Detection of Compensatory Mechanism during Gait in Individuals with Functional Ankle Instability Using Inversion Perturbation

Document Type : Original article

Authors

1 PhD student of Sport Biomechanics, School of Physical Education, Kharazmi University of Tehran. Tehran, Iran

2 Full Professor of Sport Biomechanics, School of Physical Education, Kharazmi University of Tehran Tehran, Iran

3 Associated Professor of Sport Biomechanics, School of Physical Education, University of Birjand . Birjand, Iran.

4 Full Professor of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran. Iran

5 Asistant Professor of Sport Biomechanics, School of Physical Education, Kharazmi University of Tehran

Abstract

Background and Aim: Delayed neuromuscular responses is among the most important lesions in individuals with Functional Ankle Instability (FAI), which indicates using the compensatory mechanisms. Since most of body movements occur in closed-kinetic chain, the distal lesions can affect the proximal sections leading to the use of compensatory strategies. The aim of the present study was to investigate the compensatory strategies during gait in individuals with FAI using inversion perturbation.  
Material and Method: Seven healthy individuals (age 23.40± 1.70 years; weight 72.25 ± 6.14 Kg; height 176.32 ± 6.41 cm) and seven individuals with FAI (age: 24.31± 0.81 years; weight: 71.15 ± 7.21 Kg; height: 175.12 ± 4.28 cm) volunteered in the present semi-experimental investigation. Electrical activation of the peroneus longus, tibialis anterior, gluteus medius, and erector spine muscles during gait on the inversion perturbation system was measured using the wireless EMG system. Response Time to Perturbation (RTP) in electrical signals of the muscles was extracted using MATLAB and analyzed running independent T-tests (p<0.05).
Results: FAI group, as compared with the healthy group, indicated a significant longer RTP in the peroneus longus and erector spine muscles (p<0.05), whereas RTP in gluteus medius muscle was significantly less in FAI group (p<0.05). Although RTP in tibialis anterior muscle was longer in FAI group, as compared with the healthy group, no significant difference was observed between the two groups. 
Conclusion: The results of the current study showed that RTP differ in FAI group compared with that in the healthy group. Early recruitment of gluteus medius muscle in FAI group is indicator of using the hip-based strategy to control posture. Since the FAI individuals have lesions in muscle surrounding the ankle, ankle-based strategy is not enough to response the perturbation,; therefore, the dominant strategy for controlling the posture is hip-based strategy. Alterations in RTP are reported due to variation in the central neuromuscular control, so it is suggested that  practitioners focus on detecting the compensatory mechanisms. 

Keywords

Main Subjects

References

  1. Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. The American Journal of Sports Medicine. 1977; 5:241-242.##
  2. Hertel, J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med. 2008; 27(3):353-370. ##
  3. Delahunt E, Coughlan G, Caulfield B, Nightingale E, Lin C, Hiller CE. Inclusion Criteria When Investigating Insufficiencies in Chronic Ankle Instability. Medicine and Science in Sports and Exercise. 2010; 42(11):2106. ##
  4. Donahue M. Neuromuscular response of individuals with and without functional ankle instability.2012 (Unpublished Doctoral Dissertation): Indiana University, Indiana. ##
  5. Hoch, M.C, Mckeon, P.O. Peroneal reaction time after ankle sprain. Medicine and Science in Sports and Exercise. 2013; 46(3):546-556. ##
  6. Thain, P.K, Hughes G.T.G, Mitchell, A.Ch.S. The effect of repetitive ankle perturbations on muscle reaction time and muscle activity. Journal of Electromyography and Kinsiology.2016; 30:184-190. ##
  7. Hopkins, Ty.J, Macloda, T, McCaw, S. Muscle activation following sudden ankle inversion during standing and walking. Eur J Appl Physiol.2007. 99:371-378. ##
  8. Stormont DM, Morrey B, An KN, Cass J. Stability of the loaded ankle. Relation between articular restraint and primary and secondary static restraints. The American Journal of Sports Medicine. 1985; 13(5):295-300. ##
  9. Feger, M.A, Donovan,L, Hart,J.M, Hertel, J. Lower extremity muscle activation in patients with or without chronic ankle instability during walking.Journal of Athletic Training. 2015:50(4); 350-357. ##
  10. 10.  Hass, Ch.J, Bishop, M.D, Doidge, D, Wikstrom, E.Chronic ankle instability alters central organization of movement.The American Journal of Sports Medicine.2010; 38(4): 829-834. ##

11. Beckman, S.M. Buchanan,Th,S. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. Archives of Physical Medicine and Rehabilitation.1995;76:1138-1143. ##

  1. 12.  Levin, O, Vanwanseele, B, Thijsen Jo, Helsen W.F, Staes F.F, Duysens J.Proactive and reactive neuromuscular control in subjects with chronic ankle instability: Evidence from a pilot on landing. Gait and Posture.2015;41:106-111. ##

13. Hertel, J. Functional instability following lateral ankle sprain. Sports Medicine. 2000.29, 361-371. ##

14. Munn, J, Sullivan, S. J., & Schneiders, A. G. Evidence of sensorimotor deficits in functional ankle instability. Journal of Science and Medicine Sport. 2010; 13, 2-12. ##

15. Wikstrom, E. A., Fournier, K. A., & McKeon, P. O. Postural control differs between those with and without chronic ankle instability. Gait & Posture. 2010, 32, 82-86. ##

16. Kautzky, K, Feger, M.A, Hart, J.M, Hertel, J. Surface Electromyography Variability Measures During Walking: Effect of Chronic Ankle Instability and Prophylactic Bracing. Sport Health Care.2015;7(1): 14-22. ##

17. Stegeman, D.F, Hermens H.J. Standards for surface electromyography: European project” Surface EMG for non-invasive assessment of muscles (SENIAM)”. 2007; ##

18. Robertson D.G.E, Caldwell, G.E, Hamill, J, Kamen, G, Whittlesey, S.N. Research Method in Biomechanics.2015. Human Kinetics.192-193. ##

19. Bartko J.J.The intraclass correlation coefficient as a measure of reliability.1966;19(1):3-11. ##

20. Enoka RM. Neuromechanics of Human Movement. 3rd ed. Boulder, CO: Human Kinetics; 2002. ##

21. Gutierrez, G.M, Kaminski,Th.W, Douex A.T. Neuromuscular control and ankle instability. 2009, 1; 359-365. ##

22. Santello M. Review of motor control mechanisms underlying impact absorption from falls. Gait Posture 2005; 21:85-94. ##

23. Brown C, Padua D, Marshall SW, Guskiewicz K. Individual with mechanical ankle instability exhibit different motion pattern than those with functional ankle instability and ankle sprain copers. Clinical Biomechanics 2008; 23: 822-831. ##

 

24. Wikstorm EA, Arrigena M, Tillman M and Borsa P. Dynamic postural stability in subjects with braced functional ankle. Jurnal of Athletic Training 2006; 41(3): 245-250. ##

25. Wikstrom, E. A., Bishop, M. D., Inamdar, A. D. & Hass, C. J. Gait termination control strategies are altered in chronic ankle instability subjects. 2010. Medical Science Sports Exercise, 42, 197-205. ##

26. Konradsen L, Voigt M, Højsgaard C. Ankle inversion injuries: The role of the dynamic defense mechanism. American Journal of Sports Medicine 1997;25(1):54-58. ##

27. Denyer JR, Hewitt NLA, Mitchell ACS. Foot structure and muscle reaction time to a simulated ankle sprain. Journal of Athletic Training 2013; 48(3):326-330. ##

28. Thain PK, Bleakley CM, Mitchell ACS. Muscle reaction time during a simulated lateral ankle sprain after wet-ice application or cold-water immersion. Journal of Athletic Training 2015; 50(7):697-703. ##

29. Beckman, S.M. Buchanan,Th,S. Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. Archives of Physical Medicine and Rehabilitation.1995;76:1138-1143. ##

30. Comerford, M, Mottram, S. Kinetic control the management of uncontrolled movement. 2012,Churchill Livingstone.Australlia.36-40. ##

31. HASS, C. J., BISHOP, M. D., DOIDGE, D. & WIKSTROM, E. A. Chronic ankle instability alters central organization of movement. The American journal of sports medicine.2010. 38, 829-834. ##

32. Witchalls, J.B, Waddington, G. Adams, R, Blanch, P. Chronic ankle instability affects learning rate during repeated proprioception testing. Physical Therapy in Sport.2014.15 (2); 106-111. ##

The Scientific Journal of Rehabilitation Medicine
Volume 6, Issue 4
January and February 2018
Pages 240-248

Files

History

  • Receive Date: 19 December 2016
  • Revise Date: 03 January 2017
  • Accept Date: 14 February 2017
  • First Publish Date: 22 December 2017

Share

How to cite

Statistics