Combined Effects of Strengthening and Proprioceptive Training on Stability, Balance, and Proprioception Among Subjects with Chronic Ankle Instability in Different Age Groups: Evaluation of Clinical Outcome Measures

Abstract

Background: Lateral ankle sprains are among the common injuries in the physically active population in different age groups and progress to chronic ankle instability (CAI). Accordingly, the current study assesses the effectiveness of strengthening and proprioceptive training programs on proprioception and balance in those suffering from CAI.

Design: Quasi-experimental design.

Methods: Thirty-six individuals with self-reported CAI were assigned into three groups based on age: group 1 (23 ± 1.84), group 2 (35.80 ± 1.68), group 3 (44.25 ± 4.86), then performed strength and balance exercises for 6 weeks. The study furthermore measured pre- and post-training of joint position sense (JPS), static balance, dynamic balance, chronic ankle instability tool (CAIT) and lower extremity functional scale (LEFS).

Results: Statistical analysis showed significant improvement (P < 0.01) on all outcome measures among all groups. In group 1, mainly the plantar flexion JPS improved to 3.7°, while in group 2 and group 3 the eversion JPS improved to 3.1° and 1.78° (P < 0.01). With reference to static balance with one's eyes closed and eyes open, the improvement in group 1 was 4.46, 11.05 s, group 2 was 2.23, 7.85 s and group 3 was 1.69, 4.68 s. In relation to dynamic balance, the development in group 1 was 5.85 cm, while group 2 was 4.71 cm and group 3 was 2.49 cm. Moreover, both CAIT and LEFS showed significant differences (P < 0.01) after training.

Conclusion: This study found that combined strengthening and proprioceptive training effectively improves stability, proprioception, balance, and self-reported functional outcomes.

Keywords: Ankle sprains; Joint position sense; Postural balance; Rehabilitation.

Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

© Indian Orthopaedics Association 2020.

Figures

Fig. 1

Measurement of static balance by single leg balance test

Fig. 2

Measurement of dynamic balance by functional reach test. a Starting position. b Final position

Fig. 3

Measurement of ankle proprioception by digital dual inclinometer

Fig. 4

CAIT and LEFS scores within different age groups. a CAIT scores, b LEFS scores. Pre- and post-training show significant differences in all groups. CAIT Cumberland Ankle Instability tool, LEFS lower extremity functional scale