Isometric Hip Strength and Patient-Reported Outcomes of Individuals With and Without Chronic Ankle Instability

in Journal of Sport Rehabilitation

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Katherine A. Bain
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Paige A. Clawson
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Stacey A. Slone
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Phillip A. Gribble
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Johanna M. Hoch
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Matthew C. Hoch
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Kyle B. Kosik
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Context: Strength deficits and decreased scores on generic, dimension-specific, and region-specific health-related quality of life (HRQL) PRO measures are commonly documented among individuals with chronic ankle instability (CAI). However, it is unknown if there is a relationship between hip strength and self-reported patient-reported outcome (PRO) scores. Objective: To compare isometric peak torque for hip-extension (H-EXT) and hip-abduction (H-ABD), as well as PRO scores between CAI, lateral ankle sprain copers (LAS copers), and uninjured controls (UC). The secondary purpose was to examine the relationship between isometric hip peak torque and PROs in participants with CAI. Design: Cross-sectional. Setting: Laboratory. Participants: Sixty-three individuals, 45 women (23.02 [3.83] y, 165.91 [7.55] cm, 67.28 [11.95] kg) and 18 men (26.28 [5.43] y, 179.28 [9.01] cm, 83.87 [13.26] kg), grouped as uninjured control (n = 26), LAS coper (n = 15), or CAI (n = 22). Main Outcome Measures: The Foot and Ankle Ability Measure was used to assess region-specific HRQL. The Fear Avoidance Beliefs Questionnaire was used to assess injury-related fear. The Disablement in Physically Active was used to assess global HRQL. Isometric peak torque was measured with a handheld dynamometer for H-EXT and H-ABD. Results: No group differences were observed for H-ABD (P = .34) or H-EXT (P = .35). The CAI group had significantly worse scores on all PROs compared with LAS coper (P < .001) and HC (P < .001). Moderate–weak correlations were found between H-ABD and Foot and Ankle Ability Measure—activities of daily living (P = .047; ρ = .392) and Foot and Ankle Ability Measure-Sport (P = .013; ρ = .482) and H- EXT and Fear Avoidance Beliefs Questionnaire-Work (P = .007; ρ = −.517). Conclusions: Individuals with CAI displayed lower HRQL based on worse scores on generic, dimension-specific, and region-specific PROs compared with LAS copers and uninjured controls. There were no significant between-group differences for H-EXT and H-ABD isometric peak torque production, but there was a moderate positive relationship between isometric H-ABD and self-reported ankle disability in individuals with CAI.

Bain, Gribble, J.M. Hoch, M.C. Hoch, and Kosik are with the Department of Athletic Training & Clinical Nutrition, University of Kentucky, Lexington, KY, USA. Slone is with the Department of Statistics, University of Kentucky, Lexington, KY, USA. Clawson is with the UK Healthcare Orthopedic Surgery & Sports Medicine—Morehead State University, Morehead, KY, USA.

Bain (katherine.bain@uky.edu) is corresponding author.
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  • 1.

    Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42:311319. PubMed ID: 17710181

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

    McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med. 2001;35(2):103108. PubMed ID: 11273971 doi:10.1136/bjsm.35.2.103

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

    van Rijn RM, van Os AG, Bernsen RMD, Luijsterburg PA, Koes BW, Bierma-Zeinstra SMA. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. 2008;121(4):324331.e7. PubMed ID: 18374692 doi:10.1016/j.amjmed.2007.11.Please check and verify the edits made to the Ref. 3.018.

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

    Gribble PA, Delahunt E, Bleakley C, 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 ID: 23902805 doi:10.2519/jospt.2013.0303

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Wikstrom EA, Brown CN. Minimum reporting standards for copers in chronic ankle instability research. Sports Med. 2014;44(2):251268. PubMed ID: 24122774 doi:10.1007/s40279-013-0111-4

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

    Hertel J, Corbett RO. An updated model of chronic ankle instability. J Athl Train. 2019;54(6):572588. PubMed ID: 31162943 doi:10.4085/1062-6050-344-18

  • 7.

    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 ID: 25500148 doi:10.1016/j.ptsp.2014.10.006

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

    Dejong AF, Koldenhoven RM, Hertel J. Proximal adaptations in chronic ankle instability: systematic review and meta-analysis. Med Sci Sports Exerc. 2020;52(7):15631575. PubMed ID: 31977639 doi:10.1249/MSS.0000000000002282

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

    McCann RS, Crossett ID, Terada M, Kosik KB, Bolding BA, Gribble PA. Hip strength and star excursion balance test deficits of patients with chronic ankle instability. J Sci Med Sport. 2017;20(11):992996. PubMed ID: 28595864 doi:10.1016/j.jsams.2017.05.005

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

    McCann RS, Terada M, Kosik KB, Gribble PA. Landing kinematics and isometric hip strength of individuals with chronic ankle instability. Foot Ankle Int. 2019;40(8):969977. PubMed ID: 31023077 doi:10.1177/1071100719846085

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

    Vela LI, Denegar CR. The disablement in the physically active scale, part II: the psychometric properties of an outcomes scale for musculoskeletal injuries. J Athl Train. 2010;45(6):630641, PubMed ID: 21062187 doi:10.4085/1062-6050-45.6.630

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

    Houston M, Hoch J, Hoch M. BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine, 2015.

  • 13.

    Van Baar ME, Assendelft WJ, Dekker J, Oostendorp RA& Bijlsma JW. Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review of randomized clinical trials. Arthritis Rheum. 1999;42(7):13611369. PubMed ID: 10403263 doi:10.1002/1529-0131(199907)42:7<1361::AID-ANR9>3.0.CO;2-9

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

    Lentz TA, Sutton Z, Greenberg S, Bishop MD. Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology. Arch Phys Med Rehabil. 2010;91:557561. PubMed ID: 20382287 doi:10.1016/j.apmr.2009.12.010

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

    Martin RL, Irrgang JJ, Burdett RG, Conti SF, Swearingen JMV. Evidence of validity for the foot and ankle ability measure (FAAM). Foot Ankle Int. 2005;26(11):968983. PubMed ID: 16309613 doi:10.1177/107110070502601113

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

    Cohen J. Statistical power analysis for behavioral sciences. 2nd ed. New York, NY: Lawrence Erlbaum Associates; 1988.

  • 17.

    RB, L. 321-325 (L. Erlbaum Associates 1998).

  • 18.

    Khalaj N, Vicenzino B, Heales LJ, Smith MD. Is chronic ankle instability associated with impaired muscle strength? Ankle, knee and hip muscle strength in individuals with chronic ankle instability: a systematic review with meta-analysis. Br J Sports Med. 2020;54(14):839847. PubMed ID: 31937576 doi:10.1136/bjsports-2018-100070

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

    Kosik KB, Terada M, Drinkard CP, McCann RS, Gribble PA. Potential corticomotor plasticity in those with and without chronic ankle instability. Med Sci Sports Exerc. 2017;49(1):141149. PubMed ID: 27501358 doi:10.1249/MSS.0000000000001066

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

    Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train. 2011;46(2):133141. PubMed ID: 21391798 doi:10.4085/1062-6050-46.2.133

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

    Terada M, Bowker S, Hiller CE, Thomas AC, Pietrosimone B, Gribble PA. Quantifying levels of function between different subgroups of chronic ankle instability. Scand J Med Sci Sports. 2017;27(6):650660. PubMed ID: 27292532 doi:10.1111/sms.12712

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

    Mailuhu AKE, Oei EHG, van Ochten JM, Bindels PJE, Bierma-Zeinstra SMA, van Middelkoop M. Subgroup characteristics of patients with chronic ankle instability in primary care. J Sci Med Sport. 2019;22(8):866870. PubMed ID: 30878293 doi:10.1016/j.jsams.2019.02.009

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

    Donovan L, Hertel J. A new paradigm for rehabilitation of patients with chronic ankle instability. Phys Sportsmed. 2012;40(4):4151 PubMed ID: 23306414 doi:10.3810/psm.2012.11.1987

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

    Donovan L, Hart JM, Saliba SA, et al. Rehabilitation for chronic ankle instability with or without destabilization devices: a randomized controlled trial. J Athl Train. 2016;51(3):233251. PubMed ID: 26934211 doi:10.4085/1062-6050-51.3.09

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

    Parsons JT, Snyder AR. Health-related quality of life as a primary clinical outcome in sport rehabilitation. J Sport Rehabil. 2011;20:1736. PubMed ID: 21411820 doi:10.1123/jsr.20.1.17

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

    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 ID: 26332028 doi:10.4085/1062-6050-50.9.01

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

    Wikstrom EA, Song K. Generic and psychological patient-reported deficits in those with chronic ankle instability: a cross sectional study. Phys Ther Sport. 2019;40:137142. PubMed ID: 31542637 doi:10.1016/j.ptsp.2019.09.004

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

    Houston MN, Van Lunen BL, Hoch MC. Health-related quality of life in individuals with chronic ankle instability. J Athl Train. 2014;49(6):758763. PubMed ID: 25299444 doi:10.4085/1062-6050-49.3.54

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

    Wikstrom EA, Bishop MD, Inamdar AD, Hass CJ. Gait termination control strategies are altered in chronic ankle instability subjects. Med Sci Sports Exerc. 2010;42(1):197205. PubMed ID: 20010113 doi:10.1249/MSS.0b013e3181ad1e2f

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

    DeJong AF, Mangum LC, Hertel J. Gluteus medius activity during gait is altered in individuals with chronic ankle instability: an ultrasound imaging study. Gait Posture. 2019;71:713. PubMed ID: 30999270 doi:10.1016/j.gaitpost.2019.04.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    DeJong AF, Mangum LC, Hertel J. Ultrasound imaging of the gluteal muscles during the Y-Balance test in individuals with or without chronic ankle instability. J Athl Train. 2020;55(1):4957. PubMed ID: 31876453 doi:10.4085/1062-6050-363-18

    • Crossref
    • Search Google Scholar
    • Export Citation
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