Differences in lower extremity kinematics and kinetics during a sidecutting task in patients with and without chronic ankle instability

Yue Xu^1,2Yizhang Mo^1,2Chengxiao Liu^1,2Haofan Chen^1,2Jianhao Zhao^1,2Wanxia Zhang³Yang Yu⁴Yulin Li⁵Lina Wang⁶Yingge Yuan⁷Zhongyue Sun⁸Guoxin Ni^7*Bin Song^1,2

• ¹Department of Joint Surgery and Sports Medicine, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
• ²Biomedical Innovation Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
• ³Guangxi College of Sports Education, Nanning, Guangxi Zhuang Region, China
• ⁴Anhui Professional & Technical Institute Of Athletics, Hefei, Anhui Province, China
• ⁵Beijing Sport University, Beijing, Beijing Municipality, China
• ⁶International Hospital, Peking University, Beijing, Beijing Municipality, China
• ⁷The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China
• ⁸Henan Vocational College of Nursing, Henan, China

AbstractBackground: Patients with chronic ankle instability (CAI) have demonstrated altered hip and knee movement strategies during walking and running, but these movement modalities do not involve changes in speed and direction, making it difficult to simulate the conditions of real sports, whereas side-cutting task can provide CAI patients with a more realistic athletic challenge. However, there is limited literature examining the kinematic and kinetic differences in the hip, knee, and ankle joints of CAI patients during the side-cutting task.Objective: To assess differences in lower extremity joint kinematics and kinetics during the side-cutting task in individuals with and without CAI.Design: Cross-sectional study.Participants: 48 males, 24 in each of the CAI group and healthy control group; 40 females, 20 in each of the CAI group and healthy control group.Methods: Lower extremity three-dimensional kinematic and kinetics data were evaluated by using a three-dimensional motion analysis system during the initial contact (IC) and toe off (TO) while side-cutting.Results: Compared with healthy controls, male patients with CAI exhibited greater hip flexion and external rotation angles, knee internal rotation angles, smaller knee flexion angles and ankle inversion angles, greater hip external rotation moments, and greater knee abduction moments; female patients with CAI exhibited smaller hip and knee flexion angles, greater hip external rotation angles, larger ankle inversion angles and internal rotation angles,, smaller hip external rotation moments, and greater knee abduction moments.Conclusion: Our findings indicate that patients with CAI exhibit altered lower limb joint kinematics and kinetics during side-cutting task, with significant sex-specific differences. These movement pattern changes involve proximal joint compensation to stabilize the unstable distal ankle joint; however, these compensatory changes are not always favorable. The greater hip external rotation moment and greater knee internal rotation angle demonstrated by male CAI patients, the smaller hip flexion angle and greater ankle internal rotation angle demonstrated by female CAI patients, and the smaller knee flexion angle and greater knee abduction moment common to both sexes may impair the lower limb's ability to effectively absorb and dissipate ground reaction forces, potentially elevating the risk of lower extremity injuries.