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Proactive and Reactive Mechanisms Play a Role in Stepping on Inverting Surfaces During Gait

¹Department of Rehabilitation Medicine, Radboud University of Nijmegen Medical Center; and ²Sint Maartenskliniek, SMK-Research, Nijmegen, The Netherlands

Submitted 22 November 2006; accepted in final form 19 August 2007

Ankle inversions have been studied extensively during standing conditions. However, inversion traumas occur during more dynamic conditions, like walking. Therefore in this study sudden ankle inversions were elicited in 12 healthy subjects who stepped on a trap door while walking on a treadmill. First, 10 control trials (0° of rotation) were presented. Then, 20 stimulus (25° of rotation) and control trials were presented randomly. EMG recordings were made of six lower leg muscles. All muscles showed a short-latency response (SLR) of about 40 ms and a late-latency response (LLR) of about 90 ms. The peroneal muscles showed the largest amplitudes in both responses. The functionally more important, larger, and more consistent LLR response was too late to resist the induced stretch during the inversion. The functional relevance of this response must lie after the inversion. During the first trial a widespread "startle-like" coactivation of the LLR was observed. The last trials showed only a recruitment of the peroneal muscles and, to a lesser extent, the gastrocnemius lateralis, which is seen as a switch from reactive control to more proactive adaptive strategies. These proactive strategies were investigated separately by comparing trials in which inversion was expected (but did not occur) with those in which subjects knew that no inversion would occur. Anticipation of a possible inversion was expressed in decreased tibialis anterior activity before initial contact, consistent with a more cautious and stable foot placement. Furthermore, immediately after landing, the peroneal muscles were activated to counteract the upcoming stretch.