Predicting Range of Motion Improvements Following STARS Treatments in Chronic Ankle Instability Patients

in International Journal of Athletic Therapy and Training
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  • 1 University of North Carolina at Chapel Hill
  • 2 Ithaca College
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Multiple treatment options have been shown to improve dorsiflexion range of motion (DFROM) group means in patients with chronic ankle instability (CAI). However, not all patients with CAI respond equally to these treatments. The aim of this study was to identify predictors of successfully improving dorsiflexion range of motion (DFROM) in patients with CAI. Patients with <11.41 cm of DFROM had a 98% probability of a meaningful DFROM improvement following ankle joint mobilizations. Individual predictors of success for plantar massage and calf stretching were also identified and resulted in >92% posttest probabilities. Simple pretreatment assessments can dramatically improve treatment success probability following STARS in patients with CAI.

Erik A. Wikstrom is with the Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC. Patrick O. McKeon is with the Department of Exercise and Sports Science, Ithaca College, Ithaca, NY. Matthew Hoch, PhD, ATC, University of Kentucky, is the report editor for this article.

Address author correspondence to Erik Wikstrom at wikstrom@unc.edu.
  • 1.

    Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ Jr. The epidemiology of ankle spranis in the united states. J Bone Joint Surg Am. 2010;92(13):22792284. PubMed doi:10.2106/JBJS.I.01537

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Fernandez WG, Yard EE, Comstock RD. Epidemiology of lower extremity injuries among U.S. high school athletes. Acad Emerg Med. 2007;14(7):641645. PubMed doi:10.1111/j.1553-2712.2007.tb01851.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42(2):311319. PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Anandacoomarasamy A, Barnsley L. Long term outcomes of inversion ankle injuries. Br J Sports Med. 2005;39(3):14. doi:10.1136/bjsm.2004.011676

  • 5.

    Gribble PA, Delahunt E, Bleakley CM, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the international ankle consortium. J Orthop Sports Phys Ther. 2013;43(8):585591. PubMed doi:10.2519/jospt.2013.0303

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Wikstrom EA, Hubbard-Turner T, McKeon PO. Understanding and treating lateral ankle sprains and their consequences: a constraints-based approach. Sports Med. 2013;43(6):385393. PubMed doi:10.1007/s40279-013-0043-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Houston MN, Hoch JM, Hoch MC. Patient-reported outcome measures in individuals with chronic ankle instability: a systematic review. J Athl Train. 2015;50(10):10191033. PubMed doi:10.4085/1062-6050-50.9.01

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Hubbard-Turner T, Turner MJ. Physical activity levels in college students with chronic ankle instability. J Athl Train. 2015;50(7):742747. PubMed doi:10.4085/1062-6050-50.3.05

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Hintermann B, Boss A, Schafer D. Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med. 2002;30(3):402409. PubMed doi:10.1177/03635465020300031601

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Drewes LK, McKeon PO, Kerrigan DC, Hertel J. Dorsiflexion deficit during jogging with chronic ankle instability. J Sci Med Sport. 2009;12(6):685687. PubMed doi:10.1016/j.jsams.2008.07.003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Gabriner ML, Houston MN, Kirby JL, Hoch MC. Contributing factors to start excursion balance test performance in individuals with chronic ankle instability. Gait Posture. 2015;41(4):912916. PubMed doi:10.1016/j.gaitpost.2015.03.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Hoch MC, Staton GS, McKeon PO. Dorsiflexion range of motion significantly influences dynamic balance. J Sci Med Sport. 2011;14(1):9092. PubMed doi:10.1016/j.jsams.2010.08.001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Hoch MC, Farwell KE, Gaven SL, Weinhandl JT. Weight-bearing dorsiflexion range of motion and landing biomechanics in in individuals with chronic ankle instability. J Athl Train. 2015;50(8):833839. PubMed doi:10.4085/1062-6050-50.5.07

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Houston MN, Hoch JM, Gabriner ML, Kirby JL, Hoch MC. Clinical and laboratory measures associated with health-related quality of life in individuals with chronic ankle instability. Phys Ther Sport. 2015;16(2):169175. PubMed doi:10.1016/j.ptsp.2014.10.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Hoch MC, Andreatta RD, Mullineaux DR, et al. Two-week joint mobilization intervention improves self-reported function, range of motion, and dynamic balance in those with chronic ankle instability. J Orthop Res. 2012;30(11):17981804. PubMed doi:10.1002/jor.22150

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Cruz-Diaz D, Lomas Vega R, Osuna-Perez MC, Hita-Contreras F, Martínez-Amat A. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial. Disabil Rehabil. 2015;37(7):601610. PubMed doi:10.3109/09638288.2014.935877

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Johnson E, Bradley B, Witkowski K, et al. Effect of a static calf muscle-tendon unit stretching program on ankle dorsiflexion range of motion of older women. J Geriatr Phys Ther. 2007;30(2):4952. PubMed doi:10.1519/00139143-200708000-00003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Halperin I, Jalal Aboodarda S, Button DC, Andersen LL, Behm DG. Roller massage improves range of motion of plantar flexor muscles without subsequent decrease in force parameters. Int J Sports Phys Ther. 2014;9(1):92102. PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    McKeon PO, Wikstrom EA. Sensory-targeted ankle rehabilitation strategies for chronic ankle instability. Med Sci Sports Exer. 2016;48(5):776784. doi:10.1249/MSS.0000000000000859

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Donovan L, Hertel J. A new paradigm for rehabilitation of patients with chronic ankle instability. Phys Sportsmed. 2012;40(4):4151. PubMed doi:10.3810/psm.2012.11.1987

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    McGinn TG, Guyatt GH, Wyer PC, Naylor CD, Stiell IG, Richardson WS. Users’ guides to the meduical literatuer: XXII: how to use articles about clinical decision rules. JAMA. 2000;284:7984. PubMed doi:10.1001/jama.284.1.79

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Laupacis A, Sekar N, Stiell IG. Clinical prediction rules. A review and suggested modification of methodological standards. JAMA. 1997;277:488494. PubMed doi:10.1001/jama.1997.03540300056034

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Collins GS, Reitsma JB, Altman DG, Moons KG. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. Ann Intren Med. 2015;162(1):5563. doi:10.7326/M14-0697

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Wikstrom EA, McKeon PO. Predicting balance improvements following STARS treatments in chronic ankle instability patients. J Sci Med Sport. 2017;20(4):356361. PubMed doi:10.1016/j.jsams.2016.09.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Wikstrom EA, McKeon PO. Predicting manual therapy treatment success in chronic ankle instability patients: improving self-reported function. J Athl Train. 2017;52(4):325331. PubMed doi:10.4085/1062-6050-52.2.07

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44(3):175180. PubMed doi:10.1016/S0004-9514(14)60377-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Riemann BL, Guskiewicz KM, Shields WW. Relationship between clinical and forceplate measures of postural stability. J Sport Rehabil. 1999;8:7182. doi:10.1123/jsr.8.2.71

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Whitman JM, Cleland JA, Mintken P, et al. Predicting short-term response to thrust and nonthrust manipulation and exercise in patients post inversion ankle sprain. J Orthop Sports Phys Ther. 2009;39(3):188200. PubMed doi:10.2519/jospt.2009.2940

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Vicenzino B, Collins N, Cleland J, et al. A clinical prediction rule for identifying patients with patellofemoral pain who are likely to benefit from foot orthoses: a preliminary determination. Br J Sports Med. 2010;44:862866. PubMed doi:10.1136/bjsm.2008.052613

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Hiller CE, Kilbreadth SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train. 2011;46:133141. doi:10.4085/1062-6050-46.2.133

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