Ankle muscles activation and postural stability with Star Excursion Balance Test in healthy individuals

Introduction: The ankle joint, a part of the kinetic chain of the lower limb, plays a significant role in the maintenance of postural stability during bipedal and unipedal balancing activities. This study aimed to evaluate the neuromuscular control of the ankle joint and the postural stability while executing the Star Excursion Balance Test (SEBT), by recording the EMG activity of the extrinsic ankle musculature and the displacement of the center of pressure (CoP).

Methods: The EMG activity of the tibialis anterior (TA), the peroneus brevis (PB) and the medial and lateral gastrocnemius (GM, GL), along with the anteroposterior and mediolateral displacements (APd and MLd) of CoP as well as the plantar pressure distribution of the supportive lower limb were recorded during reaching to the eight directions of SEBT in 29 healthy, physically active college students (15 males and 14 females; mean ± SD of age 25.6 ± 4.5 yrs.; height: 172.5 ± 8.2 cm; body weight: 67.7 ± 13.6 kg; and BMI: 22.6 ± 2.9 kg/m²).

Results: The tibialis anterior muscle demonstrated the greatest EMG activity during SEBT, followed by the PB, GL and GM muscles. The increased EMG activity of TA and PB during the execution of all posterior-oriented and lateral directions coincided with a decreased APd of CoP and increased reaching distances. The opposite occurred during the execution of all the anterior-oriented and medial directions. The differences among the directions of SEBT regarding the EMG activity of GL, GM and the mediolateral displacement of CoP were, in general, not significant.

Conclusions: The neuromuscular control of the ankle joint and the associated postural stability during SEBT was highly depended upon the activation level of TA and PB, which should be considered by clinicians and sports specialists when using this test for screening and/or rehabilitation purposes.