PTOTCase-ControlJournal of neuroengineering and rehabilitation2025

Distinct patterns in neuromuscular adaptation to repeated perturbations in chronic ankle instability.

Xiaohan Xu, Joanna Bowtell, William R Young and 2 others

PMID 41387893

WHAT IT FOUND

People with chronic ankle instability did not lower their ankle muscle stiffness during repeated balance perturbations, unlike healthy controls.

However, they did improve balance by shifting control to the hip. This suggests rehab should target whole-body coordination rather than just ankle stiffness.

Key findings

01Healthy controls reduced ankle muscle co-contraction (stiffness) over repeated trials, but those with chronic ankle instability showed no significant change.

02Participants with chronic ankle instability improved their balance strategy by increasing coordination between the hip and body stability, rather than by adjusting ankle control.

03Worse self-reported ankle function in the instability group was linked to higher muscle stiffness between the shin and calf muscles.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study only looked at immediate changes during a single session, so it does not show if these patterns persist or lead to long-term learning. The perturbations were predictable (fixed 7-second intervals), which might not reflect real-world sudden slips. Hip muscle activity was not recorded, so the study could not confirm if the increased hip coordination came from specific hip muscle changes. The groups were small (22 CAI, 23 HC), and one CAI participant was excluded for not completing enough trials.

Declared interests

The study was funded by the Chinese Scholarship Council. No other conflicts of interest were declared.

The easy way to misread this

Do not conclude that CAI patients cannot improve their balance. They did improve, but they did so by changing how they used their hips, not by relaxing their ankle muscles as healthy controls did.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →