Effects of Real-Time Video Feedback on Plantar Pressure Measures in Individuals With Chronic Ankle Instability During Walking

in International Journal of Athletic Therapy and Training
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Individuals with chronic ankle instability (CAI) have been shown to have increased lateral plantar pressure during walking which is thought to contribute to symptoms associated with CAI. The objective of this study was to determine whether real-time video feedback can reduce lateral plantar pressure in individuals with CAI. Twenty-six participants with CAI completed 30 s of treadmill walking while plantar pressure was measured using an in-shoe plantar pressure system (baseline). Next, participants completed an additional 30 s of treadmill walking while receiving video feedback (VID FB). During the VID FB condition, participants had a significant decrease in medial forefoot peak pressure and medial midfoot pressure-time integral; however, both changes were associated with small effect sizes. Real-time video feedback did not reduce lateral plantar pressure in individuals with CAI; therefore, other gait retraining strategies should be considered when treating patients with CAI.

Ifarraguerri, Torp, Thomas, and Donovan are with the University of North Carolina at Charlotte, Charlotte, NC.

Donovan (ldonova2@uncc.edu) is corresponding author.
  • 1.

    Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wickstrom EA. The epidemiology of lateral ligament complex ankle sprains in National Collegiate Athletic Association Sports. Am J Sports Med. 2017;45(1):201–209. PubMed ID: 27573356 doi:10.1177/0363546516660980

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ Jr. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am. 2010;92(13):2279–2284. PubMed ID: 20926721 doi:10.2106/JBJS.I.01537

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: A prospective cohort analysis. Am J Sports Med. 2016;44(4):995–1003. PubMed ID: 26912285 doi:10.1177/0363546516628870

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37(4):364–375. PubMed ID: 12937557

  • 5.

    Drewes LK, McKeon PO, Paolini G, et al. Altered ankle kinematics and shank-rear-foot coupling in those with chronic ankle instability. J Sport Rehabil. 2009;18(3):375–388. PubMed ID: 19827501 doi:10.1123/jsr.18.3.375

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Delahunt E, Monaghan K, Caulfield B. Changes in lower limb kinematics, kinetics, and muscle activity in subjects with functional instability of the ankle joint during a single leg drop jump. J Orthop Res. 2006;24(10):1991–2000. PubMed ID: 16894592 doi:10.1002/jor.20235

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Delahunt E, Monaghan K, Caulfield B. Altered neuromuscular control and ankle joint kinematics during walking in subjects with functional instability of the ankle joint. Am J Sports Med. 2006;34(12):1970–1976. PubMed ID: 16926342 doi:10.1177/0363546506290989

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Brown C. Foot clearance in walking and running in individuals with ankle instability. Am J Sports Med. 2011;39(8):1769–1777. PubMed ID: 21685315 doi:10.1177/0363546511408872

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Monaghan K, Delahunt E, Caulfield B. Ankle function during gait in patients with chronic ankle instability compared to controls. Clin Biomech. 2006;21(2):168–174. doi:10.1016/j.clinbiomech.2005.09.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Nawata K, Nishihara S, Hayashi I, Teshima R. Plantar pressure distribution during gait in athletes with functional instability of the ankle joint: preliminary report. J Orthop Sci. 2005;10(3):298–301. PubMed ID: 15928893 doi:10.1007/s00776-005-0898-4

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Huang PY, Lin CF, Kuo LC, Liao JC. Foot pressure and center of pressure in athletes with ankle instability during lateral shuffling and running gait. Scand J Med Sci Sports. 2011;21(6):e461–e467. PubMed ID: 22092510 doi:10.1111/j.1600-0838.2011.01367.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Koldenhoven RM, Feger MA, Fraser JJ, Hertel J. Variability in center of pressure position and muscle activation during walking with chronic ankle instability. J Electromyogr Kinesiol. 2018;38:155–161. PubMed ID: 29294449 doi:10.1016/j.jelekin.2017.12.003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Koldenhoven RM, Feger MA, Fraser JJ, Saliba S, Hertel J. Surface electromyography and plantar pressure during walking in young adults with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc. 2016;24(4):1060–1070. PubMed ID: 26856315 doi:10.1007/s00167-016-4015-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Donovan L, Feger MA, Hart JM, Saliba S, Park J, Hertel J. Effects of an auditory biofeedback device on plantar pressure in patients with chronic ankle instability. Gait Posture. 2016;44:29–36. PubMed ID: 27004629 doi:10.1016/j.gaitpost.2015.10.013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Willems T, Witvrouw E, Delbaere K, De Cock A, De Clercq D. Relationship between gait biomechanics and inversion sprains: a prospective study of risk factors. Gait Posture. 2005;21(4):379–387. PubMed ID: 15886127 doi:10.1016/j.gaitpost.2004.04.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Valderrabano V, Hintermann B, Horisberger M, Fung TS. Ligamentous posttraumatic ankle osteoarthritis. Am J Sports Med. 2006;34(4):612–620. PubMed ID: 16303875 doi:10.1177/0363546505281813

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Barrios JA, Crossley KM, Davis IS. Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment. J Biomech. 2010;43(11):2208–2213. PubMed ID: 20452595 doi:10.1016/j.jbiomech.2010.03.040

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011;45(9):691–696. PubMed ID: 20584755 doi:10.1136/bjsm.2009.069112

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Gribble PA, Delahunt E, Bleakley C, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med. 2014;48(13):1014–1018. PubMed ID: 24255768 doi:10.1136/bjsports-2013-093175

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Feger MA, Hart JM, Saliba S, Abel MF, Hertel J. Gait training for chronic ankle instability improves neuromechanics during walking. J Orthop Res. 2018;36(1):515–524. PubMed ID: 28653780

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Feger MA, Hertel J. Surface electromyography and plantar pressure changes with novel gait training device in participants with chronic ankle instability. Clin Biomech. 2016;37(suppl C):117–124. doi:10.1016/j.clinbiomech.2016.07.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Marcus A, Sinnott B, Bradley S, Grey I. Treatment of idiopathic toe-walking in children with autism using GaitSpot Auditory Speakers and simplified habit reversal. Res Autism Spect Dis. 2010;4(2):260–267. doi:10.1016/j.rasd.2009.09.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Vaz S, Falkmer T, Passmore AE, Parsons R, Andreou P. The case for using the repeatability coefficient when calculating test–retest reliability. PLoS ONE. 2013;8(9):e73990. PubMed ID: 24040139 doi:10.1371/journal.pone.0073990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Putti AB, Arnold GP, Cochrane L, Abboud RJ. The Pedar in-shoe system: repeatability and normal pressure values. Gait Posture. 2007;25(3):401–405. PubMed ID: 16828288 doi:10.1016/j.gaitpost.2006.05.010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    van Gelder LM, Barnes A, Wheat JS, Heller BW. The use of biofeedback for gait retraining: a mapping review. Clin Biomech. 2018;59:159–166. doi:10.1016/j.clinbiomech.2018.09.020

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Stoltenberg BE, Miller EM, Dolbeer JA, Pickens BW. Validity of an instrumented sock and on-shoe sensor to provide biometric feedback to runners. Footwear Science. 2019;1–6.

    • Search Google Scholar
    • Export Citation
  • 27.

    Torp DM, Thomas AC, Donovan L. External feedback during walking improves measures of plantar pressure in individuals with chronic ankle instability. Gait Posture. 2019;67:236–241. PubMed ID: 30380508 doi:10.1016/j.gaitpost.2018.10.023

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Schmidt H, Sauer LD, Lee SY, Saliba S, Hertel J. Increased in-shoe lateral plantar pressures with chronic ankle instability. Foot Ankle Int. 2011;32(11):1075–1080. PubMed ID: 22338958 doi:10.3113/FAI.2011.1075

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Morrison KE, Hudson DJ, Davis IS, et al. Plantar pressure during running in subjects with chronic ankle instability. Foot Ankle Int. 2010;31(11):994–1000. PubMed ID: 21189193 doi:10.3113/FAI.2010.0994

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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