Gluteus medius dysfunction in females with chronic ankle instability is consistent at different walking speeds

Patients with chronic ankle instability often present with altered gait mechanics compared to ankle sprain copers. There is increasing evidence to suggest proximal neuromuscular alterations contribute to the injury etiology, however little is known about how these changes manifest during gait. The purpose of this study was to investigate ipsilateral gluteus maximus and medius functional activity ratios throughout treadmill walking at three speeds (preferred, 120% preferred, and 1.35 m per second) in chronic ankle instability patients compared to copers.

28 females (14 chronic ankle instability, 14 copers) walked at the three gait speeds in randomized order. Ground reaction forces and 10-s gluteal ultrasound clips were simultaneously recorded. Clips were reduced using ground reaction forces to extract 55 measurement frames. Normalized gluteal thickness measures were used to determine functional activity ratios. 2 × 3 analyses of variance were run to assess group and speed effects on gluteal outcomes throughout walking using statistical parametric mapping. Post-hoc t-tests, mean differences, and Cohen's d effect sizes were assessed for significant findings (P ≤ .05).

The chronic ankle instability group had significantly decreased gluteus medius activity throughout the entire gait cycle when compared to the coper group, independent of gait speed (P < .001, mean differences: 0.10-0.18; d: 1.00-3.17). There were no significant group or speed main effects, nor an interaction for gluteus maximus activity.

Gluteal dysfunction throughout walking was identified in chronic ankle instability. The coper group remained within healthy reference muscle activity ranges, suggesting that proximal muscle activation alterations are associated chronic ankle impairments.