Background: Remodeled bicycle pedal training with multidirectional challenges through muscle strengthening and neuromuscular facilitation may increase dynamic postural control and performance during lateral shuffling for athletes with functional ankle instability (FAI). Hypothesis: The 6-week remodeled bicycle pedal training is effective on the ankle joint control and muscle activation, and especially that of the ankle evertor muscle co-contraction to improve dynamic postural control during lateral shuffling for athletes with FAI. Study Design: Laboratory randomized controlled trial. Level of Evidence: Level 2. Methods: Fourteen healthy athletes (healthy group) and 26 athletes with FAI aged 18 to 30 years were included in the study. The athletes with FAI were randomly assigned to either the training group (FAI-T group) or the nontraining group (FAI-NT group). The athletes in the FAI-T group underwent 6 weeks of remodeled bicycle pedal training, whereas those in the FAI-NT group did not undergo any intervention. Muscle co-contraction index and muscle activation in the initial contact (IC) and propulsion phases, and ankle joint angle in the IC and propulsion phases were measured during lateral shuffling before and after 6 weeks of training. Results: After remodeled bicycle pedal training, the FAI-T group demonstrated greater muscle activation in the hamstring ( P = 0.01), greater muscle coactivation of the tibialis anterior (TA) and the peroneus longus ( P = 0.01), and greater ankle eversion angle in the IC phase. Significantly greater muscle activation of the TA ( P = 0.01), greater coactivation of quadriceps and hamstring ( P = 0.03), and a smaller ankle inversion angle ( P = 0.04) in the propulsion phase were observed in the FAI-T group after training compared with those in the FAI-NT group. Conclusion: Remodeled bicycle pedal training facilitates the TA and peroneus longus activation and the coactivation of the quadriceps and hamstring muscles during lateral shuffling and resulted in enhanced ankle and knee joint stability. In addition, a better ankle movement strategy during a dynamic task can be achieved via a 6-week remodeled pedal training program. Clinical Relevance: This remodeled bicycle pedal training can be effective for rehabilitating athletes with FAI to recover lateral dynamic movement capability.
Correction to: Differences of muscle co-contraction of the ankle joint between young and elderly adults during dynamic postural control at different speeds
