Quantitative dynamic assessment in the distance between the talus and lateral malleolus during landing in individuals with chronic ankle instability

Ayano Ishida, Noriaki Maeda, Satoshi Onoue, Tsubasa Tashiro, Satoshi Arima, Rami Mizuta, Honoka Ishihara, Yukio Urabe
Purpose:

To evaluate dynamics of the distance between the talus and lateral malleolus during forward single-leg drop landing and compare between individuals with and without CAI.

Methods:

In total, 24 adults (38 feet) participated in this study, and they were divided into the healthy group (12 adults, 24 feet) and the CAI group (12 adults, 14 feet). The task movement was single-leg drop landing from a 30 cm high box. The distance between the talus and lateral malleolus and ankle joint angles during landing were captured by synchronization of ultrasound (ArtUs EXT-1H, Telemed) and three-dimensional motion capture systems (VICON, Vicon motion systems). The analysis interval was from 200 ms before to 200 ms after initial contact (IC), and it was normalized to 100% (IC was at 50%). To analyze the time course of the distance between the talus and lateral malleolus and ankle joint angles in two groups, statistical parametric mapping analysis was conducted.

Results:

The distance between the talus and lateral malleolus before IC (10％-35％) was longer in the CAI group than that of the healthy group (p0.01). Also, the CAI group showed larger ankle adduction angle before IC (0％-35％) compared to the healthy group (p0.05). 

Conclusion(s):

The distance between the talus and lateral malleolus increases with ankle adduction stress, owing to the anterior displacement and internal rotation of the talus. Anterior talofibular ligament (ATFL) prevents excessive anterior displacement and internal rotation of the talus. Due to the evidence that 98％ of LAS patients have damage on ATFL, the CAI group in this study might had decreased tension of ATFL. Also, the activity of peroneus muscles and proprioception in ankle adduction position declines before IC in case with CAI. These ankle disorders in the CAI group might cause larger ankle adduction angle and lead to longer distance between the talus and lateral malleolus.

Implications:

The increased distance between the talus and lateral malleolus before IC may be related with high lateral ankle instability. We should improve the distance between the talus and lateral malleolus before IC with the physical therapy including muscle training, taping, or orthosis. Further, the ankle instability will be lower and prevent the recurrent of the LAS injury during landing.

Funding acknowledgements:
We have no funding acknowledgement in this study.
Keywords:
Ultrasound
Motion capture system
Statistical parametric mapping
Primary topic:
Sport and sports injuries
Second topic:
Musculoskeletal: lower limb
Third topic:
Musculoskeletal
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The study protocols were approved by the Ethical Committee for Epidemiology of Hiroshima University.
Provide the ethics approval number:
E-2187
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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