Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
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©Journal of Sports Science and Medicine (2021) 20, 373 - 390   DOI: https://doi.org/10.52082/jssm.2021.373

Review article
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, 
Author Information
1 Department of Physical Education, Yonsei University, Seoul, Republic of Korea
2 International Olympic Committee Research Centre Korea, Yonsei University, Seoul, Republic of Korea
3 Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea
4 School of Universal Computing, Construction, and Engineering Education, Florida International University, Miami, FL, USA
5 Department of Clinical Research on Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea

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