Individuals with chronic ankle instability compensate for their ankle deficits using proximal musculature to maintain reduced postural sway while kicking a ball

The aim of this study was to investigate anticipatory (APA), simultaneous (SPA) and compensatory (CPA) postural adjustments in individuals with and without chronic ankle instability (CAI) as they kicked a ball while standing in a single-leg stance on a stable and unstable surface. Electromyographic activity (EMG) of postural muscles and center of pressure (COP) displacements were calculated and their magnitudes analyzed during the postural adjustment intervals. Additionally, the COP area of sway was calculated over the duration of the whole task. The activities of postural muscles were also studied using principal component analysis (PCA) to identify between-group differences in patterns of muscle activation. The individuals with CAI showed reduced magnitude of EMG at the muscles around the ankle while around the hip the activity was increased. These were associated with a reduction in balance sway across the entire task, as compared with the control group. The PCA revealed that CAI participants assemble different sets of muscle activation to compensate for their ankle instability, primarily activating hip/spine muscles. These results set up potential investigations to examine whether balance control interventions enhance these adaptations or revert them to a normal pattern as well as if any of these changes proactively address recurrent ankle sprain conditions.