Tibialis Anterior Muscle Activity Research Articles

Analysis of EEG-EMG Coherence in Low Frequency Bands.

In this, study, an attempt is made to analyze the corticomuscular coupling of the brain and muscular system in the low-frequency components during ramp descent (RD) and stair descent (SD) locomotion. For this purpose, magnitude squared coherence (MSC) is computed from the simultaneous EEG and EMG signals recorded during the ramp and stair descent tasks. The MSC is extracted from the low- frequency bands such as delta (0.1-3 Hz) and theta bands (4-7 Hz). The study utilizes a publicly available database consisting of simultaneous recorded EEG, lower limb EMG and full body motion information from ten healthy subjects. The results show that there exists corticomuscular coupling between motor cortex (C1, C2 and Cz contacts) and tibialis anterior muscle activities during RD and SD. In addition, the MSC differs for both the tasks and frequency bands. In delta band frequencies, the MSC is found to be higher in C2 regions. In the case of theta, the MSC is higher in C1 during RD and in Cz during SD. Therefore, the MSC associated with the low frequency components could be used to detect walking intentions.

Ankle Muscle Activations during Different Foot-Strike Patterns in Running.

This study analysed the landing performance and muscle activity of athletes in forefoot strike (FFS) and rearfoot strike (RFS) patterns. Ten male college participants were asked to perform two foot strikes patterns, each at a running speed of 6 km/h. Three inertial sensors and five EMG sensors as well as one 24 G accelerometer were synchronised to acquire joint kinematics parameters as well as muscle activation, respectively. In both the FFS and RFS patterns, according to the intraclass correlation coefficient, excellent reliability was found for landing performance and muscle activation. Paired t tests indicated significantly higher ankle plantar flexion in the FFS pattern. Moreover, biceps femoris (BF) and gastrocnemius medialis (GM) activation increased in the pre-stance phase of the FFS compared with that of RFS. The FFS pattern had significantly decreased tibialis anterior (TA) muscle activity compared with the RFS pattern during the pre-stance phase. The results demonstrated that the ankle strategy focused on controlling the foot strike pattern. The influence of the FFS pattern on muscle activity likely indicates that an athlete can increase both BF and GM muscles activity. Altered landing strategy in cases of FFS pattern may contribute both to the running efficiency and muscle activation of the lower extremity. Therefore, neuromuscular training and education are required to enable activation in dynamic running tasks.

Time-series changes in intramuscular coherence associated with split-belt treadmill adaptation in humans.

Humans can flexibly modify their walking patterns. A split-belt treadmill has been widely used to study locomotor adaptation. Although previous studies have examined in detail the time-series changes in the spatiotemporal characteristics of walking during and after split-belt walking, it is not clear how intramuscular coherence changes during and after split-belt walking. We thus investigated the time-series changes of intramuscular coherence in the ankle dorsiflexor muscle associated with split-belt locomotor adaptation by coherence analysis using paired electromyography (EMG) signals. Twelve healthy males walked on a split-belt treadmill. Surface EMG signals were recorded from two parts of the tibialis anterior (TA) muscle in both legs to calculate intramuscular coherence. Each area of intramuscular coherence in the beta and gamma bands in the slow leg gradually decreased during split-belt walking. Significant differences in the area were observed from 7min compared to the first minute after the start of split-belt walking. Meanwhile, the area of coherence in both beta and gamma bands in the fast leg for the first minute of normal walking following split-belt walking was significantly increased compared with normal walking before split-belt walking, and then immediately returned to the normal walking level. These results suggest that cortical involvement in TA muscle activity gradually weakens when adapting from a normal walking pattern to a new walking pattern. On the other hand, when re-adapting from the newly adapted walking pattern to the normal walking pattern, cortical involvement might strengthen temporally and then weaken quickly.

Assessment of biomechanical deficits in individuals with a trans-tibial amputation during level gait using one-dimensional statistical parametric mapping.

Most previous studies reported biomechanical deficits in individuals with a trans-tibial amputation (TTA) during gait using zero-dimensional analyses. However, these analyses do not allow to precisely determine during which part of the gait cycle these deficits occur. There is a need to use more appropriate methods to map the differences, such as one-dimensional statistical parametric mapping. What are the most relevant phases of the gait cycle during which the biomechanical deficits in TTA occur? Eight TTA and 15 healthy counterparts (CON) underwent one biomechanical gait analysis. Pelvis, hip, knee and ankle kinematics, total support moment (TSM) and gastrocnemius lateralis, vastus lateralis and tibialis anterior muscle activity were compared between the amputated (AmLL), the intact (InLL) and the control (CnLL) lower limbs using one-dimensional statistical parametric mapping. More ankle dorsiflexion and knee flexion were observed for the AmLL compared to the InLL and CnLL (ankle only) from the end of the stance phase to the beginning of the swing phase. Less knee flexion was also found for the AmLL during early stance phase. More pelvis posterior tilt and rotation toward the contralateral limb was observed during most of the gait cycle for the AmLL compared to the InLL. TSM was smaller for the AmLL compared to the CnLL during early stance phase. Using a one-dimensional statistical parametric mapping approach for TTA gait analysis, this study provides novel insights on their biomechanical gait deficits compared to CON. Greater reliance on the InLL was observed in TTA as suggested by the asymmetric kinematic and kinetic profiles.

Egzersiz, elektriksel kas stimülasyonu, elektromyografik biofeedback ve robotik rehabilitasyonun hemiplejik hastaların tibialis anterior kas aktivasyonu üzerine etkileri

Aim: The comparison of the efficiency of Classical Physical Therapy and Rehabilitation (CPTR), Electrical Muscle Stimulation (EMS), Electromyographic Biofeedback (EMG-BF) and Robotic Rehabilitation (RR) on tibialis anterior (mTA) muscle activation and functions of hemiplegic patients was aimed.Materials and Methods: Thirty hemiplegic patients aged 40-86 years were participated. The range of motion (ROM), 10 meters walk test, Modified Ashworth Scale (MAS), strength measurements, and Visual Analog Scale (VAS) were performed.Results: In the measurements including dorsi flexion ROM, EMG-BF, NMMT (right and left), a significant difference was found in all Groups. Also, the significant difference in dorsi flexion ROM was higher in Group 3 than Group 2 and Group 1. Additionally, the plantar flexion ROM was higher in Group 1 than Group 3 and Group 2. Conclusion: There were the positive effects of three different treatment methods on ROM, walking time, spasticity and mTA muscle strength. Also, three treatment modalities contributed to recovery level of hemiplegic patients.

Older adults use a motor plan that is detrimental to endpoint control

Here, we aimed to understand if older adults (OA) use a unique motor plan that is detrimental to endpoint control. We performed two experiments that used ankle ballistic contractions that reversed at the target. In Experiment 1, eight young adults (YA; 27.1 ± 4.2) and eight OA (73.3 ± 4.5) aimed to perform an ankle dorsiflexion–plantarflexion movement that reversed at 9° in 180 ms (target). We found that the coordination pattern (motor plan) differed for the two groups. OA used significantly greater soleus (SOL) activity to reverse the ankle movement than YA and exhibited greater tibialis anterior (TA) muscle activity variability (p < 0.05). OA exhibited worse endpoint control than YA, which associated with the exacerbated TA variability (R2 > 0.2; p < 0.01). Experiment 2 aimed to confirm that the OA motor plan was detrimental to endpoint control. Fifteen YA (20.5 ± 1.4) performed an ankle dorsiflexion–plantarflexion contraction that reversed at 30% MVC in 160 ms by using either a pattern that mimicked OA (High SOL) or YA (Low SOL). With the High SOL coordination pattern, YA exhibited impaired endpoint control and greater TA activation variability. These findings provide strong evidence that OA select a unique motor plan that is detrimental to endpoint control.

Effect of ankle joint fixation on tibialis anterior muscle activity during split-belt treadmill walking in healthy subjects: A pilot study.

Objectives This study aims to examine the characteristics of muscle activity change of the tibialis anterior (TA) muscle in healthy adults while they walked on a split-belt treadmill with one fixed ankle. Patients and methods This randomized controlled trial was conducted between November 2017 and July 2018. Fourteen healthy male individuals (mean age 31.4 years; range, 23 to 50 years) were divided into two groups: right ankle joint fixed by ankle-foot orthosis (fixation group) and no orthosis (control group). Both groups were asked to walk on a treadmill with the same belt speed. After familiarizing with walking on both belts at 5.0 km/h, they walked for 6 min with the right belt slower (2.5 km/h) and the left faster (5.0 km/h). For analysis, the 6 min were divided equally among three time periods. The TA muscle activity was calculated at first and last time periods. We compared muscle activities in time periods (early and late phase) and in groups (fixation and control) using two-way mixed analysis of variance. Results The TA muscle activity decreased in the late phase regardless of ankle joint fixation, and also decreased in the fixation group regardless of the time periods. There was an interaction between these factors. Conclusion These data show that changes in the TA muscle activity were smaller in the fixation group, suggesting that the ankle joint fixation reduces the adaptation.

Effect of ankle joint fixation on tibialis anterior muscle activity during split-belt treadmill walking in healthy subjects: A pilot study

Effect of ankle joint fixation on tibialis anterior muscle activity during split-belt treadmill walking in healthy subjects: A pilot study

Comparison of muscle activity during sit-to-stand movement at different chair heights between obese and normal-weight subjects.

The purpose of present study was to compare the tibialis anterior (TA), rectus femoris (RF), and erector spinae (ES) muscle activities at variety chair height during sit-to-stand (STS) on normal weight and obese subjects. Also, we compared the muscle activity difference between the normal weight and obese subjects. The study included 26 subjects (normal weight 13 and obese 13). Each subject performed STS at three chair heights (40 cm, 50 cm, 60 cm) and TA, RF, and ES muscle activities measured. According to the results of the measurement, muscle activation of TA showed significantly higher than RF and ES muscle activation during STS at all chair heights on obese subjects. The muscle activation of TA showed significantly higher than RF muscle activation during STS at all chair heights on normal weight subjects. The muscle activation of RF and ES showed significantly higher in normal weight subjects than obese subjects at 40 cm and 50 cm of chair heights. However, the TA muscle activation showed no significant difference between normal weight subjects and obese subjects. This study’s results suggested that obese subjects should practice the use of RF and ES muscles in a low-height chair during STS.

Muscle activity while ambulating on stairs and slopes: A comparison between individuals scheduled and not scheduled for knee arthroplasty and healthy controls

ObjectiveTo examine muscle activity patterns of the lower limbs while ascending and descending stairs and slope in adults with knee Osteoarthritis (knee-OA), who were scheduled or not scheduled for Total Knee Replacement (TKR) and healthy controls. MethodsThis cross-sectional study included three groups: knee-OA subjects scheduled for TKR (TKR group; N = 15) and not scheduled for TKR (NTKR group; N = 15) and age-matched controls (N = 11). Outcome measures included: joint range of motion (ROM), Timed Up and Go (TUG), joint pain levels, and functional disability (Oxford) score. Also, durations of muscle activity (rectus femoris, semitendinosus, medial gastrocnemius, bilaterally, and soleus, and tibialis anterior of the OA limb) were recorded while the subjects ascended and descended stairs and a level surface. ResultsBoth knee-OA groups had significantly higher Oxford scores and bilateral knee pain levels compared to the control group. The TKR group had higher TUG score compared to the NTKR group. The activation duration of the Tibialis Anterior of the OA limb while ascending and descending stairs and slope were higher in the TKR group compared to the NTKR group. No differences in muscle activity durations were found when comparing the OA limb to contralateral limb. ConclusionThe muscle activity strategies differentiated between individuals scheduled and not scheduled for TKR. The longer duration of muscle activity of Tibialis Anterior muscle in the TKR group compared to the NTKR group suggest that customized prehabilitation program is required for these groups.

Ankle Complex Neuromuscular Coordination Variation in People Living with HIV

Background: People living with HIV (PLHIV) can exhibit impaired postural control because of infection or secondary medication effects, even with no history of falls. In PLHIV, balance deficits are associated with neuromuscular activation variations, muscle weakness, and complications with the vestibular and proprioceptive systems. We intend to determine neuromuscular activation coordination patterns of the tibialis anterior (TA) and gastrocnemius (GA) during eight different balance activities in physically active PLHIV.Methods: 55 participants were recruited to participate in this non-randomized control trial, 24 of whom had been diagnosed with HIV. We collected the neuromuscular profile from both groups to assess TA and GA muscle activity during static balance tasks with and without cognitive dual tasking.Results: Neuromuscular coordination patterns were dissimilar (p-value ≤ 0.05) in the HIV group in GA onset during eyes open on foam (EO FOAM), GA and TA duration and decay activity during eyes closed on foam (EC FOAM), and duration during eyes-closed head up and down (EC HUD). No considerable differences (p-value &gt; 0.05) were observed with the addition of a cognitive task.Conclusion: During the disease's controlled stages, HIV or its medications cause a miscommunication between the ankle complex musculature and the vestibular input related to postural control. These neuromuscular modifications are more noticeable in single tasks requiring higher recruitment of the vestibular input to sustain balance, such as an unstable surface with no visual information. Directions for subsequent investigation include gathering participants with various physical activity levels, medications, CD4 counts, lengths of time since diagnosis, and examining balance during more advanced tasks, such as dynamic balance activities and motor dual-tasking.Clinical Relevance: Identify balance disturbances in PLHIV to reduce or prevent the risk of falls or injury. Specific deficits identified in PLHIV can be used to tailor interventions and address the balance systems at fault.

Electromyographic analysis of ankle muscles in chronic ankle instability during sudden inversion according to visual information provision

Chronic ankle instability is a condition in which the ankle is repetitively giving way, with symptoms such as pain, muscle weakness, and proprioceptive deficits. Therefore, people with chronic ankle instability require complex and systematic interactions between sensory association and the musculoskeletal system. The purpose of this study was to examine changes in ankle muscle activities and reaction times during sudden ankle inversion in chronic ankle instability patients under different visual conditions. Twenty-eight subjects with chronic ankle instability were recruited for the study. All subjects performed a trapdoor platform that was inversion by 25 degrees. This study assessed muscle activity and muscle reaction time during sudden ankle inversion three times with a 60-second rest period between tests with eyes-open and eyes-closed conditions. Muscle activities of tibialis anterior, peroneus longus, and peroneus brevis were significantly diminished with eyes closed, whereas that of gastrocnemius was not significantly different. No significant changes in tibialis anterior, peroneus longus, and peroneus brevis, and gastrocnemius reaction times were observed during sudden ankle inversion in the eyes-open and eyes-closed conditions. Blocking visual information can lower tibialis anterior, peroneus longus, and peroneus brevis muscle activities during postural perturbation in subjects with chronic ankle instability. These results provide insight into the injury mechanism and causes of injury, and thus to improve the existing preventive appliances. Die chronische Instabilität des Sprunggelenks ist eine Erkrankung, die durch wiederholtes Nachgeben des Sprunggelenkes charakterisiert wird, begleitet von Symptomen wie Schmerz, Muskelschwäche und propriozeptiven Defiziten. Menschen mit chronischer Instabilität des Sprunggelenks bedürfen daher komplexer und systematischer Interaktionen von sensorischer Verknüpfung und dem muskuloskelettalen System. Ziel dieser Studie war die Untersuchung der Veränderungen der Muskelaktivitäten im Sprunggelenk sowie der Reaktionszeiten während einer plötzlichen Gelenkkippung bei Patienten mit chronischer Instabilität des Sprunggelenks unter verschiedenen visuellen Bedingungen. 28 Patienten mit chronischer Instabilität des Sprunggelenks nahmen an der Studie teil. Alle Teilnehmer wurden auf einer Kippplattform mit 25 Grad Neigung untersucht. Im Rahmen der Studie wurden während einer plötzlichen Gelenkkippung drei Mal Daten zu Muskelaktivität und Reaktionszeit erhoben, mit jeweils 60 Sekunden Pause zwischen den Tests sowie mit geöffneten und geschlossenen Augen. Bei geschlossenen Augen waren die Muskelaktivitäten im Tibialis anterior, Peroneus longus und Peroneus brevis signifikant vermindert, während im Gastrocnemius hier keine signifikante Veränderung gemessen wurde. Bei der Messung der Reaktionszeiten im Tibialis anterior, Peroneus longus, Peroneus brevis und Gastrocnemius während einer plötzlichen Sprunggelenkkippung mit geöffneten und mit geschlossenen Augen traten keine signifikanten Veränderungen auf. Das Fehlen visueller Informationen bei Stellungsschwankungen kann die Muskelaktivität im Tibialis anterior, Peroneus longus und Peroneus brevis bei Patienten mit chronischer Instabilität des Sprunggelenks verringern. Die vorliegenden Ergebnisse gewähren Einblick in die Natur und die Ursache der Verletzung und unterstützen so die Verbesserung existierender Vorbeugemaßnahmen.

Muscle co-contraction of ankle joint in young adults in functional reach test at different distances

It has been reported that young people may be able to modulate simultaneous contraction depending on the task. The functional reach test (FRT) is widely used as a method to assess dynamic balance. Although there are several reports on the center of pressure (COP), there are few reports on muscle activity and no studies focus on muscle co-contraction during FRT at different distances. We aimed to clarify how the differences in reach distance affect the activity of the lower limb muscles by measuring COP and muscle activity during FRT at different distances. Eighteen healthy young adults performed FRT at different distances (maximum, 75%, and 50%) and measured COP and muscle activity of tibialis anterior (TA) and soleus (SOL). Postural control variables were calculated from the COP, and mean muscle activity and muscle co-contraction index (CI) were calculated from muscle activity. Each variable was compared between the reach distance conditions and the correlation between the variable was examined. Most COP variables were significantly higher as the reach distance increased. A significant increase in muscle activity and CI was similarly observed with increasing distance. There was no consistent correlation between COP variables and CI, but there was a positive correlation between TA muscle activity and CI. The results of the present study showed that the young people used task-specific strategies by modulating lower limb muscle contraction and varying the degree of simultaneous muscle contraction during reaching movements at different distances.

The influence of footwear on walking biomechanics in individuals with chronic ankle instability.

Background/PurposeThe effects of footwear on the walking kinematics, kinetics and electromyography (EMG) of individuals with chronic ankle instability (CAI) at different speeds are still unknown. The objective of this cross-sectional study was to evaluate the kinematic, kinetic and electromyography differences between shod and barefoot walking at comfortable (CW) and fast (FW) speeds in individuals with CAI.MethodsTwenty-one individuals with CAI walked on a 5-meter walkway shod and barefoot at CW and FW speeds. A force plate was used to record the ground reaction forces, a 3-D motion analysis system to record the lower limb kinematics and a surface EMG system to collect the gluteus medius, vastus lateralis, gastrocnemius lateralis, gastrocnemius medialis, peroneus longus and tibialis anterior muscles activity. The dependent variables were ankle and knee angles and moments and normalized muscle activity. The shod and barefoot data during CW and FW were compared using a one-dimensional non-parametric mapping analysis.ResultsThe main results of this study were that individuals with CAI exhibited more ankle dorsiflexion angle, knee extension and tibialis anterior muscle activation during the beginning of the stance phase during shod compared to barefoot walking. Also, the biomechanical effects of shoes are similar during walking at FW and CW.ConclusionThe biomechanical deficits associated with CAI were partly attenuated during the shod compared to the barefoot condition and these effects were similar at CW and FW. These findings are compatible with the concept that locomotor interventions using suitable shoes may enhance gait abilities in individuals with CAI.

Ankle kinematics, center of pressure progression, and lower extremity muscle activity during a side-cutting task in participants with and without chronic ankle instability

This study assessed ankle kinematics, surface electromyography, and center-of-pressure (COP) progression relative to the medial border of the foot during a side-cutting task in individuals with and without chronic ankle instability (CAI). Thirty participants (CAI = 15; Controls = 15) performed a side-cutting task on a force platform while 3-dimentional ankle kinematics, COP position, and surface electromyography from the tibialis anterior, medial gastrocnemius, fibularis longus, fibularis brevis, vastus medialis, and semitendinosus were recorded on the testing leg. Ankle kinematics, root-mean-square muscle activity and COP position relative to the medial boarder of the foot were compared between CAI and healthy controls (p < 0.05). Significantly greater ankle internal rotation from 35–54% of the stance phase (p = 0.032) was found for the CAI group compared to controls. Furthermore, significantly greater tibialis anterior muscle activity from 86–94% of the stance phase (p = 0.022) and a more medial COP position from 81–100% (p < 0.05) and of the stance phase was also observed in the CAI group. Less lateral COP progression and increased tibialis anterior activation in the CAI group could reflect a protective movement strategy during anticipated side-cutting to avoid recurrent injury. However, greater ankle internal rotation during mid-stance highlights a potential ‘giving way’ mechanism in individuals with CAI.

Effect of Isometric Hip Abduction on Foot and Ankle Muscle Activity and Medial Longitudinal Arch During Short-Foot Exercise in Individuals With Pes Planus.

The improvement of hip joint stability can significantly impact knee and rearfoot mechanics. Individuals with pes planus have a weak abductor hallucis (AbdH), and the tibialis anterior (TA) may activate to compensate for this. As yet, no studies have applied isometric hip abduction (IHA) for hip stability during short-foot exercise (SFE). To compare the effects of IHA on the muscle activity of the AbdH, TA, peroneus longus (PL), and gluteus medius (Gmed), as well as the medial longitudinal arch (MLA) angle during sitting and standing SFE. Two-way repeated analyses of variance were used to determine the statistical significance of AbdH, TA, PL, and Gmed electromyography activity, as well as the change in MLA angle. University research laboratory. Thirty-two participants with pes planus. The participants performed SFE with and without isometric hip abduction in sitting and standing positions. Surface electromyography was used to measure the activity of the AbdH, TA, PL, and Gmed muscles, and Image J was used to measure the MLA angle. Significant interactions between exercise type and position were observed in terms of the PL muscle activity and in the change in MLA angle only, while other muscles showed significant main effects. The IHA during SFE significantly increased the AbdH muscle activity, while the TA muscle activity was significantly lower. The muscle activity of Gmed and PL was significantly increased in the standing position compared with sitting, but there was no significant difference with or without IHA. The change in the MLA angle was significantly greater in SFE with IHA in a standing position than in the other SFE conditions. IHA may be an effective method for reducing compensatory TA activity and increasing AbdH muscle activity during SFE for individuals with pes planus.

Is high soleus muscle activity during the stance phase of the running cycle a potential risk factor for the development of medial tibial stress syndrome? A prospective study

ABSTRACT To assess the impact of lower-leg muscle activity during the stance phase of running on the development of medial tibial stress syndrome (MTSS), in 123 healthy participants (18.2 ± 0.8 years), dynamic and static foot posture, and soleus and tibialis anterior muscle activity during the stance phase of running were measured before a 17-week track- and field-course. After the course, MTSS was identified in 20.5% of the participants. MTSS participants had a higher body mass (ES = 1.13), body mass index (BMI) (ES = 1.31), lower previous vigorous physical activity level (ES = 0.84) and VO2max (ES = 0.61), greater dynamic foot pronation (ES = 0.66), higher soleus peak EMG amplitude during the absorption (ES = 0.60) and propulsion phases (ES = 0.56) of running, and a history of MTSS (OR = 6.38) (p < 0.05). Stepwise logistic regression showed BMI, dynamic foot index, soleus peak EMG amplitude during propulsion, MTSS history and previous vigorous physical activity were predictors of MTSS. The model predicted 96.6% of the healthy participants and 56.5% of the MTSS participants and correctly classified 88.4% of overall cases. Coaches and sports-medicine professionals that screen for injury risk should consider adopting a comprehensive evaluation that includes these parameters.

Pilot Study On Effect Of Ipsilateral Long Kinetic Chains On Shoulder Elevation Strength

There is growing evidence to suggest that kinetic chains extend far beyond the core muscles, following myofascial meridians that interestingly appear to overlap with classically-known acupuncture channels. Strengthening programs during the rehabilitation of musculoskeletal injuries utilize kinetic chain exercises; however, how lower extremity strength potentially directly affects upper extremity strength has not been quantified. PURPOSE: To examine quantitatively the effect on shoulder elevation strength (SES) in the sagittal plane on ipsilateral lower extremity tibialis anterior muscle activation. METHODS: Twenty young healthy adult volunteers (half women, half men), ages 20-60 years, having no shoulder pain were recruited. Participants had baseline SES evaluated with a hand-held dynamometer applied just proximal to the radial styloid with the arm held in 90-degree elevation in the sagittal plane. The participants underwent the following interventions: SES and ipsilateral anterior tibialis muscle activation (IATMA) while standing, SES and IATMA while seated with legs dangling, and SES with ipsilateral gastrocnemius activation while seated with legs dangling. RESULTS: In females, IATMA, in standing and seated position, reduced SES by a mean percentage of 12.57 and 14.88, respectively, from baseline. SES with gastrocsoleus activation (reciprocal relaxation of anterior tibialis) reduced SES by a mean percentage of 3.93 from baseline. In males, IATMA, in standing and seated position, reduced SES by a mean percentage of 5.58 and 10.84, respectively, from baseline. SES with gastrocsoleus activation (reciprocal relaxation of anterior tibialis) reduced SES by a mean percentage of 3.3 from baseline. CONCLUSIONS: IATMA directly reduces SES; it also produces a greater decrement in SES compared to ipsilateral gastrocsoleus activation. This kinetic chain effect appears coincident with known myofascial meridians.

Effect of Neuro-Dynamic Technique on Repetitive Inward Ankle Rolls among Young Malaysian Athletes- A Randomized Controlled Trial

Inversion ankle sprains (IAS) are the most common injuries in sports and recreational activities. Incomplete rehabilitation among injured athletes may result in repetitive inward ankle rolls. Furthermore, inversion ankle sprain causes damage to the superficial peroneal nerve during repeated ankle inversion and plantar flexion. This results in positive neurodynamic tests in patients with sprained ankles. The purpose of this study was to find the effect of the neuro-dynamic technique on repetitive inward ankle rolls and compare it with standard physiotherapy on dynamic balance, pain score, peroneal longus, and tibialis anterior muscle activation response, knee range of motion (ROM), and functional ankle disability index (FADI) among young Malaysian athletes. Fourteen participants of age ranging from 17 to 35 years with repeated ankle sprains were recruited and randomized into Intervention Group A (Neurodynamic technique and Standard Physiotherapy-NDT+SP) and Intervention Group B (Standard Physiotherapy-SP). The participants of group A received NDT (4*30 s with 1-min rest) consisting of peroneal nerve mobilization began the day after the baseline and continued through the week for 3 sessions. In addition, the participants received standard physiotherapy (pain management and exercise) whereas the group B participants received only standard physiotherapy. The participants with repeated IAS were checked for FADI followed by pain score, dynamic balance (Y-balance), and knee ROM (using electro-goniometer). The peroneal longus and tibialis anterior muscle activity response was tested by Surface Electromyography (sEMG) (Noraxon Myo-Muscle) on the injured leg. The subjects of the two groups were tested on selected variables in baseline, mid, post and follow-up measurements. Repeated Measures Analysis of Variance (ANOVA) was computed to determine the interaction effects of time and between-subject factors. ANOVA results (NDT + SP) indicated that dependent variables FADI (F (1.148, 36) = 4701.14), pain score (F (1.98, 36) = 132.697), dynamic balance (F (1.409, 36) = 16.42), knee ROM (F (1.498, 36) = 62.232), peroneal longus peak activity (F (3, 36) = 25.727), and tibialis anterior peak activity (F (3, 36) = 17.563) had a significant effect (p<0.05) within the times of intervention among participants. Based on the post hoc test. FADI, pain score and knee ROM showed consistent improvement in intervention over the injured leg. The findings of this study show improvement in dynamic balance, pain score, peroneal longus and tibialis anterior muscle activation response, knee ROM, and FADI in both groups. The neurodynamic technique together with standard physiotherapy intervention shows safe and similar effects between variables. As part of the ankle rehabilitation protocol, it also recommends the neurodynamic technique to prevent repetitive IAS.

The effect of support surface and footwear condition on postural sway and lower limb muscle action of the older women.

Diminished somatosensory function is a critical age-related change which is related to postural instability in the older population. Footwear is a cost-effective way to modulate the postural stability by altering sensorimotor inputs via mechanoreceptors on the plantar surface of the feet. Compared to insoles with indentions in the entire surface, we innovatively developed a textured insole with site-specific nodulous protrudous. This study thus aimed to investigate the immediate effect of the nodulous insole and supporting surface condition on static postural stability and lower limb muscle activation for healthy older women. This is a single-session study with repeated measurements. Twenty-three healthy older women stood on the firm (i.e., concrete floor) and foam surfaces with their eyes open in the three footwear conditions, namely barefoot, plain shoes and shoes with an innovative textured insole, for 30 seconds. Static postural sway and muscle activation of biceps femoris (BF), vastus lateralis (VL), tibialis anterior (TA), and lateral gastrocnemius (LG) of the dominant leg were measured during each testing condition. Compared to a firm surface, standing on the foam could significantly increase the body sway and lower limb muscle activation (p<0.05). When standing on the foam, compared to barefoot, wearing footwear significantly decreased the VL and TA muscle activation and minimize the postural sway in medial-lateral and anterior-posterior direction, while the influence is larger for the shoes with nodulous insloe compared to the plain shoes. No significant differences between the footwear conditions for static stability and muscle activation were observed on firm surface condition. For older women, footwear could improve the postural stability in the unstable surface, particularly the footwear with nodulous insole, with the underlying mechanism as enhancing the mechanoreceptors on the plantar surface of the feet.