Postural control and ankle joint functions: an investigation on collegiate female volleyball players
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Department of Physiotherapy and Rehabilitation English, Faculty of Health Sciences, Istanbul Gelisim University, Istanbul, Turkey
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yeditepe University, Istanbul, Turkey
Submission date: 2023-08-29
Acceptance date: 2023-12-05
Publication date: 2024-03-26
Corresponding author
Ayşem Ecem Özdemir   

İstanbul Gelisim University
Hum Mov. 2024;25(1):48-59
Ankle injuries are common in volleyball players and are linked to the athlete’s postural control. The aim of the report is to investigate the differences between ankle functions and postural control ability of volleyball players and controls, and also the relationship between the variables in order to understand the factors affecting postural control.

40 female participants (age: 21.18 ± 0.27, volleyball players/controls: 20/20) were included in the study. Ankle functions (joint range of motion (ROM), joint position sense (JPS), vibration and isometric muscle strength) and postural control variables (anterior-posterior and medial-lateral sway velocity, ellipse area and perimeter) were evaluated by static stability test. The differences between the groups and the correlation between variables were analysed.

Significant differences favoured the volleyball group in ankle dorsiflexion, inversion, and eversion ROM, JPS, dorsiflexor and plantar flexor isometric muscle strength, and postural control variables (p < 0.05). However, the control group demonstrated superior vibration sensitivity on the 1st and 5th metatarsal heads (p < 0.05). A significant correlation was observed between the anterior-posterior sway velocity and dorsiflexion ROM, medial-lateral sway velocity and sway area with inversion ROM, sway area and vibration threshold in the 1st and 5th metatarsal heads (p < 0.05).

Volleyball players showed better results in ankle ROM, JPS, muscle strength and postural control. In addition to the similarities in ankle plantar flexion ROM, invertor and evertor isometric muscle strength between the groups, the controls showed better vibration sensitivity; which reveals potential causes of ankle injuries in volleyball players. Ankle function variables are found to be linked to postural control, highlighting the need to evaluate these functions for injury prevention.

Borzucka D, Kręcisz K, Rektor Z, Kuczyński M. Differences in static postural control between top level male volleyball players and non-athletes. Sci Rep. 2020; 10(19334):1–7; doi: 10.1038/s41598-020-76390-x.
Saunders JB, Inman VT, Eberhart HD. The major determinants in normal and pathological gait. J Bone Joint Surg Am. 1953;35-A(3):543–558.
Palmieri RM, Ingersoll CD, Stone MB, Krause BA. Center- of- pressure parameters used in the assessment of postural control. J Sport Rehabil. 2002;11(1):51–66; doi: 10.1123/jsr.11.1.51.
Shen K, Chemori A, Hayashibe M. Human-Like Balance Recovery Based on Numerical Model Predictive Control Strategy. IEEE Access. 2020;8:92050–92060; doi: 10.1109/ACC ESS.2020.2995104.
Gatev P, Thomas S, Kepple T, Hallett M. Feedforward ankle strategy of balance during quiet stance in adults. J Physiol. 1999;514(3):915–928; doi: 10.1111/j.1469- 7793.1999.915ad.x.
Xu D, Jiang X, Cen X, Baker JS, Gu Y. Single-leg landings following a volleyball spike may increase the risk of anterior cruciate ligament injury more than landing on both-legs. Appl Sci. 2021;11(1):130; doi: 10.3390/ app11010130.
Borzucka D, Kręcisz K, Rektor Z, Kuczyński M. Postural control in top-level female volleyball players. BMC Sports Sci Med Rehabil. 2020;12(65); doi: 10.1186/ s13102-020-00213-9.
Powell DW, Williams DSB. Athletes trained using stable compared to unstable surfaces exhibit distinct postural control profiles when assessed by traditional and nonlinear measures. Hum Mov Sci. 2015;44:73– 80; doi: 10.1016/j.humov.2015.08.013.
Chandran A, Morris SN, Lempke LB, Boltz AJ, Robison HJ, Collins CL. Epidemiology of injuries in National Collegiate Athletic Association women’s volleyball: 2014–2015 through 2018–2019. J Athl Train. 2021; 56(7):666–673; doi: 10.4085/1062-6050-679-20.
Beynnon BD, Renström PA, Alosa DM, Baumhauer JF, Vacek PM. Ankle ligament injury risk factors: a prospective study of college athletes. J Orthop Res. 2001;19(2): 213–220; doi: 10.1016/S0736-0266(00)90004-4.
Bere T, Kruczynski J, Veintimilla N, Hamu Y, Bahr R. Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System. Br J Sports Med. 2015;49(17):1132–1137; doi: 10.1136/ bjsports-2015-094959.
Herzog MM, Kerr ZY, Marshall SW, Wikstrom EA. Epidemiology of ankle sprains and chronic ankle instability. J Athl Train. 2019;54(6):603–610; doi: 10.4085/ 1062-6050-447-17.
Ivanenko Y, Gurfinkel VS. Human postural control. Front Neurosci. 2018;12:171; doi: 10.3389/fnins.2018.00171.
Han J, Anson J, Waddington G, Adams R, Liu Y. The role of ankle proprioception for balance control in relation to sports performance and injury. Biomed Res Int. 2015;2015(842804); doi: 10.1155/2015/842804.
Kilic O, Maas M, Verhagen E, Zwerver J, Gouttebarge V. Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: a systematic review of the literature. Eur J Sport Sci. 2017;17(6):765–793; doi: 10.1080/ 17461391.2017.1306114.
Şahin N, Bianco A, Patti A, Paoli A, Palma A, Ersöz G. Evaluation of knee joint proprioception and balance of young female volleyball players: a pilot study. J Phys Ther Sci. 2015;27(2):437–440; doi: 10.1589/jpts.27.437.
Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train. 2011; 46(2):133–141; doi: 10.4085/1062-6050-46.2.133.
Mauch M, Kälin X, Rennbahn P. Reliability of the ProKin Type B Line System (TechnoBody™) Balance System. 2011. Available 01.08.2023 from: https://www.woodway. com/wp-content/uploads/2019/04/reliability_ prokinb_line_system.pdf.
Meiners KM, Loudon JK. Dynamic and static assessment of single-leg postural control in female soccer players. J Sport Rehabil. 2020;29(2):174–178; doi: 10.1123/ JSR.2018-0072.
Rein S, Fabian T, Zwipp H, Rammelt S, Weindel S. Postural control and functional ankle stability in professional and amateur dancers. Clin Neurophysiol. 2011; 122(8):1602–16010; doi: 10.1016/j.clinph.2011.01.004.
Peterka RJ. Sensory integration for human balance control. In: Day BL, Lord SR (eds.), Handbook of Clinical Neurology. Elsevier. 2018;159:27–42; doi: 10.1016/ B978-0-444-63916-5.00002-1.
Reggars JW. Vibratory sensation testing. COMSIG Rev. 1995;4(1):14–15.
Chamorro C, Armijo-Olivo S, De La Fuente C, Fuentes J, Javier Chirosa L. Absolute reliability and concurrent validity of hand held dynamometry and isokinetic dynamometry in the hip, knee and ankle joint: systematic review and meta-analysis. Open Med. 2017;12(1):359– 375; doi: 10.1515/med-2017-0052.
Hall EA, Docherty CL, Simon J, Kingma JJ, Klossner JC. Strength-training protocols to improve deficits in participants with chronic ankle instability: a randomized controlled trial. J Athl Train. 2015;50(1):36–44; doi: 10.4085/1062-6050-49.3.71.
Xu D, Zhou H, Quan W, Gusztav F, Wang M, Baker JS et al. Accurately and effectively predict the ACL force: utilizing biomechanical landing pattern before and after-fatigue. Comput Methods Programs Biomed. 2023; 241:107761; doi: 10.1016/j.cmpb.2023.107761.
Hamilton WG, Hamilton LH, Marshall P, Molnar M. A profile of the musculoskeletal characteristics of elite professional ballet dancers. Am J Sports Med. 2016; 20(3):267–273; doi: 10.1177/036354659202000306.
Han J, Waddington G, Adams R, Anson J, Liu Y. Assessing proprioception: a critical review of methods. J Sport Health Sci. 2016;5(1):80–90; doi: 10.1016/J. JSHS.2014.10.004.
Majstorović N, Dopsaj M, Grbić V, Savić Z, Vićentijević A, Aničić Z et al. Isometric strength in volleyball players of different age: a multidimensional model. Appl Sci. 2020;10(12):4107; doi: 10.3390/APP10124107.
Bartlett G, Stewart JD, Tamblyn R, Abrahamowicz M. Normal distributions of thermal and vibration sensory thresholds. Muscle Nerve. 1998;21(3):367–374; doi: 10.1002/(SICI)1097-4598(199803)21:3<367::AIDMUS11> 3.0.CO;2-X.
Baumhauer JF, Alosa DM, Renström PAFH, Trevino S, Beynnon B. A prospective study of ankle injury risk factors. Am J Sports Med. 1995;23(5):564–570; doi: 10.1177/ 036354659502300508.
De Noronha M, Refshauge KM, Herbert RD, Kilbreath SL. Do voluntary strength, proprioception, range of motion, or postural sway predict occurrence of lateral ankle sprain?. Br J Sports Med. 2006;40(10):824–828; doi: 10.1136/bjsm.2006.029645.
Hadzic V, Sattler T, Topole E, Jarnovic Z, Burger H, Dervisevic E. Risk factors for ankle sprain in volleyball players: a preliminary analysis. Isokinet Exerc Sci. 2009; 17(3):155–160; doi: 10.3233/IES-2009-0347.
Lee JW, Park JS. The Correlation between Proprioception and Postural Control in Healthy Adults. Iran J Public Health. 2022;51(10):2360–2361; doi: 10.18502/ ijph.v51i10.10995.
Eils E, Schröter R, Schröderr M, Gerss J, Rosenbaum D. Multistation proprioceptive exercise program prevents ankle injuries in basketball. Med Sci Sports Exerc. 2010;42(11):2098–2105; doi: 10.1249/MSS.0b013e31 81e03667.
Jung J, Kim MG, Kang YJ, Min K, Han KA, Choi H. Vibration perception threshold and related factors for balance assessment in patients with type 2 diabetes mellitus. Int J Environ Res Public Health. 2021;18(11): 6046; doi: 10.3390/ijerph18116046.
Inglis JT, Kennedy PM, Wells C, Chua R. The role of cutaneous receptors in the foot. In: Gandevia SC, Proske U, Stuart DG (eds.), Sensorimotor Control of Movement and Posture. Adv Exp Med Biol. 2002;508:111–117; doi: 10.1007/978-1-4615-0713-0_14.
Kaminski TW, Hartsell HD. Factors contributing to chronic ankle instability: a strength perspective. J Athl Train. 2002;37(4):394–405.
Trajković N, Kozinc Ž, Smajla D, Šarabon N. Relationship between ankle strength and range of motion and postural stability during single-leg quiet stance in trained athletes. Sci Rep. 2021;11(1):11749; doi: 10.1038/ s41598-021-91337-6.
Deussen S, Alfuth M. The influence of sensorimotor training modalities on balance, strength, joint function, and plantar foot sensitivity in recreational athletes with a history of ankle sprain: a randomized controlled pilot study. Int J Sports Phys Ther. 2018;13(6):993–1007; doi: 10.26603/ijspt20180993.
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