Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 17 Jun 2025

Corticospinal Excitability during Standing and Its Association with Postural Control Following Acute Lateral Ankle Sprain.

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DOI: 10.4085/1062-6050-0541.24
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Context:

Individuals with acute lateral ankle sprain (ALAS) demonstrate balance deficits and altered neural excitability associated with acute injury symptoms. However, it is unknown whether corticospinal excitability is altered during standing after ALAS and which factors are associated with its neural change.

Objective:

To determine the alteration of corticospinal excitability during single-leg standing and its relationship with postural control and acute injury symptoms following ALAS

Design:

Case-Control Study.

Setting:

Research Laboratory.

Patients or Other Participants:

Fourteen individuals with ALAS and 14 uninjured matched controls participated.

Main Outcome Measure (s):

We measured the normalized motor evoked potential (MEP) in the fibularis longus using transcranial magnetic stimulation at 100%, 120%, and 140% of the active motor threshold (AMT) while maintaining a single-leg stance. Postural control during the same balance task was evaluated on a force plate by analyzing center-of-pressure (COP) parameters.

Results:

Individuals with ALAS showed a higher normalized MEP at AMT100% (29%, P = 0.019) and greater COP velocities (total: 23%, P = 0.030; anterior-posterior: 20%, P = 0.013) and COP area (29%, P = 0.031) during single-leg standing compared to uninjured controls. Further, correlation analyses revealed that a higher normalized MEP was not associated with acute injury symptoms (swelling: rs = 0.387, 23 pain: r = -0.084, P > 0.05) but moderately with a greater total COP velocity (rs = 0.543, P = 0.048).

Conclusions:

Following ALAS, corticospinal excitability in the fibularis longus is altered during a single-leg stance, and the level of excitability is associated with an increased rate of postural sways. These findings suggest a compensatory supraspinal mechanism for impaired postural control following ALAS. A future longitudinal study is warranted to determine whether these early neurobehavioral changes persist throughout the recovery period following the injury.

Keywords: acute injury; balance; neural adaptation; transcranial magnetic stimulation

Contributor Notes

Address for correspondence: Dr. Kyung-Min Kim, Department of Sport Science, Sungkyunkwan University, Suwon-si 16419, South Korea Tel: +82 31 299 6917 Email: km.kim@g.skku.edu

Joosung Kim, PhD, ATC Email: j_k145@txstate.edu

Arlette C. Perry,PhD Email: aperry@miami.edu

Kevin A. Jacobs, PhD Email: k.jacobs@miami.edu

Brian Arwari, PhD Email: b.arwari@umiami.edu

Soyeon Ahn, PhD Email: s.ahn@miami.edu

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