RELATIONSHIP BETWEEN SIDE TRIPLE HOP TEST AND HIP JOINT FUNCTION (EXTERNAL ROTATORS) IN PEOPLE WITH CHRONIC ANKLE INSTABILITY

K. Yoshikawa¹, T. Jiroumaru², H. Kitagawa¹, T. Hirakawa¹, M. Ikeya³, Y. Hyodo¹, Y. Oka¹

¹Kanazawa Orthopedic & Sports Medicine Clinic, Shiga, Japan, ²Bukkyo University, Kyoto, Japan, ³Biwako Professional University of Rehabilitation, Shiga, Japan

Background: Chronic ankle instability (CAI) causes long-term physical dysfunction and influences jump performance (Yeung et al. 1994). Previous studies have revealed reduced maximum muscle strength of the hip extensors, abductors, and external rotators in patients with CAI (Negahban et al. 2013, McCann et al. 2017). In the triple hop (TH) test, athletes perform three maximum single-leg jumps to assess muscle strength and power. One study comparing the results of the forward TH test between the CAI-affected side and asymptomatic side showed no significant difference (Wikstrom et al. 2009).
The side TH test is used to assess the maximum muscle power of a side jump (Bakaraki et al. 2021). The hip abductors and external rotators control side jumping and landing (Winter 1987). No study to date has clarified the relationship between the side TH test and the strength of these hip muscles in patients with CAI.

Purpose: This study was performed to clarify the relationship among the side TH test, the maximum muscle strength of the hip abductors and external rotators, and the thickness of the hip abductors and external rotators.

Methods: Thirteen men with CAI in a single leg (mean age, 29.7 ± 5.6 years) provided informed consent. They performed the TH test in the forward, lateral, and medial directions. The isometric muscle strength of the hip abductor and external rotator were measured using a handheld dynamometer. The participants lay on a plinth in the prone position for measurement of the thickness of the gluteus medius, gluteus maximus, and quadratus femoris by ultrasound imaging. Both the muscle strength and thickness were normalized by the participants’ weight. A paired t-test was performed to compare the CAI-affected side and healthy side. When a significant difference was found, Pearson’s correlation coefficient was calculated. The level of significance was set at p < 0.05. This study was approved by the Ethics Committee of the Kanazawa Orthopedic & Sports Medicine Clinic (Kanazawa-OSMC-2022-004) and was conducted in accordance with the Declaration of Helsinki.

Results: The strength of the hip external rotators and the lateral TH test result were significantly lower on the CAI-affected side. A positive correlation was found between the lateral TH test on the CAI-affected side and the hip external rotators (r = 0.57). However, the lateral TH test on the asymptomatic side showed no correlation with the hip external rotators.

Conclusions: This study showed that CAI may cause reduced muscle strength of the hip external rotators on the symptomatic side and may affect the lateral side jump performance.

Implications: Our results may contribute to improving the jumping ability of the CAI-affected side through the development of optimal therapeutic training. Furthermore, this training may prevent recurrent ankle sprain.

Funding acknowledgements: The authors have no conflicts of interest to declare.

Keywords:
Chronic ankle instability
Triple hop test
Hip function

Topics:
Orthopaedics

Did this work require ethics approval? Yes

Institution: Kanazawa Orthopedic & Sports Medicine Clinic

Committee: The Ethics Committee of the Kanazawa Orthopedic & Sports Medicine Clinic

Ethics number: Kanazawa-OSMC-2022-004