Ankle Bracing Alters Coordination and Coordination Variability in Individuals With and Without Chronic Ankle Instability

Abstract

Context: Ankle bracing is an effective form of injury prophylaxis implemented for individuals with and without chronic ankle instability, yet mechanisms surrounding bracing efficacy remain in question. Ankle bracing has been shown to invoke biomechanical and neuromotor alterations that could influence lower-extremity coordination strategies during locomotion and contribute to bracing efficacy. Objective: The purpose of this study was to investigate the effects of ankle bracing on lower-extremity coordination and coordination dynamics during walking in healthy individuals, ankle sprain copers, and individuals with chronic ankle instability. Design: Mixed factorial design. Setting: Laboratory setting. Participants: Forty-eight recreationally active individuals (16 per group) participated in this cross-sectional study. Intervention: Participants completed 15 trials of over ground walking with and without an ankle brace. Main Outcome Measures: Coordination and coordination variability of the foot–shank, shank–thigh, and foot–thigh were assessed during stance and swing phases of the gait cycle through analysis of segment relative phase and relative phase deviation, respectively. Results: Bracing elicited more synchronous, or locked, motion of the sagittal plane foot–shank coupling throughout swing phase and early stance phase, and more asynchronous motion of remaining foot–shank and foot–thigh couplings during early swing phase. Bracing also diminished coordination variability of foot–shank, foot–thigh, and shank–thigh couplings during swing phase of the gait cycle, indicating greater pattern stability. No group differences were observed. Conclusions: Greater stability of lower-extremity coordination patterns as well as spatiotemporal locking of the foot–shank coupling during terminal swing may work to guard against malalignment at foot contact and contribute to the efficacy of ankle bracing. Ankle bracing may also act antagonistically to interventions fostering functional variability.