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Ankle strength is not strongly associated with postural stability in patients awaiting surgery for chronic lateral ankle instability

Knee Surgery, Sports Traumatology, Arthroscopy volume 28, pages 326–333 (2020)Cite this article

Abstract

Purpose

(1) To describe ankle strength and postural stability in patients with chronic lateral ankle instability and (2) to analyse the correlation between deficits in ankle strength and postural stability.

Methods

Results of preoperative isokinetic and balance tests in 203 patients whose contralateral ankle was normal were retrospectively reviewed. Isokinetic peak torque values of eversion and inversion at 2 angular velocities (30°/s and 120°/s) were measured in the injured and normal ankles. In the balance test, the percent differences of 3 actual scores (overall, anterior–posterior, and medial–lateral) between the injured and normal ankles were calculated. Additional statistical analyses were performed to evaluate weakness of ankle strength, postural stability deficits, and their correlation.

Results

Significant differences in 4 peak torque values and 4 relative peak torque values (peak torque/body weight) were found between the injured and normal ankles. All 8 values were significantly lower in the injured ankles. Weakness was severe during inversion and at 30°/s. In the balance test, 49 subjects (24.1%) had significant deficits in postural stability and 109 (53.7%) had favourable results. No strong association was found between weakness of ankle strength and deficits in postural stability.

Conclusions

Strength measurement alone is insufficient to evaluate preoperative functional deficits, and other functional tests are required to measure postural stability. The results of this study provide further evidence for a rehabilitation programme consisting of proprioceptive training as well as strengthening. The proprioceptive training must be an integral part of the rehabilitation programme in addition to strengthening exercise.

Level of evidence

Case series, Level IV.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea

    Kyung Rae Ko, Hyobeom Lee, Won-Young Lee & Ki-Sun Sung

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  1. Kyung Rae Ko
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  2. Hyobeom Lee
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  3. Won-Young Lee
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Correspondence to Ki-Sun Sung.

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Appendix

Appendix

See Tables 7 and 8.

Table 7 Reported intraclass correlation coefficient of the stability index of the Biodex Stability System
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Table 8 Test–retest reliability of the measurement systems in the pilot study
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Cite this article

Ko, K.R., Lee, H., Lee, WY. et al. Ankle strength is not strongly associated with postural stability in patients awaiting surgery for chronic lateral ankle instability. Knee Surg Sports Traumatol Arthrosc 28, 326–333 (2020). https://doi.org/10.1007/s00167-018-4960-0

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  • DOI: https://doi.org/10.1007/s00167-018-4960-0

Keywords

  • Chronic ankle instability
  • Ankle strength
  • Postural stability
  • Rehabilitation