Changes in Motor Strategy and Neuromuscular Control During Balance Tasks in People with a Bimalleolar Ankle Fracture: A Preliminary and Exploratory Study

Autores de IDIVAL

• Francisco David Barbado Murillo

  Autor

• María Esther Laguna Bercero

  Autor

• Saray Lantaron Juarez

  Autor

Autores ajenos al IDIVAL

• Salas-Gomez, Diana
• Sanchez-Juan, Pascual
• Perez-Nunez, Maria Isabel
• Fernandez-Gorgojo, Mario

Unidades

• ENFERMEDADES ESQUELÉTICAS, METABÓLICAS Y AMBIENTALES (iESQUEMA)

  

  Investigador Responsable

  José Antonio Riancho Moral

Abstract

Ankle fractures can lead to issues such as limited dorsiflexion, strength deficits, swelling, stiffness, balance disorders, and functional limitations, which complicate daily activities. This study aimed to describe neuromuscular adaptations at 6 and 12 months post-surgery during static and dynamic balance tasks, specifically using the Y-Balance Test (YBT). Additionally, the relationship between neuromuscular patterns, balance, and musculoskeletal deficits was evaluated. In 21 participants (14 at 6 months and 21 at 12 months) with bimalleolar fractures, hip strength, ankle dorsiflexion, ankle functionality, and static and dynamic balance were assessed using electromyography of five lower limb muscles (tibialis anterior, peroneus longus, lateral gastrocnemius, biceps femoris, and gluteus medius). A significant interaction effect (limb x proximal [hip]-distal [ankle] muscle) (F = 30.806, p < 0.001) was observed in the anterior direction of the Y-Balance Test (YBTA) at 6 months post-surgery. During the YBT(A )and YBT posteromedial (YBTPM), it was found that a lower dorsiflexion range of movement was associated specifically at 6 months with greater activation of the lateral gastrocnemius. However, these differences tended to diminish by 12 months. These findings suggest that neuromuscular patterns differ between operated and non-operated limbs during the YBT(A )at 6 months post-surgery. The Y-Balance Test, particularly its anterior direction, effectively highlighted these neuromuscular changes. This is a preliminary study; further research is needed to explore these findings in depth.

Keywords

• dynamic balance, electromyography, lower limb biomechanics, motor strategy, postural control