Background Altered muscle activation pattern and ground reaction force (GRF) in those with ankle instability (AI) should be clearly investigated in order to incorporate this information to retrain AI patient.
Objective To investigate muscle activation characteristics of AI patient and GRF pattern.
Data Sources Relevant studies were searched from PubMed, CINAHL, SPORTDiscus, and Web of Science through May 2019. Combination of keywords ankle instability, chronic ankle instability, ankle sprain, biomechanics, kinetics, electromyography, and landing were used to search relevant studies.
Study Selection Inclusion criteria for study selection were: 1) subjects with chronic ankle instability, functional instability, mechanical instability or recurrent ankle sprains; 2) the primary outcomes consisted of muscle activation of the lower extremity and GRF during landing; 3) peer-reviewed articles with full-text; and 4) providing appropriate information, which is mean, standard deviation, and sample size to re-analyze data.
Data Extraction Extracted data included muscle activation of the lower extremity (root mean square; integral EMG; mean), the magnitude, and time to peak GRF and was used to calculate standardized mean differences (SMD) with 95% confidence intervals (CIs).
Data Synthesis A total of twelve relevant studies (Oxford Centre for Evidence-Based Medicine level 3b) included in this study. The peroneal muscle was less activated in AI compared to control before landing (SMD=-0.59, p<0.01, CIs=-0.91, -0.27). AI had greater peak vertical GRF (SMD=0.21, p=0.03, CIs=0.02, 0.41) and exhibited shorter time to peak vertical GRF (SMD=-0.63, p<0.01, CIs=-0.85, -0.41) than those of control during landing (SMD=-0.63, p<0.01, CIs=-0.85, -0.41).
Conclusions Muscle recruitment training of the peroneal muscle may diminish the risk of the recurrent ankle sprain in addition to other lower limb injuries. The peroneal muscle could provide a sufficient range of plantar flexion to decrease vertical GRF and eversion of the subtalar joint. Therefore, peroneal muscle training may be a key factor to retrain for the altered landing strategy resulting in ankle instability.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.