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Lin JZ, Hung MH, Ko BJ, Lee HJ. Analysing lower limb motion and muscle activation in athletes with ankle instability during dual-task drop-jump. Sports Biomech 2024:1-15. [PMID: 39212147 DOI: 10.1080/14763141.2024.2369910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 06/14/2024] [Indexed: 09/04/2024]
Abstract
This study investigates the impact of chronic ankle instability (CAI) on athletes' lower extremity mechanics during bounce drop-jump landings with divided attention. Thirty Division I physical education voluntarily participated in the study. They performed two sets of bounce drop jumps: one set with a divided attention task and the other without. The obtained data were analysed using a paired t-test to compare the outcomes between the divided attention (DA) and non-divided attention (NDA) tasks. Athletes with CAI, during the DA task, displayed higher vertical landing forces, increased ankle inversion velocity, and greater range of motion of the ankle, knee, and hip in the frontal and transverse planes. They also exhibited insufficient neuromuscular preparation of the rectus femoris muscle. Notably, distinct kinematic alterations were observed in the ankle, knee, and hip joints regarding frontal and transverse lower-extremity kinematics. The findings suggest that athletes with CAI experience decreased activation of the rectus femoris muscle, which may impact their dynamic postural stability from pre-landing to ascending phases. Furthermore, the results indicate that individuals with CAI closely replicate the injury mechanisms encountered during a drop-jump landing task with divided attention. These insights offer valuable information about the real-time challenges faced by athletes with CAI.
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Affiliation(s)
- Jian-Zhi Lin
- Department of Physical Education, National Taiwan University of Sport, Taichung, Taiwan
| | - Min-Hao Hung
- Office of Physical Education, National Chin-Yi University of Technology, Taichung, Taiwan
| | - Bo-Jen Ko
- Department of Physical Education, National Taichung University of Education, Taichung, Taiwan
| | - Heng-Ju Lee
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
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Yeo EXS, Chhabra K, Kong PW. Influence of combat boot types on in-shoe forces and perceived comfort during unloaded and loaded walking. BMJ Mil Health 2024; 170:37-42. [PMID: 35296550 DOI: 10.1136/bmjmilitary-2021-002061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Combat boots are essential protective gear for military personnel. The purposes of the present study were to examine (1) the influence of combat boot type on ground reaction force (GRF) variables and perceived comfort during unloaded and loaded walking and (2) the relationship between comfort and biomechanical measurements. METHODS Four types of combat boots with different physical features (eg, mass, thickness) and mechanical properties (eg, cushioning, rigidity) were compared across 61 male participants with experience in military marching while carrying heavy loads. In each boot type, participants completed a 10-m walk under an unloaded and a 20-kg loaded conditions at their preferred speeds. Peak force and loading rate during walking were measured using the loadsol wireless in-shoe sensor system. Comfort level was assessed using a 7-point Likert scale. Difference between loaded and unloaded walking, and across boot types were statistically compared. Correlation analyses were performed between comfort and GRF variables. RESULTS On average across all boot types, participants walked 2.1% slower when carrying 20-kg loads while experiencing 24.3% higher peak force and 20.8% higher loading rate. Boot D was perceived as most comfortable, followed by boots C, B and A (χ2(2)=115.4, p<0.001). Participants walked slightly faster (p=0.022, ηp 2 = 0.052) and displayed higher loading rates (p<0.001, ηp 2=0.194) in the two more comfortable boots (C and D) than the less comfortable boots (A and B). No significant correlations were found between perceived comfort and any GRF variables. CONCLUSIONS Combat boot features can influence perceived comfort ratings substantially during walking, whereas biomechanical differences among boot types are more subtle regardless of load conditions. The lack of relationship between comfort and force variables suggests that both subjective and objective measurements should be considered for comprehensive evaluation of combat boots.
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Affiliation(s)
- Eunice X S Yeo
- Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore
| | - K Chhabra
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
| | - P W Kong
- Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore
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Kong PW, Iskandar MNS, Koh AH, Ho MYM, Lim CXE. Validation of In-Shoe Force Sensors during Loaded Walking in Military Personnel. SENSORS (BASEL, SWITZERLAND) 2023; 23:6465. [PMID: 37514763 PMCID: PMC10384313 DOI: 10.3390/s23146465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
The loadsol® wireless in-shoe force sensors can be useful for in-field measurements. However, its accuracy is unknown in the military context, whereby soldiers have to carry heavy loads and walk in military boots. The purpose of this study was to establish the validity of the loadsol® sensors in military personnel during loaded walking on flat, inclined and declined surfaces. Full-time Singapore Armed Forces (SAF) personnel (n = 8) walked on an instrumented treadmill on flat, 10° inclined, and 10° declined gradients while carrying heavy loads (25 kg and 35 kg). Normal ground reaction forces (GRF), perpendicular to the contact surface, were simultaneously measured using both the loadsol® sensors inserted in the military boots and the Bertec instrumented treadmill as the gold standard. A total of eight variables of interest were compared between loadsol® and treadmill, including four kinetic (impact peak force, active peak force, impulse, loading rate) and four spatiotemporal (stance time, stride time, cadence, step length) variables. Validity was assessed using Bland-Altman plots and 95% Limits of Agreement (LoA). Bias was calculated as the mean difference between the values obtained from loadsol® and the instrumented treadmill. Results showed similar force-time profiles between loadsol® sensors and the instrumented treadmill. The bias of most variables was generally low, with a narrow range of LoA. The high accuracy and good agreement with standard laboratory equipment suggest that the loadsol® system is a valid tool for measuring normal GRF during walking in military boots under heavy load carriage.
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Affiliation(s)
- Pui Wah Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore
| | - Muhammad Nur Shahril Iskandar
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore
| | - Ang Hong Koh
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore
| | - Mei Yee Mavis Ho
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore
| | - Cheryl Xue Er Lim
- Centre of Excellence for Soldier Performance, Singapore Armed Forces, Singapore 637901, Singapore
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Influence of Landing in Neuromuscular Control and Ground Reaction Force with Ankle Instability: A Narrative Review. Bioengineering (Basel) 2022; 9:bioengineering9020068. [PMID: 35200421 PMCID: PMC8869733 DOI: 10.3390/bioengineering9020068] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 12/26/2022] Open
Abstract
Ankle sprains are generally the most common injuries that are frequently experienced by competitive athletes. Ankle sprains, which are the main cause of ankle instability, can impair long-term sports performance and cause chronic ankle instability (CAI). Thus, a comprehensive understanding of the key factors involved in repeated ankle strains is necessary. During jumping and landing, adaptation to the landing force and control of neuromuscular activation is crucial in maintaining ankle stability. Ankle mobility provides a buffer during landing, and peroneus longus activation inhibits ankle inversion; together, they can effectively minimize the risk of ankle inversion injuries. Accordingly, this study recommends that ankle mobility should be enhanced through active and passive stretching and muscle recruitment training of the peroneus longus muscles for landing strategies should be performed to improve proprioception, which would in turn prevent ankle sprain and injury to neighboring joints.
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Jeon HG, Lee SY, Park SE, Ha S. Ankle Instability Patients Exhibit Altered Muscle Activation of Lower Extremity and Ground Reaction Force during Landing: A Systematic Review and Meta-Analysis. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:373-390. [PMID: 34211331 DOI: 10.52082/jssm.2021.373] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/05/2021] [Indexed: 12/26/2022]
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.
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Affiliation(s)
- Hyung Gyu Jeon
- Department of Physical Education, Yonsei University, Seoul, Republic of Korea.,International Olympic Committee Research Centre Korea, Yonsei University, Seoul, Republic of Korea
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul, Republic of Korea.,International Olympic Committee Research Centre Korea, Yonsei University, Seoul, Republic of Korea.,Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea
| | - Sung Eun Park
- School of Universal Computing, Construction, and Engineering Education, Florida International University, Miami, FL, USA
| | - Sunghe Ha
- International Olympic Committee Research Centre Korea, Yonsei University, Seoul, Republic of Korea.,Department of Clinical Research on Rehabilitation, National Rehabilitation Center, Seoul, Republic of Korea
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Pace MT, Green JM, Killen LG, Swain JC, Chander H, Simpson JD, O'Neal EK. Minimalist style boot improves running but not walking economy in trained men. ERGONOMICS 2020; 63:1329-1335. [PMID: 32588761 DOI: 10.1080/00140139.2020.1778096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Abstract
This study examined movement economy under load with 1000 g minimalist (MIN) vs. 1600 g traditional (TRD) style boots. Fourteen trained, male participants completed a VO2peak test (46.6 ± 7.3 ml/kg/min) while wearing a 16 kg external load. Treadmill speeds for the running economy (RE) trials were determined by the slowest pace in which participants completed a full stage with a running gait pattern during the VO2peak test. Walking economy (WE) pace was 1.6 km/h slower than RE pace. During the second session, participants completed 5-min exercise bouts at WE and RE pace under load wearing MIN and TRD. There were no differences for any measured variables during WE trials. In contrast, RE (MIN = 2.95 ± 0.28 vs. TRD = 3.04 ± 0.30 L/min; p = .003: Cohen's d = 0.32), respiratory exchange ratio (p < .001), and perceptual measures (p < .05) were all improved while wearing MIN. Practitioner summary: In trained men, 1000 g/pair minimalist style boots (MIN) resulted in improvements of approximately 3% and 5% for running economy and respiratory exchange ratio versus 1600 g/pair traditional boots while wearing a 16 kg kit. Perceptual responses, including comfort, also favoured MIN. These effects were not found at walking pace. Abbreviations: MIN: minimalist style boots; TRD: traditional style boots; RE: running economy; WE: walking economy; ES: effect size; RER: respiratory exchange ratio; HR: heart rate.
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Affiliation(s)
- M T Pace
- Department of Kinesiology, University of North Alabama, Florence, AL, USA
| | - J M Green
- Department of Kinesiology, University of North Alabama, Florence, AL, USA
| | - L G Killen
- Department of Kinesiology, University of North Alabama, Florence, AL, USA
| | - J C Swain
- Department of Kinesiology, University of North Alabama, Florence, AL, USA
| | - H Chander
- Department of Kinesiology, Mississippi State University, MS, USA
| | - J D Simpson
- Department of Movement Sciences and Health, University of West Florida, Pensacola, FL, USA
| | - E K O'Neal
- Department of Kinesiology, University of North Alabama, Florence, AL, USA
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Lai JHC, Ling SKK, Cacho P, Mok SW, Yung PSH. The effects of shoe collar height on ankle sprain mechanics in athletes: A review of literature. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720950325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Our aim was to conduct a review to summarize the existing information regarding the effects of shoe collar height in altering ankle sprain mechanics in athletes. Methods: A systematic literature search of PubMed, Embase, MEDLINE, and SPORTDiscus was conducted in September 2019. Results: There were 10 studies published from 1993 to 2019 that were included. Most studies showed high-top shoes limited ankle sprain kinematics and increased resistance to inversion moment in static but not dynamic testing. High-top shoes were associated with delayed pre-landing ankle evertor muscle activation and smaller electromyography amplitudes. Conclusions: There is currently weak evidence to support that high-top shoes can limit ankle sprain kinematics in dynamic testing. Further studies with more consistent study interventions and outcome variables are needed to definitively establish the effects of shoe collar height on ankle sprain mechanics in athletes. The Translational Potential of this Article: Multiple studies on the effects of shoe collar height and ankle sprain mechanics have been performed but there is a lack of consistency in terms of study design, intervention, and outcome measures. A formal systematic review and meta-analysis were not applicable due to the heterogeneity of studies, and mixed results from these studies can be confusing to interpret, making further research on this topic difficult as a result of lack of future direction. We summarized the existing literature on this topic to provide a clearer picture and guide future research on this controversial matter.
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Affiliation(s)
- Jojo Hoi-Ching Lai
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - Samuel KK Ling
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - Patrick Cacho
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - SW Mok
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
| | - Patrick SH Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, CUHK, Hong Kong
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Adal SA, Mackey M, Pourkazemi F, Hiller CE. The relationship between pain and associated characteristics of chronic ankle instability: A retrospective study. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:96-101. [PMID: 31921485 PMCID: PMC6943759 DOI: 10.1016/j.jshs.2019.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/03/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Up to 74% of people with a history of ankle sprain develop chronic ankle instability (CAI). One commonly reported residual impairment is ankle pain; however, it has not been included in models or inclusion criteria for CAI. We investigated the prevalence of pain in people with CAI and the association between presence of pain and other CAI characteristics. METHODS Retrospective data from 1147 participants with CAI (age 26.6 ± 10.7 years, 59% female) were collated from previous studies that used the Cumberland Ankle Instability Tool as an assessment tool. Pain was assessed from Item 1 of the Cumberland Ankle Instability Tool, which asks participants about ankle pain. Responses were divided into 3 categories: pain during daily activities, pain during moderate/vigorous physical activities, and no pain. The presence of pain was analyzed with descriptive statistics, the correlation between pain category and CAI characteristics was analyzed by χ2 tests and factors associated with each pain category were analyzed by logistic regression. RESULTS Among the participants, 60.1% (n = 689) reported ankle pain. Of all participants, 12.4% (n = 142) reported pain during daily activities, 47.7% (n = 547) reported pain during moderate/vigorous physical activities, and 39.9% (n = 458) reported no pain. There was a strong association between ankle instability and ankle pain (χ2 = 122.2, p < 0.001, OR = 5.38, 95% confidence interval (CI): 3.84-7.53). Perceived ankle instability, age and unilateral ankle sprains were independently associated with pain (ankle instability: χ2 = 43.29, p < 0.001; age: χ2 = 30.37, p < 0.001; unilateral ankle sprains: χ2 = 6.25, p < 0.05). There was no significant difference in the presence of pain between genders. CONCLUSION The prevalence of pain in people with CAI was high and was related to perceived ankle instability. Number of sprains, age, gender and unilateral or bilateral sprain did not modify this result except for the first pain category (pain during daily activities). There is large gap in current knowledge about the impact of pain in people with CAI, and this topic needs further investigation.
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Affiliation(s)
- Saeed Al Adal
- Faculty of Health Sciences, University of Sydney, Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
- Faculty of Applied Medical Sciences, Najran University, Najran, PO Box 1988, Saudi Arabia
| | - Martin Mackey
- Faculty of Health Sciences, University of Sydney, Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
| | - Fereshteh Pourkazemi
- Faculty of Health Sciences, University of Sydney, Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
| | - Claire E. Hiller
- Faculty of Health Sciences, University of Sydney, Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
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Simpson JD, Stewart EM, Rendos NK, Cosio-Lima L, Wilson SJ, Macias DM, Chander H, Knight AC. Anticipating ankle inversion perturbations during a single-leg drop landing alters ankle joint and impact kinetics. Hum Mov Sci 2019; 66:22-30. [PMID: 30908960 DOI: 10.1016/j.humov.2019.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/08/2019] [Accepted: 03/19/2019] [Indexed: 11/27/2022]
Abstract
Anticipatory responses to inversion perturbations can prevent an accurate assessment of lateral ankle sprain mechanics when using injury simulations. Despite recent evidence of the anticipatory motor control strategies utilized during inversion perturbations, kinetic compensations during anticipated inversion perturbations are currently unknown. The purpose of this investigation was to examine the influence of anticipation to an inversion perturbation during a single-leg drop landing on ankle joint and impact kinetics. Fifteen young adults with no lateral ankle sprain history completed unanticipated and anticipated single-leg drop landings onto a 25° laterally inclined platform from a height of 30 cm. One-dimensional statistical parametric mapping (SPM) was used to analyze net ankle moments and ground reaction forces (GRF) during the first 150 ms post-landing, while peak GRFs, time to peak GRF, peak and average loading rates were compared using a dependent samples t-test (p ≤ 0.05). Results from the SPM analysis revealed significantly greater plantar flexion moment from 58 to 83 ms post-landing (p = 0.004; d = 0.64-0.77), inversion moment from 89 to 91 ms post-landing (p = 0.050; d = 0.58-0.60), and medial GRF from 62 to 97 ms post-landing (p < 0.001; d = 1.00-2.39) during the unanticipated landing condition. Moreover, significantly greater peak plantarflexion (p < 0.001; d = 1.10) and peak inversion moment (p = 0.007; d = 0.94), as well as greater peak (p = 0.002; d = 1.03) and average (p = 0.042; d = 0.66) medial loading rates, were found during the unanticipated landing condition. Our findings suggest alterations to ankle joint and impact kinetics occur during a single-leg drop landing when inversion perturbations are anticipated. Researchers and practitioners using drop-landings onto a tilted surface to assess lateral ankle sprain injury risk should consider implementing protocols that mitigate anticipatory responses.
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Lower-Extremity Kinematics During Ankle Inversion Perturbations: A Novel Experimental Protocol That Simulates an Unexpected Lateral Ankle Sprain Mechanism. J Sport Rehabil 2019; 28:593-600. [DOI: 10.1123/jsr.2018-0061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/25/2018] [Accepted: 06/10/2018] [Indexed: 11/18/2022]
Abstract
Context: Lateral ankle sprains are a common injury in which the mechanics of injury have been extensively studied. However, the anticipatory mechanisms to ankle inversion perturbations are not well understood. Objective: To examine lower-extremity kinematics, including spatial and temporal variables of maximum inversion displacement and maximum inversion velocity, during landings on a tilted surface using a new experimental protocol to replicate a lateral ankle sprain. Setting: Three-dimensional motion analysis laboratory. Participants: A total of 23 healthy adults. Interventions: Participants completed unexpected (UE) and expected (EXP) unilateral landings onto a tilted surface rotated 25° in the frontal plane from a height of 30 cm. Main Outcome Measures: Ankle, knee, and hip kinematics at each discrete time point from 150 ms pre-initial contact (IC) to 150 ms post-IC, in addition to maximum ankle inversion and maximum inversion velocity, were compared between UE and EXP landings. Results: The UE landing produced significantly greater maximum inversion displacement (P < .01) and maximum inversion velocity (P = .02) than the EXP landing. Significantly less ankle inversion and internal rotation were found during pre-IC, whereas during post-IC, significantly greater ankle inversion, ankle internal rotation, knee flexion, and knee abduction were observed for the UE landing (P < .05). In addition, significantly less hip flexion and hip adduction were observed for the UE landing during pre-IC and post-IC (P < .05). Conclusions: Differences in the UE and EXP landings indicate the experimental protocol presented a UE inversion perturbation that approximates the mechanism of a lateral ankle sprain. Furthermore, knowledge of the inversion perturbation elicited a hip-dominant strategy, which may be utilized to assist with ankle joint stabilization during landing to further protect the lateral ankle from injury.
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