A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome
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| Language: | English |
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The Ohio State University / OhioLINK
2020
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| Online Access: | http://rave.ohiolink.edu/etdc/view?acc_num=osu159525742962944 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu159525742962944 |
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oai_dc |
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NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Biomechanics Medical Imaging Sports Medicine Musculoskeletal sonography biomechanics ankle high ankle sprain syndesmotic ankle sprain gait ultrasound |
| spellingShingle |
Biomechanics Medical Imaging Sports Medicine Musculoskeletal sonography biomechanics ankle high ankle sprain syndesmotic ankle sprain gait ultrasound Tatarski, Rachel Leigh A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome |
| author |
Tatarski, Rachel Leigh |
| author_facet |
Tatarski, Rachel Leigh |
| author_sort |
Tatarski, Rachel Leigh |
| title |
A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome |
| title_short |
A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome |
| title_full |
A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome |
| title_fullStr |
A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome |
| title_full_unstemmed |
A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome |
| title_sort |
novel approach to the diagnosis and prognosis of syndesmotic ankle sprain syndrome |
| publisher |
The Ohio State University / OhioLINK |
| publishDate |
2020 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=osu159525742962944 |
| work_keys_str_mv |
AT tatarskirachelleigh anovelapproachtothediagnosisandprognosisofsyndesmoticanklesprainsyndrome AT tatarskirachelleigh novelapproachtothediagnosisandprognosisofsyndesmoticanklesprainsyndrome |
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1719457598377295872 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu1595257429629442021-08-03T07:15:42Z A Novel Approach to the Diagnosis and Prognosis of Syndesmotic Ankle Sprain Syndrome Tatarski, Rachel Leigh Biomechanics Medical Imaging Sports Medicine Musculoskeletal sonography biomechanics ankle high ankle sprain syndesmotic ankle sprain gait ultrasound Patients with syndesmotic ankle sprains (SAS) often experience persistent pain and dysfunction, but little is known about the effect of SAS on ankle biomechanics during functional tasks. Furthermore, the clinical tests and imaging modalities used to diagnose syndesmotic ankle sprains are often unreliable and inaccurate. An exam that combines dynamic musculoskeletal sonography with the clinical tests for ligamentous integrity (MSKS+CE) may improve the rates of misdiagnosis and lead to better patient outcomes. Identification of which clinical and biomechanical factors are most closely related to patient-reported function will provide insight for clinical decision-making with the goal of improving patient outcomes after SAS.The objective of Experiment 1 was to assess the reliability and accuracy of musculoskeletal sonography to distinguish intact from damaged anterior inferior tibiofibular ligaments. The a priori hypotheses tested were that MSKS+CE would be (1) reliable (inter- and intra-rater reliability) and (2) accurate (distinguish between injury states). MSKS+CE demonstrated moderate inter-rater reliability for the superficial distance measurement but poor inter-rater reliability for the deep distance measurement. Intra-rater reliability of the superficial distance was excellent for the Neutral, External Rotation + Dorsiflexion, Fibular Translation, and Squeeze Tests across all injury conditions. Only the Neutral Test demonstrated excellent reliability across all injury conditions for the deep distance. The Neutral, External Rotation, and Dorsiflexion Tests could accurately distinguish between an intact and damaged AiTFL. Musculoskeletal sonography during the clinical tests is reliable and accurate overall. The neutral, external rotation, and dorsiflexion tests were most reliable and accurate.The objective of Experiment 2 was to assess the effects of SAS on ankle kinematics and kinetics during functional tasks such as gait, the Single-Leg Anterior Reach (SLAR), and the Double-Leg Deep Squat (DLDS). While there were no group differences in gait speed or step length, the participants with SAS walked with reduced ankle dorsiflexion and maximum external dorsiflexion moment on the involved limb compared to the HC group. There was no difference in anterior reach distance but there was a group-by-limb interaction for maximum ankle dorsiflexion. There were no group of limb differences for maximum external dorsiflexion moment. For the DLDS, the SAS group squatted less deep than the HC group, but there were no group or limb differences in ankle range of motion or maximum external dorsiflexion moment. Even after accounting for gait speed, reach distance, and squat depth, individuals with SAS move differently than individuals without SAS.The objective of Experiment 3 was to determine which clinical and biomechanical factors are most closely related to patient-reported function. Gait speed and the distance between the superficial AiTFL attachment sites at rest were strongly related to patient-reported function. Together these two variables explained ~80% of the variance in the model. Gait speed may be an important marker of function and can be easily measured in a clinical setting. Sonographic measurements of the AiTFL may provide additional information about the pathoanatomical severity of the injury and may also be used as a marker of function.Overall, the MSKS+CE diagnostic method is feasible, reliable, and accurate. Ankle biomechanics are altered during functional tasks in individuals with SAS and these compensation strategies may serve as markers of function and inform treatment decisions. 2020-11-06 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu159525742962944 http://rave.ohiolink.edu/etdc/view?acc_num=osu159525742962944 restricted--full text unavailable until 2025-08-25 This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |