Altered postural modulation of Hoffmann reflex in the soleus and fibularis longus associated with chronic ankle instability

Our purpose was to assess Hoffmann (H) reflex modulations of the soleus and fibularis longus in three body positions (prone, bipedal and unipedal stances) in subjects with and without chronic ankle instability (CAI). Sixteen subjects with unilateral CAI and 15 healthy controls participated. Maximum H-reflexes and motor (M) waves were recorded bilaterally from the soleus and fibularis longus while subjects lied prone and then stood in quiet bipedal and unipedal stances. Maximum H-reflexes were normalized to maximum M waves to obtain Hmax:Mmax ratios for the three positions. H-reflex modulations, for each muscle, were quantified as the percent change scores in Hmax:Mmax ratios between each pair of positions: prone to bipedal, bipedal to unipedal, and prone to unipedal. There were significant group by limb interactions found for all three modulations (P < 0.05) for the soleus. In the CAI group, soleus modulations in involved limbs were significantly lower than in uninvolved limbs and both limbs in the controls. For the fibularis longus, similar results were found for the bipedal to unipedal and prone to unipedal modulations. Constrained ability of the sensorimotor system to down regulate H-reflex in more demanding postures may represent a potential mechanism of postural control deficits associated with CAI.