Correlates of functional ankle instability in children and adolescents with Charcot-Marie-Tooth disease

Journal of Foot and Ankle Research

Joshua Burns¹  Kathryn Refshauge¹  Jacqueline Raymond³  Melissa Mandarakas¹  Claire E. Hiller¹  Kristy J. Rose² 

[1] Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia;School of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia;Exercise Physiology and Nutrition Research Team, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia

关键词: Foot posture;    Cumberland ankle instability tool;    Functional ankle instability;    Adolescent;    Child;    Charcot-Marie-Tooth disease;   

Others  :  1232033
DOI  :  10.1186/s13047-015-0118-1

 received in 2015-06-27, accepted in 2015-10-30,  发布年份 2015

【 摘 要 】

Background

Functional ankle instability (FAI) is commonly reported by children and adolescents with Charcot-Marie-Tooth disease (CMT), however,, the specific variables associated with FAI remain unknown. An improved understanding of these variables may suggest interventions to improve ankle stability and possibly prevent the long-term complications associated with ankle instability in this population. The aim of this study was to therefore investigate the relationship between FAI and other functional, structural, anthropometric and demographic characteristics in a cross sectional sample of children and adolescents with CMT.

Methods

Thirty children and adolescents with CMT aged 7–18 years were recruited from the Peripheral Neuropathy Clinics of a large tertiary paediatric hospital. Measures of FAI were obtained using the Cumberland Ankle Instability Tool (CAIT). Demographic and anthropometric data was also collected. Other variables collected included foot structure (Foot Posture Index), ankle range of motion (weight bearing lunge) and functional parameters (balance, timed motor function and falls). Descriptive statistics were calculated to characterise the participants. Pearson’s correlation coefficients were calculated to investigate the correlates of right and left FAI and demographic (age), anthropometric (height, weight, BMI), foot/ankle (foot structure and ankle flexibility) and functional parameters (balance task, timed motor function and falls frequency). Point biserial correlation was employed to correlate gender with right and left FAI.

Results

All but one study participant (n = 29) reported moderate to severe bilateral FAI with females reporting significantly greater ankle instability than males. FAI was significantly associated with cavus foot structure (r = .69, P < .001), female gender (r = −.47, P < .001) and impaired balance (r = .50, P < .001).

Conclusions

This study confirms FAI is common in children and adolescents with CMT. An examination of the correlates of FAI suggests interventions, which target balance, and normalise foot structure should be explored to evaluate whether they might help to improve ankle stability in this population.

【 授权许可】

   
2015 Rose et al.

【 参考文献 】

• [1]Barisic N, Claeys G, Sirotkovic-Skerlev M, Lofgren A, Nelis E, De Jonghe P. Charcot-Marie-tooth disease: a clinico-genetic confrontation. Ann Hum Genet. 2008; 72:416-41.
• [2]Blyton F, Ryan MM, Ouvrier RA, Burns J. Muscle cramp in pediatric Charcot-Marie-Tooth disease type 1A. Prevalence and predictors. Neurology. 2011; 77:2115-8.
• [3]Burns J, Ryan MM, Ouvrier R. Evolution of foot and ankle manifestations in children with CMT type 1A. Muscle Nerve. 2009; 39:158-66.
• [4]Arnold BL, De La Motte S, Linens S, Ross SE. Ankle instability is associated with balance impairments: a meta-analysis. Med Sci Sports Ex. 2009; 41(5):1048-62.
• [5]Hiller CE, Refshauge KM, Bundy AC, Herbert RD, Kilbreath SL. The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil. 2006; 87(9):1235-41.
• [6]Verhagen RAW, de Keizer G, van Dijk CN. Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg. 1995; 114:92-6.
• [7]Burns J, Redmond A, Ouvrier R, Crosbie J. Quantification of muscle strength and imbalance in neurogenic pes cavus, compared to health controls, using hand-held dynamometry. Foot Ankle Int. 2005; 26(7):540-4.
• [8]Larsen E, Angermann P. Association of ankle instability and foot deformity. Acta Orthop Scand. 1990; 61(2):136-9.
• [9]Willems T, Witvrouw E, Verstuyft J, De Clercq D. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train. 2002; 37(4):487-93.
• [10]Yiu EM, Burns J, Ryan MM, Ouvrier RA. Neurophysiologic abnormalities in children with Charcot-Marie-Tooth disease type 1A. J Peripher Nerv Syst. 2008; 13:236-41.
• [11]Arnheim DD, Prentice WE. Principles of athletic training. McGraw-Hill, Boston; 2000.
• [12]Munn J, Sullivan SJ, Schneiders AG. Evidence of sensorimotor deficits in functional ankle instability: a systematic review with meta-analysis. J Sci Med Sport. 2010; 13:2-12.
• [13]Bennell K, Khan KM, Matthews B et al.. Hip and ankle range of motion and hip muscle strength in young novice female ballet dancers and controls. Br J Sports Med. 1999; 33(5):340-6.
• [14]Bennell K, Talbot R, Wajswelner H, Techovanich W, Kelly D. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998; 44(3):175-80.
• [15]Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech. 2006; 21(1):89-98.
• [16]Redmond AC, Crane YZ, Menz HB. Normative values for the foot posture index. J Foot Ankle Res. 2008; 1(6):1-6.
• [17]Cain LE, Nicholson LL, Adams RD, Burns J. Foot morphology and foot/ankle injury in indoor football. J Sci Med Sport. 2007; 10(5):311-9.
• [18]Burns J, Ramchandren S, Ryan MM, Shy ME, Ouvrier RA. Determinants of reduced health-related quality of life in pediatric inherited neuropathies. Neurology. 2010; 75:726-31.
• [19]Berg K, Wood-Dauphinee S, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992; 83 Suppl 2:7-11.
• [20]Mayhew JE, Florence JM, Mayhew TP et al.. Reliable surrogate outcome measures in multicenter clinical trials of Duchenne muscular dystrophy. Muscle Nerve. 2007; 35(1):36-42.
• [21]Pourkazemi F, Hiller CE, Raymond J, Nightingale EJ, Refshauge KM. Predictors of chronic ankle instability after an index lateral ankle sprain: a systematic review. J Sci Med Sport. 2014;568–573.
• [22]Beighton P, Solomon L, Soskone CL. Articular mobility in an African population. Ann Rheum Dis. 1973; 32:413-8.
• [23]Remvig L, Jensen DV, Ward RC. Epidemiology of general joint hypermobility and basis for benign joint hypermobility syndrome: review of the literature. J Rheum. 2007; 34:804-9.
• [24]Dickinson HO, Parkinson KN, Ravens-Sieberer U. Self-reported quality of life of 8–12 year-old children with cerebral palsy: a cross sectional European study. Lancet. 2007; 369:2171-8.
• [25]Mandarakas M, Hiller CE, Rose KJ, Burns J. Measruing ankle instability in Paediatric Charcot-Marie-Tooth disease. J Child Neurol. 2013; 28(11):1456-62.
• [26]Burns J, Crosbie J, Ouvrier R, Hunt A. Effective orthotic therapy for the painful cavus foot: a randomized controlled trial. J Am Pod Med Assoc. 2006; 96(3):205-11.
• [27]Birch JG. Orthopedic management of neuromuscular disorders in children. Semin Pediatr Neurol. 1998; 5(2):78-91.
• [28]McKeon PO, Ingersoll CD, Kerrigan DC, Saliba E, Bennett BC, Hertel J. Balance training improves function and postural control in those with chronic ankle instability. Med Sci Sports Exerc. 2008; 40(10):1810-9.