Study Design Cross-sectional.

Objectives To compare gluteal muscle thickness changes measured by ultrasound imaging (USI) during lateral band walking with the resistance band positioned around the ankles or the forefeet in individuals with a history of lateral ankle sprain (LAS).

Background Evidence suggests proximal neuromuscular adaptations exist in individuals with a history of LAS. Understanding how lateral band walking exercises target the proximal musculature could be beneficial for treatment following LAS.

Methods and Measures 18 individuals (Age=22±6 years, Height=168.8±10.5 cm, Mass=74.4±28.7 kg, Previous LAS=4±3) with history of LAS participated. B-mode USI of gluteus maximus (GMax) and gluteus medius (GMed) were collected during lateral band walking. The 8 MHz wireless transducer was secured to participants using an elastic belt. Patients performed 3 trials of 5 lateral steps per band position. Thickness measures were taken from the inferior aspect of the superior muscle border to the superior aspect of the inferior border of each muscle. Images were normalised to quiet standing. The percent activity beyond quiet standing was calculated by taking the exercise muscle thickness divided by quiet muscle thickness. Paired sample t-tests were used to compare each muscle in each band position. Cohen’s d effect sizes (ES) were calculated to determine magnitude of difference.

Results The percent activity for GMax (10.63%±7.01% ankle vs. 13.98%±7.21% forefoot, p=0.009, ES=0.48) and GMed (13.61%±18.60% ankle vs. 19.10%±19.30% forefoot, p<0.001, ES=0.30) increased from the ankle position to forefoot position.

Conclusion The percent activity increased for both muscles in the forefoot position compared to the ankle position. Placing the resistance band around the forefoot may be a more challenging task for individuals with a history of LAS. During rehabilitation, it may be beneficial to begin with lateral band walks around the ankle and progress to the forefoot position as patients become more proficient at the exercise.