Effects of rehabilitation on joint-coupling in patients with chronic ankle instability.

Chronic ankle instability (CAI) is associated with kinematic changes in the lower extremity. Alterations in joint-coupling have been identified during gait in patients with CAI. Rehabilitation remains the gold-standard for clinical treatment of CAI but little is known on the effects of rehabilitation on joint-coupling variability. Wearable destabilisation devices have shown an increase in muscle activity during functional tasks and may be useful in rehabilitation. The purpose of this study is to analyse the joint-coupling variability during gait prior to and following a rehabilitation programme performed with and without destabilisation devices. Twenty-six individuals with CAI were randomly assigned to receive 4 weeks of comprehensive rehabilitation with or without destabilisation devices. A 3D motion capture system was used to collect kinematics during walking. A vector-coding analysis was used to assess the joint-coupling variability of knee and hip motion to ankle motion. The destabilisation device group had decreases in joint-coupling variability during periods of walking gait. This decrease in joint-coupling variability may represent a change in sensorimotor organisation following rehabilitation. This decrease is indicative of an adaptation to the rehabilitation using destabilisation devices and may indicate an improvement in sensorimotor function.