Attentional Demands and Postural Control in Athletes With and Without Functional Ankle Instability

Abstract

Lateral ankle sprains are one of the most common injuries among physically active individuals, especially those who participate in soccer, basketball, and volleyball.5 Furthermore, the recurrence rate has been estimated to be as high as 80%.11 The repeated ankle injury and giving-way feelings that occur in some individuals after the first sprain lead to a condition that has been defined as functional ankle instability (FAI).10 Neuromuscular deficits are believed to have a major contribution to the development of FAI. Poor postural control, which t StUdy deSiGN: Case-control study.t oBJeCtive: To compare the effect of dualtasking on postural and cognitive performance between subjects with functional ankle instability (FAI) and a matched control group without FAI.t BaCKGroUNd: Deficit and expertise in sensorimotor functions have been proposed as factors that can modify the interference between postural control and cognition. To the authors' knowledge, no study has investigated the posture-cognition interaction in individuals with recurrent ankle sprain, an orthopaedic condition with documented sensorimotor deficits.t MethodS: Single-limb postural stability was assessed in 15 recreational athletes with FAI and 15 matched healthy athletes without FAI. Each athlete stood on a Biodex Stability System at platform stabilities of 7 and 5, while they performed or did not perform a digits-backward cognitive task. Overall stability index (OSI), anteroposterior stability index (APSI), and mediolateral stability index (MLSI) were used as measures of postural performance. t reSUltS: At stability level 5, the individuals in the FAI group had poorer postural stability compared to those in the group without FAI (OSI, P.01; MLSI, P.01). A significant increase in OSI (P.01) and MLSI (P = .02) was also demonstrated by the individuals in the FAI group during dual-task performance compared to the single-task performance.t CoNClUSioN: Subjects with FAI demonstrated poorer postural stability when tested at level 5 on the Biodex Stability System, but not at level 7. Also, the results indicate that concurrent performance of a cognitive task decreased postural stability in the subjects with FAI, suggesting an increased dependency on attentional demands for maintenance of balance in that group. Such findings highlight the need for the assessment of postural control in patients with ankle sprain to include cognitive loading.

Six Weeks of Balance Training Improves Sensorimotor Function in Individuals With Chronic Ankle Instability

“…This skill was added to encourage attention to training and compliance. 6,37 The use of the marble maze encourages proper movement at the ankle (participants were instructed in the utilization of an ankle strategy versus a hip strategy during balance training). It has also been shown that the addition of this type of training may have a greater influence on changes in motoneuron pool excitability.…”

“…This protocol was a modification of a balance training protocol previously shown to produce changes in H-reflex measures. 29 A skill task (marble maze) was added because skill tasks are thought to involve presynaptic modulation, 6,36,37 and to increase participant interest and protocol adherence.…”

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

“…Reduced postural stability during dual tasking has previously been reported in people with FAI, suggesting that postural control may demand more attention in FAI [20]. The effects of the impaired feedback, feedforward and local sensorimotor deficits in FAI may therefore be compounded by the demands for cognitive attention during a movement task.…”

Effects of Kinesio Tape Compared With Nonelastic Sports Tape and the Untaped Ankle During a Sudden Inversion Perturbation in Male Athletes

“…2,12,26,39 Tests of postural control have shown that individuals with ankle instability have poorer frontal plane stability than those with unaffected ankles. 32 Due to their role as the primary everters and dynamic stabilizers of the ankle, the function of the fibularis (peroneus) muscles in relation to ankle stability and lateral sprains has been extensively studied. Studies have presented conflicting results with respect to the possibility of a longer latency of the fibularis muscles in individuals with unstable ankles.…”