ATOAC Research Highlight: University of Kentucky: Wildcat Ankle Research Group

The University of Kentucky Athletic Training research group has multiple areas of expertise, all with the focus of understanding and treating musculoskeletal injury and disease, the most common disease category facing our population.  The work at UK covers the spectrum of applied and bench research, founded in our individual clinical experiences.  Our faculty incorporates multiple approaches in biomechanical, neuromuscular and physiological testing techniques, utilizing several laboratory facilities, with our overall goal of making a positive impact on health care of musculoskeletal pathology.  Additionally, our Athletic Training faculty participate in the Cartilage Cats research group at UK, a collaboration with researchers and clinicians from the Department of Orthopedics. With the addition of the research laboratory led by our new Dean, Dr. Scott Lephart, the investigation of Injury Mitigation and Performance Optimization Strategies for the Elite Tactical Athlete will provide additional mechanisms to explore the consequence of injury on degenerative joint disease.

The Wildcats Ankle Research (W.A.R.) group is one part of the collection of Athletic Training Research at the University of Kentucky.  Led by Dr. Phillip Gribble, ATC, FNATA, the W.A.R. group is affiliated with the Musculoskeletal Research Laboratory and the Human Performance Laboratory in the College of Health Sciences.  The W.A.R. group approach is to attack the injury model of ankle instability from multiple aspects of the patient timeline, from prevention in the adolescent populations, all the way to intervention to promote healthier lifestyle in older populations suffering from long term effects of chronic ankle instability.

Ankle sprain represents the most common musculoskeletal injury in our society, with billions of dollars spent annually on treatment and more collective days of activity loss than any other injury.  Yet, there has been a lack of success in preventing the injury, as represented by the continuation of the high rate of injury.  The W.A.R. group is working with local secondary schools and collegiate teams to develop effective, clinical based prevention programs for lateral ankle sprain. Using cost and time-effective outcomes, we are creating a robust risk prediction model for ankle sprain that can be utilized in specific age, gender and sport populations.  Using the prediction model, we are developing a focused prevention program that will help reduce the incident of lateral ankle sprain, making an impact on the timeline of promoting long-term ankle joint health.

Among those that have sustained an ankle sprain, there is an alarmingly high rate of recurrence and lingering disability, resulting in chronic ankle instability (CAI).  The W.A.R. group has a focused front to ascertain the common mechanisms and consequences of CAI, as a conduit towards improved treatment.  We utilize multiple biomechanical and neuromuscular control techniques coupled with established patient and clinical outcome measures to illustrate this pathology.  One unique aspect we focus on is the complexity of CAI in its interaction with likely central nervous system alterations.  Inefficient and compensatory strategies, likely originating from the CNS, are helping to elucidate poor movement and protective strategies that are exacerbating injurious mechanisms at the ankle.  Additionally, these movement patterns are suggesting interaction with joints proximal to the ankle, which likely has value for understanding related injury at the knee and hip.

We are parlaying our mechanistic findings into innovative intervention strategies that we hypothesize will impact CAI patients positively, reducing the disability and re-injury rates and improving their quality of life.  Ankle OA development is dominated by post-traumatic mechanisms.  Therefore, it is of vital importance to combat the end stage disease by interrupting negative consequences of CAI.  The W.A.R. group wishes to contribute to the work that will promote long-term physical activity and quality of life that is compromised from poor joint health, traced to previous traumatic injury.

In 2015, our group will be presenting our work at the National Athletic Trainers’ Association meeting in St. Louis, and the International Ankle Symposium in Dublin, Ireland.  We look forward to seeing you and discussing ideas that will promote this important work.

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