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. 2022 Dec 8;10(12):23259671221139482.
doi: 10.1177/23259671221139482. eCollection 2022 Dec.

Foot and Shank Coordination During Walking in Copers Compared With Patients With Chronic Ankle Instability and Controls

Sang Jin Kweon  1 , Kathryn Harrison  2 , D S Blaise Williams 3rd  3 , Yong Ung Kwon  4   5
Affiliations

Foot and Shank Coordination During Walking in Copers Compared With Patients With Chronic Ankle Instability and Controls

Sang Jin Kweon et al. Orthop J Sports Med. .

Abstract

Background: Chronic ankle instability (CAI) alters sensorimotor function and joint coordination, but ankle coordination during walking in copers (patients with a history of ankle sprain without any residual symptoms of CAI) remains unknown.

Purpose: To identify foot and shank coordination patterns that discriminate among individuals with CAI, copers, and healthy controls and to investigate whether copers display a different strategy to overcome altered sensorimotor function after a lateral ankle sprain compared with individuals with CAI and healthy controls.

Study design: Controlled laboratory study.

Methods: A total of 51 participants (17 participants with CAI, 17 copers, 17 healthy controls) walked on an instrumented treadmill at a fixed speed of 1.20 m/s for a 10-second trial, from which 8 consecutive gait cycles were extracted for analysis. Heel strike and toe-off were identified for each stance phase, and each stance phase was normalized to 100 time frames. A curve analysis was performed to detect group mean differences in vector coding coupling angles and coordination variabilities for sagittal plane ankle motion/transverse plane tibial plane motion (SAK/TT) and frontal plane ankle motion/transverse plane tibial motion (FAK/TT) with 90% CIs.

Results: During the terminal stance, CAI and coper groups demonstrated an inversion-tibial external rotation coupling, while controls displayed a dorsiflexion-tibial internal rotation strategy. During midstance, there were no differences between the coper, CAI, or control groups. At 0% to 20% of stance, the CAI group showed the most variability, while copers showed the least. During midstance, both copers and controls displayed an increase in variability earlier than the CAI group. The CAI group displayed a peak in variability from 39% to 43% of stance, which was greater than copers. During the propulsive phase (from heel-off to toe-off), the CAI group showed greater SAK/TT variability than both copers and controls. Similar to SAK/TT variability, the CAI group showed an earlier peak in FAK/TT variability compared with controls.

Conclusion: The CAI, coper, and control groups displayed different ankle joint coupling patterns and coordination variability during a walking gait cycle.

Clinical relevance: Copers may have the ability to alter their coordination during walking, which may help us understand the underlying mechanism of CAI.

Keywords: coupling angles; gait; kinematics; variability; vector coding; walking.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2020R1G1A1008736). This research was also supported by a 2021 Chung-Ang University Research Grant. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Classification of coordination patterns for ankle-tibial mean coupling angle. FAK/TT, frontal plane ankle motion/transverse plane tibial motion; SAK/TT, sagittal plane ankle motion/transverse plane tibial plane motion.
Figure 2.
Figure 2.
Comparison between the study groups of the 90% CIs (reported as mean ± SD) for the coupling angle and variability values for (A-C) SAK/TT (sagittal plane ankle motion/transverse plane tibial plane motion) and (D-F) frontal plane ankle motion/transverse plane tibial motion (FAK/TT) during walking. Boxed areas indicate significant differences between groups. Data in the corners of the box indicate the starting and ending points. CAI, chronic ankle instability.
See this image and copyright information in PMC

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