Effect of Mindfulness Training in Chronic Ankle Instability Among Collegiate Athletes

Background:

Inversion Ankle injuries (IAS) are among the most common musculoskeletal injuries in sports and the rate of IAS accounts for 85% of ankle injuries. The hallmarks of chronic ankle instability (CAI) include repeated ankle sprains that have led to an altered patient activity level. Important factors include injuries sustained, frequency of events, localization of pain, and prior treatment modalities. The degree of disability appreciated by the patient is one of the most important factors and can be significant in both high- and low-demand individuals. The most commonly cited characteristics of CAI include giving way to the ankle, mechanical instability, pain and swelling, loss of strength, recurrent sprain, and functional instability. Residual problems can persist for decades, with up to 72% of people unable to return to their previous level of activity, such as fear of the ankle giving way. Functional ankle instability includes a perceived or actual giving way of the ankle (or both) and other characteristics previously associated with CAI in general: pain, swelling, and recurrent sprain. Functional insufficiencies among individuals with either CAI have been demonstrated by quantifying deficits in ankle neuromuscular response times, postural control, and strength.

Researchers have found that injured athletes experience clinically significant depression 6 times as often as non-injured athletes. Injured athletes also exhibit significantly greater anxiety and lower self-esteem than non-injured. Athletes with more severe injuries are more likely to become depressed than the non-injured. Since many of the players do not possess effective pain coping skills, they are at risk for lifelong impairment of their emotional, social, and physical functioning. Mindfulness-centered interventions may well serve to mitigate a pain-related disability. Training in mindfulness meditation improves anxiety, depression, stress, and cognition. Mindfulness-related health benefits are associated with enhancements in cognitive control, emotion regulation, positive mood, and acceptance, happiness each of which have been associated with pain modulation. Successively mindfulness has been proven effective in managing various health disorders and in enhancing sports performance. This study aims to apply the video-assisted mindfulness deep breathing training (VAMDBT) approach in rehabilitating CAI, the most common sports injury. In addition, applies Quantitative Electroencephalogram (QEEG) as one of the parameters to measure the pain response of collegiate athletes.

Literature Chronic ankle pain can affect all age groups, ranging from young athletes to elderly patients with degenerative joint and soft-tissue disorders. Although physical activity brings a range of lifelong health benefits, it may also lead to injuries that pose a significant threat to health. Among 90 Plus League volleyball players age 18-37, over 87% of the respondents suffered from at least one sport-related injury. In total, 362 injuries occurred, on average 4.02 injuries per one volleyball player. The most commonly involved sports injuries were ankle sprains (46 injuries), knee and lower leg muscles (30), interphalangeal articulations of fingers (30) as well as the shoulder joint. More than half of the injuries (57%) occurred twice or three times.

The pattern of musculoskeletal injuries sustained by Malaysian badminton players who attended the National Sports Institute (NSI) Clinic, Kuala Lumpur, Malaysia. The mean age of the players who attended the clinic was 19.2 (range 13-52) years. Approximately 60 percent of the injuries occurred in players younger than 20 years of age. The majority of injuries (91.5 percent) were categorized as mild overuse injuries and mostly involved the knee and ankle. The prevalence of sports injuries among 475 male professional athletes participating in ball sports who are aged 15 years and older, from 5 sports clubs in Kuwait. About 452 athletes from four ball games (football (soccer), basketball, handball, and volleyball) were included in this study. The study found that the overall 12-month and lifetime prevalence of sports injuries were 73.8 and 89.8%, respectively. Lower limbs (73.1%) were the most common site of injuries and joint injuries (43.6%) were the most common type of injury reported. The study analyzed the characteristics of injuries and associated personal and training characteristics in young basketball players of both sexes. A conducted one-year retrospective cross-sectional survey with 581 basketball players (350 males and 231 females) participated in the school games and high school Olympics in the state of São Paulo, Brazil. The study used a questionnaire that contained items addressing anthropometric data and characteristics of injuries that have occurred in the previous 12 months. Results showed a total of 167 of the athletes reported injuries and the male gender exhibited a greater risk of injury than the female gender. The most affected anatomic sites were the ankle/foot and knee. A study that investigates the pattern of muscle injuries and the factors that predict the return-to-play duration among Malaysian athletes who attended the National Sports Institute Clinic. About 397 muscle injuries were diagnosed among 360 athletes from the period June 2006 to December 2009. The median age of the athletes with muscle injuries was 20.0 years. Muscle injuries were mostly diagnosed among national-level athletes and frequently involved the lower limb. There is a twofold increased risk for ankle injury recurrence for at least one-year post-injury. In up to 50% of all cases, recurrences result in disability and lead to chronic pain or instability, requiring prolonged medical care. Therefore, ankle sprain recurrence prevention in athletes is essential. A study that measured preseason anxiety and depression reported a total of 597 injuries with 40.6% preseason injuries, 28.8%, and 21.7% of athletes suffered from anxiety and depressive symptoms. Another study stated depression and anxiety disorders have a negative effect on subjective well-being. The Oxford Happiness Scale, Life Satisfaction Scale response among 284 patients shows that participants were found to be moderately happy and satisfied.