The effects of kinesiophobia on postural control with chronic ankle instability.

BACKGROUND: Patients with chronic ankle instability (CAI) often experience injury-related fear following ankle injuries, a condition known as kinesiophobia. Little research has investigated the impact of kinesiophobia in patients with CAI. RESEARCH QUESTION: How does kinesiophobia impact the static and dynamic balance of individuals with CAI? METHODS: Fifty patients with CAI were divided into 2 subgroups based on their responses to the Tampa Scale of Kinesiophobia: 25 with kinesiophobia (CAI-K) and 25 without kinesiophobia (CAI-N). These groups were compared to 20 control participants. All participants performed a single-leg balance test with eyes open (EO) and eyes closed (EC). They also performed the Y-balance test (YBT) with EO. Romberg ratios were calculated as EC/EO and used for statistical analysis. RESULTS: No differences in static balance with EO and EC were found among three groups. However, the CAI-K group displayed a higher Romberg ratio in the mediolateral direction during static balance than both CAI-N and control groups. Additionally, both CAI-K and CAI-N groups displayed higher Romberg ratio in the anterior-posterior than controls. During YBT, the CAI-K group showed reduced reach distance in the anterior direction than CAI-N and control groups. SIGNIFICANCE: The CAI-K group relies more on visual feedback during static balance in the mediolateral direction than CAI-N and control groups. Furthermore, the CAI-K group displayed less anterior reach distance during YBT compared to the CAI-N and control groups. Clinicians should consider both psychological and physical factors when designing rehabilitation programs.

Effects of anticipation on joint kinematics during inversion perturbation in individuals with chronic ankle instability.

BACKGROUND: Although chronic ankle instability (CAI) patients display altered reactive joint kinematics after inversion perturbation, little is known about the effects of anticipation on reactive joint kinematics among CAI, coper, and control groups. OBJECTIVE: To assess changes in reactive joint kinematics after different inverted landing situations including planned- and unplanned-condition among groups of CAI, coper, and control. METHODS: Sixty-six volunteers participated (22 per group). Participants completed three trials of both planned and unplanned single-leg landing onto an inverted force platform while reactive joint kinematic data were collected from initial-contact to 200 ms after initial-contact. Two-way repeated measures ANOVAs were used to examine the differences between condition (planned-, unplanned-conditions) and group (CAI, coper, control). RESULTS: There were significant group by condition interactions for total ankle displacement in the frontal plane (p < 0.01) and maximum ankle inversion velocity (p = 0.01). CAI patients displayed increased ankle displacement (p < 0.01) and maximum inversion velocity (p < 0.01) under the unplanned condition compared to the planned condition. However, copers did not show any differences in ankle displacement and maximum inversion velocity between the two conditions. CONCLUSIONS: CAI patients displayed greater changes in ankle joint displacement and maximum ankle inversion velocity occurred after inversion perturbation under unplanned condition compared with copers and controls. Current data suggest that altered reactive joint kinematics under the unanticipated condition in CAI patients may contribute to the condition of CAI after ankle sprains. Clinicians should focus on rehabilitation programs to recover and/or develop feedback control for CAI patients during functional movements under unanticipated condition to prevent further injuries.

Acute effects of external visual feedback using cross-line laser on landing neuromechanics and postural control in chronic ankle instability.

Although neuromuscular training (NMT) programmes positively enhance clinical deficits in chronic ankle instability (CAI) patients, the effectiveness of NMTs in restoring movement patterns during jump landing is still questionable. Before developing new prolonged motor-learning interventions, it is important to determine the immediate effects of intervention on movement patterns during jump-landing in patients with CAI. Therefore, the purpose of this study was to determine whether real-time external feedback using a crossline laser device changes the movement patterns during jump-landing and balance tasks in patients with CAI. Eighteen patients with CAI completed three successful single-leg jump-landing tasks and single-leg balance tasks under the conditions of with and without external feedback. Lower-extremity joint angles, moments, and EMG activation of six muscles were collected during the single leg jump-landing task and centre of pressure data were collected during the single-leg balance test. Real-time external feedback allowed to change neuromechanical characteristics in the entire lower-extremity (i.e., ankle, knee, and hip joints) during jump-landing. However, there were no differences in static postural control between the two conditions. Clinicians should carefully consider incorporating a cost-effective laser device into an augmented NMT programme of longer duration to improve movement patterns during functional tasks in patients with CAI.