Tricia Hubbard-Turner

Physical Activity Levels in College Students With Chronic Ankle Instability.

CONTEXT Ankle sprains are the most common orthopaedic pathologic condition, and more concerning is the high percentage of persons who develop chronic ankle instability (CAI). Researchers have reported that patients with CAI are restricted occupationally, have more functional limitations, and have a poorer health-related quality of life. We do not know if these limitations decrease physical activity levels. OBJECTIVE To assess total weekly steps taken between persons with CAI and persons with healthy ankles. DESIGN Case-control study. SETTING University research laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 20 participants with unilateral CAI (9 men, 11 women; age = 21.2 ± 1.9 years, height = 174.3 ± 6.9 cm, mass = 71.9 ± 11.7 kg) and 20 healthy participants (9 men, 11 women; age = 20.4 ± 2.1 years, height = 172.1 ± 5.5 cm, mass = 73.1 ± 13.4 kg) volunteered. MAIN OUTCOME MEASURE(S) We provided all participants with a pedometer and instructed them to wear it every day for 7 days and to complete a daily step log. They also completed the Foot and Ankle Ability Measure (FAAM), the FAAM Sport version, and the International Physical Activity Questionnaire. A 2-way analysis of variance (group × sex) was used to determine if differences existed in the total number of weekly steps, ankle laxity, and answers on the International Physical Activity Questionnaire between groups and between sexes. RESULTS We found no group × sex interaction for step count (F range = 0.439-2.108, P = .08). A main effect for group was observed (F(1,38) = 10.45, P = .04). The CAI group took fewer steps than the healthy group (P = .04). The average daily step count was 6694.47 ± 1603.35 for the CAI group and 8831.01 ± 1290.01 for the healthy group. The CAI group also scored lower on the FAAM (P = .01) and the FAAM Sport version (P = .01). CONCLUSIONS The decreased step count that the participants with CAI demonstrated is concerning. This decreased physical activity may be secondary to the functional limitations reported. If this decrease in physical activity level continues for an extended period, CAI may potentially be a substantial health risk if not treated appropriately.

Acute Ankle Sprain in a Mouse Model.

INTRODUCTION Ankle sprains remain the most common orthopedic pathology. Conducting long-term studies in humans is difficult and costly, so the long-term consequences of an ankle sprain are not entirely known. PURPOSE The objective of this study is to develop and test a mechanical ankle instability model in mice. METHODS Thirty male mice (CBA/2J) were randomly placed into one of three groups: the transected calcaneal fibular ligament (CFL) group, the transected anterior talofibular ligament (ATFL)/CFL group, and a SHAM group. Three days after surgery, all of the mice were individually housed in a cage containing a solid surface running wheel, and daily running wheel measurements were recorded. Before and after surgery, measures of balance and gait were measured on all mice for 4 wk. RESULTS The mice in the ATFL/CFL group had significantly decreased duration (P = 0.0239), distance (P = 0.013), and speed (P = 0.003) compared with the SHAM group during week 1. During weeks 2 and 3, the ATFL/CFL group had significantly less distance (P = 0.0001) and duration (P = 0.002) compared with the SHAM and CFL-only group. The transection of the lateral ankle ligaments did affect the number of slips experienced during the balance test. The ATFL/CFL group had greater slips at 1 and 4 wk postsurgery (P = 0.05), whereas the CFL-only group had greater slips at 3 d and 1 wk postsurgery (P = 0.05). Relative to the SHAM group, the ATFL/CFL group and CFL-only group had smaller right-stride lengths (involved limb) at 3 d postsurgery (P = 0.05). The ATFL/CFL group also had smaller right-side stride lengths at 1 and 4 wk postsurgery (P = 0.05). CONCLUSIONS The results of this study indicate that a mouse model can be used to induce mechanical instability in the ankle.

Epidemiology of Posttraumatic Osteoarthritis.

Osteoarthritis is a leading cause of disability whose prevalence and incidence continue to increase. History of joint injury represents an important risk factor for posttraumatic osteoarthritis and is a significant contributor to the rapidly growing percentage of the population with osteoarthritis. This review will present the epidemiology associated with posttraumatic osteoarthritis, with particular emphasis on the knee and ankle joints. It is important to understand the effect of posttraumatic osteoarthritis on the population so that sufficient resources can be devoted to countering the disease and promoting optimal long-term health for patients after joint injury.

Lifelong physical activity and knee osteoarthritis development in mice.

To examine the effect of lifelong physical activity on the development of knee osteoarthritis (OA).

Developing a Mouse Model of Chronic Ankle Instability.

INTRODUCTION Ankle sprains are the most common orthopedic pathology experienced during sport and physical activity and often result in chronic ankle instability (CAI). Understanding how to prevent CAI is difficult because of the costs and logistics associated with clinical trials aimed at preventing the heterogeneous symptoms associated with CAI. Thus, a need exists to develop an animal model that presents similar long-term consequences as CAI to assess preclinical data. Thus, the purpose was to determine whether surgically transecting the lateral ligaments of a mouse hind limb results in the development of CAI-like symptoms 12 months after injury. METHODS Thirty male mice (CBA/J) were randomly placed into a SHAM (control), CFL (calcaneofibular ligament; mild ankle sprain), or ATFL/CFL (anterior talofibular ligament/CFL; severe) ankle sprain group and housed individually. Three days after surgically transecting the respective lateral ligaments, mice were given a solid surface running wheel and daily running wheel measurements were recorded. Outcome measures of balance and gait were obtained before and at 4, 48, 54, and 60 wk after injury. RESULTS The ATFL/CFL group had significantly more hind foot slips than the CFL and SHAM groups (P < 0.05). The CFL also had more hind foot slips relative to the SHAM group (P < 0.05). The ATFL/CFL group was significantly less physically active relative to the SHAM and CFL groups (P < 0.05). A cut score of 4.75 foot slips had a sensitivity of 0.68 and specificity of 1.00 and indicates that 70% (14/20) of mice with an ankle sprain had developed CAI. CONCLUSIONS The results of this study indicate that an acute ankle sprain in mice can result in the development of CAI-like symptoms 12 months after injury.

Acute Ankle Sprain in a Mouse Model: Changes in Knee-Joint Space

CONTEXT   Ankle sprains remain the most common orthopaedic injury. Conducting long-term studies in humans is difficult and costly, so the long-term consequences of an ankle sprain are not entirely known. OBJECTIVE   To measure knee-joint space after a single surgically induced ankle sprain in mice. DESIGN   Randomized controlled trial. SETTING   University research laboratory. PATIENTS OR OTHER PARTICIPANTS   Thirty male mice (CBA/2J) were randomly placed into 1 of 3 surgical groups: the transected calcaneofibular ligament (CFL) group, the transected anterior talofibular ligament/CFL group, or a sham treatment group. The right ankle was operated on in all mice. MAIN OUTCOME MEASURE(S)   Three days after surgery, all of the mice were individually housed in cages containing a solid-surface running wheel, and daily running-wheel measurements were recorded. Before surgery and every 6 weeks after surgery, a diagnostic ultrasound was used to measure medial and lateral knee-joint space in both hind limbs. RESULTS   Right medial (P = .003), right lateral (P = .002), left medial (P = .03), and left lateral (P = .002) knee-joint spaces decreased across the life span. The mice in the anterior talofibular ligament/CFL group had decreased right medial (P = .004) joint space compared with the sham and CFL groups starting at 24 weeks of age and continuing throughout the life span. No differences occurred in contralateral knee-joint degeneration among any of the groups. CONCLUSIONS   Based on current data, mice that sustained a surgically induced severe ankle sprain developed greater joint degeneration in the ipsilateral knee. Knee degeneration could result from accommodation to the laxity of the ankle or biomechanical alterations secondary to ankle instability. A single surgically induced ankle sprain could significantly affect knee-joint function.

Weekly Physical Activity Levels of Older Adults Regularly Using a Fitness Facility.

The aim of this paper was to determine if weekly physical activity levels were greater in an independent-living older adult population that was regularly participating in structured fitness activities. Also, lifetime exercise history and sex differences were investigated in an effort to understand how they relate to current weekly step activity. Total weekly step counts, measured with a pedometer, were assessed in two older adult groups; the first consisted of members of a local senior center who regularly used the fitness facility (74.5 ± 6.0 yrs; mean ± SD) while the second group consisted of members who did not use the fitness facility (74.8 ± 6.0 yrs). Participants also completed the Lifetime Physical Activity Questionnaire (LPAQ). No significant difference was found in the total number of weekly steps between groups (p = 0.88) or sexes (p = 0.27). The LPAQ suggested a significant decline in activity with aging (p = 0.01) but no difference between groups (p = 0.54) or sexes (p = 0.80). A relationship was observed between current step activity and MET expenditure over the past year (p = 0.008, r 2 = 0.153) and from ages 35 to 50 years (p = 0.037, r 2 = 0.097). The lack of difference in weekly physical activity level between our groups suggests that independent-living older adults will seek out and perform their desired activity, in either a scheduled exercise program or other leisure-time activities. Also, the best predictor of current physical activity level in independent-living older adults was the activity performed over the past year.

Ankle sprains: treating to prevent the long-term consequences.

&NA; Ankle sprains are often believed—quite wrongly—to be inconsequential. As a result, more than half of people who sprain an ankle do not seek medical treatment.

Lateral Ankle Sprain in a Mouse Model: Lifelong Sensorimotor Dysfunction

CONTEXT   Ankle sprains are the most common orthopaedic injury that occurs during sport and physical activity. Many individuals who sprain their ankles develop chronic ankle instability (CAI), a condition characterized by recurrent injury, decreased physical activity, and decreased quality of life. These residual impairments are believed to persist for the remainder of the patients life, in part due to the link between CAI and posttraumatic ankle osteoarthritis. However, this belief remains speculative due to the lack of long-term prospective investigations. OBJECTIVE   To use a mouse model of mild (MILD) and severe (SEVERE) ankle sprains to quantify balance and locomotor adaptations across the lifespan. DESIGN   Cohort study. SETTING   University research laboratory. PATIENTS OR OTHER PARTICIPANTS   Fifty male mice (CBA/J) were randomly placed into a control (SHAM), MILD, or SEVERE group and housed individually. INTERVENTION(S)   The MILD group underwent surgical transection of a single right hind-limb lateral ankle ligament, and the SEVERE group had 2 of the lateral ligaments transected. The SHAM group underwent a sham surgery during which no lateral ligaments were transected. MAIN OUTCOME MEASURE(S)   After surgically inducing the ankle sprain, we measured balance and gait using a balance beam and footprint test before and every 6 weeks for 78 weeks. RESULTS   Age-related declines in balance but not stride length were exacerbated by an ankle sprain ( P < .001). Balance and stride lengths changed with age ( P < .001). Foot slips were worse in the SEVERE (4.32 ± 0.98) and MILD (3.53 ± 0.98) groups than in the SHAM group (2.16 ± 0.99; P < .001). Right-limb stride length was shorter in the SEVERE group (6.45 cm ± 0.41 cm) than in the SHAM group (6.87 cm ± 0.40 cm; P = .04). CONCLUSIONS   Transecting the lateral ligaments of a mouse hind foot resulted in lifelong sensorimotor dysfunction. Declines starting at 42 weeks postinjury may have represented the onset of posttraumatic osteoarthritis.

Number of knee and ankle injuries is associated with poor physical but not mental health

ABSTRACT The knee and ankle are among the most commonly injured joints in the body. Long-term strength and neuromuscular control deficits are common following these injuries, yielding lifelong disability and poor quality of life. However, it is unknown how the number of injuries sustained influences quality of life. Objectives: Determine the association between the number of ankle or knee injuries sustained and physical and mental quality of life. Methods: A total of 806 ankle-injured (age:45.2 ± 15.3 yrs; body mass index [BMI]:28.6 ± 7.4 kg/m2), 658 knee-injured (age:49.3 ± 16.1 yrs; BMI:28.4 ± 7.4 kg/m2), and 996 uninjured (age:43.4 ± 16.1 yrs; BMI:26.9 ± 6.5 kg/m2) adults completed the SF-8 survey to determine the physical (PCS) and mental (MCS) contributions to quality of life. Respondents were categorized by injury history (ankle, knee, none) and number of injuries (0, 1, 2, or 3 or more [3+]) to the same joint. Backward linear regression models were used to determine the association between quality of life, age, and injury history separately for SF-8 PCS and MCS, as well as ankle versus knee injury. Results: Reporting 1, 2, or 3+ ankle injuries along with age predicted SF-8 PCS (P < 0.001). Further, 1 or 2 ankle injuries and age (P < 0.001) predicted SF-8 MCS. Reporting 1, 2, or 3+ knee injuries along with age significantly predicted SF-8 PCS (P < 0.001). Age, but not knee injury history, significantly predicted SF-8 MCS (P < 0.001). Conclusion: Current age and history of sustaining at least one injury negatively impact physical quality of life following either a knee or ankle injury. However, mental quality of life was predicted most consistently by age. Efforts to reduce injuries should be employed to improve quality of life, but more research is needed to determine what other factors contribute to quality of life across the lifespan.