Review article - (2021)20, 373 - 390
DOI: https://doi.org/10.52082/jssm.2021.373
Ankle Instability Patients Exhibit Altered Muscle Activation of Lower Extremity and Ground Reaction Force during Landing: A Systematic Review and Meta-Analysis
Hyung Gyu Jeon1,2, Sae Yong Lee1,2,3, Sung Eun Park4, Sunghe Ha2,5,
1Department of Physical Education, Yonsei University, Seoul, Republic of Korea
2International Olympic Committee Research Centre Korea, Yonsei University, Seoul, Republic of Korea
3Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea
4School of Universal Computing, Construction, and Engineering Education, Florida International University, Miami, FL, USA
5Department of Clinical Research on Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea

Sunghe Ha
✉ Ph.D., CSCS Department of Clinical Research on Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
Email: hasunghe7@gmail.com
Received: 19-02-2021 -- Accepted: 05-04-2021
Published (online): 15-04-2021
ABSTRACT

This review aimed to investigate characteristics of muscle activation and ground reaction force (GRF) patterns in patients with ankle instability (AI). Relevant studies were sourced from PubMed, CINAHL, SPORTDiscus, and Web of Science through December 2019 for case-control study in any laboratory setting. Inclusion criteria for study selection were (1) subjects with chronic, functional, or mechanical instability or recurrent ankle sprains; (2) primary outcomes consisted of muscle activation of the lower extremity and GRF during landing; and (3) peer-reviewed articles with full text available, including mean, standard deviation, and sample size, to enable data reanalysis. We evaluated four variables related to landing task: (1) muscle activation of the lower extremity before landing, (2) muscle activation of the lower extremity during landing, (3) magnitude of GRF, and (4) time to peak GRF. The effect size using standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for these variables to make comparisons across studies. Patients with AI had a lower activation of peroneal muscles before landing (SMD = -0.63, p < 0.001, CI = -0.95 to -0.31), greater peak vertical GRF (SMD = 0.21, p = 0.03, CI = 0.01 to 0.40), and shorter time to peak vertical GRF (SMD = -0.51, p < 0.001, CI = -0.72 to -0.29) than those of normal subjects during landing. There was no significant difference in other muscle activation and GRF components between the patients with AI and normal subjects (p > 0.05). Altered muscle activation and GRF before and during landing in AI cases may contribute to both recurrent ankle and ACL injuries and degenerative change of articular.
Key words: Ankle injury, non-contact injury, kinetic chain system, impact force, risk factor

Key Points
  • Patients with ankle instability have a lower activation of peroneal muscles before landing.
  • Additionally, patients with ankle instability have greater peak vertical GRF and shorter time to peak vertical GRF than those of normal subjects during landing.
  • Altered landing strategy in cases of ankle instability may contribute both to the recurrent ankle and other injuries of the lower extremity (e.g., ACL tear and degenerative change of articular cartilage).








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Ankle Instability Patients Exhibit Altered Muscle Activation of Lower Extremity and Ground Reaction Force during Landing: A Systematic Review and Meta-Analysis
Hyung Gyu Jeon, Sae Yong Lee, Sung Eun Park, Sunghe Ha
2021(20), 373 - 390.
DOI: https://doi.org/10.52082/jssm.2021.373