Distinct patterns in neuromuscular adaptation to repeated perturbations in chronic ankle instability

 The reason I needed an AFO is because of ankle rolling; so, ask your COMPETENT? DOCTOR how this will be used in your recovery! Your doctor better be knowledgeable in EXACTLY HOW YOU WILL GET RECOVERED!

The key word there is 'will'; NO EXCUSES ARE ALLOWED FROM YOUR DOCTOR!  With NO exact recovery protocols; your doctor IS COMPLETELY FUCKING INCOMPETENT!

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name(If you can't stand by your name don't bother replying anonymously) and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you aren't working on 100% recovery protocols with NO EXCUSES! You've known since medical school that stroke recovery is a complete shitshow! Incompetence is DOING NOTHING ABOUT IT! Well, are you incompetent or not?

Distinct patterns in neuromuscular adaptation to repeated perturbations in chronic ankle instability

• Xiaohan Xu,
• Joanna Bowtell,
• William R. Young,
• Daniel T. P. Fong &
• Genevieve K. R. Williams 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Neuromuscular impairments following ankle sprains are central to chronic ankle instability (CAI), potentially leading to compensatory muscle co-contraction to regulate ankle stiffness, particularly in response to external perturbations. The acute effect of practice on muscle activation and postural responses reveal initial deficits in motor control and indicate the capacity of individuals with CAI to overcome these deficits within their specific constraints. This study aimed to examine adaptive changes in lower limb muscle co-contraction between CAI and healthy control (HC) participants during repeated perturbations and assess whether practice influences postural control and strategy.

Methods

Twenty-three CAI and 23 HC participants performed a single-leg balance task involving repetitive mediolateral perturbations. Surface electromyography, ground reaction force and whole-body kinematics were recorded, and margin of stability (MoS) and the coupling between MoS and ankle-/ hip-joint torques were calculated.(I always failed the single leg standing test in the Berg Balance scale. Of course, my physical therapist was useless in addressing the problem, did absolutely nothing about it! But I was tested on a weekly basis, what amazing incompetence displayed!)

Results

Individuals with CAI demonstrated different adaptive changes in muscle co-contraction for Tibialis Anterior (TA) - Peroneus Longus (PL) and TA - Soleus compared to HC. In healthy controls, TA-PL co-contraction decreased significantly with practice, while no changes were observed in the CAI group. Repeated perturbations improved MoS and MoS-Hip torque coordination in CAI, suggesting improved postural control and hip strategy.

Conclusions

Rehabilitation for CAI should target both the whole-body coordination and ankle adaptation exercise since ankle joint appears refractory to change in CAI individuals. Future research should explore whether co-contraction patterns influence risk of ankle sprain in CAI populations, linking lab-based performance to real-world injury risks.

Data availability

The datasets analysed during the current study are available from the corresponding author (XX) on reasonable request.