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Altered spinal-level sensorimotor control related to pain and perceived instability in people with chronic ankle instability
Authors:Cassandra S. Thompson  Claire E. Hiller  Siobhan M. Schabrun
Affiliation:1. School of Science and Health, Western Sydney University, Australia;2. Faculty of Health Sciences, The University of Sydney, Australia
Abstract:

Objectives

To compare soleus spinal reflex excitability, presynaptic inhibition and recurrent inhibition between chronic ankle instability (CAI), acute Lateral Ankle Sprain coper (LAS-coper) and healthy populations. The relationship between spinal reflex excitability and pain and perceived instability in people with CAI was also examined.

Design

Cross-sectional laboratory experiment.

Methods

Twelve individuals with CAI, twelve ‘copers’ and twelve healthy age, limb and gender-matched controls participated. Soleus H-reflex recruitment curves, pre-synaptic excitability and recurrent inhibition of the spinal-reflex pathway were examined during static double- and single-leg stance. Reporting of pain and perceived instability were used to perform a regression analysis on measures of soleus spinal excitability in people with CAI, LAS-coper and healthy controls.

Results

Soleus spinal reflex excitability was greater during single-leg stance in CAI compared to healthy and coper individuals (p = <0.001). Pre-synaptic inhibition was three-times less in CAI participants compared to both healthy controls and copers (p = <0.001). There were no differences between healthy and coper participants in spinal-level measures of sensorimotor control. Reports of pain explained 15–16% of the variance in soleus spinal reflex excitability and presynaptic inhibition during single and double-leg stance, while perceived instability explained 20% of the variance in spinal reflex during single leg stance only.

Conclusions

CAI participants presented with an inability to suppress soleus spinal reflexes during tasks with increased postural threat; likely due to disinhibition of pre-synaptic mechanisms. Pain and perceived instability may contribute to changes in spinal-level sensorimotor control in CAI.
Keywords:Sprains and strains  H-reflex  Peripheral nerves  Sensory feedback  Sensorimotor gating
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