ORCID Profile
0000-0002-6478-7215
Current Organisation
Western Sydney Local Health District
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Publisher: American Thoracic Society
Date: 04-2023
Publisher: Springer Science and Business Media LLC
Date: 08-09-2017
DOI: 10.1007/S40279-017-0781-4
Abstract: Many factors are thought to contribute to chronic ankle instability (CAI). Multiple systematic reviews have synthesised the available evidence to identify the primary contributing factors. However, readers are now faced with several systematic reviews that present conflicting findings. The aim of this systematic review and meta-analysis was to establish the statistical significance and effect size of primary factors contributing to CAI and to identify likely reasons for inconsistencies in the literature. Relevant health databases were searched: CINAHL, MEDLINE, PubMed, Scopus and SPORTDiscus. Systematic reviews were included if they answered a focused research question, clearly defined the search strategy criteria and study selection/inclusion and completed a comprehensive search of the literature. Included reviews needed to be published in a peer-reviewed journal and needed to review observational studies of factors and/or characteristics of persons with CAI, with or without meta-analysis. There was no language restriction. Studies using a non-systematic review methodology (e.g. primary studies and narrative reviews) were excluded. Methodological quality of systematic reviews was assessed using the modified R-AMSTAR tool. Meta-analysis on included primary studies was performed. Only 17% of primary studies measured a clearly defined CAI population. There is strong evidence to support the contribution of dynamic balance, peroneal reaction time and eversion strength deficits and moderate evidence for proprioception and static balance deficits to non-specific ankle instability. Evidence from previous systematic reviews does not accurately reflect the CAI population. For treatment of non-specific ankle instability, clinicians should focus on dynamic balance, reaction time and strength deficits however, these findings may not be translated to the CAI population. Research should be updated with an adequately controlled CAI population. PROSPERO 2016, CRD42016032592.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.JSAMS.2018.10.009
Abstract: To compare soleus spinal reflex excitability, presynaptic inhibition and recurrent inhibition between chronic ankle instability (CAI), acute Lateral Ankle Sprain coper (LAS-coper) and healthy populations. The relationship between spinal reflex excitability and pain and perceived instability in people with CAI was also examined. Cross-sectional laboratory experiment. Twelve in iduals with CAI, twelve 'copers' and twelve healthy age, limb and gender-matched controls participated. Soleus H-reflex recruitment curves, pre-synaptic excitability and recurrent inhibition of the spinal-reflex pathway were examined during static double- and single-leg stance. Reporting of pain and perceived instability were used to perform a regression analysis on measures of soleus spinal excitability in people with CAI, LAS-coper and healthy controls. Soleus spinal reflex excitability was greater during single-leg stance in CAI compared to healthy and coper in iduals (p=<0.001). Pre-synaptic inhibition was three-times less in CAI participants compared to both healthy controls and copers (p=<0.001). There were no differences between healthy and coper participants in spinal-level measures of sensorimotor control. Reports of pain explained 15-16% of the variance in soleus spinal reflex excitability and presynaptic inhibition during single and double-leg stance, while perceived instability explained 20% of the variance in spinal reflex during single leg stance only. CAI participants presented with an inability to suppress soleus spinal reflexes during tasks with increased postural threat likely due to disinhibition of pre-synaptic mechanisms. Pain and perceived instability may contribute to changes in spinal-level sensorimotor control in CAI.
No related grants have been discovered for Cassandra Thompson.