The Effect of Short-Term Neuromuscular Training on Ankle Biomechanics in Individuals with Functional Ankle Instability

Abstract

Functional ankle instability (FAI) results from multiple ankle sprains, causing a perceived sense of joint instability due to muscle and ligament imbalances. Neuromuscular training (NMT) is employed to enhance ankle stability in individuals with FAI. The study included 24 male university students with FAI, who underwent ankle NMT on three surfaces. OpenSim musculoskeletal model analyzed the effects on ankle muscle activity, kinetics, and kinematics. Utilizing repeated measures analysis of variance (ANOVA) and one-dimensional statistical non-parametric mapping (SNPM1d) to identify distinctions between training surfaces. NMT on foam cushion (FC) significantly enhanced tibialis anterior (TA) and gastrocnemius medial (GM) activation during walking compared to level-ground (LG) and artificial turf (AT) (p<0.05). However, no differences observed for peroneus longus (PL), gastrocnemius lateral (GL), and peak ankle plantarflexion (PF). During jogging and fast running, post FC training increased TA, PL, GM, GL activation, and peak ankle PF moment (p<0.05). Additionally, post FC training, subtalar mobility was significantly reduced (p<0.05), and ankle joints exhibited greater dorsiflexion (DF) angles during jogging and fast running (p<0.05). Consequently, selecting FC for short-term ankle NMT proves more advantageous in enhancing ankle stability among individuals with FAI, yielding a more positive impact on FAI improvement.