Does a not-so-recent ankle sprain influence interjoint coordination during walking?

Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021

This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI). Depending on many factors, impairments may continue following injury. While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI. The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice. J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80. doi:10.2519/jospt.2021.0302.

The coordination of upper and lower limbs in curve-turning walking of healthy preschoolers: Viewed in continuous relative phase

BACKGROUND

Coordination is the ability to assemble and maintain appropriate relations between joints. Investigating limb coordination in curve-turning (CT) walking could provide insightful information about the coordinating strategies and neuro-musculoskeletal system (NMSS) control in human motion.

RESEARCH QUESTION

Although preschoolers have already established an adult-like gait, how preschoolers perform their specific gait pattern when walking in CT and what coordination strategies they would choose during the turning process have not yet been systematically considered. Therefore, this study was aimed to investigate preschoolers' coordination mechanism during asymmetric motion, in order to understand the development of their NMSS control in locomotion.

METHODS

Kinematics data in the lower and upper limbs of 45 healthy preschoolers walking with the curve-turning task was measured by the Coda Motion System. The Continuous Relative Phase (CRP) angle and the variability between the knee and ankle, hip and knee, as well as the thorax-humerus joint (THJ) and elbow were calculated.

RESULTS

The outcome demonstrates that as the curve angles increased, the stride length and Froude number of preschoolers significantly decreased (p < 0.05 for all); meanwhile, a more out of phase coordination pattern in CRP and an increase in VCRP values were found. Group analysis showed that the significant differences in CRP and VCRP between preschoolers and adults increased with curve angles in all coupled joints - the highest in that of the Knee-Ankle coupling, followed by those of the Hip-Knee and THJ-Elbow.

SIGNIFICANCE

Our results suggest that to achieve curve-turning, preschoolers first chose to modify their STP, then to adjust coordination for coupling-joints in the Knee-Ankle, Hip-Knee, and THJ-Elbow systems. Additionally, preschoolers are still in a gait fine-tuning period and their NMSS control of motion is not as precise as that of adults.