This study investigates the acute effects of single-leg squat exercises conducted under different attentional focus strategies (internal, external, and no focus) on plantar pressure distribution and posterior chain muscle activation in individuals with a history of unilateral ankle sprain. The study aims to determine whether external focus improves neuromuscular efficiency and postural control compared to internal or no attentional focus.
Unilateral ankle sprain is a common condition that compromises proprioception and neuromuscular control, often leading to chronic ankle instability. This randomized crossover trial examines the impact of attentional focus strategies during single-leg squats on surface electromyography (sEMG) activity of posterior chain muscles (gluteus medius, biceps femoris, lateral gastrocnemius, and peroneus) and plantar pressure parameters (COP path length and ellipse area) using pedobarographic analysis. Results may guide rehabilitation protocols by integrating cognitive-motor strategies for improved stability and performance.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Administration: Participants were instructed to focus on specific muscular or joint movements during single-leg squats (3 sets of 8 repetitions on the affected side, 1-minute rest between sets). Verbal cues included "contract your glutes" or "keep your knee aligned." Data Collected: Surface EMG (Gluteus Medius, Biceps Femoris, Lateral Gastrocnemius, Peroneus) and pedobarographic parameters.
Administration: Participants were instructed to focus on the environmental effects of single-leg squats (3 sets of 8 repetitions on the affected side, 1-minute rest between sets). Verbal cues included "push against the floor" or "drive your foot downward." Data Collected: Surface EMG (Gluteus Medius, Biceps Femoris, Lateral Gastrocnemius, Peroneus) and pedobarographic parameters.
Administration: Participants performed single-leg squats naturally without specific attentional instructions (3 sets of 8 repetitions on the affected side, 1-minute rest between sets). Data Collected: Surface EMG (Gluteus Medius, Biceps Femoris, Lateral Gastrocnemius, Peroneus) and pedobarographic parameters.
Gülhane Fizyoterapi ve Rehabilitasyon Fakültesi, Application Laboratory, Sağlık Bilimleri Üniversitesi
Ankara, Turkey (Türkiye)
Muscle Activation (%MVIC)
Measured via sEMG for Gluteus Medius, Biceps Femoris, Lateral Gastrocnemius, and Peroneus muscles during single-leg squats under each attentional focus condition.
Time frame: Immediately post-intervention in a single session.
Center of Pressure (COP) Path Length
Postural control was assessed immediately after each intervention using a pedobarographic platform. Participants stood barefoot on the affected leg for 30 seconds in a standardized posture (hands on hips, eyes open). The primary outcome in this measure is the COP path length, which represents the total displacement of the pressure center during the trial. Longer COP path lengths indicate greater postural instability. Data were sampled at 100 Hz and analyzed using standardized software to evaluate the immediate effects of attentional focus strategies on postural stability.
Time frame: Immediately post-intervention in a single session.
COP Ellipse Area
In the same testing conditions as described above, the COP ellipse area was measured. This reflects the 95% confidence area of sway, providing a spatial measure of postural control. Larger ellipse areas denote impaired balance and increased sway. This variable was computed using pedobarographic data sampled at 100 Hz and processed with standardized software.
Time frame: Immediately post-intervention, in a single session.
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