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Disablement Model:

A Framework for Injury Prevention and Qualty Of Life

Marcellus Hill

Doctorate iN Athletic Training Student

Indiana State University

Disablement Model (1)

Disablement Model

  • Characterizes effects of acute or chronic physical conditions on:
  • Function
  • Performance
  • HRQoL

Origin

  • Health Condition
  • Lateral Ankle Sprain
  • Most common injury in NCAA (2)
  • 26% in Men's basketball

Origin

Organ

  • Body Structure and Function
  • Mental and Physical Aspects
  • Decrease strength and range of motion
  • Unable to weight bear
  • Pain
  • Instability
  • Swelling
  • Bruising
  • Tender to touch

Person

  • Activity
  • A task that has meaning
  • Performed in the environment
  • Inability to meet demands of sport
  • Running
  • Jumping
  • Agility
  • Lateral movement
  • Back pedal
  • LE Resistance training
  • Decreased balance
  • Low FADI, FAAM, FAOS

Society

  • Participation
  • Application of activtiy to life
  • Component of performance and fucntion
  • Hobbies/leisure time
  • Social events with friends, family, and significant other

Environment

  • Relationships, Attitudes, Policies
  • Athletic Trainer
  • Coaches
  • Teammates
  • Personal
  • Age
  • Education
  • Access to resources
  • Spirit
  • Psyche

Single Leg Balance Test (2)

Injury Screening Tool

  • Perform
  • Standing on one foot
  • Contralateral hip flexed to 90 degrees
  • Eyes closed
  • Score
  • Postural sway
  • Instability
  • Failure to balance

Risk Factors (2,3)

Risk Factors

  • History of ankle sprains
  • Chronic Ankle Instability (CAI)
  • Propioceptive deficits
  • Asymmetry in dominant v. non-dominant Limb
  • Non-compliance to rehabilitation plan
  • Postural Sway
  • Musculoskeletal fatigue and reaction time
  • Gender
  • Anatomical Foot Type
  • Height and weight relative to at-risk position
  • Mechanism (contact v. non-contact)
  • Orthotics/Foot wear

Injury Prevention (4,5)

Injury Prevention

  • Prophylactic bracing/taping
  • Strength
  • Agility
  • Plyometrics
  • Neuromuscular/balance
  • Stretching
  • Technique
  • Warm-up
  • Efficacious and cost effective

Strategy

Strategy (6)

  • Immobilize
  • Lymphatic Drainage
  • OKC-E
  • ROM
  • Functional Strength
  • CKC-E
  • DL to SL
  • Intrinsic MSK control
  • Mobilizations
  • Address biomechanical deficits and habits
  • Modified LE lifts
  • Gait training
  • Sports Specific movement
  • Agility
  • Offensive/Defensive Drills
  • Shooting
  • Improve PROM

Citations

Citations

1 Struminger, A. A Framework for Whole Person, Patient-Centered Healthcare: Disablement Models. NATA. https://cdn.zephyrcms.com/676b7d6e-7082-4687-88e4-134566c0ff09/-/inline/yes/z.19%20NATA_Disablement_Model_Presentation_Thursday.pdf

2 Trojian, TH., McKeag, DB. Single leg balance test to identify risk iof ankle sprains. Br J Sports Med. 2006;40:610-613. doi: 10.1136/bjsm.2005.024356

3 Beynnon, BD., Murphy DF., Alosa, DM. Predictive Factors for Lateral Ankle Sprains: A Literature Review. Journal of Athletic Training. December 2002;37(4):376-380. www.journalofathletictraining.org

4 Hootman, JM., Dick, R., Agel, J. Epidemiology of Collegiate Injuries for 15 Sports : Summary and Recommendations for Injury Prevention Initiatives. Journal of Athletic Training. 2007; 42(2):311-319. www.journalofathletictraining.org

5 Brunner, R., Friesenbichler, B., Casartelli, NC.,Effectiveness of multicomponent lower extremity injury prevention programmes in team-sport athletes: an umbrella review. Br J Sports Med. 2019;53:282-288. doi: 10.1136/bjsports-2017-098944

6 Dabadghav, R. (2019). Rehabilitation of Lateral Ankle Sprains in Sports. In C. Suarez-Ahedo, A. Olivos-Meza, & A. M. Rijke (Eds.), Essentials in Hip and Ankle. IntechOpen. https://doi.org/10.5772/intechopen.89505

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