Prevalence and factors associated with chronic ankle instability among children aged 7 to 12 years

Main Article Content

Raweewan Lekskulchai
Supannikar Kadli

Abstract

Background: Ankle sprain is the most common cause of chronic ankle instability (CAI). After a sprain, CAI and related components may develop and adversely affect movement performances. Prevalence of CAI in specific groups of children has been reported, however, the prevalence in typical children is lacking.


Objectives: This study aimed to determine the prevalence of CAI and related components in school-age children. Additionally, factors associated with the components were also examined.


Materials and methods: Three hundred and eighty-eight children aged between 7 and 12 years with no past or present serious diseases or disabilities were recruited from normal schools. They were interviewed and assessed to identify CAI components and risk factors. Children with at least one of the 3 components of CAI, including perceived instability (PI), mechanical instability (MI) and recurrent sprain (RS) were recorded as having CAI.


Results: The children’s mean age was 9.76±1.55 years, and 57% of them were girls. There were 142 children with at least one component of the CAI. Therefore, the prevalence of CAI among the population was 36.60 %. The prevalence of MI, PI and RS were 11.6%, 35.3% and 27.3%, respectively. Significant variables on bivariate analyses (p<0.05) for related components of CAI were overweight, sport participation, living in urban area, moderate degree of initial ankle sprain and poor standing balance in eyes closed condition. After adjusting for the significant variables, overweight (aOR: 1.083, [95%CI: 1.036-1.192], p<0.001) and poor standing balance in eyes closed condition (aOR: 1.142 [95% CI: 1.194-1.311], p<0.001), were associated with RS. Overweight (aOR: 1.229 [95%CI: 1.063-2.264], p<0.001), sport participation (aOR: 1.192 [95%CI: 1.052-3.308], p=0.013), moderate ankle sprain (aOR: 1.143 [95%CI: 1.038-3.541], p=0.004) and poor standing balance in eyes closed condition (aOR: 3.476 [95% CI: 1.872- 6.453], p=0.006) were associated with PI. Moderate ankle sprain (aOR: 1.099 [95%CI: 1.027-4.370], p<0.001), and poor standing balance in eyes closed condition (aOR: 4.251 [95% CI: 1.248- 14.485] p=0.021) were associated with MI.


Conclusion: CAI and related components were existed among typical school-age children. The risk of all CAI components was high in children with poor standing balance. Overweight children were at higher risk of RS and PI. Children with moderate degree of ankle sprain were at higher risk for developing PI and MI. Further studies are recommended to develop preventive managements for this population.

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How to Cite
Lekskulchai, R., & Kadli, S. (2019). Prevalence and factors associated with chronic ankle instability among children aged 7 to 12 years. Journal of Associated Medical Sciences, 53(1), 42–48. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/208646
Section
Research Articles

References

Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med 2014; 44(1): 123-40.

Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ Jr. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am 2010; 92(13): 2279-84.

Swenson DM, Yard EE, Fields SK, Comstock RD. Patterns of recurrent injuries among US high school athletes. Am J Sports Med 2009; 37:1586-93.

Willems T, Witvrouw E, Verstuyft J, Clercq DD. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 2002; 37: 487–93.

Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train 2011; 46: 133-41.

Kerin F, Delahunt E. Physiotherapists’ understanding of functional and mechanical insufficiencies contributing to chronic ankle instability. Athl Train Sports Health Care 2011; 3: 125-30.

Gribble PA, Bleakley CM, Caulfield BM, Docherty CL, Fourchet F, Fong DT, et al. 2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 2016; 50 (24): 1493-5.

Konradsen L, Bech L, Ehrenbjerg M, Nickelsen T. Seven years follow-up after ankle inversion trauma. Scand J Med Sci Sports 2002; 12: 129-35.

] Hiller CE, Nightingale EJ, Raymond J, Kilbreath SL, Burns J, Black DA, et al. Prevalence and impact of chronic musculoskeletal ankle disorders in the community. Arch Phys Med Rehabil 2012; 20: 1-7.

Verhagen RAW, Keizer G, Dijk CN. Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg 1995; 114: 92-6.

Shumway-Cook, A, Woollacott, M. Motor Control: Translating Research into Clinical Practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2011.

Mandarakas M, Pourkazemi F, Sman A, Burns J, Hiller CE. Systematic review of chronic ankle instability in children. J Foot Ankle Res 2014; 7(1): 21. doi: 10.1186/1757-1146-7-21.

Tanen L, Docherty CL, Van Der Pol B, Simon J, Schrader J. Prevalence of Chronic Ankle Instability in High School and Division I Athletes. Foot Ankle Spec 2014; 4: 37-43.

Delahunt B. Neuromuscular contributions to functional instability of the ankle joint. J Bodywork Mov Ther 2007; 11: 203-13.

Funder V, Jørgensen JP, Andersen A, Bryde AS, Lindholmer B, Niedermann B, et al. Ruptures of the Lateral Ligaments of the Ankle: Clinical Diagnosis. Act Ortho Scand 1982; 53: 6, 997-1000.

Petersen W, Rembitzki IV, Koppenburg AG, Ellermann A, Liebau C, Brüggemann GP, et al. Treatment of acute ankle ligament injuries: a systematic review. Arch Orthop Trauma Surg 2013; 133: 1129-41.

WHO. Obesity: Preventing and managing the global epidemic, WHO technical report series. Geneva: World Health Organization; 2004.

Kegel AD, Dhooge I, Cambier D, Baetens T, Palmans AT,Van WH. Test–retest reliability of the assessment of postural stability in typically developing children and in hearing impaired children. Gait Posture 2011; 33: 679-85.

Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences. 7th ed. New York: John Wiley & Sons; 1999.

Timm NL, Grupp-Phelan J, Ho ML. Chronic ankle morbidity in obese children following an acute ankle injury. Arch Pediatr Adolesc Med 2005; 159:33-6.

Sparto PJ, Redfern MS, Jasko JG, Casselbrant ML, Mandel EM, Furman JM. The influence of dynamic visual cues for postural control in children aged 7-12 years. Exp Brain Res 2006; 168 (4): 505-16.

Hollwarth M, Linhart WE, Wildburger R, Schimpl G. Instability after distortion of the ankle joint in children. Unfallchirurg 1985; 88: 231-34.