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- Title
Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.
- Authors
Hanlon, Shawn; Caccese, Jaclyn; Knight, Christopher A.; Swanik, Charles "Buz"; Kaminski, ThomasW.
- Abstract
Context: Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding. Objectives: To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding. Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: Thirty-three participants aged 20.2 ± 1.7 years were tested. Intervention(s): The ankle was loaded under 2 test conditions (relaxed, simulated muscle guarding) at 2 knee positions (0°, 90° of flexion) while gastrocnemius electromyography (EMG) activity was recorded. Main Outcome Measure(s): Anterior displacement (mm), inversion-eversion motion (°), and peak EMG amplitude values of the gastrocnemius (μV). Results: Anterior displacement did not differ between the positions of 0° and 90° of knee flexion (P = .193). Inversioneversion motion was greater at 0° of knee flexion compared with 90° (P <.001). Additionally, peak EMG amplitude of the gastrocnemius was not different between 0° and 90° of knee flexion during anterior displacement (P=.101). As expected, the simulated muscle-guarding trial reduced anterior displacement compared with the relaxed condition (0° of knee flexion, P = .008; 90° of knee flexion, P = .016) and reduced inversioneversion motion (0° of knee flexion, P =.03; 90° of knee flexion, P = .001). Conclusions: In a relaxed state, the gastrocnemius muscle did not appear to affect anterior ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscleguarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when performing these clinical examination techniques immediately postinjury.
- Subjects
KNEE physiology; ANKLE; ELECTROMYOGRAPHY; JOINT hypermobility; RANGE of motion of joints; MUSCLE contraction; QUESTIONNAIRES; CALF muscles; CROSS-sectional method; DESCRIPTIVE statistics
- Publication
Journal of Athletic Training (Allen Press), 2016, Vol 51, Issue 2, p111
- ISSN
1062-6050
- Publication type
Article
- DOI
10.4085/1062-6050-51.3.06