How do neuromuscular characteristics of the peroneal muscles differ in adults with and without chronic ankle instability? A systematic review with meta-analysis

IF 2.4 3区医学 Q3 NEUROSCIENCES Gait & posture Pub Date : 2025-01-22 DOI:10.1016/j.gaitpost.2025.01.019

Abdulaziz Altun , Sharon Dixon , Michael Nunns , Hannah Rice

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Abstract

Background

Chronic ankle instability (CAI) has been associated with neuromuscular control dysfunction, particularly of the peroneal musculature.

Research question

How do neuromuscular characteristics of the peroneal muscles, including corticospinal excitability, strength, proprioception (force sense) and electromyographic measures differ in individuals with CAI compared to healthy control counterparts aged 18–45?

Methods

A systematic review with meta-analysis was conducted by retrieving relevant articles from electronic databases including EBSCOhost (CINAHL Complete, AMED, SPORTDiscus), Ovid (MEDLINE, Embase), Web of Science, Scopus and Cochrane Library as well as Grey literature sources. The eligibility and methodological quality of the included case-control and cross-sectional studies were assessed by two reviewers. The random effects model and the standard mean difference with a 95 % confidence interval were utilised to calculate pooled estimates of the overall effect size.

Results

Of the total 13,670 studies retrieved, 42 were included in the systematic review. Of these, 25 were eligible for the meta-analyses. Two of the meta-analyses, each consisting of two studies, showed less evertor force sense accuracy at 10 % (d=0.50, p = 0.03) and 20 % of maximum voluntary isometric contraction (d=1.14, p < 0.00001) in individuals with CAI than the control group. In addition, another meta-analysis of two studies showed that the CAI population had longer peroneus longus latency (d=1.69, p < 0.0001) than the control group during single-leg landing inversion perturbation test under unexpected conditions.

Significance

Individuals with CAI showed specific sensorimotor impairments in evertor force sense accuracy and peroneus longus latency, which may indicate that neuromuscular dysfunction of the peroneal muscles is associated with the underlying mechanisms of the CAI pathogenesis. However, the meta-analyses are limited by the inclusion of only two studies with small sample sizes. Therefore, these findings should be cautiously interpreted, and further research is required to validate them.

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有和没有慢性踝关节不稳的成年人腓骨肌的神经肌肉特征有何不同？荟萃分析的系统综述。

背景：慢性踝关节不稳定（CAI）与神经肌肉控制功能障碍有关，特别是腓骨肌肉。研究问题：与18-45岁的健康对照者相比，CAI患者腓肌的神经肌肉特征，包括皮质脊髓兴奋性、强度、本体感觉（力感）和肌电图测量有何不同？方法：从EBSCOhost （CINAHL Complete、AMED、SPORTDiscus）、Ovid （MEDLINE、Embase）、Web of Science、Scopus、Cochrane Library等电子数据库以及灰色文献源中检索相关文章，进行系统评价和meta分析。纳入的病例对照研究和横断面研究的合格性和方法学质量由两名审稿人评估。使用随机效应模型和95% %置信区间的标准均值差来计算总体效应大小的汇总估计。结果：在检索到的13,670项研究中，有42项纳入了系统评价。其中25人符合荟萃分析的条件。两项由两项研究组成的meta分析显示，在10 % （d=0.50, p = 0.03）和20 %的最大自主静力收缩（d=1.14, p ）时，前向力感觉准确性较低。意义：CAI患者在前向力感觉准确性和腓骨长肌潜伏期方面表现出特定的感觉运动障碍，这可能表明腓骨肌肉的神经肌肉功能障碍与CAI发病的潜在机制有关。然而，荟萃分析由于只纳入了两项小样本量的研究而受到限制。因此，这些发现应谨慎解释，并需要进一步的研究来验证。

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.