Using Shimmer sensing technology to assess the insufficiency of ankle evertors.
The excellence of Shimmer technology has made it the ICC Physio team’s choice for the treatment of ankle and knee injuries and poor posture. The Myolux™ concept is designed to help treat ankle sprain, and was developed by a France-based team comprising health researchers and practitioners.
Background and Objectives
Sprains of the ankle are among the most frequently encountered sports trauma. The cause of chronic ankle instability (CAI) is considered to be significantly weak ankle evertors.
However, this is a muscular deficit of eccentric ankle eversion on weight bearing is one often missed on clinical examination. The gold standard is isokinetic testing, but this is too expensive to be used for everyday practice, and not functional.
As a result, the Myolux e-volution device is designed to offer a test of ankle eversion which is both easy and functional, with the added benefit of providing an even higher sensitivity than conventional isokinetic testing.
The Myolux is designed to provide rearfoot destabilization in a targeted and specific manner, according to normal physiology, which allows optimal functional rehabilitation of weak ankles via proprioceptive and strengthening exercises specifically directed at the ankle.
The Shimmer3 IMU is used to yield data on the relevant parameters tested in order to set up a biofeedback for the client. It is fitted on the back foot of a patented mechanical device specifically designed for this use.
The software used is also specially developed for ankle evertor analysis, being based on the experience of several years spent studying the sensorimotor control of both normal and unstable ankles.
Study and Results
For the study, two experimental groups were used: 12 healthy subjects and 12 CAI subjects. The inclusion criteria followed Gribble et al, 2013. All subjects had repeated single-leg weight-bearing ankle inversion using a specialized ankle destabilization device, the Myolux Medik e-volution, which was equipped with a Shimmer3 IMU.
Control of ankle inversion is achieved using eccentric recruitment of ankle evertors. The subjects are instructed to perform ankle inversion as slowly as they can while the body weight is applied completely on the tested ankle.
CAI subjects showed weakness of ankle evertors seen as impaired control of ankle inversion under weight bearing conditions. They showed higher angular velocity peaks during their performance of controlled single leg ankle inversion in contrast to healthy subjects.
60°/s is possibly the inversion angular velocity which distinguishes CAI from healthy subjects. The Shimmer3 was able to record the angular velocity of ankle inversion in each case.
Normalized ankle evertors’ peak torque data (N.m/kg) obtained during eccentric isokinetic testing
Performance during functional test (weight bearing ankle inversion control). Data showed significant lower performance (lower negative angular velocity peaks) for CAI subjects (right), in comparison with healthy subjects (left). **p<0.01
The Myolux offers a simple but functional test for ankle evertor weakness in patients with CAI, with higher discriminatory value than the gold standard isokinetic testing.
It can be used to provide objective monitoring of improvement in evertor strength during rehabilitation, with a reduction in inversion angular velocity being the marker of improvement at a threshold of 60°/s.
- Gribble,P.A.,etal.,2013.Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the international ankle consortium, J. Orthop. Sports Phys. Ther.
- Terrier, R., et al., 2014. Impaired control of weight bearing ankle inversion in subjects with chronic ankle instability, Clin. Biomech.
- Terrier, R., et al., 2016. Assessment of evertor weakness in patients with chronic ankle instability: Functional versus isokinetic testing, Clin. Biomech.
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