Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2007

01-05-2007 | Sports Medicine

Effect of isokinetic training on strength, functionality and proprioception in athletes with functional ankle instability

Authors: Ufuk Sekir, Yavuz Yildiz, Bulent Hazneci, Fatih Ors, Taner Aydin

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2007

Login to get access

Abstract

The purpose of this study was to investigate the effects of isokinetic exercise on strength, joint position sense and functionality in recreational athletes with functional ankle instability (FAI). Strength, proprioception and balance of 24 recreational athletes with unilateral FAI were evaluated by using isokinetic muscle strength measurement, ankle joint position sense and one leg standing test. The functional ability was evaluated using five different tests. These were; single limb hopping course (SLHC), one legged and triple legged hop for distance (OLHD–TLHD), and six and cross six meter hop for time (SMHT–CSMHT). Isokinetic peak torque of the ankle invertor and evertor muscles were assessed eccentrically and concentrically at test speeds of 120°/s. Isokinetic exercise protocol was carried out at an angular velocity of 120°/s. The exercise session was repeated three times a week and lasted after 6 weeks. At baseline, concentric invertor strength was found to be significantly lower in the functionally unstable ankles compared to the opposite healthy ankles (p < 0.001). This difference was not present after executing the 6 weeks exercise sessions (> 0.05). Ankle joint position sense in the injured ankles declined significantly from 2.35 ± 1.16 to 1.33 ± 0.62° for 10° of inversion angle (p < 0.001) and from 3.10 ± 2.16 to 2.19 ± 0.98° for 20° of inversion angle (p < 0.05) following the isokinetic exercise. One leg standing test score decreased significantly from 15.17 ± 8.50 to 11.79 ± 7.81 in the injured ankles (p < 0.001). Following the isokinetic exercise protocol, all of the worsened functional test scores in the injured ankles as compared to the opposite healthy ankles displayed a significant improvement (p < 0.01 for OLHD and CSMHT, p < 0.001 for SLHC, TLHD, and SMHT). These results substantiate the deficits of strength, proprioception, balance and functionality in recreational athletes with FAI. The isokinetic exercise program used in this study had a positive effect on these parameters.
Literature
1.
go back to reference Aydin T, Yildiz Y, Yildiz C, Atesalp S, Kalyon TA (2002) Proprioception of the ankle: a comparison between female teenaged gymnasts and controls. Foot Ankle Int 23:123–129PubMed Aydin T, Yildiz Y, Yildiz C, Atesalp S, Kalyon TA (2002) Proprioception of the ankle: a comparison between female teenaged gymnasts and controls. Foot Ankle Int 23:123–129PubMed
2.
go back to reference Bernier JN, Perrin DH (1998) Effect of coordination training on proprioception of the functionally unstable ankle. J Orthop Sports Phys Ther 27:264–275PubMed Bernier JN, Perrin DH (1998) Effect of coordination training on proprioception of the functionally unstable ankle. J Orthop Sports Phys Ther 27:264–275PubMed
3.
go back to reference Bernier JN, Perrin DH, Rijke AM (1997) Effect of unilateral functional instability of the ankle on postural sway and inversion and eversion strength. J Athl Train 32:226–232PubMed Bernier JN, Perrin DH, Rijke AM (1997) Effect of unilateral functional instability of the ankle on postural sway and inversion and eversion strength. J Athl Train 32:226–232PubMed
4.
go back to reference Bosien WR, Staples S, Russel SW (1955) Residual disability following acute ankle sprains. J Bone Joint Surg Am 37:1237–1243PubMed Bosien WR, Staples S, Russel SW (1955) Residual disability following acute ankle sprains. J Bone Joint Surg Am 37:1237–1243PubMed
5.
go back to reference Brunt D, Andersen JC, Huntsman B, et al. (1992) Postural responses to lateral perturbation in healthy subjects and ankle sprain patients. Med Sci Sports Exerc 24:171–176PubMed Brunt D, Andersen JC, Huntsman B, et al. (1992) Postural responses to lateral perturbation in healthy subjects and ankle sprain patients. Med Sci Sports Exerc 24:171–176PubMed
6.
go back to reference Demeritt KM, Shultz SJ, Docherty CL, Gansneder BM, Perrin DH (2002) Chronic ankle instability does not affect lower extremity functional performance. J Athl Train 37:507–511PubMed Demeritt KM, Shultz SJ, Docherty CL, Gansneder BM, Perrin DH (2002) Chronic ankle instability does not affect lower extremity functional performance. J Athl Train 37:507–511PubMed
7.
go back to reference Docherty CL, Moore JH, Arnold BL (1998) Effects of strength training on strength development and joint position sense in functionally unstable ankles. J Athl Train 33:310–314PubMed Docherty CL, Moore JH, Arnold BL (1998) Effects of strength training on strength development and joint position sense in functionally unstable ankles. J Athl Train 33:310–314PubMed
8.
go back to reference Freeman MA, Dean MR, Hanham IW (1965) The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 47:678–685PubMed Freeman MA, Dean MR, Hanham IW (1965) The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 47:678–685PubMed
9.
go back to reference Fu AS, Hui-Chan CW (2005) Ankle joint proprioception and postural control in basketball players with bilateral ankle sprains. Am J Sports Med 33:1174–1182PubMedCrossRef Fu AS, Hui-Chan CW (2005) Ankle joint proprioception and postural control in basketball players with bilateral ankle sprains. Am J Sports Med 33:1174–1182PubMedCrossRef
10.
go back to reference Garn SN, Newton RA (1988) Kinesthetic awareness in subjects with multiple ankle sprains. Phys Ther 68:1667–1671PubMed Garn SN, Newton RA (1988) Kinesthetic awareness in subjects with multiple ankle sprains. Phys Ther 68:1667–1671PubMed
11.
go back to reference Garrick J, Requa R (1988) The epidemiology of foot and ankle injuries in sport. Clin Sports Med 7:29–36PubMed Garrick J, Requa R (1988) The epidemiology of foot and ankle injuries in sport. Clin Sports Med 7:29–36PubMed
12.
go back to reference Glencross D, Thornton E (1981) Position sense following joint injury. J Sports Med Phys Fitness 21:23–27PubMed Glencross D, Thornton E (1981) Position sense following joint injury. J Sports Med Phys Fitness 21:23–27PubMed
13.
go back to reference Guskiewicz KM, Perrin DH (1996) Effect of orthotics on postural sway following inversion ankle sprain. J Orthop Sports Phys Ther 23:326–331PubMed Guskiewicz KM, Perrin DH (1996) Effect of orthotics on postural sway following inversion ankle sprain. J Orthop Sports Phys Ther 23:326–331PubMed
14.
go back to reference Hartsell HD, Spaulding SJ (1999) Eccentric/concentric ratios at selected velocities for the invertor and evertor muscles of the chronically unstable ankle. Br J Sports Med 33:255–258PubMed Hartsell HD, Spaulding SJ (1999) Eccentric/concentric ratios at selected velocities for the invertor and evertor muscles of the chronically unstable ankle. Br J Sports Med 33:255–258PubMed
15.
go back to reference Hazneci B, Yildiz Y, Sekir U, Aydin T, Kalyon TA (2005) Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome. Am J Phys Med Rehabil 84:521–527PubMedCrossRef Hazneci B, Yildiz Y, Sekir U, Aydin T, Kalyon TA (2005) Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome. Am J Phys Med Rehabil 84:521–527PubMedCrossRef
16.
go back to reference Heitman RJ, Kovaleski J, Gurchiek L (1997) Isokinetic eccentric strength of the ankle evertors after injury. Percept Mot Skills 84:258PubMedCrossRef Heitman RJ, Kovaleski J, Gurchiek L (1997) Isokinetic eccentric strength of the ankle evertors after injury. Percept Mot Skills 84:258PubMedCrossRef
17.
go back to reference Kaminski TW, Buckley BD, Powers ME, Hubbard TJ, Ortiz C (2003) Effect of strength and proprioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability. Br J Sports Med 37:410–415PubMedCrossRef Kaminski TW, Buckley BD, Powers ME, Hubbard TJ, Ortiz C (2003) Effect of strength and proprioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability. Br J Sports Med 37:410–415PubMedCrossRef
18.
go back to reference Kaminski T, Perrin D, Gansneder B (1999) Eversion strength analysis of uninjured and functionally unstable ankles. J Athl Train 34:239–245PubMed Kaminski T, Perrin D, Gansneder B (1999) Eversion strength analysis of uninjured and functionally unstable ankles. J Athl Train 34:239–245PubMed
19.
go back to reference Konradsen L, Olesen S, Hansen HM (1998) Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. Am J Sports Med 26:72–77PubMed Konradsen L, Olesen S, Hansen HM (1998) Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. Am J Sports Med 26:72–77PubMed
20.
go back to reference Konradsen L, Ravn JB (1990) Ankle instability caused by prolonged peroneal reaction time. Acta Orthop Scand 61:388–390PubMedCrossRef Konradsen L, Ravn JB (1990) Ankle instability caused by prolonged peroneal reaction time. Acta Orthop Scand 61:388–390PubMedCrossRef
21.
go back to reference Konradsen L, Ravn JB (1991) Prolonged peroneal reaction time in ankle instability. Int J Sports Med 12:290–292PubMed Konradsen L, Ravn JB (1991) Prolonged peroneal reaction time in ankle instability. Int J Sports Med 12:290–292PubMed
22.
go back to reference Leanderson J, Ekstam S, Salomonsson C (1996) Taping of the ankle: the effect on postural sway during perturbation, before and after a training session. Knee Surg Sports Traumatol Arthrosc 4:53–56PubMedCrossRef Leanderson J, Ekstam S, Salomonsson C (1996) Taping of the ankle: the effect on postural sway during perturbation, before and after a training session. Knee Surg Sports Traumatol Arthrosc 4:53–56PubMedCrossRef
23.
go back to reference Lentell G, Baas B, Lopez D, et al. (1995) The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. J Orthop Sports Phys Ther 21:206–215PubMed Lentell G, Baas B, Lopez D, et al. (1995) The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. J Orthop Sports Phys Ther 21:206–215PubMed
24.
go back to reference Lentell GL, Katzman LL, Walters MR (1990) The relationship between muscle function and ankle stability. J Orthop Sports Phys Ther 11:605–611PubMed Lentell GL, Katzman LL, Walters MR (1990) The relationship between muscle function and ankle stability. J Orthop Sports Phys Ther 11:605–611PubMed
25.
go back to reference Lephart SM, Pincivero DM, Giraldo JL, Fu FH (1997) The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med 25:130–137PubMed Lephart SM, Pincivero DM, Giraldo JL, Fu FH (1997) The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med 25:130–137PubMed
26.
go back to reference Lofvenberg R, Karrholm J, Sundelin G, Ahlgren O (1995) Prolonged reaction time in patients with chronic lateral instability of the ankle. Am J Sports Med 23:414–417PubMed Lofvenberg R, Karrholm J, Sundelin G, Ahlgren O (1995) Prolonged reaction time in patients with chronic lateral instability of the ankle. Am J Sports Med 23:414–417PubMed
27.
go back to reference McKnight C, Armstrong C (1997) The role of ankle strength in functional ankle instability. J Sport Rehabil 6:21–29 McKnight C, Armstrong C (1997) The role of ankle strength in functional ankle instability. J Sport Rehabil 6:21–29
28.
go back to reference Munn J, Beard D, Refshauge K, Lee RJ (2002) Do functional-performance tests detect impairment in subjects with ankle instability? J Sport Rehabil 11:40–50 Munn J, Beard D, Refshauge K, Lee RJ (2002) Do functional-performance tests detect impairment in subjects with ankle instability? J Sport Rehabil 11:40–50
29.
go back to reference Munn J, Beard DJ, Refshauge KM, et al. (2003) Eccentric muscle strength in functional ankle instability. Med Sci Sports Ecerc 35:245–250CrossRef Munn J, Beard DJ, Refshauge KM, et al. (2003) Eccentric muscle strength in functional ankle instability. Med Sci Sports Ecerc 35:245–250CrossRef
30.
go back to reference Pintsaar A, Brynhildsen J, Tropp H (1996) Postural corrections after standardised perturbations of single limb stance: effect of training and orthotic devices in patients with ankle instability. Br J Sports Med 30:151–155PubMedCrossRef Pintsaar A, Brynhildsen J, Tropp H (1996) Postural corrections after standardised perturbations of single limb stance: effect of training and orthotic devices in patients with ankle instability. Br J Sports Med 30:151–155PubMedCrossRef
31.
go back to reference Robbins S, Waked E, Rappel R (1995) Ankle taping improves proprioception before and after exercise in young men. Br J Sports Med 29:242–247PubMed Robbins S, Waked E, Rappel R (1995) Ankle taping improves proprioception before and after exercise in young men. Br J Sports Med 29:242–247PubMed
32.
go back to reference Ronkonkoma NY (1995) Cybex Norm Int Inc: testing and rehabilitation system: pattern selection and set up: automated protocols. User’s guide. Blue Sky Software Corporation, New York Ronkonkoma NY (1995) Cybex Norm Int Inc: testing and rehabilitation system: pattern selection and set up: automated protocols. User’s guide. Blue Sky Software Corporation, New York
33.
go back to reference Ryan L (1994) Mechanical stability, muscle strength, and proprioception in the functionally unstable ankle. Aust J Physiother 40:41–47 Ryan L (1994) Mechanical stability, muscle strength, and proprioception in the functionally unstable ankle. Aust J Physiother 40:41–47
34.
go back to reference Safran MR, Benedetti RS, Bartolozzi AR, et al. (1999) Lateral ankle sprains: a comprehensive review. Part:1 etiology, pathoanatomy, histopathogenesis, and diagnosis. Med Sci Sports Exerc 31:S429–S437PubMedCrossRef Safran MR, Benedetti RS, Bartolozzi AR, et al. (1999) Lateral ankle sprains: a comprehensive review. Part:1 etiology, pathoanatomy, histopathogenesis, and diagnosis. Med Sci Sports Exerc 31:S429–S437PubMedCrossRef
35.
go back to reference Sherrington CS (1906) On the proprioceptive system, especially in its reflex aspect. Brain 29:467–482CrossRef Sherrington CS (1906) On the proprioceptive system, especially in its reflex aspect. Brain 29:467–482CrossRef
36.
go back to reference Sheth P, Yu B, Laskowski ER, et al. (1997) Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med 25:538–543PubMed Sheth P, Yu B, Laskowski ER, et al. (1997) Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med 25:538–543PubMed
37.
go back to reference Tropp H (1986) Pronator muscle weakness in functional instability of the ankle joint. Int J Sports Med 7:291–294PubMedCrossRef Tropp H (1986) Pronator muscle weakness in functional instability of the ankle joint. Int J Sports Med 7:291–294PubMedCrossRef
38.
go back to reference Tropp H, Odenrick P, Gillquist J (1985) Stabilometry recordings in functional and mechanical instability of the ankle joint. Int J Sports Med 6:180–182PubMed Tropp H, Odenrick P, Gillquist J (1985) Stabilometry recordings in functional and mechanical instability of the ankle joint. Int J Sports Med 6:180–182PubMed
39.
go back to reference Weir JP, Housh DJ, Housh TJ, et al. (1997) The effect of unilateral concentric weight training and detraining on joint angle specificity, cross-training, and the bilateral deficit. J Orthop Sports Phys Ther 25:264–270PubMed Weir JP, Housh DJ, Housh TJ, et al. (1997) The effect of unilateral concentric weight training and detraining on joint angle specificity, cross-training, and the bilateral deficit. J Orthop Sports Phys Ther 25:264–270PubMed
40.
go back to reference Weir JP, Housh TJ, Weir LL (1994) Electromyographic evaluation of joint angle specificity and cross-training after isometric training. J Appl Physiol 77:197–201PubMed Weir JP, Housh TJ, Weir LL (1994) Electromyographic evaluation of joint angle specificity and cross-training after isometric training. J Appl Physiol 77:197–201PubMed
41.
go back to reference Wilkerson G, Nitz A (1994) Dynamic ankle stability: mechanical and neuromuscular interrelationships. J Sport Rehabil 3:43–57 Wilkerson G, Nitz A (1994) Dynamic ankle stability: mechanical and neuromuscular interrelationships. J Sport Rehabil 3:43–57
42.
go back to reference Wilkerson GB, Pinerola JJ, Caturano RW (1997) Invertor vs. evertor peak torque and power deficiencies associated with lateral ankle ligament injury. J Orthop Sports Phys Ther 26:78–86PubMed Wilkerson GB, Pinerola JJ, Caturano RW (1997) Invertor vs. evertor peak torque and power deficiencies associated with lateral ankle ligament injury. J Orthop Sports Phys Ther 26:78–86PubMed
43.
go back to reference Willems T, Witvrouw E, Verstuyft J, Vaes P, De Clercq D (2002) Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 37:487–493PubMed Willems T, Witvrouw E, Verstuyft J, Vaes P, De Clercq D (2002) Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 37:487–493PubMed
44.
go back to reference WMADH (2000) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Med Assoc 284:3043–3045 WMADH (2000) World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Med Assoc 284:3043–3045
45.
go back to reference Yildiz Y, Aydin T, Sekir U, et al. (2003a) Peak and end range eccentric evertor/concentric invertor muscle strength ratios in chronically unstable ankles: comparison with healthy individuals. J Sports Sci Med 2:70–76 Yildiz Y, Aydin T, Sekir U, et al. (2003a) Peak and end range eccentric evertor/concentric invertor muscle strength ratios in chronically unstable ankles: comparison with healthy individuals. J Sports Sci Med 2:70–76
46.
go back to reference Yildiz Y, Aydin T, Sekir U, et al. (2003b) Relation between isokinetic muscle strength and functional capacity in recereational athletes with chondromalacia patellae. Br J Sports Med 37:475–479CrossRef Yildiz Y, Aydin T, Sekir U, et al. (2003b) Relation between isokinetic muscle strength and functional capacity in recereational athletes with chondromalacia patellae. Br J Sports Med 37:475–479CrossRef
Metadata
Title
Effect of isokinetic training on strength, functionality and proprioception in athletes with functional ankle instability
Authors
Ufuk Sekir
Yavuz Yildiz
Bulent Hazneci
Fatih Ors
Taner Aydin
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2007
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-006-0108-8

Other articles of this Issue 5/2007

Knee Surgery, Sports Traumatology, Arthroscopy 5/2007 Go to the issue

Letter to the Editor

About ACL registries