Individuals with chronic ankle instability exhibit altered ankle kinematics and neuromuscular control compared to copers during inversion single-leg landing

Context:Kinematic patterns during gait have not been extensively studied in relation to chronic ankle instability (CAI).Objective:To determine whether individuals with CAI demonstrate altered ankle kinematics and shank-rear-foot coupling compared with controls during walking and jogging.Design:Case control.Setting:Motion-analysis laboratory.Participants:7 participants (3 men, 4 women) suffering from CAI (age 24.6 ± 4.2 y, height 172.6 ± 9.4 cm, mass 70.9 ± 8.1 kg) and 7 (3 men, 4 women) healthy, matched controls (age 24.7 ± 4.5 y, height 168.2 ± 5.9 cm, mass 66.5 ± 9.8 kg).Interventions:Subjects walked and jogged on a treadmill while 3-dimensional kinematics of the lower extremities were captured.Main Outcome Measures:The positions of rear-foot inversion–eversion and shank rotation were calculated throughout the gait cycle. Continuous relative-phase angles between these segments were calculated to assess coupling.Results:The CAI group demonstrated more rear-foot inversion and shank external rotation during walking and jogging. There were differences between groups in shank-rear-foot coupling during terminal swing at both speeds.Conclusions:Altered ankle kinematics and joint coupling during the terminal-swing phase of gait may predispose a population with CAI to ankle-inversion injuries. Less coordinated movement during gait may be an indication of altered neuromuscular recruitment of the musculature surrounding the ankle as the foot is being positioned for initial contact.

Download Full-text

Spatiotemporal gait characteristics and ankle kinematics of backward walking in people with chronic ankle instability

Scientific Reports ◽

10.1038/s41598-020-68385-5 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Tharani Balasukumaran ◽

Uri Gottlieb ◽

Shmuel Springer

Keyword(s):

Ankle Instability ◽

Chronic Ankle Instability ◽

Backward Walking ◽

Gait Characteristics ◽

Ankle Kinematics

Download Full-text

Neuromuscular control of the ankle during pre-landing in athletes with chronic ankle instability: Insights from statistical parametric mapping and muscle co-contraction analysis

Physical Therapy in Sport ◽

10.1016/j.ptsp.2020.11.023 ◽

2021 ◽

Vol 47 ◽

pp. 46-52

Author(s):

Jarugool Tretriluxana ◽

Ampika Nanbancha ◽

Komsak Sinsurin ◽

Weerawat Limroongreungrat ◽

Hsing-Kuo Wang

Keyword(s):

Ankle Instability ◽

Statistical Parametric Mapping ◽

Neuromuscular Control ◽

Chronic Ankle Instability ◽

Parametric Mapping

Download Full-text

Alterations in Neuromuscular Control at the Knee in Individuals With Chronic Ankle Instability

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.28 ◽

2014 ◽

Vol 49 (5) ◽

pp. 599-607 ◽

Cited By ~ 17

Author(s):

Masafumi Terada ◽

Brian G. Pietrosimone ◽

Phillip A. Gribble

Keyword(s):

Confidence Interval ◽

Effect Size ◽

Muscle Activation ◽

Sagittal Plane ◽

Ankle Instability ◽

Force Plate ◽

Neuromuscular Control ◽

Chronic Ankle Instability ◽

Electromyographic Activity ◽

Vastus Medialis

Context: Few authors have assessed neuromuscular knee-stabilization strategies in individuals with chronic ankle instability (CAI) during functional activities. Objective: To investigate the influence of CAI on neuromuscular characteristics around the knee during a stop-jump task. Design: Case-control study. Setting: Research laboratory. Participants or Other Participants: A total of 19 participants with self-reported unilateral CAI and 19 healthy control participants volunteered for this study. Intervention(s): Participants performed double-legged, vertical stop-jump tasks onto a force plate, and we measured muscle activation around the knee of each limb. Main Outcome Measure(s): We calculated the integrated electromyography for the vastus medialis oblique, vastus lateralis, medial hamstrings, and lateral hamstrings muscles during the 100 ms before and after initial foot contacts with the force plate and normalized by the ensemble peak electromyographic value. Knee sagittal-plane kinematics were also analyzed during a stop-jump task. Results: Compared with control participants, the CAI group demonstrated greater prelanding integrated electromyographic activity of the vastus medialis oblique (CAI = 52.28 ± 11.25%·ms, control = 43.90 ± 10.13%·ms, t36 = 2.41, P = .021, effect size = 0.78, 95% confidence interval = 0.11, 1.43) and less knee-flexion angle at the point of initial foot contact (CAI = 7.81° ± 8.27°, control = 14.09° ± 8.7°, t36 = −2.28, P = .029, effect size = −0.74, 95% confidence interval = −1.38, −0.07) and at 100 ms post–initial foot contact (CAI = 51.36° ± 5.29°, control = 58.66° ± 7.66°, t36 = −3.42, P = .002, effect size = −1.11, 95% confidence interval = −1.77, −0.40). No significant results were noted for the other electromyographic measures. Conclusions: We found altered feed-forward patterns of the vastus medialis oblique and altered postlanding knee sagittal-plane kinematics in the CAI group. These observations may provide insight regarding sensorimotor characteristics that may be associated with CAI.

Download Full-text

Neuromuscular Control Training Does Not Improve Gait Biomechanics in Those With Chronic Ankle Instability: A Critically Appraised Topic

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2019-0014 ◽

2020 ◽

Vol 25 (4) ◽

pp. 165-169

Author(s):

Kimmery Migel ◽

Erik Wikstrom

Keyword(s):

Ankle Instability ◽

Balance Training ◽

Neuromuscular Control ◽

Chronic Ankle Instability ◽

Program Completion ◽

Ankle Sprains ◽

Bottom Line ◽

Gait Biomechanics ◽

Rehabilitation Programs ◽

Evidence Grade

Introduction/Clinical Scenario: Ankle sprains are highly common within the population and can lead to chronic ankle instability (CAI). Individuals with CAI have both functional and mechanical impairments, which are thought to contribute to maladaptive gait biomechanics. Neuromuscular control and balance training are frequently incorporated into rehabilitation programs, however the effect of balance training on gait biomechanics remains unknown. Focused Clinical Question: Does balance or neuromuscular training improve gait biomechanics in individuals with CAI? Summary of Key Findings: Three studies assessed 4–6 weeks of progressive neuromuscular control training and found no improvements in gait biomechanics. One study found a worsening of eversion position at midstance upon program completion. However, when training was augmented with destabilizing shoes, improvements in dorsiflexion were noted. Clinical Bottom Line: Cumulative findings suggest that neuromuscular control training does not improve gait biomechanics in those with CAI. However, augmentation of programs may be beneficial. Strength of Recommendation: There is high-quality evidence(Grade B) that balance training does not alter gait biomechanics in patients with CAI.

Download Full-text

Ankle kinematics of individuals with chronic ankle instability while walking and jogging on a treadmill in shoes

Physical Therapy in Sport ◽

10.1016/j.ptsp.2012.10.001 ◽

2013 ◽

Vol 14 (4) ◽

pp. 232-239 ◽

Cited By ~ 63

Author(s):

Lisa Chinn ◽

Jay Dicharry ◽

Jay Hertel

Keyword(s):

Ankle Instability ◽

Chronic Ankle Instability ◽

Ankle Kinematics

Download Full-text

Neuromuscular control in individuals with chronic ankle instability: A comparison of unexpected and expected ankle inversion perturbations during a single leg drop-landing

Human Movement Science ◽

10.1016/j.humov.2019.01.013 ◽

2019 ◽

Vol 64 ◽

pp. 133-141 ◽

Cited By ~ 4

Author(s):

Jeffrey D. Simpson ◽

Ethan M. Stewart ◽

Alana J. Turner ◽

David M. Macias ◽

Samuel J. Wilson ◽

...

Keyword(s):

Ankle Instability ◽

Neuromuscular Control ◽

Chronic Ankle Instability ◽

Ankle Inversion ◽

Drop Landing

Download Full-text

Effects of Dry Needling on Neuromuscular Control of Ankle Stabilizer Muscles and Center of Pressure Displacement in Basketball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042092 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2092

Author(s):

Luis López-González ◽

Deborah Falla ◽

Irene Lázaro-Navas ◽

Cristina Lorenzo-Sánchez-Aguilera ◽

Isabel Rodríguez-Costa ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Postural Control ◽

Center Of Pressure ◽

Ankle Instability ◽

Controlled Trial ◽

Neuromuscular Control ◽

Chronic Ankle Instability ◽

Dry Needling ◽

Basketball Players ◽

Randomized Controlled

This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.

Download Full-text