Copers adopt an altered dynamic postural control compared to individuals with chronic ankle instability and controls in unanticipated single-leg landing

BackgroundSeveral prior studies involving “expected” single-leg landings have not succeeded in establishing a difference between copers and a control group.Research questionDoes expected and unanticipated single-leg landing affect dynamic postural stability in lateral ankle sprain individuals with chronic ankle instability (CAI), copers, and controls?MethodsIn this prospective cross-sectional study, physically active adults with CAI (n = 12), copers (n = 12), and controls (n = 12) were included. Participants performed expected single-leg landing by stepping off a 30-cm box. They also performed unanticipated landings including side-step cutting, side-step cutting at 60°, single-leg landing, and forward stepping. The expected and unanticipated conditions of each groups were compared in terms of time to stabilization (TTS) and center of pressure (COP) for the anterior-posterior (AP) and medial-lateral (ML) conditions. To analyze the data, a mixed-model one-way analysis of variance and a Tukey-Kramer post hoc test were performed.ResultsA significant condition × group interaction was observed in only TTS ML, with the CAI group demonstrating a significantly longer TTS ML than the coper (p < 0.001) and control (p < 0.001) groups during unanticipated trials. In addition, group interaction effects were observed for COP AP and TTS AP. The coper group demonstrated significantly longer COP AP and TTS AP than the control group (p < 0.001).SignificanceThe CAI group demonstrated a significantly longer TTS ML than the coper and control groups during the unanticipated condition, and the coper group demonstrated significantly longer TTS AP and COP AP than the control group. Thus, longer COP AP and TTS AP sway time in the coper group may be a protection mechanism, allowing greater freedom in the AP plane while quickly controlling ML sway and preventing lateral ankle sprains. These findings can help in the prevention of lateral ankle sprains and assessment of dynamic postural control.     

Differences in postural control between healthy and subjects with chronic ankle instability

IntroductionChronic ankle instability (CAI) is characterized by the occurrence of repetitive inversion mechanism of the ankle, resulting in numerous ankle sprains. CAI occurs in approximately 70% of patients with a history of a lateral ankle sprain. Many causes of functional ankle instability have been postulated and include deficits in proprioception, impaired neuromuscular-firing patterns, disturbed balance and postural control.ObjectiveThe purpose of this study was to compare postural control behaviour in subjects with chronic ankle instability and healthy subjects, using the traditional linear and nonlinear variables for the centre of pressure (CoP) displacement, during one-leg stance on stable and unstable surfaces.Methods16 CAI subjects and 20 healthy subjects were evaluated with the single leg stance on a stable surface and an unstable surface, for 60 s with a force plate. The traditional linear variables like CoP displacement, CoP amplitude and CoP velocity were calculated. Variability of CoP displacement was also submitted to nonlinear analysis and the approximated entropy, sample entropy, correlation dimension and Lyapunov exponent were calculated.ResultsOn the stable surface, no differences between groups for all the traditional variables were found but the correlation dimension of CoP mediolateral displacement had lower values on the CAI group with statistical significance (p < 0.05). On the unstable surface, no differences were found neither with linear variable neither with variability nonlinear analysis.ConclusionCorrelated dimension of CoP displacement during one-leg stance on a stable surface was the only variable that show significant differences between the two groups. The lower values of this variable in the CAI subjects may implicate a balance control system with more difficulties to adapt to the environment and the task demands. More studies are needed to better understand CAI subjects balance control.     

Individuals with chronic ankle instability exhibit altered ankle kinematics and neuromuscular control compared to copers during inversion single-leg landing

ObjectivesThis study compares the ankle kinematics and muscle activities of the individuals with chronic ankle instability (CAI), coper, and control groups in normal and inversion single-leg landings.Designcross-sectional study;SettingBiomechanics laboratory.ParticipantsPhysically active adults with CAI (N = 12); and coper (N = 12) and control (N = 12) groups.Main outcome measuresThe participants performed normal and inversion single-leg landing. The muscle activity 200 ms before and after landing of the tibialis anterior, the medial gastrocnemius, and the fibularis longus (FL) were recorded. The FL latency, sagittal and frontal co-contraction indexes (CCI), ankle inversion angle at the initial contact, and the maximum inversion angle were recorded.ResultsSignificantly longer FL latency, decreased FL muscle activity, frontal CCI, and an increased maximum inversion angle at post-landing were discovered during inversion single-leg landing in the CAI group compared to the coper and control groups. However, no significant difference was observed among the CAI and coper groups during normal single-leg landing.ConclusionThese results suggest prolonged FL latency and altered ankle kinematics suggest an increased risk of recurrent lateral ankle sprains in CAI with inversion single-leg landing.     

Coper has altered foot joint coordination pattern compared to individuals with chronic ankle instability during running

BackgroundThere is limited information regarding the cause for the different etiologies in individuals with initial lateral ankle sprains (LAS) who have chronic ankle instability (CAI) and no recurrence or instability for > 12 months (copers) following initial LAS. Assessing the movement patterns of copers and individuals with CAI and LAS recurrence is essential for identifying the mechanical factors that affect patient outcomes.Research questionDoes coordination and coordination variability of rearfoot, midfoot, and forefoot present a potentially causative pattern for CAI or coper?MethodsThis cross-sectional study included 35 males who were divided into the CAI (n = 13), coper (n = 12), and control group (n = 10). Participants performed rearfoot strike running on the treadmill at a fixed speed of 3.5 m/s. The coupling angle between the rearfoot, midfoot, and forefoot, representing intersegmental coordination, was calculated using the modified vector coding technique and categorized into four coordination patterns. The coupling angle standard deviation served represented coordination variability during the stance phase.ResultsOne control participant and one CAI participant were excluded, and final analyses were performed on the CAI (n = 12), coper (n = 12), and control (n = 9) groups. During late stance, the coper group showed a significantly greater proportion of in-phase with distal dominancy (p = 0.02, effect size=0.17) and a significantly lower proportion of in-phase with proximal dominancy (p = 0.05, effect size=0.17), than the CAI group. During the early stance, the coper group showed a significantly lower proportion of anti-phase with distal dominancy than the CAI group (p = 0.03, effect size=0.18). There were no differences in intra-foot variability among the groups.SignificanceThe intra-foot coordination observed in the coper group suggests that this movement pattern may reduce the risk of ankle sprains.     

Short-term and long-term effects of ankle joint taping and bandaging on balance,proprioception and vertical jump among volleyball players with chronic ankle instability

ObjectiveThis study hypothesized that the prolonged use of taping during athletic activities produces more significant increases in proprioception, balance, and vertical jump among volleyball players with CAI.DesignA randomized controlled study.ParticipantsOne-hundred participants with chronic ankle instability (CAI) participated in this study. Participants were distributed into 3-groups: taping group, bandaging group, and control group.Primary outcome measuresProprioception (ankle range of motion absolute error), balance(Y-balance test), and vertical jump (vertical jump tester).InterventionsThree interventions were performed: ankle rigid taping, ankle bandaging, and placebo taping. The measurements were performed at baseline, immediately, 2-weeks and 2-months after support.ResultsImmediately after supports, there were non-significant differences between all groups for proprioception, balance (P < .05). There was a significant difference between banding and control groups, and taping and control groups for the vertical jump (P < .05). After 2-weeks and 2-months, there were significant differences between bandaging and control groups, and taping and control groups for proprioception, balance, and vertical jump (P < .05). There were non-significant differences between taping and bandaging groups (P < .05) during all assessments.ConclusionThis study indicated that ankle taping and bandaging immediately improve vertical jump only; while they improve proprioception, balance, and vertical jump after 2-weeks and 2-months.     

Asymmetry in multi-directional jumping tasks

ObjectivesQuantify and compare average symmetry indexes (ASI) across jumping directions (vertical, lateral and horizontal) and variables (jump distance and height, peak force and peak power) in a non-injured population of netball players.MethodsNineteen sub-elite netball players (age: 19.5 ± 1.1 years, body mass: 75.1 ± 11.8 kg, height: 177.6 ± 5.2 cm) performed three single-leg countermovement jumps from a force plate in the vertical, horizontal and lateral directions. Force, power and jump height ASI’s were calculated from force plate data. Jump distance ASI was calculated as the distance jumped.ResultsIndividual ASI’s ranged from 0.0 to 48.6% while averaged ASI’s ranged from 3.1% (peak force) to 11.4% (peak power). Significant (p ≤ 0.05) ASI differences were observed between vertical force (3.0%) and power (9.2%) (p = 0.02), horizontal power (11.4%) and jump distance (4.6%) (p < 0.001), horizontal force (8.0%) and distance (4.6%) (p < 0.001) and lateral power (10.0%) and jump distance (6.2%) (p = 0.05). The greatest ASI was found for the lateral direction (8.4 ± 1.2% averaged across the three variables).ConclusionsThere appears to be some variation in the magnitude of the ASI depending on the variable and direction used to quantify the asymmetry. Decisions need to be made by the strength and conditioning practitioner as to which variables and directions are specific to the requirements of their sport, position or activity.     

Instrumented measures of postural control in college dancers with and without chronic ankle instability

ObjectivesTo determine whether collegiate dancers with chronic ankle instability (CAI) demonstrated impaired postural control during instrumented measures of single-leg static balance compared to dancers without CAI.DesignCross sectional design.SettingUniversity dance studios.ParticipantsWe included N = 39 dance majors from a large, public university. We stratified participants into CAI (n = 20, age = 20 ± 1.8, IdFAI = 17.3 ± 5.7, number of sprains = 1.9 ± 1.1) and Control groups (n = 19, age = 20 ± 1.2, IdFAI = 2.5 ± 3.0).Main outcome measuresParticipants performed 3 x 10-s single-leg, static balance trials on a pressure mat in two different conditions, foot-flat eyes closed and demi-pointe eyes open. We measured six different time-to-boundary (TTB) measurements during each balance trial and calculated the average of the 3 trials for each condition. Participants also completed the Foot and Ankle Ability Measure (FAAM) sport and activities of daily living (ADL) questionnaires.ResultsThe CAI group reported greater IdFAI and lower FAAM-ADL and FAAM-Sport scores compared to the control group. We observed no significant differences in TTB measurements between the CAI and control groups during either balance conditions.ConclusionsInstrumented measures of static postural control were not impaired in college dancers with CAI compared dancers without CAI.     

The effects of stroboscopic balance training on cortical activities in athletes with chronic ankle instability

ObjectivesTo investigate the effect of a 6-week stroboscopic balance training program on cortical activities in athletes with chronic ankle instability.DesignRandomized controlled trial. Setting: Single-center.ParticipantsThirty-nine participants were assigned to the strobe group (SG, n = 13), non-strobe group (NSG, n = 13), and control group (CG, n = 13).Main outcome measuresCortical activity and balance velocity were evaluated while the athletes were on the HUBER balance device. Electroencephalographic measurements of cortical activity were made at the transition from bipedal stance to single-leg stance.ResultsThe SG showed significant increases in Cz theta and alpha values and COP-v (center of pressure velocity) between pretest and posttest (p < 0.001, p = 0.003, p < 0.001). Posttest Cz theta was significantly higher in the SG compared to the CG (p = 0.009) and posttest Cz alpha was significantly higher in the SG compared to the NSG (p = 0.039) and CG (p = 0.001). Posttest COP-v was significantly higher in the SG than in the CG (p = 0.031) and NSG (p = 0.03).ConclusionsStroboscopic training may be clinically beneficial to improve balance parameters in athletes with CAI, and may have utility in sport-specific activity phases of rehabilitation to reduce visual input and increase motor control.     

Bracing does not improve dynamic stability in chronic ankle instability subjects

ObjectivesTo investigate the effects of an ankle brace on dynamic postural stability, measured with Time to Stabilization (TTS), in subjects with chronic ankle instability (CAI).DesignTwo-within (Condition, Side) repeated measures.SettingResearch laboratory.ParticipantsFifteen subjects with unilateral CAI.Main outcome measuresSubjects participated in two testing sessions during which a single-limb jump-landing task was performed with one of two conditions: lace-up ankle brace or no ankle brace. Ground reaction forces were used to calculate Resultant Vector TTS (RVTTS).ResultsFor RVTTS, there were no statistically significant main effects for Side (F_1,14 = 1.005; p = 0.33) or Condition (F_1,14 = 2.48; p = 0.14), as well as no significant interaction effect (F_1,14 = 1.67; p = 0.22).ConclusionWhile TTS is a useful outcome tool for identifying deficits in subjects with CAI and improvements related to ankle rehabilitation, this measure of dynamic stability does not appear to be sensitive in detecting the influence of the application of an ankle brace in this pathological group. Researchers need to establish what other testing methods will be the best for determining the outcome of the application of an ankle brace in the laboratory setting to coincide with the epidemiology data that support the use of these devices.     

Ankle muscle activation during the limits of stability test in subjects with chronic ankle instability

ObjectiveTo study postural control and muscle activity during the limit of stability test (LOS) in subjects with chronic ankle instability.DesignObservational study.SettingUniversity laboratory.Participants10 healthy subjects were included in the control group and 10 subjects in the CAI group (age between 18 and 30 years, with history of the multiple ankle “giving way” episodes in the last six months and score ≤24 in the Cumberland Ankle Instability Tool).Main outcome measuresA computerized dynamic posturography equipment was used for assessing the LOS. The electromyography activity of tibialis anterior (TA), soleus (SOL), medial gastrocnemius (MG) and peroneus longus (PL) was registered.ResultsSubjects with CAI had a greater activation in TA to forward (p < .01), forward affected (p = .001), backward affected (p = .007) and backward directions (p < .01); in PL to forward affected (p < .01) and affected directions (p = .001); in MG to forward (p = .023) and affected directions (p < .01) and in SOL to the affected direction (p = .009). We observed restricted excursions and less directional control in subjects with CAI.ConclusionsSubjects with CAI exhibited poorer ability to move their center of gravity within stability limits. In addition, they have an altered ankle muscle activity during LOS test toward the affected ankle joint.     

Test–retest reliability of the Vestibular Ocular Motor Screening (VOMS) tool and modified Balance Error Scoring System (mBESS) in US military personnel

The Military Acute Concussion Evaluation 2 (MACE 2), which includes the Vestibular-Ocular Motor Screening (VOMS) tool and the single-leg stance component of the modified Balance Error Scoring System (mBESS), was introduced in 2018 as an assessment of acute mTBI in US military personnel. However, the reliability of the VOMS and mBESS in this population has not been established.ObjectivesThe primary purpose of this study was to examine the reliability of the VOMS across a 6-month period in healthy, uninjured US Army Special Operations Command (USASOC) personnel.DesignActive duty/heathy military personnel (n = 108) completed the VOMS and mBESS at baseline and follow-up 6 months later (±1 month).MethodCronbach's alpha was used to examine the internal consistency of the VOMS and mBESS at both time points. Two-way mixed intra-class correlation coefficients (ICC) with consistency agreement were used to evaluate test–retest reliability.ResultsVOMS demonstrated excellent internal consistency (α = 0.99), whereas, the mBESS demonstrated poor internal consistency (α = 0.29). Test–retest reliability of VOMS items was moderate-to-good with ICCs ranging from 0.60 to 0.81. Test–retest reliability was moderate for mBESS total score (ICC = 0.59) and double-leg stance (ICC = 0.73), while single-leg (ICC = 0.49) and tandem (ICC = 0.02) stances were poor.ConclusionsThe findings suggest that VOMS has high internal consistency and moderate-to-good test–retest reliability. mBESS has poor internal consistency and poor-to-moderate test–retest reliability. The results suggest that VOMS is a reliable addition to the MACE-2, whereas, mBESS single-leg stance is less reliable. As such, mBESS double-leg stance may be a more reliable measure of balance in this population.     

Directions of single-leg landing affect multi-segment foot kinematics and dynamic postural stability in male collegiate soccer athletes

BackgroundUnderstanding lower limb kinematics and postural control in different directions of single-leg landings is critical to evaluate postural control and prevent lower limb injuries. However, foot and ankle kinematics and postural control during single-leg landings in different directions are less known.Research questionDoes the difference in the direction of single-leg landing affect the foot kinematics on the frontal plane and dynamic postural stability?MethodsA cross-sectional study was conducted. Forty-nine male collegiate soccer players performed single-leg forward (FL), 45° lateral (LL), and medial (ML) direction landings. The lower limb, foot (rearfoot, midfoot, forefoot), and ankle kinematics during an impact phase were evaluated, and a curve analysis was performed using a statistical parametric mapping method to compare the three landings. The three landings were compared in terms of postural control parameters, including time to stabilization (TTS), peak of ground reaction forces (GRFs), root-mean-square of the mediolateral GRFs for 0–0.4 s (GRFML0.4), loading rate, and magnitude of horizontal GRFs from 0–0.4 s (HGRF-0.4), 0.4–2.4 s (HGRF-2.4), and 3.0–5.0 s.ResultsAnkle and rearfoot kinematics in LL exhibited smaller eversion and pronation positions than FL and ML (p < 0.01). The TTS-mediolateral (TTS-ML) was longer in the LL than in FL and ML (p < 0.001). The GRFML0.4, HGRF-0.4, and -2.4 in the LL and ML were greater than those in the FL (p < 0.001).SignificanceDirections of single-leg landing affect foot and ankle kinematics and postural stability. Specifically, the LL exhibits more inverted ankle and supinated rearfoot positions, and longer TTS-ML. Thus, the LL may induce stretching of the lateral ankle ligament. These findings can help understand foot kinematics and assess dynamic postural control.     

Effects of kinesiophobia and pain on performance and willingness to perform jumping tests in Achilles tendinopathy: A cross-sectional study

ObjectivesFear of movement may be a source of systemic bias in studies reporting functional deficits in patients with Achilles tendinopathy. The purpose of this study was to assess the effects of kinesiophobia on completion rate and performance on tests evaluating lower extremity function, while controlling for self-reported pain.DesignCross-sectional study;SettingTendon research laboratory.ParticipantsNinety-four participants with Achilles tendinopathy.Main outcome measuresCompletion (yes/no) and performance (cm) on the counter-movement jump, hopping, and drop counter-movement jump.ResultsThe models fit the data (R^2 = 0.81, both models). TSK score did not predict completion (beta = −0.01, 95% CI = −0.13 – 0.09, P = 0.74) but pain did (beta = −0.36, 95% CI = −0.53 to −0.19, P < 0.0001). TSK score did not predict performance (beta = −0.06, 95% CI = −0.14 – 0.003, P = 0.07), but pain did (beta = −0.15, 95% CI = −0.22 to −0.07, P < 0.0001).ConclusionsKinesiophobia did not affect the physical performance tests in patients with Achilles tendinopathy. Measures of physical performance should be interpreted alongside self-reported pain.     

Biomechanical analysis of single-leg stance using a textured balance board compared to a smooth balance board and the floor: A cross-sectional study

BackgroundPrevious research showed that standing on textured surfaces can improve postural control by adapting somatosensory inputs from the plantar foot. The additional stimulation of plantar cutaneous mechanoreceptors by a textured surface during single-leg stance on a balance board may increase afferent information to the central nervous system to accelerate muscular responses and to enhance their accuracy. The additional impact of textured surface during single-leg stance on a balance board on postural control and muscle activity is unknown.Research questionTo investigate the differences of a) postural control during single-leg stance on a textured balance board compared to a smooth balance board and b) activity of lower extremity muscles during single-leg stance on a textured balance board compared to a smooth balance board and the floor.MethodsTwenty-six healthy adults (12 females, 14 males; mean age = 25.4 years) were asked to balance on their randomly assigned left or right leg on a force plate (floor; stable condition), a textured balance board and a smooth balance board (unstable conditions). Center of pressure (CoP) displacements (force plate, Bertec, 1000 Hz) and electromyographic activity (EMG) of eight leg muscles were measured and compared between conditions, respectively.ResultsNeither CoP-displacements, nor EMG activities differed significantly between the textured and the smooth balance board (p > 0.05). Significantly higher muscle activities (p < 0.05) were observed using the balance boards compared to the floor.SignificanceSingle-leg stance using a textured balance board seems not to lead to reduced CoP-displacements compared to a smooth balance board. Muscle activation is significantly increased in both balance board conditions compared to the floor, however, it is not different when both balance board surfaces are compared. It could not be recommended to use a textured balance board for altering muscle activity and improving postural control during single-leg stance in favor of a smooth textured balance board.     

Sex differences in total frontal plane knee movement and velocity during a functional single-leg landing

ObjectivesFemales land with more knee valgus than males. While most studies have evaluated lower extremity mechanics during double leg landing, most sports require single-leg landing from a double or single leg takeoff. Further, knee movement occurs toward both varus and valgus during functional landing. The purpose of this study was to determine if differences exist between females and males in total frontal plane movement and velocity of the knee during single-leg landing.DesignExperimental cohort.SettingMotion analysis laboratory.ParticipantsForty healthy, physically-active females (n = 20) and males (n = 20).Main outcome measuresThree-dimensional motion analysis was completed on the lower extremities during double-leg jumping followed by a single-leg landing. Student's t-tests (p ≤ 0.05) were used to determine if differences exist in frontal plane knee angles (valgus and varus excursion) and angular velocities between females and males.ResultsFemales demonstrated greater knee valgus and varus excursion, and valgus and varus velocities compared to males (p < 0.05).ConclusionsThese findings suggest that total movement in the frontal plane at the knee may be an important factor in injury mechanics in females. Further, single-leg landing from a functional jump should be considered when comparing landing biomechanics between females and males.     

Lower limb joint motion during a cross cutting movement differs in individuals with and without chronic ankle instability

ObjectiveTo compare the kinematics of lower limb joints between individuals with and without chronic ankle instability (CAI) during cross-turn and -cutting movements.DesignCross-sectional study.SettingMotion analysis laboratory.ParticipantsTwelve subjects with CAI and twelve healthy controls.Main outcome measuresHip flexion, adduction, and internal rotation, knee flexion, and ankle dorsiflexion and inversion angles were calculated in the 200 ms before initial ground contact and from initial ground contact to toe-off (stance phase) in a cross-turn movement during gait and a cross-cutting movement from a forward jump, and compared across the two groups.ResultsIn the cross-cutting movement, the CAI group exhibited greater hip and knee flexion than the control group during the stance phase, and more hip abduction during the period before initial contact and the stance phase. In the cross-turn movement the joint kinematics were similar in the two groups.ConclusionsCAI subjects exhibited an altered pattern of the proximal joint kinematics during a cross-cutting movement. It is important for clinicians to assess the function of the hip and knee as well as the ankle, and to incorporate coordination training for the entire lower limb into rehabilitation after lateral ankle sprains.     

Evidence of sensorimotor deficits in functional ankle instability: A systematic review with meta-analysis

Functional ankle instability (FAI) has been associated with impaired sensorimotor function; however individual studies have produced conflicting results. In an attempt to reduce this ambiguity, a systematic review with meta-analysis was undertaken to determine which sensorimotor deficits exist with FAI. Fifty-three studies assessing sensorimotor factors in subjects with FAI were included from 465 identified articles. Studies were rated for methodological quality and data were pooled for peroneal reaction time, joint position sense, and postural sway during single-leg stance and time to stabilisation from a single-leg jump. Data on joint movement sense were unable to be pooled. When subjects with unstable ankles were compared to healthy controls, sensorimotor impairments were demonstrated for passive joint position sense (mean difference (MD) = 0.7°, 95% confidence interval (CI): 0.2–1.2°, p = 0.004), active joint position sense (MD = 0.6°, 95% CI: 0.2–1.0°, p = 0.002), postural sway in single-leg stance (standardised MD (SMD) = 0.6, 95% CI: 0.2–1.0, p = 0.002), the star excursion balance test (SMD = 0.4, 95% CI: 0.1–0.7, p = 0.009), and time to stabilisation from a single-leg jump in a medio-lateral (MD = 0.6 ms, 95% CI: 0.4–0.8, p < 0.0001) and an antero-posterior direction (MD = 0.7 ms, 95% CI: 0.4–1.0, p < 0.0001). Peroneal reaction time was not affected. Sensorimotor deficits occur for joint position sense and postural control in subjects with FAI. Deficits in peroneal muscle reaction time following perturbation are not evident.     

Effect of chronic ankle instability on lower extremity kinematics,dynamic postural stability,and muscle activity during unilateral jump-landing tasks: A systematic review and meta-analysis

ObjectiveTo determine if individuals with chronic ankle instability (CAI) demonstrate altered landing kinematics, muscle activity, and impaired dynamic postural stability during a unilateral jump-landing task.Methods21 studies were included from PubMed, MEDLINE, Embase and CINAHL searched on September 26, 2021. Mean differences in joint angles and muscle activity between CAI and controls were analysed as continuous variables and pooled using a random-effects model to obtain standardised mean differences and 95% confidence intervals. Dynamic postural stability measured using time to stabilisation (TTS) was assessed qualitatively.ResultsWe found greater plantarflexion (pooled SMD = 0.33, 95%CI [0.02,0.65]), reduced knee flexion (pooled SMD = −0.67, 95%CI [−0.97, −0.37]), and reduced hip flexion (pooled SMD = −0.52, 95%CI [−0.96, −0.07]) in CAI after landing. Regarding muscle activity, we observed reduced peroneus longus muscle activation (pooled SMD = −0.77, 95% CI [−1.17, −0.36]) in CAI prior to landing.ConclusionOur study provides preliminary evidence of altered landing kinematics in the sagittal plane and reduced peroneus muscle activity in CAI during a dynamic jump-landing task. These results may have clinical implications in the development of more effective and targeted rehabilitation programmes for patients with CAI.