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Alteration in global motor strategy following lateral ankle sprain.

Bastien M, Moffet H, Bouyer LJ, Perron M, Hébert LJ, Leblond J - BMC Musculoskelet Disord (2014)

Bottom Line: The global body centre of mass variables were significantly correlated to SEBT performance (MRD).Modifications in global motor strategies were found in participants with LAS as well as a decreased performance on the SEBT for the injured and uninjured lower limbs.These results support the hypothesis that following LAS, there may be a maladaptive reorganization of the central motor commands. 3b.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Rehabilitation Department, Laval University, Quebec, QC, Canada. Helene.Moffet@rea.ulaval.ca.

ABSTRACT

Background: Lateral ankle sprain (LAS) has often been considered an injury leading to localized joint impairments affecting the musculoskeletal system. Persistent chronic ankle instability and bilateral alterations in motor control after a first ankle sprain episode suggest that the origin of relapses might be a maladaptive reorganization of central motor commands. The objectives of this study were (1) to compare the quality of motor control through motor strategy variables of two groups (with and without LAS) from a military population (n = 10/group), (2) to evaluate the contribution of the lower limbs and the trunk to global body strategy and (3) to identify which global variable best estimates performance on the Star Excursion Balance Test (SEBT) for each group, reaching direction, and lower limb.

Methods: Personal and clinical characteristics of the participants of both groups were collected. Their functional ability was measured using questionnaires and they performed a series of functional tests including the SEBT. During this test, the maximal reach distance (MRD) and biomechanical data were collected to characterize whole body and segmental strategies using a 3D motion capture system.

Results: At maximal lower limb reach, participants with LAS had a smaller variation in their vertical velocity in lowering-straightening and lowered the body centre of mass less for all injured limb conditions and some conditions with the uninjured lower limb. The global body centre of mass variables were significantly correlated to SEBT performance (MRD).

Conclusion: Modifications in global motor strategies were found in participants with LAS as well as a decreased performance on the SEBT for the injured and uninjured lower limbs. These results support the hypothesis that following LAS, there may be a maladaptive reorganization of the central motor commands.

Level of evidence: 3b.

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Related in: MedlinePlus

Comparison of SEBT performance and motor strategies variables associated with CoMgl lowering between limbs (injured and uninjured) of the LAS group and the dominant limb of the healthy group for each direction. Bar graphs represent the mean (n = 10 limbs per direction) and 1 standard deviation. Significant differences between groups are identified by asterisk (MANOVA test; *p <0.05; # p = 0.052). A: SEBT performance (maximal reach distance) expressed in percentage of the body height. B: Global motor strategy: Global CoM lowering, C: Segmental motor strategy: Pelvis lowering and D: Segmental motor strategy: Maximal knee flexion.
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Fig4: Comparison of SEBT performance and motor strategies variables associated with CoMgl lowering between limbs (injured and uninjured) of the LAS group and the dominant limb of the healthy group for each direction. Bar graphs represent the mean (n = 10 limbs per direction) and 1 standard deviation. Significant differences between groups are identified by asterisk (MANOVA test; *p <0.05; # p = 0.052). A: SEBT performance (maximal reach distance) expressed in percentage of the body height. B: Global motor strategy: Global CoM lowering, C: Segmental motor strategy: Pelvis lowering and D: Segmental motor strategy: Maximal knee flexion.

Mentions: Around “foot contact,” the LAS group shows a smaller magnitude of CoMgl lowering (MD, 95% CI: 4.17 cm, (0.51 to 7.82) to 5.92 cm, (1.56 to 10.28), p < 0.05) and a smaller peak-to-peak CoMgl vertical velocities than the healthy group in all directions (0.08 cm/s, (0.01 to 0.15) to 0.12 cm/s, (0.04 to 0.20), p < 0.05) (Figure 2A). These results suggest that global body strategy along the vertical axis around foot contact is modified following LAS. There were significant differences between the injured and uninjured limb compared to the dominant limb of the healthy group for the CoMgl lowering variable in AM and in PM directions (MD, (95% CI): 4.57 cm, (0.85 to 8.28) to 7.18 cm (0.88 to 13.48), p value <0.05) (Figure 4B). The healthy group performed better at SEBT in all directions (Figure 4A), as measured by the MRD, except for the uninjured limb in the M direction (MD, (95% CI): 3.13% of height, (0.87 to 5.40) to 4.56% of height, (1.47 to 7.65), p value <0.05). They also significantly lowered their pelvis more and flexed the knee of the stance limb more than participants with LAS except for the uninjured limb in the M direction (see* = p <0.05; Figure 4C-D). The difference in maximal knee flexion between groups for the injured and dominant limb varied from 11.92° (95% CI: 0.98 to 22.85) (M direction) to 20.20° (95% CI: 5.72 to 34.69) (AM direction; Figure 4D). No difference across groups was found for other variables such as the maximal amplitude of ankle dorsiflexion (except in the AM direction, MD, (95% CI): 6.11°, (0.03 to 12.18)), hip flexion or relative trunk lowering.Figure 4


Alteration in global motor strategy following lateral ankle sprain.

Bastien M, Moffet H, Bouyer LJ, Perron M, Hébert LJ, Leblond J - BMC Musculoskelet Disord (2014)

Comparison of SEBT performance and motor strategies variables associated with CoMgl lowering between limbs (injured and uninjured) of the LAS group and the dominant limb of the healthy group for each direction. Bar graphs represent the mean (n = 10 limbs per direction) and 1 standard deviation. Significant differences between groups are identified by asterisk (MANOVA test; *p <0.05; # p = 0.052). A: SEBT performance (maximal reach distance) expressed in percentage of the body height. B: Global motor strategy: Global CoM lowering, C: Segmental motor strategy: Pelvis lowering and D: Segmental motor strategy: Maximal knee flexion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4300726&req=5

Fig4: Comparison of SEBT performance and motor strategies variables associated with CoMgl lowering between limbs (injured and uninjured) of the LAS group and the dominant limb of the healthy group for each direction. Bar graphs represent the mean (n = 10 limbs per direction) and 1 standard deviation. Significant differences between groups are identified by asterisk (MANOVA test; *p <0.05; # p = 0.052). A: SEBT performance (maximal reach distance) expressed in percentage of the body height. B: Global motor strategy: Global CoM lowering, C: Segmental motor strategy: Pelvis lowering and D: Segmental motor strategy: Maximal knee flexion.
Mentions: Around “foot contact,” the LAS group shows a smaller magnitude of CoMgl lowering (MD, 95% CI: 4.17 cm, (0.51 to 7.82) to 5.92 cm, (1.56 to 10.28), p < 0.05) and a smaller peak-to-peak CoMgl vertical velocities than the healthy group in all directions (0.08 cm/s, (0.01 to 0.15) to 0.12 cm/s, (0.04 to 0.20), p < 0.05) (Figure 2A). These results suggest that global body strategy along the vertical axis around foot contact is modified following LAS. There were significant differences between the injured and uninjured limb compared to the dominant limb of the healthy group for the CoMgl lowering variable in AM and in PM directions (MD, (95% CI): 4.57 cm, (0.85 to 8.28) to 7.18 cm (0.88 to 13.48), p value <0.05) (Figure 4B). The healthy group performed better at SEBT in all directions (Figure 4A), as measured by the MRD, except for the uninjured limb in the M direction (MD, (95% CI): 3.13% of height, (0.87 to 5.40) to 4.56% of height, (1.47 to 7.65), p value <0.05). They also significantly lowered their pelvis more and flexed the knee of the stance limb more than participants with LAS except for the uninjured limb in the M direction (see* = p <0.05; Figure 4C-D). The difference in maximal knee flexion between groups for the injured and dominant limb varied from 11.92° (95% CI: 0.98 to 22.85) (M direction) to 20.20° (95% CI: 5.72 to 34.69) (AM direction; Figure 4D). No difference across groups was found for other variables such as the maximal amplitude of ankle dorsiflexion (except in the AM direction, MD, (95% CI): 6.11°, (0.03 to 12.18)), hip flexion or relative trunk lowering.Figure 4

Bottom Line: The global body centre of mass variables were significantly correlated to SEBT performance (MRD).Modifications in global motor strategies were found in participants with LAS as well as a decreased performance on the SEBT for the injured and uninjured lower limbs.These results support the hypothesis that following LAS, there may be a maladaptive reorganization of the central motor commands. 3b.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medicine, Rehabilitation Department, Laval University, Quebec, QC, Canada. Helene.Moffet@rea.ulaval.ca.

ABSTRACT

Background: Lateral ankle sprain (LAS) has often been considered an injury leading to localized joint impairments affecting the musculoskeletal system. Persistent chronic ankle instability and bilateral alterations in motor control after a first ankle sprain episode suggest that the origin of relapses might be a maladaptive reorganization of central motor commands. The objectives of this study were (1) to compare the quality of motor control through motor strategy variables of two groups (with and without LAS) from a military population (n = 10/group), (2) to evaluate the contribution of the lower limbs and the trunk to global body strategy and (3) to identify which global variable best estimates performance on the Star Excursion Balance Test (SEBT) for each group, reaching direction, and lower limb.

Methods: Personal and clinical characteristics of the participants of both groups were collected. Their functional ability was measured using questionnaires and they performed a series of functional tests including the SEBT. During this test, the maximal reach distance (MRD) and biomechanical data were collected to characterize whole body and segmental strategies using a 3D motion capture system.

Results: At maximal lower limb reach, participants with LAS had a smaller variation in their vertical velocity in lowering-straightening and lowered the body centre of mass less for all injured limb conditions and some conditions with the uninjured lower limb. The global body centre of mass variables were significantly correlated to SEBT performance (MRD).

Conclusion: Modifications in global motor strategies were found in participants with LAS as well as a decreased performance on the SEBT for the injured and uninjured lower limbs. These results support the hypothesis that following LAS, there may be a maladaptive reorganization of the central motor commands.

Level of evidence: 3b.

Show MeSH
Related in: MedlinePlus