Control motor en el tobillo: implicaciones para la fisioterapia en inestabilidad y rehabilitación funcional

• Autores: Teresa Sierra Pascual, Andrea Fumanal Escartín, Ignacio Conde Arias, Raquel Magaz Montaner, Patricia Costa Rodriguez, Ana María Lascorz Goicoechea
• Localización: Revista Sanitaria de Investigación, ISSN-e 2660-7085, Vol. 6, Nº. 9, 2025
• Idioma: español
• Enlaces
  • Texto completo
• Resumen
  • español

    Objetivo: analizar la importancia del control motor en el tobillo, especialmente en el contexto de la inestabilidad crónica y la rehabilitación tras esguinces, revisando los mecanismos neurofisiológicos implicados y la evidencia sobre intervenciones fisioterápicas.

    Métodos: revisión narrativa de la literatura (PubMed, Scopus, Cochrane Library, 2005–2025), incluyendo ensayos clínicos, revisiones sistemáticas y guías de práctica clínica. Se abordaron estudios en población deportiva y general, con especial énfasis en protocolos de control motor, ejercicio terapéutico y entrenamiento propioceptivo.

    Resultados: la inestabilidad crónica de tobillo se asocia con alteraciones en la activación muscular, retrasos en los tiempos de reacción y déficits en la integración sensoriomotora. Los programas de fisioterapia basados en control motor, que combinan entrenamiento de la estabilidad, ejercicios de fuerza, tareas funcionales y retroalimentación visual, muestran mejoras significativas en la función, la prevención de recidivas y la calidad de vida. La incorporación de estrategias de control motor parece superior a los programas convencionales de fortalecimiento aislado.

    Conclusiones: el control motor es un componente esencial en la rehabilitación del tobillo. Los fisioterapeutas deben integrar intervenciones centradas en la reeducación neuromuscular y la optimización del patrón de movimiento para mejorar resultados clínicos y prevenir recurrencias.

  • English

    Objective: To analyze the relevance of motor control in the ankle, particularly in the context of chronic instability and post-sprain rehabilitation, reviewing neurophysiological mechanisms and evidence-based physiotherapy interventions.

    Methods: Narrative literature review (PubMed, Scopus, Cochrane Library, 2005–2025), including randomized trials, systematic reviews and clinical guidelines. Studies on both athletic and general populations were considered, focusing on motor control protocols, therapeutic exercise and proprioceptive training.

    Results: Chronic ankle instability is associated with deficits in muscle activation, delayed reaction times and altered sensorimotor integration. Physiotherapy programs based on motor control, combining stability training, strengthening, functional tasks and visual feedback, provide significant improvements in function, prevention of recurrence and quality of life. Motor control strategies appear superior to isolated strengthening programs.

    Conclusions: Motor control is essential for ankle rehabilitation. Physiotherapists should integrate interventions targeting neuromuscular re-education and optimization of movement patterns to improve clinical outcomes and prevent recurrence.

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