Attentional Demands of Postural Control in Chronic Ankle Instability, Copers and Healthy Controls: A Controlled Cross-sectional Study

Somayeh Mohamadi; Ismail Ebrahimi; Mahyar Salavati; Mehdi Dadgoo; Amir Salar Jafarpisheh; Zahra Sadat Rezaeian

doi:10.1016/j.gaitpost.2020.03.007

Attentional Demands of Postural Control in Chronic Ankle Instability, Copers and Healthy Controls: A Controlled Cross-sectional Study

Gait Posture. 2020 Jun:79:183-188. doi: 10.1016/j.gaitpost.2020.03.007. Epub 2020 Apr 25.

Authors

Somayeh Mohamadi¹, Ismail Ebrahimi², Mahyar Salavati³, Mehdi Dadgoo⁴, Amir Salar Jafarpisheh⁵, Zahra Sadat Rezaeian⁶

Affiliations

¹ Department of Physiotherapy, Iran University of Medical Sciences, 13487-15459, Tehran, Iran. Electronic address: mohammadi.so@tak.iums.ac.ir.
² Department of Physiotherapy, Iran University of Medical Sciences, Tehran, Iran. Electronic address: ebrahimitakamjani.e@iums.ac.ir.
³ Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Electronic address: mahyarsalavati@gmail.com.
⁴ Department of Physiotherapy, Iran University of Medical Sciences, 13487-15459, Tehran, Iran. Electronic address: dadgoo.m@iums.ac.ir.
⁵ Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Electronic address: Jafarpisheh@gmail.com.
⁶ Department of Physiotherapy, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: zrezaeian@rehab.mui.ac.ir.

PMID: 32422558
DOI: 10.1016/j.gaitpost.2020.03.007

Abstract

Background: It has been shown that cognitive loading affects postural control in different populations. However, there is limited and conflicting information about dual task challenges on postural control in chronic ankle instability (CAI).

Research question: Does cognitive task performance change standing postural control in individuals with CAI, copers and healthy subjects?

Methods: A descriptive, analytic, and controlled cross-sectional study was conducted on 75 individuals. They were assigned into three matched groups, including CAI, copers, and healthy controls. Postural control variables were collected during single leg standing on a force plate with and without vision and cognition. Parameters of center of pressure (COP), including mean COP area, range, sway index and velocity, were measured. Additionally, cognitive task performance by auditory stroop was assessed by calculating the reaction time and error ratio. Mixed model ANOVAs were used to determine the effects of group and testing conditions.

Results: The CAI group demonstrated greater COP sway parameters compared to other groups under all testing conditions. The main significant effect of vision was observed for all COP parameters with greater COP sway during eyes closed compared to eyes open (P < 0.05). The main effect of a cognitive task was significant with reduced COP sway while performing the secondary cognitive compared to a single task in all three groups (P < 0.05). The cognitive task results revealed significantly longer reaction times in the CAI group compared to copers and healthy individuals (p < 0.05).

Significance: Considering postural control deficits in CAI, especially in eye-closed condition and effects of cognitive loading, may guide us to improve postural control in those with CAI with neurocognitive training. Furthermore, no difference between coper and healthy groups may imply a successful compensatory postural control mechanism in copers.

Keywords: Chronic ankle instability; Cognitive task; Dual task; Postural control; Sprain; Stroop.

MeSH terms

Adult
Ankle Joint*
Case-Control Studies
Cognition
Cross-Sectional Studies
Female
Humans
Joint Instability / physiopathology*
Joint Instability / rehabilitation
Male
Postural Balance*
Surveys and Questionnaires
Task Performance and Analysis