Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability

Category: Sports; Ankle Introduction/Purpose: Even after a considerable period following the modified Broström procedure, it is not uncommon for individuals to fail to fully regain their pre-injury sports activity capabilities. Return to sports activity can be influenced by various factors beyond th...

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Main Authors: Byung-Ki Cho MD, PhD, Seung-myung Choi MD, Sunghoo Kim MD, Yoon-ho Kim MD
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011424S00287
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author Byung-Ki Cho MD, PhD
Seung-myung Choi MD
Sunghoo Kim MD
Yoon-ho Kim MD
author_facet Byung-Ki Cho MD, PhD
Seung-myung Choi MD
Sunghoo Kim MD
Yoon-ho Kim MD
author_sort Byung-Ki Cho MD, PhD
collection DOAJ
description Category: Sports; Ankle Introduction/Purpose: Even after a considerable period following the modified Broström procedure, it is not uncommon for individuals to fail to fully regain their pre-injury sports activity capabilities. Return to sports activity can be influenced by various factors beyond the patient's determination (hope for sports activity), including residual pain or swelling, inadequate mechanical stability, deficits in postural control abilities or proprioception, among others. This study aimed to investigate the factors influencing the return to sports activity after anatomical ligament repair for chronic ankle instability. Methods: We conducted a study involving 62 patients under the age of 35 who underwent the modified Broström procedure for chronic ankle instability and were followed up for over 3 years. Among them, 51 patients (82.3%) were able to return to their pre-injury level of sports activity (return group), while 11 patients (17.7%) experienced some or significant limitations (non-return group). Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM). Mechanical stability was assessed through physical examination and stress radiography. peroneal strength was evaluated using Biodex isokinetic dynamometer to measure peak torque and total work during eversion movement. Postural control abilities were analyzed using the static and dynamic stability assessment modes of Biodex posturography. Results: There was a significant difference between the two groups in FAOS pain (94.7 points in return group vs 85.1 points in non-return group, p=0.004) and sports (91.2 points vs 78.8 points, p<.001) subscales. In FAAM assessment, there was a significant difference in the sports activity (90.5 points vs 77.4 points, p<.001). Recurrence of mechanical instability was confirmed in 2 patients (3.9%) in the return group and 4 patients (36.4%) in the non-return group. There were no significant differences between the groups in evertor peak torque and total work. Regarding posturography assessment, static postural control ability(overall stability index) did not show significant differences between the groups, but significant differences were observed in dynamic postural control ability (1.4 vs 2.3, p=0.002). Conclusion: It has been analyzed that residual pain, recurrence of mechanical instability, and inadequate recovery of dynamic postural control ability affect the return to pre-injury level of sports activity after the modified Broström procedure for chronic ankle instability. It is deemed necessary to develop effective treatment strategies considering these factors during the rehabilitation process aimed at returning to sports activity after surgery.
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spelling doaj-art-b648493be1bc48fe82a4c453b0a6348e2025-08-20T02:35:29ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-12-01910.1177/2473011424S00287Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control AbilityByung-Ki Cho MD, PhDSeung-myung Choi MDSunghoo Kim MDYoon-ho Kim MDCategory: Sports; Ankle Introduction/Purpose: Even after a considerable period following the modified Broström procedure, it is not uncommon for individuals to fail to fully regain their pre-injury sports activity capabilities. Return to sports activity can be influenced by various factors beyond the patient's determination (hope for sports activity), including residual pain or swelling, inadequate mechanical stability, deficits in postural control abilities or proprioception, among others. This study aimed to investigate the factors influencing the return to sports activity after anatomical ligament repair for chronic ankle instability. Methods: We conducted a study involving 62 patients under the age of 35 who underwent the modified Broström procedure for chronic ankle instability and were followed up for over 3 years. Among them, 51 patients (82.3%) were able to return to their pre-injury level of sports activity (return group), while 11 patients (17.7%) experienced some or significant limitations (non-return group). Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM). Mechanical stability was assessed through physical examination and stress radiography. peroneal strength was evaluated using Biodex isokinetic dynamometer to measure peak torque and total work during eversion movement. Postural control abilities were analyzed using the static and dynamic stability assessment modes of Biodex posturography. Results: There was a significant difference between the two groups in FAOS pain (94.7 points in return group vs 85.1 points in non-return group, p=0.004) and sports (91.2 points vs 78.8 points, p<.001) subscales. In FAAM assessment, there was a significant difference in the sports activity (90.5 points vs 77.4 points, p<.001). Recurrence of mechanical instability was confirmed in 2 patients (3.9%) in the return group and 4 patients (36.4%) in the non-return group. There were no significant differences between the groups in evertor peak torque and total work. Regarding posturography assessment, static postural control ability(overall stability index) did not show significant differences between the groups, but significant differences were observed in dynamic postural control ability (1.4 vs 2.3, p=0.002). Conclusion: It has been analyzed that residual pain, recurrence of mechanical instability, and inadequate recovery of dynamic postural control ability affect the return to pre-injury level of sports activity after the modified Broström procedure for chronic ankle instability. It is deemed necessary to develop effective treatment strategies considering these factors during the rehabilitation process aimed at returning to sports activity after surgery.https://doi.org/10.1177/2473011424S00287
spellingShingle Byung-Ki Cho MD, PhD
Seung-myung Choi MD
Sunghoo Kim MD
Yoon-ho Kim MD
Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability
Foot & Ankle Orthopaedics
title Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability
title_full Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability
title_fullStr Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability
title_full_unstemmed Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability
title_short Factors Influencing Return to Sports after Modified Broström Procedure for Chronic Ankle Instability: Clinical Evaluation Scores, Mechanical Stability, Peroneal Strength, Postural Control Ability
title_sort factors influencing return to sports after modified brostrom procedure for chronic ankle instability clinical evaluation scores mechanical stability peroneal strength postural control ability
url https://doi.org/10.1177/2473011424S00287
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