Altered Movement Biomechanics in Chronic Ankle Instability, Coper, and Control Groups: Energy Absorption and Distribution Implications

Abstract

Context Patients with chronic ankle instability (CAI) exhibit deficits in neuromuscular control, resulting in altered movement strategies. However, no researchers have examined neuromuscular adaptations to dynamic movement strategies during multiplanar landing and cutting among patients with CAI, individuals who are ankle-sprain copers, and control participants. Objective To investigate lower extremity joint power, stiffness, and ground reaction force (GRF) during a jump-landing and cutting task among CAI, coper, and control groups. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants A total of 22 patients with CAI (age = 22.7 ± 2.0 years, height = 174.6 ± 10.4 cm, mass = 73.4 ± 12.1 kg), 22 ankle-sprain copers (age = 22.1 ± 2.1 years, height = 173.8 ± 8.2 cm, mass = 72.6 ± 12.3 kg), and 22 healthy control participants (age = 22.5 ± 3.3 years, height = 172.4 ± 13.3 cm, mass = 72.6 ± 18.7 kg). Intervention(s) Participants performed 5 successful trials of a jump-landing and cutting task. Main Outcome Measure(s) Using motion-capture cameras and a force plate, we collected lower extremity ankle-, knee-, and hip-joint power and stiffness and GRFs during the jump-landing and cutting task. Functional analyses of variance were used to evaluate between-groups differences in these dependent variables throughout the contact phase of the task. Results Compared with the coper and control groups, the CAI group displayed (1) up to 7% of body weight more posterior and 52% of body weight more vertical GRF during initial landing followed by decreased GRF during the remaining stance and 22% of body weight less medial GRF across most of stance; (2) 8.8 W/kg less eccentric and 3.2 W/kg less concentric ankle power, 6.4 W/kg more eccentric knee and 4.8 W/kg more eccentric hip power during initial landing, and 5.0 W/kg less eccentric knee and 3.9 W/kg less eccentric hip power; and (3) less ankle- and knee-joint stiffness during the landing phase. Concentric power patterns were similar to eccentric power patterns. Conclusions The CAI group demonstrated altered neuromechanics, redistributing energy absorption from the distal (ankle) to the proximal (knee and hip) joints, which coincided with decreased ankle and knee stiffness during landing. Our data suggested that although the coper and control groups showed similar landing and cutting strategies, the CAI group used altered strategies to modulate impact forces during the task.

Does ipsilateral chronic ankle instability alter kinematics of the other joints of the lower extremities: a biomechanical study

“…The current study demonstrated, for the first time, the effects of CAI on lower extremity kinematics during a landing task. Similarly [15], another study evaluated and compared 22 patients with CAI with 22 control and 22 ankle sprain copers, using motion capture cameras. They found that kinetics including ankle joint power in the CAI group compared to the control group had 3.5 W/kg more and 7.9 W/kg less eccentric ankle power during the 0 to 8% and 10 to 50% of the stance phase, respectively (p < 0.05).…”

Current trends in the biokinetic analysis of the foot and ankle

“…The ability to generate safe movement and to improve performance depends on the movement of joints in segments with stable bases. Literature on the importance of functional ankle stability for injury prevention and rehabilitation (2,6,11) is extensive and relates chronic ankle instability to a lower capacity of generating functional strength by the triceps surae muscle (11) , lower power production during jump propulsion (12) , and a higher risk of ligament and cartilage injuries (13) . Therefore, reducing this instability through specific training or surgery is crucial and should be done before the adoption of an overloading activity such as an increase in sports performance.…”

“…Several studies have demonstrated changes in the movement patterns of hips, knees, and ankles in individuals with chronic ankle instability (2,6,22) , demonstrating that the same condition can lead to different motor adaptations and each case requires individual evaluation. The motor variability among these individuals may reflect either an attempt to explore alternative stabilizing strategies or an inadequate sensory-motor control (23) .…”

“…Moreover, individuals with similar anatomopathological diag noses have been reported to present different biokinetic findings, demonstrating that the functional assessment of specific movements should be seen as a complementary examination that is essential to the conventional practice of ankle and foot specialists (6) . The purpose of this article is to review the biomechanics of the foot and ankle combining classic knowledge with new concepts of functional biomechanics in order to lay the foundation for the clinical application of 3-dimensional (3D) biokinetic analysis in diagnostic and/or treatment decisions.…”

Radiologic Evaluation of the Effect of Distal Tibiofibular Joint Anatomy on Arthroscopically Proven Ankle Instability

“…Ankle sprains, which have significant social and economic consequences, are the most common musculoskeletal disorder in athletes and ordinary individuals. 12 Every day, 1 in 10 000 people around the world present to the physician's office with a sprained ankle. In the young and athletic population, ankle sprains constitute 30% of all injuries.…”