Pain alleviation improves balance control and muscular coordination of lower limbs in patients with chronic ankle instability during sinusoidal perturbations

• Published in: Clinical biomechanics (Bristol) 2024-01, Vol.111, p.106165-106165, Article 106165
• Main Authors: Chen, Yungu, Cao, Shengxuan, Chen, Wenming, Zhang, Chao, Huang, Jiazhang, Wang, Xu, Ma, Xin
• Format: Article
• Language: English
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2023.106165

It is well established that individuals with chronic ankle instability manifest deficits in balance control and muscle activation. Given the prevalence of pain as a prominent symptom in this population, there is a need for in-depth investigation of its role in contributing to these impairments. A Stewart platform was used to generate translational sinusoidal perturbations in the antero-posterior direction. Eighteen individuals with chronic ankle instability and concurrent ankle pain were recruited. They were instructed to assume a central stance on the support surface with open eyes both before and 30 min after local analgesia. Data of center of pressure and electromyography of the tibialis anterior and medial gastrocnemius were recorded. Statistical analysis was performed to make comparisons pre- and post-analgesia using two-tailed paired t-test for the continuous variables. Pain intensity was significantly decreased after local anesthetic injections. Antero-posterior center of pressure parameters significantly decreased following the injection. Also, there was an increase in the regularity of the center of pressure pattern. The electromyographic pattern of the tibialis anterior and medial gastrocnemius exhibited various activation patterns. After pain alleviation, the characteristic electromyographic response of the tibialis anterior and medial gastrocnemius was reciprocal contraction and relaxation that corresponded with the sinusoidal pattern of the perturbations. Individuals who had chronic ankle instability and ankle pain demonstrated impaired balance control during sinusoidal perturbations. Mitigating pain improved their balance performance, evident in the center of pressure pattern and the coordination of lower limb muscles.