{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:14:35Z","timestamp":1790007275457,"version":"4.0.1"},"reference-count":60,"publisher":"National Athletic Trainers' Association","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Individuals with acute lateral ankle sprain (ALAS) demonstrate balance deficits and altered neural excitability associated with acute injury symptoms. However, it is unknown whether corticospinal excitability is altered during standing after ALAS and which factors are associated with neural change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate corticospinal excitability during single-legged standing and its relationship with postural control and acute injury symptoms after ALAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Case-control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Research laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>A total of 14 individuals with ALAS (age = 19.8 \u00b1 2.0 years, height = 171.9 \u00b1 8.2 cm, mass = 69.7 \u00b1 8.2 kg) and 14 uninjured matched controls (age = 20.7 \u00b1 2.3 years, 174.2 \u00b1 8.8 cm, mass = 69.5 \u00b1 14.9 kg) participated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>We measured the normalized motor-evoked potential (MEP) in the fibularis longus using transcranial magnetic stimulation at 100%, 120%, and 140% of the active motor threshold (AMT) while participants maintained a single-legged stance. Postural control was assessed using a 10-second single-legged stance immediately before transcranial magnetic stimulation testing. Center-of-pressure (COP) variables were recorded and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Individuals with ALAS demonstrated a trend toward facilitated corticospinal excitability of the fibularis longus during single-legged balance, with 64% (n = 9) of patients with ALAS exceeding the 95% CI upper limit for MEP at 100% of the AMT of the control group. Of the 4 patients with grade II ankle sprains, 75% (n = 3) exceeded this boundary for MEP at 100% of the AMT of the control group, and 100% (n = 4) exceeded the boundaries for all COP measures. Furthermore, correlation analyses revealed that a higher normalized MEP was associated with greater total COP velocity (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      = 0.543,\n                      <jats:italic>P<\/jats:italic>\n                      = .048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After ALAS, corticospinal excitability in the fibularis longus may have been facilitated during a single-legged stance, and the level of excitability tended to be associated with an increased rate of postural sway. The severity of ALAS appeared to influence both outcomes. These findings suggested a potential compensatory supraspinal mechanism for impaired postural control after ALAS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0541.24","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T08:37:37Z","timestamp":1750235857000},"page":"845-856","source":"Crossref","is-referenced-by-count":2,"title":["Corticospinal Excitability During Standing and Its Association With Postural Control After Acute Lateral Ankle Sprain"],"prefix":"10.4085","volume":"60","author":[{"given":"Joosung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Health and Human Performance, Texas State University, San Marcos"},{"name":"Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlette C.","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Educational and Psychological Studies, University of Miami, Coral Gables, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Arwari","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soyeon","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Educational and Psychological Studies, University of Miami, Coral Gables, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL"},{"name":"Department of Sport Science, Sungkyunkwan University, Suwon-si, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"6","key":"i1938-162X-60-12-845-b01","series-title":"J Athl Train","first-page":"603","article-title":"Epidemiology of ankle sprains and chronic ankle instability","volume":"54","author":"Herzog","year":"2019","unstructured":"Herzog MM,\nKerr ZY,\nMarshall SW,\nWikstrom EA. Epidemiology of ankle sprains and chronic ankle instability. J Athl Train. 2019;54(6):603\u2013610. doi:10.4085\/1062-6050-447-17"},{"issue":"7","key":"i1938-162X-60-12-845-b02","series-title":"Am J Sports Med","first-page":"1943","article-title":"One in three patients with chronic lateral ankle instability has a cartilage lesion","volume":"51","author":"Wijnhoud","year":"2023","unstructured":"Wijnhoud EJ,\nRikken QGH,\nDahmen J,\nSierevelt IN,\nStufkens SAS,\nKerkhoffs GMMJ. One in three patients with chronic lateral ankle instability has a cartilage lesion. Am J Sports Med. 2023;51(7):1943\u20131951. doi:10.1177\/03635465221084365"},{"issue":"4","key":"i1938-162X-60-12-845-b03","series-title":"Gait Posture","first-page":"407","article-title":"Bilateral balance impairments after lateral ankle trauma: a systematic review and meta-analysis","volume":"31","author":"Wikstrom","year":"2010","unstructured":"Wikstrom EA,\nNaik S,\nLodha N,\nCauraugh JH. Bilateral balance impairments after lateral ankle trauma: a systematic review and meta-analysis. Gait Posture. 2010;31(4):407\u2013414. doi:10.1016\/j.gaitpost.2010.02.004"},{"issue":"9","key":"i1938-162X-60-12-845-b04","series-title":"Medicina (Kaunas)","first-page":"1510","article-title":"Is there a difference in the distribution of mechanoreceptors among the three sections of the anterior talofibular ligament","volume":"59","author":"Lee","year":"2023","unstructured":"Lee Y,\nPark W,\nLee H, et al. Is there a difference in the distribution of mechanoreceptors among the three sections of the anterior talofibular ligament? Medicina (Kaunas). 2023;59(9):1510. doi:10.3390\/medicina59091510"},{"issue":"4","key":"i1938-162X-60-12-845-b05","series-title":"J Athl Train","first-page":"363","article-title":"Serial testing of postural control after acute lateral ankle sprain","volume":"36","author":"Hertel","year":"2001","unstructured":"Hertel J,\nBuckley WE,\nDenegar CR. Serial testing of postural control after acute lateral ankle sprain. J Athl Train. 2001;36(4):363\u2013368."},{"issue":"6","key":"i1938-162X-60-12-845-b06","series-title":"J Sport Rehabil","first-page":"717","article-title":"Arthrogenic muscle inhibition: best evidence, mechanisms, and theory for treating the unseen in clinical rehabilitation","volume":"31","author":"Norte","year":"2022","unstructured":"Norte G,\nRush J,\nSherman D. Arthrogenic muscle inhibition: best evidence, mechanisms, and theory for treating the unseen in clinical rehabilitation. J Sport Rehabil. 2022;31(6):717\u2013735. doi:10.1123\/jsr.2021-0139"},{"issue":"3","key":"i1938-162X-60-12-845-b07","series-title":"J Athl Train","first-page":"263","article-title":"Motor-neuron pool excitability of the lower leg muscles after acute lateral ankle sprain","volume":"46","author":"Klykken","year":"2011","unstructured":"Klykken LW,\nPietrosimone BG,\nKim KM,\nIngersoll CD,\nHertel J. Motor-neuron pool excitability of the lower leg muscles after acute lateral ankle sprain. J Athl Train. 2011;46(3):263\u2013269. doi:10.4085\/1062-6050-46.3.263"},{"issue":"4","key":"i1938-162X-60-12-845-b08","series-title":"J Sport Health Sci","first-page":"559","article-title":"Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control","volume":"13","author":"Kim","year":"2024","unstructured":"Kim KM,\nKim JS,\nNeedle AR. Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control. J Sport Health Sci. 2024;13(4):559\u2013568. doi:10.1016\/j.jshs.2024.02.005"},{"key":"i1938-162X-60-12-845-b09","series-title":"Front Hum Neurosci","first-page":"303","article-title":"In standing, corticospinal excitability is proportional to COP velocity whereas M1 excitability is participant-specific","volume":"12","author":"Nandi","year":"2018","unstructured":"Nandi T,\nLamoth CJC,\nvan Keeken HG, et al. In standing, corticospinal excitability is proportional to COP velocity whereas M1 excitability is participant-specific. Front Hum Neurosci. 2018;12:303. doi:10.3389\/fnhum.2018.00303"},{"issue":"1","key":"i1938-162X-60-12-845-b10","series-title":"J Sport Health Sci","first-page":"58","article-title":"Corticospinal activity during a single-leg stance in people with chronic ankle instability","volume":"11","author":"Terada","year":"2022","unstructured":"Terada M,\nKosik KB,\nMcCann RS,\nDrinkard C,\nGribble PA. 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Chronic ankle instability and corticomotor excitability of the fibularis longus muscle. J Athl Train. 2012;47(6):621\u2013626. doi:10.4085\/1062-6050-47.6.11"},{"issue":"8","key":"i1938-162X-60-12-845-b13","series-title":"J Athl Train","first-page":"847","article-title":"Chronic ankle instability and neural excitability of the lower extremity","volume":"50","author":"McLeod","year":"2015","unstructured":"McLeod MM,\nGribble PA,\nPietrosimone BG. Chronic ankle instability and neural excitability of the lower extremity. J Athl Train. 2015;50(8):847\u2013853. doi:10.4085\/1062-6050-50.4.06"},{"issue":"10","key":"i1938-162X-60-12-845-b14","series-title":"J Pain","first-page":"1680","article-title":"The effect of acute and sustained pain on corticomotor excitability: a systematic review and meta-analysis of group and individual level data","volume":"23","author":"Chowdhury","year":"2022","unstructured":"Chowdhury NS,\nChang WJ,\nMillard SK, et al. 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Front Hum Neurosci. 2018;12:68. doi:10.3389\/fnhum.2018.00068"},{"issue":"12","key":"i1938-162X-60-12-845-b29","series-title":"J Athl Train","first-page":"1187","article-title":"Neural-targeted rehabilitation strategies to address neuroplasticity after joint injury","volume":"59","author":"Needle","year":"2024","unstructured":"Needle AR,\nHoward JS,\nDowning MB,\nSkinner JW. Neural-targeted rehabilitation strategies to address neuroplasticity after joint injury. J Athl Train. 2024;59(12):1187\u20131196. doi:10.4085\/1062-6050-0215.23"},{"issue":"14","key":"i1938-162X-60-12-845-b30","series-title":"J Physiol","first-page":"2917","article-title":"Effect of movement-related pain on behaviour and corticospinal excitability changes associated with arm movement preparation","volume":"596","author":"Neige","year":"2018","unstructured":"Neige C,\nMavromatis N,\nGagn\u00e9 M,\nBouyer LJ,\nMercier C. 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One in three patients with chronic lateral ankle instability has a cartilage lesion. Am J Sports Med. 2023;51(7):1943\u20131951. doi:10.1177\/03635465221084365"},{"issue":"4","key":"i1938-162X-60-12-845-b03","series-title":"Gait Posture","first-page":"407","article-title":"Bilateral balance impairments after lateral ankle trauma: a systematic review and meta-analysis","volume":"31","author":"Wikstrom","year":"2010","unstructured":"Wikstrom EA,\nNaik S,\nLodha N,\nCauraugh JH. Bilateral balance impairments after lateral ankle trauma: a systematic review and meta-analysis. Gait Posture. 2010;31(4):407\u2013414. doi:10.1016\/j.gaitpost.2010.02.004"},{"issue":"9","key":"i1938-162X-60-12-845-b04","series-title":"Medicina (Kaunas)","first-page":"1510","article-title":"Is there a difference in the distribution of mechanoreceptors among the three sections of the anterior talofibular ligament","volume":"59","author":"Lee","year":"2023","unstructured":"Lee Y,\nPark W,\nLee H, et al. Is there a difference in the distribution of mechanoreceptors among the three sections of the anterior talofibular ligament? Medicina (Kaunas). 2023;59(9):1510. doi:10.3390\/medicina59091510"},{"issue":"4","key":"i1938-162X-60-12-845-b05","series-title":"J Athl Train","first-page":"363","article-title":"Serial testing of postural control after acute lateral ankle sprain","volume":"36","author":"Hertel","year":"2001","unstructured":"Hertel J,\nBuckley WE,\nDenegar CR. Serial testing of postural control after acute lateral ankle sprain. J Athl Train. 2001;36(4):363\u2013368."},{"issue":"6","key":"i1938-162X-60-12-845-b06","series-title":"J Sport Rehabil","first-page":"717","article-title":"Arthrogenic muscle inhibition: best evidence, mechanisms, and theory for treating the unseen in clinical rehabilitation","volume":"31","author":"Norte","year":"2022","unstructured":"Norte G,\nRush J,\nSherman D. Arthrogenic muscle inhibition: best evidence, mechanisms, and theory for treating the unseen in clinical rehabilitation. J Sport Rehabil. 2022;31(6):717\u2013735. doi:10.1123\/jsr.2021-0139"},{"issue":"3","key":"i1938-162X-60-12-845-b07","series-title":"J Athl Train","first-page":"263","article-title":"Motor-neuron pool excitability of the lower leg muscles after acute lateral ankle sprain","volume":"46","author":"Klykken","year":"2011","unstructured":"Klykken LW,\nPietrosimone BG,\nKim KM,\nIngersoll CD,\nHertel J. Motor-neuron pool excitability of the lower leg muscles after acute lateral ankle sprain. J Athl Train. 2011;46(3):263\u2013269. doi:10.4085\/1062-6050-46.3.263"},{"issue":"4","key":"i1938-162X-60-12-845-b08","series-title":"J Sport Health Sci","first-page":"559","article-title":"Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control","volume":"13","author":"Kim","year":"2024","unstructured":"Kim KM,\nKim JS,\nNeedle AR. Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control. J Sport Health Sci. 2024;13(4):559\u2013568. doi:10.1016\/j.jshs.2024.02.005"},{"key":"i1938-162X-60-12-845-b09","series-title":"Front Hum Neurosci","first-page":"303","article-title":"In standing, corticospinal excitability is proportional to COP velocity whereas M1 excitability is participant-specific","volume":"12","author":"Nandi","year":"2018","unstructured":"Nandi T,\nLamoth CJC,\nvan Keeken HG, et al. In standing, corticospinal excitability is proportional to COP velocity whereas M1 excitability is participant-specific. Front Hum Neurosci. 2018;12:303. doi:10.3389\/fnhum.2018.00303"},{"issue":"1","key":"i1938-162X-60-12-845-b10","series-title":"J Sport Health Sci","first-page":"58","article-title":"Corticospinal activity during a single-leg stance in people with chronic ankle instability","volume":"11","author":"Terada","year":"2022","unstructured":"Terada M,\nKosik KB,\nMcCann RS,\nDrinkard C,\nGribble PA. Corticospinal activity during a single-leg stance in people with chronic ankle instability. J Sport Health Sci. 2022;11(1):58\u201366. doi:10.1016\/j.jshs.2020.08.008"},{"issue":"3","key":"i1938-162X-60-12-845-b11","series-title":"Acta Physiol (Oxf)","first-page":"385","article-title":"An enhanced level of motor cortical excitability during the control of human standing","volume":"195","author":"Tokuno","year":"2009","unstructured":"Tokuno CD,\nTaube W,\nCresswell AG. 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