title: Evaluation of the lateral instability of the ankle by inversion simulation device and assessment of the rehabilitation program.
abstract: OBJECTIVE
  To assess the correctibility of the muscle atrophy, proprioceptive loss, and slowing of the reflex arc around the ankle after ankle sprain with rehabilitation.
  
  
  METHODS
  The study group consisted of 20 cases with chronic instability who had at least two episodes of ankle sprains (mean 20.6 years, range 16-32 years); control group consisted of 20 patients with same demographic characteristics but without instability. Isokinetic muscle strength measurements and proprioceptive evaluations were made using the Cybex device before and 1.5-month after rehabilitation period. Additionally, the inversion simulation device, which was developed together with the mechanical engineering department of our university, was correlated with the EMG device, and response periods of muscles to stimulation were measured.
  
  
  RESULTS
  The proprioceptive loss present in all cases with ankle instability before treatment significantly improved after effective rehabilitation (p=0.001). It was detected that lengthened peroneal latent periods shortened with effective rehabilitation (p=0.001). Cross-interaction of rehabilitation was shown with the preservation of the difference between the pathologic and normal sides regarding proprioception and peroneal latent periods before and after treatment, without any difference between the control group and the pathologic sides.
  
  
  CONCLUSIONS
  After ankle sprains, especially in patients with chronic instability, strengthening of the muscles around the ankle with well-planned proprioceptive exercises helps the patients return to normal living and sports activities, and prevents unnecessary surgery, especially in cases with functional instability.
authors.affiliation: Akdeniz University Faculty of Medicine, Department of Orthopedics and Traumatology, Antalya, Turkey. urguden@akdeniz.edu.tr
authors.forename: Mustafa
authors.initials: M
authors.lastname: Urgüden
authors.forename: Ferah
authors.initials: F
authors.lastname: Kızılay
authors.forename: Hazım
authors.initials: H
authors.lastname: Sekban
authors.forename: Nehir
authors.initials: N
authors.lastname: Samancı
authors.forename: Sibel
authors.initials: S
authors.lastname: Ozkaynak
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozdemir
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D003937:Diagnosis, Differential; D004576:Electromyography / Q000295:instrumentation*; D004867:Equipment Design; D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D011434:Proprioception / Q000502:physiology*; D012189:Retrospective Studies; D055815:Young Adult