Background: We aimed to synthesize the kinematics and kinetics during landing and walking/running tasks of ankle copers compared with patients with chronic ankle instability and controls.
Methods: We systematically searched PubMed, CINAHL, SPORTDiscus, and Web of Science. Tri-planar lower extremity biomechanics (joint angle and moment at maximum and initial contact, and joint displacement) were synthesized using standard mean difference and 95 % confidence intervals. We assessed methodological quality, study heterogeneity, and publication bias.
Findings: We identified 13 studies. Pooled evidence indicated that copers had less inversion and eversion angles, and ankle frontal displacement during landing compared with patients with chronic ankle instability (|standard mean difference| 0.31-0.40). Copers revealed greater dorsiflexion, plantarflexion, and ankle sagittal displacement during landing and less plantarflexion moment during walking than patients with chronic ankle instability (|standard mean difference| 0.29-0.46); however, most ankle biomechanics of copers were not significantly different from those of controls. In the proximal joints, copers revealed less knee valgus angle at maximum and initial contact (|standard mean difference| 0.25-0.33); and less hip flexion angle at maximum and initial contact, hip external rotation angle and sagittal and frontal displacement during landing (standard mean difference 0.49-0.73) than patients with chronic ankle instability. Copers had less hip extension moment during walking and greater maximum hip adduction angle during landing than controls (|standard mean difference| 0.66-0.77).
Interpretations: Our results provide insight into the lower extremity biomechanics of copers during dynamic tasks, contributing injury coping mechanisms and developing rehabilitation programs to return to sports.
Keywords: Ankle injury; Biomechanics; Chronic ankle instability; Lower extremity.
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