The effect of three weeks of deep sensory training with ultrasound on pain and electromyographic activity of selected muscles in futsal players with chronic ankle pain while walking

 Background: Following a serious injury, microtrauma and as a result of microscopic damage in joint surfaces, pain disorders in the skeletal and muscular system develop over time. Pain in the musculoskeletal system, in addition to injury, causes secretion and fatigue in the pastoral structure, which leads to disruption of the neuromuscular system. Although the foot is the last part of the lower limb chain and resists the incoming forces, it is expected to cause movement pathology, pathokinesiology and increased stress and thus injury due to improper distribution of forces. It reaches the tissues and muscles of the leg, and as a result, the risk of joint pain increases. In futsal, which is one of the vulnerable sports, most of the injuries of the lower limbs are assigned to the wrist and knee (1) According to the report of the National Association of American Sports Science Colleges, ankle injuries compared to other body joints in disciplines such as; It has basketball, volleyball, futsal, etc. Ankle pain can be caused by aspirin, instability, arthritis, gout, tendonitis, fracture, nerve compression and infection in this joint (2). In this popular field, due to the fact that players have to withdraw from this sport due to pain and injury in their basic ages, and as a result, talents are not lost, attention was paid to movement sciences and rehabilitation. Familiarity with biomechanical principles in injury or disease is a very important part of air and treatment activity. If we can provide a targeted ability in ankle pain and evaluate and perform the tasks they do in static and dynamic conditions, it will allow athletes and even non-athletes to return to sports faster and more confidently. And they do everyday (3) was a witness The first step in this field is to know the rehabilitation method that optimally minimizes the frequency of pain and re-injury (4). As a result, biomechanical principles and evaluations become reliable in treatment and help to increase better performance. Research shows that mechanical proprioception movements with ultrasound supplements improve and increase neuromuscular function and balance of the plantar pressure center, as well as a significant reduction in pain, in the same direction, from existing changes and the degree of impact on foot posture or position. in which the patient is located, by using biomechanical evaluations in the initial or final stages of the rehabilitation period, it helps the treatment to increase the effectiveness of the methods used with higher validity and to use better methods with higher effectiveness. take. take (5) Therapeutic strategies to prevent and increase the return to daily and sports activities include: external supporters, manual therapy, and deep sensory exercises, which generally divide rehabilitation into two types, mechanical and physical (6). Studies have shown that deep sensory exercises and orthoses and tapings reduce the amount of damage by 50%. In addition, the postural changes or the condition in which the patient or the injured person is located, recovery during the rehabilitation phase helps the specialists to take appropriate actions to have a better effect. In the meantime, examining the amount of electrical muscle activity and the pressures on the person in the biomechanical analysis of the person will give valuable information about treatment and rehabilitation strategies (7). According to the available documents, foot and ankle problems even cause pain in the upper limb areas such as the back due to its effects on the posture and the way the forces interact in walking over time. Considering the increasing trend of basic ages in futsal, in order to avoid re-injury or to prevent it, it is necessary to take preventive measures. In this approach, the use of proprioception exercises and the use of ultrasound waves on the injured area of the ankle have a significant effect on the walking process, the sense of the position of the ankle joint, and the function of the muscles around the joint (8). Failure to use proprioception exercises reduces performance and ankle sprains, which is the result of instability followed by chronic ankle pain. is looking for To get a better result, the use of ultrasound therapy modality by applying a length of heat in the ankle along with deep sensory exercises will be useful in controlling and improving the function of the device and foot posture. In rehabilitation planning, understanding the mechanism of applied forces will help professionals to provide the appropriate protocol to increase the function of the device and joints. Because a period of rehabilitation before and after the changes in the posture or the condition in which the patient or athlete is located, can have a great help in the therapeutic methods of care and treatment of its effectiveness in the treatment protocol. it shows. In most cases, in the field of rehabilitation, the therapist is unwilling and according to the conditions of the teams and the pressure of the coaches and sports managers upon the player's return, he trains and competes with the speed of action of the fields. But this athlete's return is mostly temporary and causes joint injuries and choices in the future. Therefore, in the evaluations and screenings at the beginning and end of the season, as in the field of football, in this field as well, the amount of injuries can be minimized by taking into account clinical evaluation tests. In this study, our aim was to investigate the effects of deep sensory training with ultrasound therapy on the chronic ankle pain of young players along with the evaluation of the center of pressure and the changes in the activities of the 2 specialized muscles, tibialis anterior and peroneus longus during walking, in response to changes in their activity can help people with ankle injuries.                                                                                                                                                                         Methods: In this study, 20 futsal players suffering from chronic ankle pain who are active in the East Azarbaijan Provincial League; They were divided into experimental and control groups. Pain intensity in both groups was assessed through the standard Visual analogue scale form, which is characterized by a pain scale of 1 to 10, and the selection criterion was a score of 7 (high pain intensity). Also, for analysis and evaluation of electrical muscle function by electromyography system of anterior tibialis and peroneus longus muscles, subjects of both groups were recorded using UK Biometrics system in stance phase in 14-meter path of both groups (pre-test). The experimental group then received a deep sensory training protocol with 3 MHz ultrasound for three weeks. The control group performed its normal activities during this period. After the treatment period, both groups re-tested and checked the pain and recorded the electrical activity of the muscles as a pre-test (post-test).                                                                                                                                                                              Results: The results showed a significant difference only in the activity of Peroneus longus muscle in comparison with pre- and post-test of the experimental group (p = 0.005). Also, a significant difference in the amount of pain in the experimental group before and after rehabilitation interventions was observed in the comparison within the group (p = 0.016).                                                                                                                                                                            Conclusion: Based on the results of this study, it can be mentioned that the use of deep sensory exercises with ultrasound waves as an effective method in the rehabilitation of the musculoskeletal system in chronic pain can be used by physiotherapists and other sports rehabilitation specialists. Because its effectiveness was effective in reducing the amount of pain and normal function of selected muscles in static and dynamic positions (walking).