Differences in temporal gait mechanics are associated with decreased perceived ankle joint health in individuals with chronic ankle instability

Background: Chronic ankle instability (CAI) is associated with an increased risk of developing post-traumatic osteoarthritis (PTOA). Altered temporal gait parameters likely contribute to the early development and progression of PTOA in CAI. However, it is unknown if increased clinical symptoms of ankle PTOA influence temporal gait parameters among those with CAI. Research question: Compare temporal gait parameters and Ankle Osteoarthritis Scale (AOS) scores between individuals with and without CAI. Methods: Thirty CAI participants and 30 healthy-controls volunteered to participate in this retrospective case-control study. Participants completed the Pain and Disability subscales of the AOS. Temporal gait parameters were assessed using a GAITRite® electronic walkway. Participants performed 5 walking trials, which were subsequently combined into a single test. Temporal variables (swing, stance, single-limb support and double-limb support) were extracted for the involved limb and normalized to percent of gait cycle (%GC). Results: Participants with CAI had higher scores on the Pain (P < 0.001) and Disability (P = 0.001, d = 0.87[0.33,1.39]) subscales of the AOS. CAI individuals spent less time during swing (P = 0.022]) and single-limb support (P = 0.030) phases and more time during the double-limb support (P = 0.021) phase. Single-limb support time was moderately correlated with higher scores on the AOS pain (r=-0.416, P = 0.011) and disability (r=-0.473 P = 0.004) subscales. Significance: Individuals with CAI spend varying times in each phase of the gait cycle compared to uninjured controls. Individuals with CAI may adopt this abnormal gait strategy due to increased clinical symptoms of ankle PTOA. Rehabilitation programs should focus on minimizing the symptoms of ankle PTOA to restore normal temporal gait parameters.