ORIGINAL RESEARCH article
Front. Sports Act. Living
Sec. Injury Prevention and Rehabilitation
This article is part of the Research TopicLateral Ankle Sprain, Chronic Ankle Instability and Ankle Osteoarthritis: Unraveling Mechanisms and Exploring Management ApproachesView all 15 articles
Effects of Stochastic Resonance on Reflexive and Perceptual Outcomes in Chronic Ankle Instability
Provisionally accepted
Annalee MH Friedman1*
Leif P Madsen2- 1Indiana State University, Terre Haute, United States
- 2Indiana University, Bloomington, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abnormal lower-limb cutaneous reflex characteristics following stimulation during gait have been observed among those with chronic ankle instability (CAI), which have been linked to perceptions of instability. These outcomes have the potential to serve as biomarkers of CAI or functional measures of sensorimotor recovery following lateral ankle sprain or clinical rehabilitation. However, no studies, to date, have identified a targeted intervention to regulate cutaneous reflexes in this population. Therefore, the purpose of this study was to explore the effects of stochastic resonance (SR) on lower-limb cutaneous reflexes and perceived instability during gait in those with CAI and healthy controls. Participants walked on a treadmill at 4km/hr while receiving random, non-noxious sural nerve stimulations throughout the stance phases of gait, reporting their perceived instability following each stimulation on an 11-point numeric rating scale. Mixed-factor ANOVAs were used to determine if a subthreshold stimulation applied to the ankle via an SR device affected ipsilateral lower leg reflexes and perceptions of ankle instability between groups. Results indicate that the CAI group exhibited elevated PL facilitation and gastrocnemius reflex variability during midstance as well as increased perceptions of instability following sural stimulation. SR may enhance consistency of cutaneous reflexes and reduce perceptions of instability following sural stimulation among those with CAI, indicating this intervention should be explored in a clinical setting as an accessible intervention to improve sensorimotor and patient-reported outcomes.
Keywords: Chronic ankle instability, Lateral ankle sprain, cutaneous reflexes, stochastic resonance, suralnerve stimulation
Received: 18 Aug 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Friedman and Madsen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Annalee MH Friedman, annalee.friedman@indstate.edu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.