Lower-Extremity Kinematics During Ankle Inversion Perturbations: A Novel Experimental Protocol That Simulates an Unexpected Lateral Ankle Sprain Mechanism

J Sport Rehabil. 2019 Aug 1;28(6):593-600. doi: 10.1123/jsr.2018-0061.

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.

Keywords: ankle stability; anticipated landings; lateral ankle sprain mechanics; lower-extremity injury.

MeSH terms

  • Ankle
  • Ankle Injuries / physiopathology*
  • Biomechanical Phenomena*
  • Female
  • Hip
  • Humans
  • Knee
  • Lower Extremity
  • Male
  • Movement
  • Range of Motion, Articular*
  • Rotation
  • Sprains and Strains / physiopathology*
  • Young Adult