Should physical therapists evaluate musculoskeletal disorders of the hip district in patients with chronic ankle instability? A systematic review
Autori
Alessio Mantineo [Alma Mater Studiorum, University of Bologna, Bologna, Italy]
Alex Lando [Department of Biomedical and Neuromotor Sciences-DIBINEM, Alma Mater University of Bologna, Bologna Italy]
Angela Scariato [Alma Mater Studiorum, University of Bologna, Bologna, Italy]
Martina Andò [Department of Biomedical and Neuromotor Sciences-DIBINEM, Alma Mater University of Bologna, Bologna Italy]
Giorgia Pregnolato [Insight SFI Research Centre, University College Dublin, Dublin, Ireland]
Tiziana Manni [Alma Mater Studiorum, University of Bologna, Bologna, Italy]
Andrea Turolla [Department of Biomedical and Neuromotor Sciences-DIBINEM, Alma Mater University of Bologna; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy]
Background and aims
Background:
Literature has demonstrated the presence of regional interdependence between ankle and hip joint in people with “Chronic Ankle Instability” (CAI), but is not possible to determine whether the muscular strength deficits of the hip and knee are associated with the development of CAI, or are just a consequence of that.
Aims:
The purpose of the study is to systematically review primaries studies that provide an evaluation on hip joint muscle strength, activation, kinematics, pain and coordination in subjects with CAI and suggest physical therapists in the evaluation of that during their physical examination and clinical reasoning.
Methods
The study design is a systematic review of literature conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
The search protocol was registered in PROSPERO database (ID:CRD42024608731).
Search string was launched in MEDLINE, Cochrane Library, Web of Science, CINAHL, Scopus, PEDro, Embase.
Inclusion criteria was any primary studies with a population of subjects with CAI symptoms (based on selection criteria for patient with CAI established from International Ankle Consortium) and presence of physical or instrumental evaluation of hip joint district muscles. The primary outcome was an evaluation of hip muscles strength. Secondary outcomes were muscle activation evaluated by electromyography studies of hip district, pain, kinematics and physical tests.
Abstract and full text screening was assessed by two independent reviewer and a third to resolve conflict.
Risk of Bias assessment was assessed with ROB2 tool and CASP Checklist.
Results
From 1570 studies, 58 was included and analysed. We found that in subjects with CAI there was an alteration of hip muscle strength, hip muscle activation and hip kinematics during functional tasks, that involved also static and dynamic balance, causing an alteration of frontal and sagittal hip kinematic plane, during walking, running, jumping, cutting movements and other functional movements, and an increased hip muscle activation during those tasks to maintain postural control.
Conclusion
The results of this study suggest the importance of a clinical assessment of hip district, focused on hip muscles strength, in chronic ankle instability patients; so this can help physical therapists in their clinical practice for a broader view of patient dysfunction from a regional interdependence perspective. It will be important in the future to carry out a quantitative analysis of data, that would allow generalization of data about the population under consideration.
REFERENCES
- Delahunt E, Coughlan GF, Caulfield B, Nightingale EJ, Lin CWC, Hiller CE. Inclusion Criteria When Investigating Insufficiencies in Chronic Ankle Instability. Med Sci Sports Exerc. novembre 2010;42(11):2106–21.
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- Delahunt E, Monaghan K, Caulfield B. Altered Neuromuscular Control and Ankle Joint Kinematics during Walking in Subjects with Functional Instability of the Ankle Joint. Am J Sports Med. dicembre 2006;34(12):1970–6.