Detection of dynamic stability deficits in subjects with functional ankle instability

WIKSTROM. E. A., M. D. TILLMAN, and P. A. BORSA. Detection of Dynamic Stability Deficits in Subjects with Functional Ankle Instability. Med. Sci. Sports Exerc., Vol. 37, No. 2, pp. 169-175, 2005. Purpose: To determine which combination of landing protocol and analysis technique would be the most effective at detecting differences in dynamic stability between healthy subjects and subjects with functional ankle instability (FAI). Methods: Fifty-eight subjects participated in this investigation: 29 healthy individuals and 29 individuals with FAI. Subjects were assessed during a single test session for time to stabilization (TTS) in the anterior/posterior, medial/lateral, and vertical directions from two protocols: a step down and jump protocol. The step down protocol started with each subject atop a 20-cm-high platform, and the jump protocol started with subjects in a standing position 70 cm from the center of a force plate and required each subject to jump off both legs and touch a designated marker placed at a position equivalent to 50% of the subject's maximum vertical leap. TTS scores in the anterior/posterior, media/Materal, and vertical direction were compared between group, protocol. and type of analysis. Results: A significant protocol by analysis by group interaction (F(1,56) 6.9, P = 0.011) was observed for anterior/posterior TTS. Likewise, protocol by group (F(1,56) = 4.4, P = 0.042) and protocol by analysis (F(1,56) = 14. 1, P < 0.001) interactions were also noted in anterior/posterior TTS. The jump protocol (2381.7 +/- 36.5 ms) produced significantly greater TTS scores in the vertical direction than the step protocol (1533.5 +/- 71.8 ms), whereas the unbounded third order polynomial (UTOP) method (2554.4 +/- 68.7 ms) produced significant greater TTS scores as compared with the sequential estimation (SE) method (1360.8 +/- 52.1 ms). Conclusions: The jump protocol and UTOP method of analysis are the most effective TTS combination in detecting differences between healthy and FAI groups.