TY - GEN A1 - Nair, Alexandra A1 - Lin, Chiao-I A1 - Khajooei, Mina A1 - Heikkila, Mika A1 - Engel, Tilman A1 - Mayer, Frank T1 - Side comparison of knee muscle activities in response to perturbed walking of unilateral ankle instability T2 - Medicine and science in sports and exercise : MSSE N2 - Acute ankle sprain leads in 40% of all cases to chronic ankle instability (CAI). CAI is related to a variety of motor adaptations at the lower extremities. Previous investigations identified increased muscle activities while landing in CAI compared to healthy control participants. However, it remains unclear whether muscular alterations at the knee muscles are limited to the involved (unstable) ankle or are also present at the uninvolved leg. The latter might potentially indicate a risk of ankle sprain or future injury on the uninvolved leg. Purpose: To assess if there is a difference of knee muscle activities between the involved and uninvolved leg in participants with CAI during perturbed walking. Method: 10 participants (6 females; 4 males; 26±4 years; 169±9 cm; 65±7 kg) with unilateral CAI walked on a split-belt treadmill (1m/s) for 5 minutes of baseline walking and 6 minutes of perturbed walking (left and right side, each 10 perturbations). Electromyography (EMG) measurements were performed at biceps femoris (BF) and rectus femoris (RF). EMG amplitude (RMS; normalized to MVIC) were analyzed for 200ms pre-heel contact (Pre200), 100ms post heel contact (Post100) and 200ms after perturbation (Pert200). Data was analyzed by paired t-test/Wilcoxon test based on presence or absence of normal distribution (Bonferroni adjusted α level p≤ 0.0125). Results: No statistical difference was found between involved and uninvolved leg for RF (Pre200: 4±2% and 11± 22%, respectively, p= 0.878; Post100: 10± 5 and 18±31%, p=0.959; Pert200: 6±3% and 13±24%, p=0.721) as well as for BF (Pre200: 12±7% and 11±6, p=0.576; Post100: 10±7% and 9±7%, p=0.732; Pert200: 7±4 and 7±7%, p=0.386). Discussion: No side differences in muscle activity could be revealed for assessed feedforward and feedback responses (perturbed and unperturbed) in unilateral CAI. Reduced inter-individual variability of muscular activities at the involved leg might indicate a rather stereotypical response pattern. It remains to be investigated, whether muscular control at the knee is not affected by CAI, or whether both sides adapted in a similar style to the chronic condition at the ankle. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000671088.10003.6b SN - 0195-9131 SN - 1530-0315 VL - 52 IS - 17 SP - 97 EP - 97 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Lin, Chiao-I A1 - Khajooei, Mina A1 - Nair, Alexandra A1 - Heikkila, Mika A1 - Kaplick, Hannes A1 - Tilman, Engel A1 - Mayer, Frank T1 - Activities of hip muscles in response to perturbed walking in individual with chronic ankle instability T2 - Medicine and science in sports and exercise : MSSE N2 - Chronic ankle instability (CAI) is not only an ankle issue, but also affects sensorimotor system. People with CAI show altered muscle activation in proximal joints such as hip and knee. However, evidence is limited as controversial results have been presented regarding changes in activation of hip muscles in CAI population. PURPOSE: To investigate the effect of CAI on activity of hip muscles during normal walking and walking with perturbations. METHODS: 8 subjects with CAI (23 ± 2 years, 171 ± 7 cm and 65 ± 4 kg) and 8 controls (CON) matched by age, height, weight and dominant leg (25 ± 3 years, 172 ± 7 cm and 65 ± 6 kg) walked shoed on a split-belt treadmill (1 m/s). Subjects performed 5 minutes of baseline walking and 6 minutes walking with 10 perturbations (at 200 ms after heel contact with 42 m/s2 deceleration impulse) on each side. Electromyography signals from gluteus medius (Gmed) and gluteus maximus (Gmax) were recorded while walking. Muscle amplitudes (Root Mean Square normalized to maximum voluntary isometric contraction) were calculated at 200 ms before heel contact (Pre200), 100 ms after heel contact (Post100) during normal walking and 200 ms after perturbations (Pert200). Differences between groups were examined using Mann Whitney U test and Bonferroni correction to account for multiple testing (adjust α level p≤ 0.0125). RESULT: In Gmed, CAI group showed lower muscle amplitude than CON group after heel contact (Post100: 18±7 % and 47±21 %, p< .01) and after walking perturbations ( 31±13 % and 62±26 %, p< .01), but not before heel contact (Pre200: 5±2 % and 11±10 %, p= 0.195). In Gmax, no difference was found between CAI and CON groups in all three time points (Pre200: 12±5 % and 17±12 %, p= 0.574; Post100: 41±21 % and 41±13 %, p= 1.00; Pert200: 79±46 % and 62±35 %, p= 0.505). CONCLUSION: People with CAI activated Gmed less than healthy control in feedback mechanism (after heel contact and walking with perturbations), but not in feedforward mechanism (before heel contact). Less activation on Gmed may affect the balance in frontal plane and increase the risk of recurrent ankle sprain, giving way or feeling ankle instability in patients with CAI during walking. Future studies should investigate the effect of Gmed strengthening or neuromuscular training on CAI rehabilitation. Y1 - 2020 U6 - https://doi.org/10.1249/01.mss.0000671060.98581.0b SN - 0195-9131 SN - 1530-0315 VL - 52 IS - 17 SP - 94 EP - 94 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - GEN A1 - Lin, Chiao-I A1 - Khajooei, Mina A1 - Engel, Tilman A1 - Nair, Alexandra A1 - Heikkila, Mika A1 - Kaplick, Hannes A1 - Mayer, Frank T1 - The effect of chronic ankle instability on muscle activations in lower extremities T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background/Purpose Muscular reflex responses of the lower extremities to sudden gait disturbances are related to postural stability and injury risk. Chronic ankle instability (CAI) has shown to affect activities related to the distal leg muscles while walking. Its effects on proximal muscle activities of the leg, both for the injured- (IN) and uninjured-side (NON), remain unclear. Therefore, the aim was to compare the difference of the motor control strategy in ipsilateral and contralateral proximal joints while unperturbed walking and perturbed walking between individuals with CAI and matched controls. Materials and methods In a cross-sectional study, 13 participants with unilateral CAI and 13 controls (CON) walked on a split-belt treadmill with and without random left- and right-sided perturbations. EMG amplitudes of muscles at lower extremities were analyzed 200 ms after perturbations, 200 ms before, and 100 ms after (Post100) heel contact while walking. Onset latencies were analyzed at heel contacts and after perturbations. Statistical significance was set at alpha≤0.05 and 95% confidence intervals were applied to determine group differences. Cohen’s d effect sizes were calculated to evaluate the extent of differences. Results Participants with CAI showed increased EMG amplitudes for NON-rectus abdominus at Post100 and shorter latencies for IN-gluteus maximus after heel contact compared to CON (p<0.05). Overall, leg muscles (rectus femoris, biceps femoris, and gluteus medius) activated earlier and less bilaterally (d = 0.30–0.88) and trunk muscles (bilateral rectus abdominus and NON-erector spinae) activated earlier and more for the CAI group than CON group (d = 0.33–1.09). Conclusion Unilateral CAI alters the pattern of the motor control strategy around proximal joints bilaterally. Neuromuscular training for the muscles, which alters motor control strategy because of CAI, could be taken into consideration when planning rehabilitation for CAI. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 712 KW - Electromyography KW - Hip KW - Skeletal joints KW - Knees KW - Legs KW - Musculoskeletal injury KW - Walking KW - Ankles Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-515632 SN - 1866-8364 ER - TY - JOUR A1 - Lin, Chiao-I A1 - Khajooei, Mina A1 - Engel, Tilman A1 - Nair, Alexandra A1 - Heikkila, Mika A1 - Kaplick, Hannes A1 - Mayer, Frank T1 - The effect of chronic ankle instability on muscle activations in lower extremities JF - PLOS ONE / Public Library of Science N2 - Background/Purpose Muscular reflex responses of the lower extremities to sudden gait disturbances are related to postural stability and injury risk. Chronic ankle instability (CAI) has shown to affect activities related to the distal leg muscles while walking. Its effects on proximal muscle activities of the leg, both for the injured- (IN) and uninjured-side (NON), remain unclear. Therefore, the aim was to compare the difference of the motor control strategy in ipsilateral and contralateral proximal joints while unperturbed walking and perturbed walking between individuals with CAI and matched controls. Materials and methods In a cross-sectional study, 13 participants with unilateral CAI and 13 controls (CON) walked on a split-belt treadmill with and without random left- and right-sided perturbations. EMG amplitudes of muscles at lower extremities were analyzed 200 ms after perturbations, 200 ms before, and 100 ms after (Post100) heel contact while walking. Onset latencies were analyzed at heel contacts and after perturbations. Statistical significance was set at alpha≤0.05 and 95% confidence intervals were applied to determine group differences. Cohen’s d effect sizes were calculated to evaluate the extent of differences. Results Participants with CAI showed increased EMG amplitudes for NON-rectus abdominus at Post100 and shorter latencies for IN-gluteus maximus after heel contact compared to CON (p<0.05). Overall, leg muscles (rectus femoris, biceps femoris, and gluteus medius) activated earlier and less bilaterally (d = 0.30–0.88) and trunk muscles (bilateral rectus abdominus and NON-erector spinae) activated earlier and more for the CAI group than CON group (d = 0.33–1.09). Conclusion Unilateral CAI alters the pattern of the motor control strategy around proximal joints bilaterally. Neuromuscular training for the muscles, which alters motor control strategy because of CAI, could be taken into consideration when planning rehabilitation for CAI. KW - Ankles KW - Walking KW - Electromyography KW - Hip KW - Skeletal joints KW - Knees KW - Legs KW - Musculoskeletal injury Y1 - 2020 U6 - https://doi.org/10.1371/journal.pone.0247581 SN - 1932-6203 VL - 16 IS - 2 PB - PLOS CY - San Francisco ER -