The Alteration of Neuromuscular Control Strategies During Gait Initiation in Individuals with Chronic Ankle Instability

Abstract

Background: Providing a clear picture of neuromuscular control mechanisms and deficits in patients with chronic ankle instability (CAI) requires further investigation. Gait initiation (GI) is a perfect task to evaluate concurrent open-loop (planned GI) and closedloop (unplanned GI) neuromuscular control mechanisms in patients with CAI. Objectives: The current study aimed at evaluating neuromuscular control mechanisms via assessment of the center of pressure (COP) displacements during planned and unplanned GI in patients with CAI and healthy individuals. Methods: It was a case-control study. Twenty-two subjects with unilateral CAI and 22 healthy subjects stood on a force plate and initiated gait with maximal velocity under 2 conditions: i) planned (initiated gait after hearing the "all set" signal, when subjects felt ready to walk) and ii) unplanned (initiated gait "as soon as possible" after hearing acoustic signal). The COP parameters were assessed during the preparatory and the execution phase of GI. Results: The peak COP displacement toward swing leg decreased significantly, with P value = 0.003, in the preparatory phase of

Effect of Chronic Ankle Instability on the Biomechanical Organization of Gait Initiation: A Systematic Review

“…Among the selected studies, three focused on gait initiation triggered in response to an auditory signal [26,30,41], two studies examined both self-generated and externally triggered gait initiation [22,29], and one provided no information on the mode of gait initiation (i.e., self-generated or triggered by an external stimulus) [21]. All studies examined gait initiation in the forward direction, and two of them also examined gait initiation in two additional directions (30 • in the medial direction and 30 • in the lateral direction) [26,29].…”

“…All studies examined gait initiation in the forward direction, and two of them also examined gait initiation in two additional directions (30 • in the medial direction and 30 • in the lateral direction) [26,29]. Gait was initiated at a self-selected speed in three studies [21,30,41] and at maximum speed in the other three studies [22,26,29]. Gait was initiated with the injured limb in two studies [21,41], with the non-injured limb in one study [29], and with both limbs in three studies [22,26,30].…”

“…Gait initiation, which represents the transition from a quiet stance to steady-state walking, is a functional task of daily living [20][21][22]. It is also a classical model used in the literature to investigate postural control in healthy and pathological individuals [23].…”

“…Quantitative analysis of APAs and muscular activity during gait initiation can provide important insights into the supraspinal motor control mechanisms [22]. Previous research has identified altered neuromuscular strategies in individuals with CAI, including changes in muscle activation patterns during walking, landing, and cutting tasks [34][35][36].…”

Reliability of Nonlinear Kinematic Analysis in Patients with Functional Ankle Instability During Dual-Task Walking

“…Although individuals with FAI exhibit no signs of ligament laxity, they experience impaired function and recurrent ankle sprains due to their ankles frequently giving way (2). Proprioceptive impairment, weakness deficiencies, poor muscle recruitment, decreased ankle range of motion, and altered neuromuscular function may influence postural control and gait patterns in individuals with FAI (3)(4)(5)(6)(7)(8). Individuals with FAI have altered gait patterns during functional tasks, such as walking, which is the most common task in daily activities (9).…”