Altered Ankle Kinematics and Shank-Rear-Foot Coupling in Those with Chronic Ankle Instability

Drewes, Lindsay K.; McKeon, Patrick O.; Paolini, Gabriele; Riley, Patrick O.; Kerrigan, D. Casey; Ingersoll, Christopher D.; Hertel, Jay

doi:10.1123/jsr.18.3.375

Cited by 127 publications

(129 citation statements)

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“…Increased rearfoot inversion has been reported before, at and immediately after initial contact (IC) during walking, throughout the gait cycle during walking and jogging, and in the pre landing phase of running [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

The effect of dual tasking on foot kinematics in people with functional ankle instability

2016

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Background: Some cases of repeated inversion ankle sprains are thought to have a neurological basis and are termed functional ankle instability (FAI). In addition to factors local to the ankle, such as loss of proprioception, cognitive demands have the ability to influence motor control and may increase the risk of repetitive lateral sprains.Objective: The purpose of this study was to investigate the effect of cognitive demand on foot kinematics in physically active people with functional ankle instability.

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Section: Introductionmentioning

confidence: 99%

The effect of dual tasking on foot kinematics in people with functional ankle instability

2016

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“…Compared to healthy subjects, CAI patients have been found to have a more laterally situated center of pressure during gait [69,70]. More complex analysis of movement has found more sensitive alterations in joint coupling around the ankle [47]. Drewes et al [47] and McKeon et al [71] identified changes in the relationship of shank transverse motion and rearfoot inversion and eversion.…”

Section: Sensorimotor Function and Ankle Instabilitymentioning

confidence: 99%

“…More complex analysis of movement has found more sensitive alterations in joint coupling around the ankle [47]. Drewes et al [47] and McKeon et al [71] identified changes in the relationship of shank transverse motion and rearfoot inversion and eversion. The analysis of joint coupling may further expand on central changes associated with coordinating gait in subjects with CAI.…”

Section: Sensorimotor Function and Ankle Instabilitymentioning

confidence: 99%

“…The muscles surrounding the joint may also be affected when damage occurs to the mechanoreceptors of the lateral ligaments affecting postural control [39,40] and muscle function [41][42][43]. Alterations in the sensorimotor control also have been associated with kinematic and kinetic changes during gait [44][45][46][47]. Clinical deficits have been identified in dynamic and static balance [48][49][50][51] and subjective function [17].…”

Section: Sensorimotor Function and Ankle Instabilitymentioning

confidence: 99%

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Current concepts on the pathophysiology and management of recurrent ankle sprains and chronic ankle instability

Herb

Hertel

2014

Curr Phys Med Rehabil Rep

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Lateral ankle sprains occur more than any other musculoskeletal injury in an athletic population. The greatest risk for an inversion ankle sprain is a history of a previous sprain. Recurring instability associated with subjective complaints of giving way is often termed chronic ankle instability (CAI). CAI has been associated with altered postural control, sensorimotor deficits, reduced physical activity, functional limitations, and long-term degeneration of the joint. Alterations, including muscle activity and changes in the kinematics of the lower extremity may predispose this population to continued instability at the joint and long term health issues. Common treatments include using external support, therapeutic modalities, and directed rehabilitation. Wearing ankle braces and performing balance training has been shown to reduce the risk of recurrent ankle sprains. Directed rehabilitation may improve function in patients with CAI. By identifying and minimizing dysfunction following ankle sprains, clinicians may improve the short-term and longterm function of this population.

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“…18 Ankle-dorsiflexion deficits 9 and increased subtalar-inversion and shank external-rotation ranges of motion have been demonstrated during both walking and jogging in CAI patients compared with healthy control participants. 19 Altered muscle function after joint injury has been hypothesized to have neural origins rooted partially in a clinical impairment known as the arthrogenic muscle response. 20 This impairment is characterized by an abnormal facilitation or inhibition of neural drive to the undamaged musculature surrounding an injured joint.…”

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Chronic Ankle Instability and Neural Excitability of the Lower Extremity

McLeod

Gribble

Pietrosimone

2015

Journal of Athletic Training

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Context: Neuromuscular dysfunction of the leg and thigh musculature, including decreased strength and postural control, is common in patients with chronic ankle instability (CAI). Understanding how CAI affects specific neural pathways may provide valuable information for targeted therapies.Objective: To investigate differences in spinal reflexive and corticospinal excitability of the fibularis longus and vastus medialis between limbs in patients with unilateral CAI and between CAI patients and participants serving as healthy controls.Design: Case-control study. Setting: Research laboratory. Patients or Other Participants: A total of 56 participants volunteered, and complete data for 21 CAI patients (9 men, 12 women; age ¼ 20.81 6 1.63 years, height ¼ 171.57 6 11.44 cm, mass ¼ 68.84 6 11.93 kg) and 24 healthy participants serving as controls (7 men, 17 women; age ¼ 22.54 6 2.92 years, height ¼ 172.35 6 10.85 cm, mass ¼ 69.15 6 12.30 kg) were included in the final analyses. Control participants were matched to CAI patients on sex, age, and limb dominance. We assigned ''involved'' limbs, which corresponded with the involved limbs of the CAI patients, to control participants.Main Outcome Measure(s): Spinal reflexive excitability was assessed via the Hoffmann reflex and normalized to a maximal muscle response. Corticospinal excitability was assessed using transcranial magnetic stimulation. Active motor threshold (AMT) was defined as the lowest transcranial magnetic stimulation intensity required to elicit motor-evoked potentials equal to or greater than 100 lV in 5 of 10 consecutive stimuli. We obtained motor-evoked potentials (MEPs) at percentages ranging from 100% to 140% of AMT.Results: Fibularis longus MEP amplitudes were greater in control participants than in CAI patients bilaterally at 100% AMT (control involved limb: 0.023 6 0.031; CAI involved limb: 0.014 6 0.008; control uninvolved limb: 0.021 6 0.022; CAI uninvolved limb: 0.015 6 0.007; F 1,41 ¼ 4.551, P ¼ .04) and 105% AMT (control involved limb: 0.029 6 0.026; CAI involved limb: 0.021 6 0.009; control uninvolved limb: 0.034 6 0.037; CAI uninvolved limb: 0.023 6 0.013; F 1,35 ¼ 4.782, P ¼ .04). We observed no differences in fibularis longus MEP amplitudes greater than 110% AMT and no differences in vastus medialis corticospinal excitability (P . .05). We noted no differences in the Hoffmann reflex between groups for the vastus medialis (F 1,37 ¼ 0.103, P ¼ .75) or the fibularis longus (F 1,41 ¼ 1.139, P ¼ .29).Conclusions: Fibularis longus corticospinal excitability was greater in control participants than in CAI patients.Key Words: transcranial magnetic stimulation, Hoffmann reflex, lateral ankle sprain Key PointsCorticospinal excitability in the fibularis longus at transcranial magnetic stimulation intensities of 100% and 105% of active motor threshold was higher in the healthy control group bilaterally than in the chronic ankle instability group. Transcranial magnetic stimulation intensities at 110% or more of the active motor threshold did not result ...

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Altered Ankle Kinematics and Shank-Rear-Foot Coupling in Those with Chronic Ankle Instability

Cited by 127 publications

References 28 publications

The effect of dual tasking on foot kinematics in people with functional ankle instability

The effect of dual tasking on foot kinematics in people with functional ankle instability

Current concepts on the pathophysiology and management of recurrent ankle sprains and chronic ankle instability

Chronic Ankle Instability and Neural Excitability of the Lower Extremity

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