Effects of chronic ankle instability on kinetics, kinematics and muscle activity during walking and running: A systematic review

The aim of this study is to systematically review and appraise studies assessing the effects of chronic ankle instability (CAI) on kinetics, kinematics and muscle activity during walking and running. The primary search was conducted in PubMed, Embase, CINAHL, AMED and SPORTDiscus. Only studies that compared participants with CAI with healthy participants and assessed kinetics, kinematics or muscle activity during walking or running were included. The risk of bias assessment was conducted using a modified version of the Quality Index checklist. A total of 509 articles were retrieved. After the title and abstract review, 34 articles underwent full-text review and risk of bias assessment. Following a complementary search and assessment of full manuscripts, 24 articles fulfilled all inclusion criteria and methodological requirements, of which 8 articles investigated muscle activity, 14 kinematics and 7 kinetics. During walking, participants with CAI presented increased ankle and rearfoot inversion, ankle plantarflexion, lateral foot vertical forces and peroneus longus muscle activity. During running, kinematic differences were similar to those during walking, but few studies quantified kinetics and muscle activity to draw sound conclusions. This systematic review reports new information on the effects of CAI on gait parameters since the last published review, especially with regard to muscle activity, kinematic and kinetic parameters during running. Methodological quality of the studies assessing kinetics during walking was found to be poor. Future studies should use standardized selection criteria when assessing participants with CAI to increase the external validity of the results.