth International Ankle Symposium - July 16-18, Sydney, Australia

Wed, 30 Sep 2009 00:00:00 EST

The Fourth International Ankle Symposium (IAS4), a multidisciplinary conference focused on topics related to ankle injury, was recently held in Sydney, Australia at the University of Sydney. The conference theme was "new dimensions on old problems," with a different emphasis on each day of the symposium: new dimensions on science, new dimensions on interventions, and new dimensions in the clinic, reflecting the mix of basic science and clinical practice. This issue includes a summary statement of the conference, abstracts of the invited lectures and workshops, and the abstracts of the original research presentations, both podium and poster presentations, from IAS4.

J Orthop Sports Phys Ther 2009;39(10):A1-A24. doi:10.2519/jospt.2009.0302

Relationship Between Functional Ankle Instability and Postural Control

Fri, 24 Oct 2008 00:00:00 EST

Marcos de Noronha, Kathryn M. Refshauge, Jack Crosbie, Sharon L. Kilbreath
STUDY DESIGN: Controlled laboratory study using a cross-sectional design. OBJECTIVES: To investigate the relationship between postural control and functional ankle instability during a hop-landing task, and to investigate whether postural control is altered in people with functional ankle instability. METHODS AND MEASURES: Sixty volunteers classified by the Cumberland Ankle Instability Tool (CAIT) scores formed the external control group (CAIT score, ≥ 28, n = 31) and the instability group (CAIT score, ≤ 27 and history of at least 1 ankle sprain; n = 29). Postural control was measured with the landing test, in which participants stood on 1 lower extremity for 3 seconds on a step, then hopped down onto a force plate and regained postural stability after landing. The main outcome measurements were time to stability (TTS) after landing for ankle inversion, dorsiflexion, and summated electromyographic (EMG) signal amplitude for the tibialis anterior, soleus, and fibularis longus. The secondary outcomes were the proportion of movement in the frontal plane for hip and ankle, the variability of inversion movement prior to hopping, and the variables from ground reaction force. RESULTS: There were no associations (P > .05) between the CAIT scores and the TTS for ankle inversion (r = -0.25), dorsiflexion (r = -0.04), summated EMG (r = -0.13) and proportion of movement in the frontal plane (r = 0.005). Participants in the instability group took longer to regain stability in inversion and displayed greater inversion variability prejump than the control group (P = .05 and .009, respectively). CONCLUSIONS: Ankle inversion control is affected in people with functional ankle instability in tasks of postural control after landing from a hop.

J Orthop Sports Phys Ther. 2008;38(12):782-789, published online 24 October 2008. doi:10.2519/jospt.2008.2766

KEY WORDS: ankle injuries, ankle sprain, joint instability, postural control

Swing Kinematics in Skilled Male Golfers Following Putting Practice

Tue, 15 Apr 2008 00:00:00 EST

Kerrie Evans, Kathryn M. Refshauge, Roger D. Adams, Rod Barrett
STUDY DESIGN: Control laboratory study consisting of preintervention and postintervention measurements. OBJECTIVE: To determine the effects of a putting practice session on the kinematics of full golf swings made by skilled male golfers. BACKGROUND: Skilled golfers perform putting practice for prolonged periods. The combination of sustained trunk flexion with minimal trunk motion may affect the endurance capacity of the trunk extensor muscles. Because of their important role in the golf swing, any impairment of the trunk extensors may negatively influence full-swing kinematics, but this has not been previously evaluated. METHODS AND MEASURES: Three-dimensional swing kinematics and holding time on the Biering-Sørensen test of isometric trunk extensor endurance were evaluated in 29 skilled male golfers before and after performing a 40-minute putting task. RESULTS: After the intervention, peak segmental speeds were reduced and total swing duration increased (mean ± SD, 36 ± 55 milliseconds). There were reductions in the magnitude of pelvis and torso axial rotation during the downswing (mean ± SD, -2.3° ± 2.6° and -2.3° ± 4.7°, respectively). The peak difference between torso rotation and pelvis rotation during early downswing was also significantly reduced by 0.9° ± 2.0° (P<.05). The effects on pelvis and torso rotation were smallest for golfers with higher body mass index (BMI). Holding time on the Biering-Sørensen test after putting practice was significantly reduced by 25.7 ± 23.8 seconds (P = .01). CONCLUSION: Changes in swing kinematics observed following 40 minutes of putting practice might have resulted from fatigue-related impairment of the trunk extensor muscles, a view supported by the poorer performance on the postintervention Biering-Sørensen test. Results showed that swing kinematics of golfers with high BMI were least affected by the putting practice. LEVEL OF EVIDENCE: Harm, level 5.

J Orthop Sports Phys Ther. 2008;38(7):425-433, published online 15 April 2008. doi:10.2519/jospt.2008.2617

KEY WORDS: erector spinae, golf, lumbar spine

Deficits in Detection of Inversion and Eversion Movements Among Subjects With Recurrent Ankle Sprains

Mon, 05 Feb 2007 09:45:00 EST

Kathryn M. Refshauge, Jacquelene Raymond, Sharon L. Kilbreath
Study Design: Observational cross-sectional design. Objectives: To determine whether a deficit exists in the ability to perceive inversion and eversion movements among subjects with recurrent ankle sprains. Background: Although unproven, ankle sprains are thought to recur because proprioception is impaired subsequent to the original sprain. Proprioception has been widely studied, however, the specific property of movement perception has not been rigorously examined for both inversion and eversion movements. Methods and Measures: The ability to perceive passive inversion and eversion movements imposed at the relaxed ankle was measured in 39 subjects with recurrent ankle sprains (sprainers) and 30 subjects with no history of ankle injury (controls) by an assessor masked to subject group. The 70% detection level for movement perception was determined for 3 velocities, 0.1°/s, 0.5°/s, and 2.5°/s, tested in random order. Results: The 70% detection level for inversion and eversion movements improved with increasing velocity in both groups. At all velocities, the 70% detection level for movements imposed at the ankle of the sprainers was significantly worse than for controls. Conclusions: Perception of passive inversion and eversion movements imposed at the ankle was impaired in subjects with recurrent ankle sprains. The impairment was evident at the 3 velocities tested, 0.1°/s, 0.5°/s, and 2.5°/s.

J Orthop Sports Phys Ther. 2003; 33(4):166-176.

Key Words: kinesthesia, proprioception, sensory function