Literature Review Outline Topic: Ankle rehabilitation
I. Introduction to topic and general information on ankle injuries A. Prevalence of injury B. Types of ankle injuries C. Clinical importance (missed time playing/practicing, projected time for recovery, re-
injury rate, etc.) II. Phases of ankle rehabilitation
A. Acute phase 1. General Information 2. Recommended Treatments
a. Ice i. Protocol
ii. Claims iii. Clinical Evidence
b. Compression i. Protocol
ii. Claims iii. Clinical Evidence
c. Elevation i. Protocol
ii. Claims iii. Clinical Evidence
d. Gluteus medius i. Claims
ii. Clinical evidence B. Fibroblast phase
1. General Information 2. Recommended treatments
a. Cryotherapy i. Protocols
ii. Claims iii. Clinical Evidence
b. Ice bath with ROM i. Protocols
ii. Claims iii. Clinical Evidence
c. Open –kinetic chain exercise i. Protocols (Alphabet ROM, Toe Curls and marble pickup, Four plane
theraband, etc.) ii. Claims
iii. Clinical evidence d. Closed kinetic Chain
i. Protocols (heel raise, toe raise, lunge steps, etc.) ii. Claims
iii. Clinical evidence C. Remodeling phase
1. General information 2. Recommended treatments
a. Proprioception i. Protocols and types
– Stable surfaces (floor, etc.) – Unstable surfaces (BAPS, Bosu, Aero, Wobble board, etc.)
ii. Claims iii. Clinical Evidence
b. Plyometric i. Protocols and types (examples below, but not limited to)
– Four square hoping – Side to side – Front to back – Triangles – Straight ling hop – Line zig-zag hop – Box jumping
ii. Claims iii. Clinical evidence
III. Physiological aspects A. Physiology of Ankle Injuries B. Modalities
1. Ice 2. Compression 3. Elevation 4. Cryotherapy
C. Rehabilitation 1. ROM 2. Strengthening
a. Contractile machinery of skeletal muscle fiber types i. Sarcomere
ii. Thick filament: myosin iii. Thin filament; action iv. Troponin v. Tropomyosin
b. Cross-bridge cycle i. Myosin walking along action
c. Excitation-contraction coupling d. Motor unit
i. Synapse ii. Sarcoplasmic reticulum regulates intracellular-calcium
e. Muscle fiber Types i. Α-type
ii. Β-type IIa, IIb f. Motor unit recruitment i. Energy supply systems
g. Aspects of strength metabolism i. Energy storage and transfer
ii. Creatine phosphate system iii. Glycolysis
3. Proprioception a. Neurological function
i. Motor unit ii. Neural control mechanism
iii. Firing on the muscle iv. Spinal reflexes
b. Synchronization 4. Plyometric
a. Mechanical Model b. Neurophysiological Model
i. Potentiation ii. Stretch reflex
iii. Muscle spindles c. Stretch-Shorting cycle
i. Eccentric Phase – Rapid muscle lengthening ( preload of the agonist) – Storage of elastic energy
ii. Amortization phase – Type Ia afferent nerves synapse – Alpha motor neuron – Agonist muscle group – Antagonist muscle group
iii. Contractile phase – Use of energy stored capabilities – Myotonic reflex – Muscle spindles – Contractile component
o Primary sources of muscle force during concentric action o Contractile machinery
Actin Myosin Cross-bridge cycle
IV. Conclusion drawn from the literature V. Implications for future research
