Ankle Proprioception Assessed in Landing: The Effects of Height, Strategy and Gender

Objectives: To investigate the effects of landing height, descent strategy, and gender on ankle proprioception, and to explore the correlation between ankle proprioception performance, landing height, and step-off/drop-off descent strategy. Design: Cross-sectional study. Methods: Thirty-four participants (21 males and 13 females) volunteered. Ankle proprioception was assessed by a customized ankle inversion discrimination apparatus for landing (AIDAL) under different descent strategies (step-off vs. drop-off) and with two landing heights (15 cm vs. 30 cm). Area under the receiver operating curve (AUC) was employed as the ankle proprioceptive discrimination score. Three-way repeated measure analysis of variance (RM-ANOVA) was used to examine the main effects of landing height, strategy, and gender, and interactions. Pearson's correlation analysis was used to investigate correlations between ankle proprioception and landing conditions. Results: Three-way RM-ANOVA revealed a main effect of landing height on ankle proprioception (i.e. 15 cm vs. 30 cm) (F = 6.090, p = 0.019, η_p² = 0.160), while there was neither a main effect of descent strategy (F = 1.727, p = 0.198, η_p² = 0.051), or gender (F = 0.016, p = 0.898, η_p² = 0.001), nor any interactions (p = 0.100-0.932). Pearson's correlation analysis indicated that at two different landing heights, ankle proprioception AUC scores with the same descent strategy had moderate correlations (Pearson's r = 0.400-0.430, p = 0.012-0.031), but there was no significant correlation between the two different landing strategies (r = 0.110-0.250, p > 0.050). Conclusion: Altered descent strategy for landing did not significantly affect ankle proprioception, whereas increased landing heights were associated with worse ankle proprioception performance. Ankle proprioception performance in landing showed significant correlations between different heights, but not between strategies. There was no gender difference observed across all landing conditions. The current findings may inform task-specific training, injury prevention, and the design of proprioception assessments based on different testing circumstances.