{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:09:00Z","timestamp":1790885340949,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Chronic ankle instability (CAI) is associated with alterations in lower limb biomechanics. However, little is known about the knee\u2013ankle joint coordination characteristics in individuals with CAI. This study aimed to investigate sagittal plane kinematic differences and knee\u2013ankle coordination strategies in football players with CAI under different locomotor load conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty male football players (CAI:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920; control:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) completed low\u2010load (walking: mean 3.76\u2009km\/h, 3.2\u20134.8\u2009km\/h) and high\u2010load (running: mean 14.33\u2009km\/h, 12.2\u201316.8\u2009km\/h) treadmill tasks. A 3D motion capture system was used to record knee and ankle kinematics. Statistical Parametric Mapping (SPM) was used to analyse group and speed effects. Vector coding (VC) was applied to quantify knee\u2013ankle coordination patterns, categorised into four coupling modes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with healthy controls, participants with CAI showed significantly reduced ankle dorsiflexion during running at 22%\u201342% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, \u20134.9\u00b0 to \u201311.3\u00b0) and 75%\u2013100% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, \u20135.2\u00b0 to \u20137.0%) of the gait cycle. Knee flexion was significantly reduced across the entire running cycle (0%\u2013100%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, \u201312.3\u00b0 to \u201333.4\u00b0). VC analysis revealed particularly transitions toward proximal\u2010dominant strategies, such as at 43%\u201346% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic>\u0394<\/jats:italic>\n                      \u2009=\u2009154.46\u00b0) and 62%\u201363% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008,\n                      <jats:italic>\u0394<\/jats:italic>\n                      \u2009=\u20099.39\u00b0), indicating increased reliance on knee control. Moreover, at 47%\u201349%, a rigid coupling state was maintained (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003,\n                      <jats:italic>\u0394<\/jats:italic>\n                      \u2009=\u2009170.19\u00b0), while 69%\u201375% of the gait cycle saw a reemergence of distal\u2010dominant control during swing (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025\u2013\u2009&lt;\u20090.001,\n                      <jats:italic>\u0394<\/jats:italic>\n                      \u2009=\u200924.06\u00b0\u201348.45\u00b0).\n                      <jats:italic>Note<\/jats:italic>\n                      :\n                      <jats:italic>\u0394<\/jats:italic>\n                      refers to the mean difference between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study revealed significant differences in knee\u2013ankle joint coordination between CAI patients and healthy controls. The findings suggest that CAI\u2010related motor control adaptations are load\u2010dependent and follow a distal\u2010to\u2010proximal compensatory strategy. These results highlight the importance of incorporating inter\u2010joint coordination retraining into rehabilitation, particularly under high\u2010load locomotor scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70443","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:48:17Z","timestamp":1760557697000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Proximal\u2010dominant knee\u2013ankle coordination compensations in football players with chronic ankle instability under high load"],"prefix":"10.1002","volume":"12","author":[{"given":"Minghua","family":"Xian","sequence":"first","affiliation":[{"name":"School of Public Health Shantou University Shantou Guangdong 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