Changes in spinal and corticospinal excitability in patients with chronic ankle instability: a systematic review with meta-analysis

Kim, Kyung-Min; Kim, Joo-Sung; Cruz-Díaz, David; Ryu, Seungho; Kang, Minsoo; Taube, Wolfgang

doi:10.3390/jcm8071037

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Journal article

Changes in spinal and corticospinal excitability in patients with chronic ankle instability: a systematic review with meta-analysis

Kim, Kyung-Min Department of Kinesiology and Sport Sciences, University of Miami, USA
Kim, Joo-Sung Department of Kinesiology and Sport Sciences, University of Miami, USA
Cruz-Díaz, David Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Spain
Ryu, Seungho Health and Sport Analytics Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, USA
Kang, Minsoo Health and Sport Analytics Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, USA
Taube, Wolfgang Department of Neurosciences and Movement Sciences, University of Fribourg, Switzerland

2019

Published in:

Journal of Clinical Medicine. - 2019, vol. 8, no. 7, p. 1037

English The objective of this systematic review with meta-analysis was to determine alterations in spinal and corticospinal excitability of ankle muscles in patients with chronic ankle instability (CAI) compared to uninjured controls. Independent researchers performed comprehensive literature searches of electronic databases and included studies that compared groups with and without CAI and investigated neural excitability with Hoffmann reflex (H-reflex) and/or transcranial magnetic stimulation (TMS). A fixed-effect meta-analysis was conducted to determine group differences for (1) soleus and fibularis maximal H-reflex (Hmax)/maximal M-wave (Mmax)-ratios, and (2) soleus and fibularis longus cortical motor thresholds (CMTs). Seventeen studies were included in the current meta-analysis. They showed that the Hmax/Mmax-ratios of the soleus and the fibularis longus in the CAI group were significantly lower than those in the uninjured control group (soleus: d = −0.41, p < 0.001; fibularis longus: d = −0.27, p = 0.04). There was no evidence for changes in the CMT. This systematic review is the first to demonstrate evidence that patients with CAI present decreased spinal reflex excitability in the soleus and fibularis longus. However, there is no evidence of changes in supraspinal excitability when considering only the CMT. The latter result needs to be interpreted with caution as all except one study demonstrate some changes at the supraspinal level with CAI.

Faculty

Faculté des sciences et de médecine

Department

Département de Médecine

Language