The Effects of Unilateral Balance Training Among Athletes With Chronic Ankle Instability

The Effects of Unilateral Balance Training on Bilateral Balance and Explosive Power Among Athletes With Chronic Ankle Instability

The aim of the study is to investigate the effects of a 4-week, unilateral balance exercise training program on bilateral balance and explosive power in athletes with chronic ankle instability. The participants were randomly divided into Stable Ankle Training Group (SG) (n=9), Unstable Ankle Training Group (UG) (n=9) and control group (CG) (n=10). The balance exercise training program was administered for only the stable ankle of athletes in SG and only the unstable ankle of athletes in UG, twice a week and for a 4-week duration.

Study Overview

• Status: Completed
• Conditions: Ankle Injuries; Ankle Sprains
• Intervention / Treatment: Procedure: Balance Exercise Training for Stable Ankle; Procedure: Balance Exercise Training for Unstable Ankle

Detailed Description

The aim of the study is to investigate the effects of a 4-week, unilateral balance exercise training program on bilateral balance and explosive power in athletes with chronic ankle instability (CAI). The study included 28 volunteer athletes with a history of CAI who registered as a team player at Yeditepe University Culture and Sports Directorate February 2019 - June 2019. The severity of functional ankle instability of all the athletes was assessed by the Cumberland Ankle Instability Tool (CAIT). Functional limitations of the athletes with CAI were evaluated by Foot and Ankle Ability Measure Activity of Daily Living Subscale (FAAM-ADL) and Sports Subscale (FAAM-S). Balance Error Scoring System (BESS) was used to determine the static balance performance of athletes. Dynamic balance was evaluated by the Y Balance Test (YBT). Sport performance including vertical jumping and hopping was assessed with Single-Legged Countermovement Jump (CMJ) Test, Figure-of-Eight Hop Test, and Side Hop Test. The athletes were randomly divided into Rehabilitation for the Stable Ankle Group (SG) (n=9), Rehabilitation for the Unstable Ankle Group (UG) (n=9) and Control Group (CG) (n=10). Athletes in SG and UG were included balance exercise training program. The balance exercise training program was administered for only the stable ankle of athletes in SG and only the unstable ankle of athletes in UG, twice a week and for a 4-week duration.

• Study Type: Interventional
• Enrollment (Actual): 28
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Ataşehir
    • Istanbul, Ataşehir, Turkey, 34755
      • Yeditepe University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 25 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participating in the study on a voluntary basis
• Athletes with 18-25 years old
• Being a player in one of the basketball, volleyball, and handball team sports
• Athletes with a history of at least 2 significant lateral ankle sprains which were classified as a second degree and related to inflammatory symptoms (pain, swelling)
• The self-reported sensation of giving away and instability at the injured ankle confirmed by the Cumberland Ankle Instability Tool with a score ≤25
• Recurrent lateral ankle sprain episodes of the injured ankle occurred at least 12 months
• The self-reported function of the injured ankle confirmed by Foot and Ankle Ability Measure with a score <90% from activities of daily living subscale and <80% from sport subscale.

Exclusion Criteria:

• A history of surgery to the musculoskeletal structures in either lower extremity
• A history of a fracture in either lower extremity necessitating realignment
• Acute injury of musculoskeletal structures of other joints of the lower extremity in the previous 3 months affecting joint function and integrity
• Presence of bilateral ankle instability
• Balance or vestibular disorder

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Stable Ankle Training Group (SG); Balance Exercise Training for Only The Stable Ankle	Procedure: Balance Exercise Training for Stable Ankle; Balance and hop stabilization exercises were administered for 30 minutes of each exercise session.
EXPERIMENTAL: Unstable Ankle Training Group (UG); Balance Exercise Training for Only The Unstable Ankle	Procedure: Balance Exercise Training for Unstable Ankle; Balance and hop stabilization exercises were administered for 30 minutes of each exercise session.
NO_INTERVENTION: Control Group (CG); No balance exercise training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Foot and Ankle Ability Measure	The FAAM is a self-reported tool improved to evaluate the physical functions of individuals with musculoskeletal disorders related to foot and ankle.	4 weeks
Balance Error Scoring System	The BESS is a valid test to find out deficits in static postural control of individuals with CAI.	4 weeks
Y Balance Test	The Y Balance Test is the functional test that is able to find out impairments in dynamic postural control among individuals with CAI	4 weeks
Single-Leg Countermovement Jump Test	The Single-LegCountermovement jump test is used to evaluate the lower-extremity power of athletes, and indirectly the functional performance.	4 weeks
Figure-of-Eight Hop Test	Figure-of-8 Hop Test is used to measure the explosive power of the lower extremity of athletes.	4 weeks
Side Hop Test	Side Hop test is a test used to evaluate the explosive power of the lower extremity of athletes.	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cumberland Ankle Instability Tool	Cumberland Ankle Instability Tool including a 30-point scale of 9-items is a valid and reliable questionnaire for distinguishing and quantifying the severity of functional instability.	Baseline

Collaborators and Investigators

• Sponsor: Yeditepe University
• Investigators: Principal Investigator: Ayça Yağcıoğlu, MSc, Yeditepe University, Health Sciences Faculty, Physiotherapy and Rehabilitation; Study Chair: Gökhan Metin, Professor, Istanbul University, Faculty of Medicine, Sports Medicine; Study Chair: Feryal Subaşı, Professor, Yeditepe University, Health Sciences Faculty, Physiotherapy and Rehabilitation

Study record dates

Study Major Dates

• Study Start (ACTUAL): February 18, 2019
• Primary Completion (ACTUAL): November 14, 2019
• Study Completion (ACTUAL): December 18, 2019

Study Registration Dates

• First Submitted: October 23, 2019
• First Submitted That Met QC Criteria: October 23, 2019
• First Posted (ACTUAL): October 25, 2019

Study Record Updates

• Last Update Posted (ACTUAL): October 22, 2020
• Last Update Submitted That Met QC Criteria: October 20, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Keywords: ankle, joint instability, cross-education, rehabilitation
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Ankle Injuries
• Other Study ID Numbers: YeditepeUptr

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No