Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 4, pp 1060–1070 | Cite as

Surface electromyography and plantar pressure during walking in young adults with chronic ankle instability

  • Rachel M. KoldenhovenEmail author
  • Mark A. Feger
  • John J. Fraser
  • Susan Saliba
  • Jay Hertel



Lateral ankle sprains are common and can manifest into chronic ankle instability (CAI) resulting in altered gait mechanics that may lead to subsequent ankle sprains. Our purpose was to simultaneously analyse muscle activation patterns and plantar pressure distribution during walking in young adults with and without CAI.


Seventeen CAI and 17 healthy subjects walked on a treadmill at 4.8 km/h. Plantar pressure measures (pressure–time integral, peak pressure, time to peak pressure, contact area, contact time) of the entire foot and nine specific foot regions and medial–lateral location of centre of pressure (COP) were measured. Surface electromyography (EMG) root mean square (RMS) amplitudes throughout the entire stride cycle and area under RMS curve for 100 ms pre-initial contact (IC) and 200 ms post-IC for anterior tibialis, peroneus longus, medial gastrocnemius, and gluteus medius were collected.


The CAI group demonstrated a more lateral COP throughout the stance phase (P < 0.001 and Cohen’s d > 0.9 for all 10 comparisons) and significantly increased peak pressure (P = 0.025) and pressure–time integral (P = 0.049) under the lateral forefoot. The CAI group had lower anterior tibialis RMS areas (P < 0.001) and significantly higher peroneus longus, medial gastrocnemius, and gluteus medius RMS areas during 100 ms pre-IC (P < 0.003). The CAI group had higher gluteus medius sEMG amplitudes during the final 50 % of stance and first 25 % of swing (P < 0.05).


The CAI group had large lateral deviations of their COP location throughout the entire stance phase and increased gluteus medius muscle activation amplitude during late stance through early swing phase.

Level of evidence



Ankle sprain Gait Muscle activation Gluteus medius Peroneus longus 



The study protocol was approved by the University of Virginia Institutional Review Board in compliance with all applicable federal regulations governing the protection of human subjects.

Compliance with ethical standards

Conflict of interest


Disclosure statement

The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US Government. Lieutenant Commander John J. Fraser is a military service member, and this work was prepared as part of his official duties. Title 17, USC, §105 provides that ‘Copyright protection under this title is not available for any work of the US Government’. Title 17, USC, §101 defines the US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016

Authors and Affiliations

  • Rachel M. Koldenhoven
    • 1
    • 3
    Email author
  • Mark A. Feger
    • 1
  • John J. Fraser
    • 1
    • 2
  • Susan Saliba
    • 1
  • Jay Hertel
    • 1
  1. 1.Department of KinesiologyUniversity of VirginiaCharlottesvilleUSA
  2. 2.US Navy Medicine Professional Development CenterBethesdaUSA
  3. 3.Memorial GymnasiumCharlottesvilleUSA

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