Isometric Hip Strength and Dynamic Stability of Individuals With Chronic Ankle Instability.

TitleIsometric Hip Strength and Dynamic Stability of Individuals With Chronic Ankle Instability.
Publication TypeJournal Article
Year of Publication2018
AuthorsMcCann RS, Bolding BA, Terada M, Kosik KB, Crossett ID, Gribble PA
JournalJ Athl Train
Volume53
Issue7
Pagination672-678
Date Published2018 Jul
ISSN1938-162X
KeywordsAdult, Ankle Injuries, Ankle Joint, Case-Control Studies, Chronic Disease, Female, Hip, Humans, Joint Instability, Male, Movement, Muscle Strength, Muscle, Skeletal, Rotation, Young Adult
Abstract

CONTEXT:   Compared with individuals who have a history of lateral ankle sprain (LAS) without markers of chronic ankle instability (CAI; LAS copers) and healthy people, those with CAI often exhibit neuromuscular impairments and dynamic-stability deficits at the hip. However, the influence of hip-strength deficits on dynamic stability remains unknown.

OBJECTIVE:   To compare isometric hip strength and dynamic stability in individuals with or without CAI and examine the degree of dynamic-stability variance explained by isometric hip strength.

DESIGN:   Case-control study.

SETTING:   Research laboratory.

PATIENTS OR OTHER PARTICIPANTS:   Sixty individuals (47 women, 13 men; age = 23.7 ± 4.6 years, height = 166.6 ± 7.7 cm, mass = 70.8 ± 15.7 kg) separated into CAI, LAS coper, and control groups based on previously established criteria.

MAIN OUTCOME MEASURE(S):   Group differences in resultant vector time to stabilization (RVTTS) and isometric hip-extension, -abduction, and external-rotation strength were determined using 1-way analyses of covariance that controlled for sex and limb (dominant or nondominant) tested and Cohen d effect sizes (95% confidence intervals). Backward linear regressions and Cohen f effect sizes (95% confidence intervals) determined the amount of RVTTS variance explained by isometric hip strength. Significance was set a priori at P < .05.

RESULTS:   The CAI group had less isometric hip-extension strength than LAS copers ( P = .02, d = 0.72 [0.06, 1.34]) and controls ( P = .01, d = 1.19 [0.50, 1.84]) and less external-rotation strength than LAS copers ( P = .03, d = 0.78 [0.13, 1.41]) and controls ( P = .01, d = 1.02 [0.34, 1.65]). No group differences existed for RVTTS ( F = 1.16, P = .32) or abduction strength ( F = 2.84, P = .07). Resultant vector time to stabilization was explained by isometric hip strength for LAS copers ( R = 0.21, f = 0.27 [0.22, 0.32], P = .04) but not for the CAI ( R = 0.12, f = 0.14 [0.06, 0.22], P = .22) or control ( R = 0.10, f = 0.11 [0.03, 0.19], P = .18) groups.

CONCLUSIONS:   Participants with CAI had decreased isometric hip strength, but that did not equate to dynamic-stability deficits. Clinicians should include hip-muscle strengthening in rehabilitation protocols for patients with CAI, yet these gains may not enhance dynamic stability when landing from a jump.

DOI10.4085/1062-6050-238-17
Alternate JournalJ Athl Train
PubMed ID30084648
PubMed Central IDPMC6138277