Jump landing among chronic ankle instability individuals who did or did not attend rehabilitation at the time of injury

Kyle B. Kosik, Matthew C. Hoch, Jacob T. Hartzell, Katherine A. Bain, Stacey Slone, Phillip A. Gribble

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: The purpose was to compare vertical ground reaction forces and sagittal-plane energy dissipation patterns of the lower extremity during a single-limb jump-stabilization task between individuals with chronic ankle instability who did or did not attend rehabilitation after their initial ankle sprain. Design: Cross-sectional. Setting: Research laboratory. Participants: Eight participants with chronic ankle instability who did and 12 participants who did not attend rehabilitation were enrolled. Main outcome measures: Normalized vertical ground reaction force data were used to calculate the average loading rate, time to peak force, and the peak force. Sagittal plane kinematics and joint moments at the ankle, knee, and hip, were used to calculate each joint's relative energy dissipation at 50, 100, 150, and 200 ms post-landing. Results: Participants who attended rehabilitation had a slower average loading rate (P = 0.025) and smaller peak vertical ground reaction force (P = 0.025). The average relative energy dissipation at the knee was higher in those who attended rehabilitation at the 100 ms (P = 0.041), 150 ms (P = 0.046), and 200 ms (P = 0.042) time intervals. Conclusions: Attending rehabilitation after an ankle sprain may have a beneficial effect on jump-stabilization outcomes among individuals with chronic ankle instability.

Original languageEnglish
Pages (from-to)26-32
Number of pages7
JournalPhysical Therapy in Sport
Volume57
DOIs
StatePublished - Sep 2022

Bibliographical note

Funding Information:
We sought to compare vGRF outcomes and sagittal-plane energy dissipation patterns during a single-limb jump-stabilization task between individuals with CAI who did or did not self-report having attended supervised physical rehabilitation after their initial LAS. The results support our hypothesis as individuals with CAI who attended rehabilitation had a slower average loading rate and a smaller peak vGRF. Additionally, we observed that participants who attended rehabilitation exhibited higher knee joint contributions to the total energy dissipation in the lower extremity at 100, 150, and 200 ms after landing. All of these group differences were associated with large effect sizes and wide confidence intervals. Cumulatively, the results from our study suggest that having attended supervised physical rehabilitation for a lateral ankle sprain may have a beneficial effect on reducing impact forces during a jump-landing task, which might be related to the adjustments in joint-specific contributions to the total energy dissipation.We used a single-limb jump-stabilization task previously incorporated into laboratory studies comparing outcomes between individuals with and without CAI. Most of these studies have demonstrated individuals with CAI have diminished dynamic postural control (Cathleen Brown, Ross, Mynark, & Guskiewicz, 2004; P. Gribble & Robinson, 2010; Ross & Guskiewicz, 2004; Wikstrom et al., 2005), land with less knee flexion (P. Gribble & Robinson, 2010), or have with less variability in hip and knee sagittal-plane motion than un-injured controls (C. Brown, Bowser, & Simpson, 2012). However, we are unaware of any previous study that has examined the vGRF profile associated with the jump-stabilization task used in the current study. Instead, researchers incorporating a single-limb drop-vertical jump task have shown that individuals with CAI produce a higher and quicker onset of the vGRF during the loading phase (B. Caulfield & Garrett, 2004; Delahunt et al., 2006). Other researchers reported those with CAI had higher peak vGRF, increased loading rates, and shorter time to peak vGRF while running than un-injured controls (Bigouette et al., 2016). Our results support these prior investigations by demonstrating that individuals with CAI who did not attend supervised physical rehabilitation after their initial LAS produced a higher and quicker normalized peak vGRF during a single-leg jump-stabilization task compared to those who did attend rehabilitation. A higher and quicker vGRF is well documented as a detrimental outcome during functional tasks and may increase the risk for sustaining future lower extremity injuries or episodes of giving way (B. Caulfield & Garrett, 2004). Therefore, our results build upon these prior studies by demonstrating that having attended supervised physical rehabilitation after the first LAS positively impacts outcomes among individuals with CAI.Lower extremity muscle activation levels might provide another explanation. Li et al. (Y. Li et al., 2018) demonstrated that individuals with CAI had an increased ankle muscle co-contraction in the sagittal- and frontal-plane compared to un-injured controls during a drop landing task on a tilted surface. The authors speculated that increased ankle muscle co-contraction was a protective feed-forward mechanism (Y. Li et al., 2018). However, the authors suggested the increased ankle muscle co-contraction combined with a more inverted ankle at initial contact and decreased eversion moment might limit the energy dissipation of these muscles (Yumeng Li et al., 2018; Y. Li et al., 2018). As a result, individuals with CAI would have a greater reliance on the knee extensors to absorb the external forces and stabilize the lower extremity. This is supported by the higher quadriceps-to-hamstring co-contraction ratio Li et al. (Y. Li et al., 2018) observed among those with CAI. The higher knee muscle co-contraction suggests that individuals with CAI activated the knee extensors more to generate greater eccentric work to dissipate the energy while landing to compensate for the ankle joint. Therefore, the increased knee contribution to the total energy dissipation observed among our participants with CAI who attended rehabilitation suggests they might have adopted a similar muscle activation strategy while performing the jump-stabilization task. Further research needs to confirm or refute this speculation because we did not record lower extremity muscle activation levels. Additionally, future research should consider examining the frontal and/or transverse planes of motion to determine their role in potentially impacting outcomes.

Publisher Copyright:
© 2022 Elsevier Ltd

Keywords

  • Forceplate
  • Jump-stabilization
  • Vertical ground reaction force

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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