title: Eversion Strength and Surface Electromyography Measures With and Without Chronic Ankle Instability Measured in 2 Positions.
abstract: BACKGROUND
  Individuals with chronic ankle instability (CAI) have demonstrated strength deficits compared to healthy controls; however, the influence of ankle position on force measures and surface electromyography (sEMG) activation of the peroneus longus and brevis has not been investigated. The purpose of this study was to compare sEMG amplitudes of the peroneus longus and brevis and eversion force measures in 2 testing positions, neutral and plantarflexion, in groups with and without CAI.
  
  
  METHODS
  Twenty-eight adults (19 females, 9 males) with CAI and 28 healthy controls (19 females, 9 males) participated. Hand-held dynamometer force measures were assessed during isometric eversion contractions in 2 testing positions (neutral, plantarflexion) while surface sEMG amplitudes of the peroneal muscles were recorded. Force measures were normalized to body mass, and sEMG amplitudes were normalized to a resting period.
  
  
  RESULTS
  The group with CAI demonstrated less force when compared to the control group ( P < .001) in both the neutral and plantarflexion positions: neutral position, CAI: 1.64 Nm/kg and control: 2.10 Nm/kg) and plantarflexion position, CAI: 1.40 Nm/kg and control: 1.73 Nm/kg). There were no differences in sEMG amplitudes between the groups or muscles ( P > .05). Force measures correlated with both muscles' sEMG amplitudes in the healthy group (neutral peroneus longus: r = 0.42, P = .03; plantarflexion peroneus longus: r = 0.56, P = .002; neutral peroneus brevis: r = 0.38, P = .05; plantarflexion peroneus longus: r = 0.40, P = .04), but not in the group with CAI ( P > .05).
  
  
  CONCLUSIONS
  The group with CAI generated less force when compared to the control group during both testing positions. There was no selective activation of the peroneal muscles with testing in both positions, and force output and sEMG activity was only related in the healthy group.
  
  
  CONCLUSIONS
  Clinicians should assess eversion strength and implement strength training exercises in different sagittal plane positions and evaluate for other pathologies that may contribute to reduced eversion strength in patients with CAI.
  
  
  METHODS
  Level III, cross-sectional.
authors.affiliation: 1 Department of Kinesiology, University of Virginia, Charlottesville, VA, USA.
authors.forename: Lindsy
authors.initials: L
authors.lastname: Donnelly
authors.affiliation: 2 Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, USA.
authors.forename: Luke
authors.initials: L
authors.lastname: Donovan
authors.affiliation: 3 Department of Kinesiology and Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Hart
authors.affiliation: 3 Department of Kinesiology and Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Hertel
mesh_terms: D000842:Ankle / Q000502:physiology*; D000843:Ankle Joint / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004576:Electromyography / Q000379:methods*; D005081:Exercise Therapy; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D016138:Walking / Q000502:physiology*
keywords: ankle sprains; handheld dynamometry; manual muscle testing; peroneus brevis; peroneus longus