Gluteal Musculature Activation to Improve Ankle Stability
Condition: Ankle Disease; Muscle Weakness
MeSH terms: Muscle Weakness
Study type: Observational

Summary: 
      The goal of this observational study is to to evaluate and correlate muscle activation in the
      gluteal musculature and ankle stability in a healthy population. The main question it aims to
      answer is: Is there a significant positive correlation between gluteal muscle activation and
      ankle stability?

      Participants will complete questionnaires on the functionality of foot and ankle pathologies
      related to their daily life and sports activities, and perform specific physical tests to
      assess muscle strength, ankle stability, and activation of the lower extremity musculature.
    

Detailed description: 
      The main outcomes were the muscle activation (gluteus maximus, gluteus medius, tibialis
      anterior, and peroneus longus) of both limbs during a Single Leg Stance test and a Hurdle
      Step test (Check Your Motion, Albacete, Spain). Muscle activation was assessed using surface
      electromyography, and the results will be described as a percentage of Maximum Isometric
      Voluntary Contraction (%MVIC). Ankle stability was evaluated according to the criteria
      established by Perrot using a force platform (Dynamic Walkway P6000, BTS Bioengineering,
      Milan, Italy).

      There are no previous studies evaluating a possible correlation between gluteus maximus
      muscle activity and ankle stabilization capacity. Therefore, a sample size calculation was
      performed with the aim of detecting a strong correlation as statistically significant (r=0.5)
      according to the criteria of Hopkins et al [33]. The G*Power 3.1 program was used to
      calculate the sample size. The statistical test used was "Correlation: Bivariate Normal
      Model", the type of power analysis was "A priori: compute required sample size - given alpha,
      power and effect size". An error α=0.05 and a statistical power of 0.80 (β=0.20) was used.
      The result of the test was 29 subjects required to perform this research.

      The study investigators will sign a data confidentiality sheet where they commit to use the
      data with appropriate confidentiality. In addition, after analyzing the results, the
      participant's face will be hidden so that he/she cannot be recognized.

      The data will be collected on a form designed for this purpose and will be entered into a
      database created with the Microsoft Office Excel® 2021 program, in a URV system subject to
      the security measures of the National Security Scheme, always in areas where only the
      research staff of this project can access. Subsequently, the SPSS program (Statistical
      Package for the Social Sciences) version 26.0 for Windows® will be used to analyze the data.

      The normality of all variables will be examined using the Saphiro Wilk statistical test.
      Descriptive statistics for all variables will be expressed as mean (standard deviation) if
      the variable follows a normal distribution and as median (interquartile range) if the
      variable does not follow a normal distribution. Subsequently, correlation analysis will be
      performed using Pearson's correlation test (if both variables are normal) or Spearman's Rho
      (if either variable does not follow a normal distribution). Correlations will be classified
      as weak (r=0.1), moderate (r=0.3), strong (r=0.5), large (r=0.7) or very large (r=0.9) [33].
      Correlations will be described as statistically significant if the p-value is less than 0.05.
      If the correlation coefficient is statistically significant, the coefficient of determination
      (R2) will be calculated. Bonferroni correction for multiple comparisons will be applied based
      on the correlations finally evaluated.
    

Intervention name(s): Physical Therapy
Intervention type(s): Behavioral
Intervention description(s): Specific physical tests to assess muscle strength, ankle stability and activation of the lower extremity musculature: Single Leg Stance Test, Hurdle Step test and Single leg vertical jump.
Observational model: Ecologic or Community
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Health students from the Faculty of Medicine and Health Sciences of the Rovira i Virgili
        University.
      
Keywords: biomechanics; electromyography; ankle stability; gluteal musculature