This study aims to investigate the relationship between PTFJ mobility and tibial rotation in patients with CAI, and to assess the impact of joint mobility asymmetries between the injured and uninjured sides on dynamic balance. By addressing this gap, the study seeks to provide insights into how restricted PTFJ mobility may contribute to both impaired rotational kinematics and balance deficits in individuals with CAI.
Eighty participants (32 males and 48 females, mean age: 24.40 ± 5.22 years) participated in this study. A comprehensive evaluation was conducted, assessing ankle and PTFJ mobility, tibial rotation, and dynamic balance of each subject. Ankle dorsiflexion was measured using the weight-bearing lunge test, while tibial rotation were quantified with a tibial rotation disc. PTFJ mobility was assessed through accessory movement testing, and goniometric measurements were employed to quantify the ankle mobility. Dynamic balance performance was evaluated via the Y-balance test, with participants performing single-leg reaches in three directions. Reliability of all assessments was confirmed through pilot testing to ensure accurate data collection.
Significant reductions in tibial rotation, particularly internal rotation, were observed on the injured side, correlating with reduced PTFJ mobility (p = 0.01). Ankle dorsiflexion ROM and subtalar joint eversion were also significantly lower on the injured side (p = 0.01), with 70% of participants exhibiting restrictions in either tibial internal rotation or ankle dorsiflexion. Subtalar inversion was notably greater on the injured side (p = 0.006). Dynamic balance was impaired in all directions (p 0.001), with limited PTFJ and ankle joint mobility on the injured side correlating with poorer balance performance (r = -0.42, p = 0.01).
The findings of this study highlight the significant relationship between PTFJ mobility, tibial rotation, and dynamic balance in patients with CAI. The observed limitations in PTFJ mobility and tibial internal rotation on the injured side contribute to alterations in lower limb mechanics, resulting in impaired dynamic balance. Given the high incidence of recurrent sprains and chronic instability among these patients, addressing PTFJ mobility may be crucial for optimizing rehabilitation outcomes.
Clinicians may incorporate specific assessment techniques for PTFJ mobility as part of a comprehensive examination for individuals with ankle instability. Targeted interventions, such as manual therapy to enhance PTFJ mobility and exercises to improve tibial rotation, may be beneficial in restoring normal joint function and improving dynamic balance.
Proximal tibiofibular joint
Balance
