Open Access
Volume 8, 2022
Article Number 22
Number of page(s) 6
Section Ankle
Published online 26 May 2022

© The Authors, published by EDP Sciences, 2022

Licence Creative CommonsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


One of the most common single types of acute sports trauma that accounts for 14% of all visits to the emergency room is the ligamentous sprain injury which is followed by a significant socioeconomic cost as well [14]. Among the ligamentous sprain injuries, lateral ankle sprains are most commonly encountered during athletic or occasional daily activities [514]. It is reported that almost 70% of the general population have incurred an ankle injury during their lifetime [15, 16]. The most common ankle injury is the one that combines rapid inversion and internal rotation of the foot with a subsequent injury to the lateral ligaments of the ankle [1, 1618]. Although this injury is usually assumed to be benign, a group of patients will develop recurrent sprains and chronic ankle instability [9, 19, 20]. The peroneal muscles seem to play a preventive role in the lateral ankle sprain by preventing excessive inversion [3, 2124].

Furthermore, various risk factors for ankle sprains have been described and classified. One of these classifications divides them into extrinsic and intrinsic. As extrinsic risk factors are defined as those that come from outside of the body, while intrinsic factors are those from within the body, such as height, weight, and gender [3, 25, 26]. Most proposed risk factors remain controversial [26], while different conclusions are reported [9, 20, 21, 27, 28].

One way to approach the protective action of the peroneal muscles is to assess their response by measuring their electromechanical delay (EMD) [22]. EMD is defined as the time interval from the stimulation of a muscle by the alpha motoneuron to the first detected movement this muscle produces at a given joint [29]. It has been reported that the quantification of peroneus longus EMD can be used to assess ankle instability, which has been verified to be sensitive to musculotendinous stiffness at the ankle [3032]. EMD of the peroneal muscles can be affected by many factors, including fatigue [33, 34].

Considering that the peroneal muscles are of significant interest in preventing ankle sprains and that no consensus has been reached regarding extremity dominance as an intrinsic risk factor, this study has two purposes. It investigates the effect of (1) laterality and (2) fatigue on peroneal EMD reaction times.

Materials and methods


Fifteen healthy male volunteers who were all amateur athletes on a regional level participated in the study. They had a mean age of 32.3 years (mean ± SD, age: 32.3 ± 3.11) and a mean Tegner activity score of 7.06 (range: 6–8, SD: 0.57). Eleven participants declared as dominant extremity their right leg and 4 participants their left leg.

None of them had any history of surgery or fracture on either lower extremity and was not under any medication or treatment for ankle injury for at least 6 months before the study. Furthermore, none of them had any neurological problems.

Clinical evaluation

All participants were clinically evaluated before data collection, and the same clinician evaluated the same conditions. First, the investigator explained the study protocol and obtained informed consent (on a form approved by the senior author’s institute). In order to exclude any acute injury, a physical examination was performed on each participant. Furthermore, all participants completed the lower extremity functional scale (LEFS) and the Tegner scale.

This study received ethics approval from the scientific committee of the senior author’s institute.

Electromechanical delay

All subjects underwent torque measurements for both ankles using an isokinetic dynamometer (Biodex System 3, Biodex Corp Shirley, NY, USA). The participants sat on the testing chair with their backs at 70° inclination. The dynamometer tilt was set at 50°, and the dynamometer rotation was set at 0°. The position of the knee was at 70° of flexion and that of the ankle at 10° of plantarflexion. After positioning, the lower extremity was secured tightly with straps and also the upper body of the participant.

A wireless 8-channel EMG system (Telemyo 2400T, Noraxon, Scottsdale, Arizona, USA) was used to record the EMG data, and these data were displayed online on a computer using dedicated software (MyoResearch XP, Noraxon, Scottsdale, Arizona, USA). In order to obtain EMG from the peroneus longus (PL), circular, preamplified, pre-gelled Ag/AgCl electrodes with a 10-mm diameter and fixed inter-electrode spacing of 20 mm (Noraxon) were used bilaterally. The same examiner placed the two active electrodes bilaterally 3 cm distally to the fibular head along the course of the peroneal muscle belly. Before the electrode placement, the skin in the area was shaved, abraded, and cleaned with isopropyl alcohol. The tibial tuberosity was used for placing the reference electrode [35]. In order to avoid artefacts due to movement, the electrodes were secured with surgical tape.

Each participant completed his testing in a single session. The isokinetic and EMG equipment was calibrated and “zeroed-off” as per the manufacturers’ recommendations. The order of the dominant and non-dominant lower extremity test was randomized.

The EMG signals were acquired at a sampling rate of 1000 Hz. The root-mean-square (RMS) amplitude for each muscle burst was calculated as follows: the raw EMG signals were full-wave rectified; high-pass filtered with a Butterworth filter to remove movement artefacts with a cut-off frequency of 20 Hz. A 100-ms RMS algorithm was used to smooth the signals. Accordingly, the protocol developed by Zhou et al. was used to measure EMD using the isokinetic dynamometer and the surface EMG unit [36]. This protocol suggests that the onset of torque development is defined as a 3.6-N·m deviation above the baseline level. The onset of EMG activity is defined as a 15 μV deviation above the baseline EMG signal.

Participants were asked to perform 5 maximal isometric contractions with the ankle in neutral (0°), and measurements were taken. The first and the last contraction were not taken into account, and the EMD values of the middle three contractions were averaged.

Fatigue protocol

An isokinetic fatigue protocol was followed after collecting the isometric data for the non-fatigued state for both ankles of each subject. During this protocol, which was followed in previous research [37], each participant executed concentric contractions for ankle eversion and inversion until eversion torque fell below 50% of initial torque for three consecutive repetitions. After achieving a fatigued state, the same isometric data collection protocol was followed.

The whole testing protocol has been used before and described in the literature [22, 35, 36]. Our previous work [22] examined the EMD time reactions in patients with chronic ankle instability under different angles and fatigue. In this work, the testing protocol is used to assess an ankle sprain factor before and after fatigue, and we are only using data from the neutral position in the current paper.

Statistical analysis

Repeated ANOVA (analysis of variance) was used for statistical analysis to assess the effect of laterality and fatigue on EMD. The α level was set a priori at p ≤ 0.05.


The results of the study revealed no significant difference regarding laterality. The EMD times for the dominant leg of the participants had a mean value of 124 ms (23) and for the non-dominant leg, 122 ms (24). The difference between these EMD times was not significant (p = 0.940).

Mean EMD times after the fatigue protocol was 134 ms (24) for the dominant leg of the participants and 137 ms (38) for the non-dominant leg. Fatigue caused a significant increase in EMD by 10 and 15 ms, respectively (p = 0.003), while the leg × fatigue interaction was not proven significant (p = 0.893) (Table 1).

Table 1

Electromechanical delay (EMD) in msec for leg laterality and fatigue.


Lateral ankle sprains have been reported to be the most common musculoskeletal injuries in patients considered physically active [116]. The anatomic area, including the foot and ankle joints, is regarded as the most common area of orthopaedic injuries [38] and can lead to recurrent sprains and chronic ankle instability [9, 19, 20]. This study aimed to assess the effect of laterality and fatigue on peroneal EMD times in healthy athletes. The findings reported here suggest that: (1) the dominant and the non-dominant extremities of an amateur athlete do not present any significant differences in peroneal EMD times, and (2) fatigued ankles demonstrate longer EMD times.

There are some limitations noted in this study. First, only male subjects were tested, which eliminates the generalizability of the findings to females. As this is laboratory research, the task that subjects were tested at was not functional; they may exhibit a different behaviour under more realistic tasks. EMD was measured during a volitional contraction that does not account for reflexive contractions that may play an important role in preventing ankle sprains. Finally, the small sample size raises the possibility of type II error.

An important component for preventing a lateral ankle sprain is the peroneal muscles [39, 40]. These muscles constitute the primary evertors of the foot and play a significant role in maintaining foot position during movement and functional activity by producing an eccentric force during inversion [17, 18, 22, 24]. The time these muscles need to react after the mechanoreceptors in the lateral ankle ligaments are activated the time they have to offer protection against a lateral ankle sprain [4044]. Subsequently, a longer peroneal reaction time may increase the risk of a lateral ankle sprain [45] and has been proposed among the aetiologies of this entity [3, 46]. This reaction time can be assessed with the EMD, which can highlight the true effectiveness of the muscles [22, 29, 30, 32].

This work correlates the peroneal reaction time with a debatable ankle sprain risk factor. There has not been an investigation of laterality as an ankle sprain factor with the use of EMD. A classification divides risk factors for an ankle injury into extrinsic or intrinsic. Intrinsic factors for ankle injuries have been proposed a previous sprain, foot type and size, ankle instability, height, weight, generalized joint laxity, lower extremity strength, anatomic malalignment and limb dominance [26]. Although there is a partial consensus between authors regarding orthosis, foot type and generalized joint laxity, most proposed risk factors remain controversial [26]. Regarding extremity dominance, there are different conclusions reported. Ekstrand and GiIlquist [27] and Yeung et al. [9] report increased risk for the dominant ankle with a higher incidence of ankle sprain [20]. Surve et al. [21] report no differences in the incidence of ankle sprains between dominant and non-dominant ankles in soccer players [21]. Baumhauer et al. [28] found no statistically significant differences between the injured and uninjured ankles upon examining limb dominance and ankle ligament stability. However, they report an increased risk of ankle sprain in the left ankle for left low extremity dominant players [28]. The literature seems to be divided regarding laterality. Limb dominance has been reported as a possible risk factor that may increase incidence [9, 20, 26, 27, 47]. However, some studies reported no increased incidence of ankle sprains between dominant and non-dominant lower extremities [21, 48]. In the study conducted by Slevin et al. [20], only the dominant leg of the participants was assessed, based on the claim of Yeung et al. [9] of a higher incidence of ankle sprains. Subsequently, the results of this study were in favour of limb dominance being a risk factor for ankle sprains since this parameter has been accepted as a priori situation. There is also a study with reported results that are not clearly in favour or not of limb dominance. This study suggests that although no statistically significant differences between the injured and uninjured ankles were found, there is an increased risk of sprain in the left ankle for left dominant players [28]. However, these contrasting findings may result from different study designs or different methods used for data analysis [49].

Since it seems that no consensus has been reached regarding extremity laterality as an ankle sprain risk factor, we tried to investigate if the protective reaction of the peroneal muscles is related to it. The results showed no significant difference between the dominant and non-dominant lower extremities of the participants. Subsequently, this finding implies that in a non-injured athlete, both ankles seem to be under the same protection of the reactive response of the peroneal muscles. Furthermore, since EMD has been suggested to be an indirect sign of muscle stiffness and tone, it can be a useful means to assess joint stability [30]. Thus, the lack of any difference in EMD times might imply that the muscle system in both the dominant and non-dominant leg provides the same ankle joint stability. Most athletes place a greater demand on their dominant limb, and subsequently, they put great effort around the knee and ankle, particularly during high-demand activities that place the ankle and knee at risk [49]. The combination of these assumptions should raise awareness among athletes and consider that their extremities are equally exposed to the danger of an ankle injury.

Another finding of the present study was that both the dominant and non-dominant extremities demonstrated longer EMD after fatigue. The protocol used in this study reinduces fatigue through repetitive isokinetic contractions [36, 50]. Fatigue results in limited force generation capacity during muscle contractions due to the impairment of membrane excitability through various electrolytic disturbances [51, 52]. Fatigue can also affect the neuromuscular mechanism, and as a result, it may induce changes in EMD [34]. Our findings regarding fatigue and EMD agree with previous studies that report an increase in EMD times after fatigue on the peroneal muscles [22] and knee muscles [34, 53]. On the other hand, McLoda et al. [35] did not find any change in peroneal muscle EMD after a task failure fatigue protocol, but they used an induced contraction of the peroneal. Forestier et al., in another study, showed that ankle proprioception is impaired after fatigue [54].

This work might have some important clinical implications since understanding the injury mechanism is an integral part of injury prevention research [55]. The “sequence of injury prevention” has been proposed by van Mechelen et al. and describes how sports injury-related studies came together to form the research framework [56]. Some studies demonstrated decreased peroneal muscle reaction times in healthy subjects after a 6-week neuromuscular training program [57] and a 6-week eccentric/concentric isokinetic training program [40]. These findings imply that the reaction times of the peroneal muscles can be decreased even in healthy subjects. However, it remains questionable whether the improved reflex latencies of the peroneus longus are clinically relevant and could protect an individual from sudden inversion injury.


In conclusion, we report that laterality does not affect the peroneal longus muscle EMD times. There was no significant difference between dominant and non-dominant ankles in the amateur athlete population. Thus, the protective action of the peroneal muscles is the same at both extremities, and both extremities seem to be equally exposed to an ankle injury. Furthermore, the finding that fatigue causes a significant increase in EMD is concomitant with the current literature. It emphasizes the importance of improving resistance to fatigue in order to prevent delayed peroneal response for both ankles, either dominant leg or not. Combining these findings, training or rehabilitation programs should focus on retraining reaction time to prevent injuries to both legs, either dominant or not. Additionally, isolated and functional fatigue training of the peroneals may add another layer of protection that can potentially prevent ankle sprain recurrence. These may be interesting and potentially useful research questions for future studies aiming to identify and assess intrinsic and extrinsic risk factors of ankle sprains and CAI.

Conflict of interest

All the authors declare that they have no conflict of interest.


This research did not receive any specific funding.

Ethical approval

This study received ethics approval from the Scientific Committee of Senior Author’s Institute.

Informed consent

All patients have read and signed a consent form before data collection.

Authors contributions

D.A. Flevas: Conceptualization, Writing original draft. E. Pappas: Conceptualization, Methodology, Editing. S. Ristanis: Conceptualization. G. Giakas: Reviewing and Editing. M. Vekris: Reviewing and Editing. A.D. Georgoulis: Reviewing and Editing


All authors declare no funding source or sponsor involvement in the study design, collection, analysis and interpretation of the data in writing the manuscript and in the submission of the manuscript for publication.


  1. Fong DTP, Hong Y, Chan LK, Yung PSH, Chan KM (2007) A systematic review on ankle injury and ankle sprain in sports. Sports Med 37(1), 73–94. [CrossRef] [PubMed] [Google Scholar]
  2. Fong DTP, Man CY, Yung PSH, Cheung SY, Chan KM (2008) Sport-related ankle injuries attending an accident and emergency department. Injury 39(10), 1222–1227. [CrossRef] [PubMed] [Google Scholar]
  3. Fong DT, Chan YY, Mok KM, Yung PS, Chan KM (2009) Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol 1, 14. [PubMed] [Google Scholar]
  4. Doherty C, Bleakley C, Delahunt E, Holden S (2017) Treatment and prevention of acute and recurrent ankle sprain: An overview of systematic reviews with meta-analysis. Br J Sports Med 51(2), 113–125. [CrossRef] [PubMed] [Google Scholar]
  5. Fernandez WG, Yard EE, Comstock RD (2007) Epidemiology of lower extremity injuries among U.S. high school athletes. Acad Emerg Med 14(7), 641–645. [CrossRef] [PubMed] [Google Scholar]
  6. Garrick JG, Requa RK (1989) The epidemiology of foot and ankle injuries in sports. Clin Podiatr Med Surg 6(3), 629–637. [PubMed] [Google Scholar]
  7. Holmer P, Sondergaard L, Konradsen L, Nielsen PT, Jorgensen LN (1994) Epidemiology of sprains in the lateral ankle and foot. Foot Ankle Int 15(2), 72–74. [CrossRef] [PubMed] [Google Scholar]
  8. Hootman JM, Dick R, Agel J (2007) Epidemiology of collegiate injuries for 15 sports: Summary and recommendations for injury prevention initiatives. J Athl Train 42(2), 311–319. [PubMed] [Google Scholar]
  9. Yeung MS, Chan KM, So CH, Yuan WY (1994) An epidemiological survey on ankle sprain. Br J Sports Med 28(2), 112–116. [CrossRef] [PubMed] [Google Scholar]
  10. Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C (2014) The incidence and prevalence of ankle sprain injury: A systematic review and meta-analysis of prospective epidemiological studies. Sports Med 44(1), 123–140. [CrossRef] [PubMed] [Google Scholar]
  11. Gribble PA, Bleakley CM, Caulfield BM, et al. (2016) Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains. Br J Sports Med 50(24), 1496–1505. [CrossRef] [PubMed] [Google Scholar]
  12. Nelson AJ, Collins CL, Yard EE, Fields SK, Comstock RD (2007) Ankle injuries among United States high school sports athletes, 2005–2006. J Athl Train 42(3), 381. [PubMed] [Google Scholar]
  13. Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA (2017) The epidemiology of lateral ligament complex ankle sprains in National Collegiate Athletic Association sports. Am J Sports Med 45(1), 201–209. [CrossRef] [PubMed] [Google Scholar]
  14. Donovan L, Hetzel S, Laufenberg CR, McGuine TA (2020) Prevalence and impact of chronic ankle instability in adolescent athletes. Orthop J Sports Med 8(2), 2325967119900962. [PubMed] [Google Scholar]
  15. Hiller CE, Nightingale EJ, Raymond J, et al. (2012) Prevalence and impact of chronic musculoskeletal ankle disorders in the community. Arch Phys Med Rehabil 93, 1801–1807. [CrossRef] [PubMed] [Google Scholar]
  16. Delahunt E, Bleakley CM, Bossard DS, et al. (2019) Infographic. International Ankle Consortium Rehabilitation-Oriented Assessment. Br J Sports Med 53(19), 1248–1249. [CrossRef] [PubMed] [Google Scholar]
  17. Garrick JG (1977) The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med 5(6), 241–242. [CrossRef] [PubMed] [Google Scholar]
  18. Weil LS, Moore JW, Kratzer CD, Turner DL (1979) A biomechanical study of lateral ankle sprains in basketball. J Am Podiatry Assoc 69(11), 687–690. [CrossRef] [Google Scholar]
  19. Verhagen RA, de Keizer G, van Dijk CN (1995) Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg 114(2), 92–96. [CrossRef] [PubMed] [Google Scholar]
  20. Slevin ZM, Arnold GP, Wang W, Abboud RJ (2020) Immediate effect of kinesiology tape on ankle stability. BMJ Open Sport Exerc Med 6(1), e000604. Published 2020 Feb 4. [CrossRef] [PubMed] [Google Scholar]
  21. Surve I, Schwellnus MP, Noakes T, Lombard C (1994) A fivefold reduc- tion in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am J Sports Med 22(5), 601–606. [CrossRef] [PubMed] [Google Scholar]
  22. Flevas DA, Bernard M, Ristanis S, Moraiti C, Georgoulis AD, Pappas E (2017) Peroneal electromechanical delay and fatigue in patients with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 25(6), 1903–1907. [CrossRef] [PubMed] [Google Scholar]
  23. Konradsen L (2002) Sensori-motor control of the uninjured and injured human ankle. J Electromyogr Kinesiol 12(3), 199–203. [CrossRef] [PubMed] [Google Scholar]
  24. Richie DH Jr (2001) Functional instability of the ankle and the role of neuromuscular control: A comprehensive review. J Foot Ankle Surg 40(4), 240–251. [CrossRef] [PubMed] [Google Scholar]
  25. Lysens R, Steverlynck A, van den Auweele Y, Lefevre J, Renson L, Claessens A, Ostyn M (1984) The predictability of sports injuries. Sports Med 1(1), 6–10. [CrossRef] [Google Scholar]
  26. Barker HB, Beynnon BD, Renstrom PA (1997) Ankle injury risk factors in sports. Sports Med 23(2), 69–74. [CrossRef] [PubMed] [Google Scholar]
  27. Ekstrand J, GiIlquist J (1983) Soccer injuries and their mechanisms: A prospective study. Med Sci Sports Exerc 15, 267–270. [CrossRef] [PubMed] [Google Scholar]
  28. Baumhauer J, Alosa DM, Renstrom PAFH, et al. (1995) A prospective study of ankle injury risk factors. Am J Sports Med 23, 564–570. [CrossRef] [PubMed] [Google Scholar]
  29. Cavanagh PR, Komi PV (1979) Electromechanical delay in human skeletal muscle under concentric and eccentric contractions. Eur J Appl Physiol Occup Physiol 42(3), 159–163. [CrossRef] [PubMed] [Google Scholar]
  30. Mora I, Quinteiro-Blondin S, Perot C (2003) Electromechanical assessment of ankle stability. Eur J Appl Physiol 88(6), 558–564. [CrossRef] [PubMed] [Google Scholar]
  31. Norman RW, Komi PV (1979) Electromechanical delay in skeletal muscle under normal movement conditions. Acta Physiol Scand 106(3), 241–248. [CrossRef] [PubMed] [Google Scholar]
  32. Vos EJ, Harlaar J, van Ingen Schenau GJ (1991) Electromechanical delay during knee extensor contractions. Med Sci Sports Exerc 23(10), 1187–1193. [PubMed] [Google Scholar]
  33. Bigland-Ritchie B, Woods JJ (1984) Changes in muscle contractile properties and neural control during human muscular fatigue. Muscle Nerve 7(9), 691–699. [CrossRef] [PubMed] [Google Scholar]
  34. Zhou S, Carey MF, Snow RJ, Lawson DL, Morrison WE (1998) Effects of muscle fatigue and temperature on electromechanical delay. Electromyogr Clin Neurophysiol 38(2), 67–73. [PubMed] [Google Scholar]
  35. McLoda TA, Stanek JM, Hansen AJ, McCaw ST (2009) A task failure has no effect on the electromechanical delay of the peroneus longus. Electromyogr Clin Neurophysiol 49(2–3), 109–115. [PubMed] [Google Scholar]
  36. Zhou S, Lawson DL, Morrison WE, Fairweather I (1995) Electromechanical delay in isometric muscle contractions evoked by voluntary, reflex and electrical stimulation. Eur J Appl Physio Occup Physiol 70(2), 138–145. [CrossRef] [PubMed] [Google Scholar]
  37. Gutierrez GM, Jackson ND, Dorr KA, Margiotta SE, Kaminski TW (2007) Effect of fatigue on neuromuscular function at the ankle. J Sport Rehabil 16(4), 295–306. [CrossRef] [PubMed] [Google Scholar]
  38. Thevendran G, Kadakia AR, Giza E, Haverkamp D, D’Hooghe JP, Veljkovic A, Abdelatif NMN (2021) Acute foot and ankle injuries and time return to sport. SICOT J 7, 27. [CrossRef] [EDP Sciences] [PubMed] [Google Scholar]
  39. Heckman DS, Reddy S, Pedowitz D, Wapner KL, Parekh SG (2008) Operative treatment for peroneal tendon disorders. J Bone Joint Surg 90, 404–418. [CrossRef] [PubMed] [Google Scholar]
  40. Keles SB, Sekir U, Gur H, Akova B (2014) Eccentric/concentric training of ankle evertor and dorsiflexors in recreational athletes: Muscle latency and strength. Scand J Med Sci Sports 24(1), e29–e38. [CrossRef] [PubMed] [Google Scholar]
  41. Hertel J (2002) Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 37(4), 364–375. [PubMed] [Google Scholar]
  42. Jackson ND, Gutierrez GM, Kaminski T (2009) The effect of fatigue of and habituation on the stretch reflex of the ankle musculature. J Electromyogr Kinesiol 19(1), 75–84. [CrossRef] [PubMed] [Google Scholar]
  43. Hopkins TJ, McLoda T, McCaw S (2007) Muscle activation following sudden ankle inversion during standing and walking. Eur J Appl Physiol 99, 371–378. [CrossRef] [PubMed] [Google Scholar]
  44. Vaes P, Duquet W, Van Gheluwe B (2002) Peroneal reaction times and eversion motor response in healthy and unstable ankles. J Athl Train 37(4), 475–480. [PubMed] [Google Scholar]
  45. Wilkerson GB, Nitz AJ (1994) Dynamic ankle stability: Mechanical and neuromuscular relationships. J Sports Rehab 3, 43–57. [Google Scholar]
  46. Ashton-Miller JA, Ottaviani RA, Hutchinson C, Wojtys EM (1996) What best protects the inverted weightbearing ankle against further inversion? Evertor muscle strength compares favorably with shoe height, athletic tape, and three orthoses. Am J Sports Med 24(6), 800–809. [CrossRef] [PubMed] [Google Scholar]
  47. Halabchi F, Angoorani H, Mirshahi M, Pourgharib Shahi MH, Mansournia MA (2016) The prevalence of selected intrinsic risk factors for ankle sprain among elite football and basketball players. Asian J Sports Med 7(3), e35287. [PubMed] [Google Scholar]
  48. Beynnon BD, Renstrӧm PA, Alosa DM, Baumhauer JF, Vacek PM (2001) Ankle ligament injury risk factors: A prospective study of college athletes. J Orthop Res 19, 213–220. [CrossRef] [PubMed] [Google Scholar]
  49. Beynnon BD, Murphy DF, Alosa DM (2002) Predictive factors for lateral ankle sprains: A literature review. J Athl Train 37(4), 376–380. [PubMed] [Google Scholar]
  50. Gabriel DA, Boucher JP (1998) Effects of repetitive dynamic contractions upon electromechanical delay. Eur J Appl Physiol Occup Physiol 79(1), 37–40. [CrossRef] [Google Scholar]
  51. Maclaren DP, Gibson H, Parry-Billings M, Edwards RH (1989) A review of metabolic and physiological factors in fatigue. Exerc Sport Sci Rev 17, 29–66. [PubMed] [Google Scholar]
  52. Westerblad H, Lee JA, Lannergren J, Allen DG (1991) Cellular mechanisms of fatigue in skeletal muscle. Am J Physiol 261(2 Pt 1), C195–C209. [CrossRef] [Google Scholar]
  53. Zhou S, McKenna MJ, Lawson DL, Morrison WE, Fairweather I (1996) Effects of fatigue and sprint training on electromechanical delay of knee extensor muscles. Eur J Appl Physiol Occup Physiol 72(5–6), 410–416. [PubMed] [Google Scholar]
  54. Forestier N, Teasdale N, Nougier V (2002) Alteration of the position sense at the ankle induced by muscular fatigue in humans. Med Sci Sports Exerc 34(1), 117–122. [PubMed] [Google Scholar]
  55. Bahr R, Krosshaug T (2005) Understanding injury mechanisms: A key component of preventing injuries in sport. Br J Sports Med 39(6), 324–329. [CrossRef] [PubMed] [Google Scholar]
  56. van Mechelen W, Hlobil H, Kemper HCG (1992) Incidence, severity, aetiology and prevention of sports injuries: A review of concepts. Sports Med 14(2), 82–99. [CrossRef] [PubMed] [Google Scholar]
  57. Linford CW, Hopkins JT, Schulthies SS, Freland B, Draper DO, Hunter I (2006) Effects of neuromuscular training on the reaction time and electromechanical delay of the peroneus longus muscle. Arch Phys Med Rehabil 87(3), 395–401. [CrossRef] [PubMed] [Google Scholar]

Cite this article as: Flevas DA, Pappas E, Ristanis S, Giakas G, Vekris M & Georgoulis AD (2022) Effect of laterality and fatigue in peroneal electromechanical delay. SICOT-J 8, 22

All Tables

Table 1

Electromechanical delay (EMD) in msec for leg laterality and fatigue.

Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.

Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.

Initial download of the metrics may take a while.