Evidence map›Paper›PMID 39885584›Full record

ArticleBMC sports science, medicine & rehabilitation2025

Postural stability measures as diagnostic tools for chronic ankle instability: a comprehensive assessment.

Makan Piri, Kazem Malmir, Khadijeh Otadi, Azadeh Shadmehr

Abstract read
In one paragraph

Article in BMC sports science, medicine & rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

What it found

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Makan PiriDepartment of Physiotherapy, School of Rehabilitation, Tehran University of Medical Science, Enghelab St, Pich-e-Shemiran, Tehran, Iran.
Kazem MalmirDepartment of Physiotherapy, School of Rehabilitation, Tehran University of Medical Science, Enghelab St, Pich-e-Shemiran, Tehran, Iran. kmalmir@tums.ac.ir.
Khadijeh OtadiDepartment of Physiotherapy, School of Rehabilitation, Tehran University of Medical Science, Enghelab St, Pich-e-Shemiran, Tehran, Iran.
Azadeh ShadmehrDepartment of Physiotherapy, School of Rehabilitation, Tehran University of Medical Science, Enghelab St, Pich-e-Shemiran, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic ankle instability (CAI) is characterized by recurrent sprains and persistent symptoms, which impair postural control. This study evaluates the diagnostic utility of various linear and nonlinear postural stability measures in distinguishing individuals with CAI from healthy controls.

methodsPostural stability was assessed in 24 participants (12 with CAI and 12 healthy controls) using a force platform under four conditions: hard surface with eyes open, hard surface with eyes closed, soft surface with eyes open, and soft surface with eyes closed. Linear measures of center of pressure (COP) included range in the anteroposterior (Rfa) and mediolateral (Rsw) directions, mean velocity (MV), and sway area. Nonlinear measures included approximate entropy (ApEn), the largest Lyapunov exponent, and correlation dimension (CD) with its standard deviation. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) analysis to determine cutoff scores, allowing effective differentiation between CAI and healthy participants.

resultAI individuals exhibited increased mediolateral COP sway and higher mean velocity on hard surfaces with both eyes open and closed. On soft surfaces with eyes closed, they showed significant deficits in sway area and mean velocity, reflecting challenges in postural control. ROC analysis revealed that certain linear and nonlinear measures showed strong diagnostic accuracy in distinguishing individuals with CAI from healthy controls. Nonlinear analysis revealed elevated ApEn and reduced CD in CAI participants, indicating greater postural irregularity and reduced dynamic stability. On a hard surface with eyes open both Rsw (cutoff: 1.18 cm, OR: 4.55) and ApEn (cutoff: 0.07, OR: 4.0) were particularly strong diagnostic indicators.

conclusionLinear and nonlinear postural stability measures effectively differentiate individuals with CAI from healthy controls. Key metrics, including Rsw, MV, ApEn, and CD, offer strong diagnostic value for early detection and personalized rehabilitation. Incorporating these measures into clinical practice may improve CAI management and patient outcomes. ETHICAL CODE: IR.TUMS.FNM.REC.1400.236. March 14, 2022.

Indexed as

Center of pressureChronic ankle instabilityPostural ControlROC analysis

Identifiers

PMID39885584
PMCPMC11784114

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.