Neuromuscular Control During Stepping Down in Continuous Gait in Individuals with and Without Ankle Instability

Ankle sprains are a common injury and those affected are at a risk of developing chronic ankle instability (CAI). Complications of an acute sprain include increased risk of re-injury and persistent disability; however, the exact link between ankle sprains and chronic instability has yet to be elucidated. The purpose of this study was to investigate neuromuscular control (including kinematics, kinetics and EMG) during stepping down from a curb, a common yet challenging daily activity, in persons with ankle instability (n = 11), those with a history of ankle sprain without persistent instability, called ankle sprain "copers" (CPRs) (n = 9) and uninjured controls (CTLs) (n = 13). A significant group difference was noted as the CPR group demonstrated increased tibialis anterior activity in both the preparatory (pre-touchdown) and reactive (post-touchdown) phases when compared to healthy and unstable groups (P < 0.05). It follows that the CPR group also demonstrated a significantly less plantar-flexed position at touchdown than the other two groups (P < 0.05). This is a more stable position to load the ankle and this strategy differed from that used by participants with CAI and uninjured CTLs. These findings provide insight into the neuromuscular control strategies of CPRs, which may allow them to more appropriately control ankle stability following sprains.