Static Postural Stability in Chronic Ankle Instability, an Ankle Sprain and Healthy Ankles

Abstract

To identify the single leg balance (SLB) test that discriminates among healthy, coper, and chronic ankle instability (CAI) groups and to determine effects of ankle muscles on the balance error scoring system (BESS) among the three populations. 60 subjects (20 per group) performed the SLB test with eyes open (EO) and eyes closed (EC). Normalized mean amplitude (NMA) of the tibia anterior (TA), fibularis longus (FL), and medial gastrocnemius (MG) muscles and BESS were measured while performing the SLB test. The coper group had a lower error score than the CAI group in the EC. NMA was greater in the CAI group compared to in the healthy and coper groups regardless of muscle type. NMA of the TA was less than the PL and MG regardless of the group in the EO. The CAI group demonstrated greater NMAs of the PL and MG than the healthy and coper groups in the EC. The CAI group demonstrated greater NMA of the PL and MG by compensating their ankle muscles in the EO and EC. BESS suggests that the coper group may have coping mechanisms to stabilize static postural control compared to the CAI group. The EC may be better to detect static postural instability in the CAI or coper group.

Key words

single-leg balance test - electromyography - balance error scoring system - mean amplitude - eyes open - eyes closed

• References

• 1 Arnold BL, Linens SW, de la Motte SJ, Ross SE. Concentric evertor strength differences and functional ankle instability: A meta-analysis. J Athl Train 2009; 44: 653-662
• 2 Bowker S, Terada M, Thomas AC, Pietrosimone BG, Hiller CE, Gribble PA. Neural excitability and joint laxity in chronic ankle instability, coper, and control groups. J Athl Train 2016; 51: 336-343
• 3 Brown C, Padua D, Marshall SW, Guskiewicz K. Individuals with mechanical ankle instability exhibit different motion patterns than those with functional ankle instability and ankle sprain copers. Clin Biomech (Bristol, Avon) 2008; 23: 822-831
• 4 Burcal CJ, Wikstrom EA. Cognitive loading-induced sway alterations are similar in those with chronic ankle instability and uninjured controls. Gait Posture 2016; 48: 95-98
• 5 De Ridder R, Willems T, Vanrenterghem J, Robinson M, Pataky T, Roosen P. Gait kinematics of subjects with ankle instability using a multisegmented foot model. Med Sci Sports Exerc 2013; 45: 2129-2136
• 6 Docherty CL, Valovich McLeod TC, Shultz SJ. Postural control deficits in participants with functional ankle instability as measured by the balance error scoring system. Clin J Sport Med 2006; 16: 203-208
• 7 Duysens J, Trippel M, Horstmann GA, Dietz V. Gating and reversal of reflexes in ankle muscles during human walking. Exp Brain Res 1990; 82: 351-358
• 8 Gabriner ML, Houston MN, Kirby JL, Hoch MC. Contributing factors to star excursion balance test performance in individuals with chronic ankle instability. Gait Posture 2015; 41: 912-916
• 9 Gribble PA, Delahunt E, Bleakley CM, Caulfield B, Docherty CL, Fong DT, Fourchet F, Hertel J, Hiller CE, Kaminski TW, McKeon PO, Refshauge KM, van der Wees P, Vicenzino W, Wikstrom EA. Selection criteria for patients with chronic ankle instability in controlled research: A position statement of the international ankle consortium. J Athl Train 2014; 49: 121-127
• 10 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38: 1126-1131
• 11 Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: Evolution of the model. J Athl Train 2011; 46: 133-141
• 12 Hopkins JT, Brown TN, Christensen L, Palmieri-Smith RM. Deficits in peroneal latency and electromechanical delay in patients with functional ankle instability. J Orthop Res 2009; 27: 1541-1546
• 13 Linens SW, Ross SE, Arnold BL, Gayle R, Pidcoe P. Postural-stability tests that identify individuals with chronic ankle instability. J Athl Train 2014; 49: 15-23
• 14 Liu W, Jain TK, Santos M, Heller D, Hiller C. Important issues concerning use of term 'copers' in chronic ankle instability research. Sports Med 2014; 44: 1775-1776
• 15 Pionnier R, Decoufour N, Barbier F, Popineau C, Simoneau-Buessinger E. A new approach of the star excursion balance test to assess dynamic postural control in people complaining from chronic ankle instability. Gait Posture 2016; 45: 97-102
• 16 Pozzi F, Moffat M, Gutierrez G. Neuromuscular control during performance of a dynamic balance task in subjects with and without ankle instability. Int J Sports Phys Ther 2015; 10: 520-529
• 17 Ross SE, Guskiewicz KM, Gross MT, Yu B. Balance measures for discriminating between functionally unstable and stable ankles. Med Sci Sports Exerc 2009; 41: 399-407
• 18 Shakked R, Sheskier S. Acute and chronic lateral ankle instability diagnosis, management, and new concepts. Bull Hosp Jt Dis (2013) 2017; 75: 71-80
• 19 Song K, Burcal C, Hertel J, Wikstrom EA. Increased visual utilization in chronic ankle instability: A meta-analysis. Med Sci Sports Exerc 2016; 48: 2046-2056
• 20 Trojian TH, McKeag DB. Single leg balance test to identify risk of ankle sprains. Br J Sports Med 2006; 40: 610-613
• 21 Van Deun S, Staes FF, Stappaerts KH, Janssens L, Levin O, Peers KK. Relationship of chronic ankle instability to muscle activation patterns during the transition from double-leg to single-leg stance. Am J Sports Med 2007; 35: 274-281
• 22 Wikstrom EA, Brown CN. Minimum reporting standards for copers in chronic ankle instability research. Sports Med 2014; 44: 251-268
• 23 Wikstrom EA, Fournier KA, McKeon PO. Postural control differs between those with and without chronic ankle instability. Gait Posture 2010; 32: 82-86
• 24 Wikstrom EA, Tillman MD, Chmielewski TL, Cauraugh JH, Naugle KE, Borsa PA. Dynamic postural control but not mechanical stability differs among those with and without chronic ankle instability. Scand J Med Sci Sports 2010; 20: e137-e144
• 25 Willems T, Witvrouw E, Verstuyft J, Vaes P, De Clercq D. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 2002; 37: 487-493
• 26 Wright CJ, Arnold BL, Ross SE, Linens SW. Recalibration and validation of the Cumberland ankle instability tool cutoff score for individuals with chronic ankle instability. Arch Phys Med Rehabil 2014; 95: 1853-1859