Examining Neuromuscular Control During Landings on a Supinating Platform in Persons With and Without Ankle Instability

Abstract

Background: Ankle instability is a costly public health concern because of the associated recurrent sprains. It is evident there are neuromuscular control deficits predisposing these individuals to their ankle “giving way.” Individuals with a history of lateral ankle sprain, who did not develop instability, may hold the key to understanding proper neuromuscular control after injury.

Hypotheses: On the basis of previous research, the authors hypothesized that individuals with ankle instability would demonstrate reduced peroneal activation, causing a more inverted position of the ankle, before and after landing.

Study Design: Controlled laboratory study.

Methods: This study aimed to evaluate preparatory and reactive neuromuscular control when landing on a custom-designed ankle supinating device in individuals with ankle instability (AI), individuals with a history of lateral ankle sprains without instability (LAS), and uninjured controls (CON). Forty-five participants (15 per group) were asked to land on a device built to simulate the mechanism of a lateral ankle sprain (supination) while kinematics and muscle activity of the lower extremity were monitored.

Results: Contrary to our hypotheses, the AI group displayed significantly increased preparatory (P = .01) and reactive (P = .02) peroneal activation, while the LAS group demonstrated a trend toward increased preparatory tibialis anterior muscle activation (P = .07), leading to a decreased plantar flexion of the ankle at landing.

Conclusion: The AI group was likely acting in a protective fashion to a potentially injurious situation, indicating these individuals can activate the peroneals if needed. The LAS group’s strategy may be a safer strategy in that a less plantar-flexed position of the ankle is more close-packed and stable. Further, it appears the long-latency response of the peroneals may be enhanced in these individuals, which indicates motor learning at the supraspinal level to promote dynamic restraint.

Clinical Relevance: Individuals with AI can increase peroneal activation when necessary to dynamically stabilize the ankle, indicating the potential for training/rehabilitation. Further, the LAS group may deploy a different control strategy after injury to protect the ankle from subsequent sprains, which deserves investigation during activities of daily living. A greater understanding of these strategies will lead to the development of more appropriate treatment paradigms after injury to minimize the incidence of instability.