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European Journal of Applied Physiology

, Volume 119, Issue 9, pp 2041–2052 | Cite as

Decreased supraspinal control and neuromuscular function controlling the ankle joint in athletes with chronic ankle instability

  • Ampika Nanbancha
  • Jarugool TretriluxanaEmail author
  • Weerawat Limroongreungrat
  • Komsak Sinsurin
Original Article

Abstract

Purpose

Chronic ankle instability (CAI) alters lower extremity neuromuscular function, associated with a change in corticomotor excitability. The aim of this study was to compare corticomotor excitability and neuromuscular function of the muscles around the ankle between athletes with CAI and without CAI (non-CAI).

Methods

Nineteen CAI athletes (15 men and 4 women) and 19 non-CAI athletes (15 men and 4 women) participated (age- and sex-matched). Corticomotor excitability was measured by transcranial magnetic stimulation for the following muscles: the tibialis anterior (TA), peroneus longus (PL) and gastrocnemius medialis (GM). The resting motor threshold (rMT), motor evoked potential (MEP), and latency (Lat) were subsequently measured. Neuromuscular function was assessed with a jump test, using the EMG activity before foot contact, peak torque, and joint position sense.

Results

The corticomotor excitability in CAI showed a lower normalized MEP in the TA (p = 0.026) and PL (p = 0.003), and longer latency in the TA (p = 0.049) and GM (p = 0.027) compared with non-CAI. The neuromuscular assessment showed CAI had less EMG activity of the PL (p < 0.001), less peak torque of the dorsiflexor (p = 0.019) muscle compared with non-CAI.

Conclusion

Athletes with CAI had lower corticomotor excitability in the TA and PL and a longer latency in the TA and GM muscles. Additionally, CAI demonstrated functional neuromuscular deficits by decreasing EMG activity of the PL muscle and strength of the dorsiflexor muscle. Our findings indicated maladaptation at both cortical and peripheral levels among athletes with CAI.

Keywords

Ankle sprains Chronic ankle instability Cortical plasticity Corticomotor excitability Neuromuscular function Supraspinal control 

Abbreviations

CAI

Chronic ankle instability

Non-CAI

Non-chronic ankle instability

TA

Tibialis anterior

PL

Peroneus longus

GM

Gastrocnemius medialis

EMG

Electromyography

CAIT

Cumberland ankle instability tool

MVC

Maximum voluntary contraction

TMS

Transcranial magnetic stimulation

rMT

Resting motor threshold

MEP

Motor evoked potential

Lat

Latency

CNS

Central nervous system

ACL

Anterior cruciate ligament

SPM

Statistical parametric mapping

SENIAM

Surface electromyography for the non-invasive assessment of muscles

Notes

Acknowledgements

The Faculty of Physical Therapy and Graduated School, Mahidol University supported this study. We thank Assoc.Prof. James J. Laskin, PhD, PT, for providing helpful comments on this manuscript.

Author contributions

Ampika Nanbancha and Jarugool Tretriluxana formulate research questions, designed experiment interpreted the findings and prepared the manuscript. Ampika Nanbancha performed data collection Komsak Sinsurin, and Weerawat Limroongreungrat were involved in research design supervised and providing guidance. All authors provided critical feedback and helped shape the research, analysis, and approved the manuscript.

Compliance with ethical standards

Conflict of interest

The authors report they have no potential conflict of interest.

Supplementary material

421_2019_4191_MOESM1_ESM.docx (26 kb)
Supplementary file1 (DOCX 25 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of Physical TherapyMahidol UniversitySalayaThailand
  2. 2.College of Sport Science and TechnologyMahidol UniversitySalayaThailand

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