Two 4-Week Balance-Training Programs for Chronic Ankle Instability

Abstract

Context: Traditional single-limb balance (SLB) and progressive dynamic balance-training programs for those with chronic ankle instability (CAI) have been evaluated in the literature. However, which training program may be more beneficial is not known.

Objective: To investigate the effects of a progressive hop-to-stabilization balance (PHSB) program compared with an SLB program on self-reported function, dynamic postural control, and joint position sense (JPS) where angle and direction were self-reported by participants with CAI.

Design: Randomized controlled clinical trial.

Setting: A single testing location in a mid-Atlantic state.

Patients or other participants: A total of 18 participants (age = 18.38 ± 1.81 years; height = 175.26 ± 6.64 cm; mass = 75.79 ± 12.1 kg) with CAI.

Intervention(s): Participants were randomly assigned to the PHSB or SLB program. The PHSB and SLB groups pursued their 4-week programs 3 times a week. The PHSB group performed a battery of single-limb hop-to-stabilization exercises, while the SLB group performed a series of SLB exercises. Exercises were advanced throughout the 4 weeks for both groups.

Main outcomes measure(s): Pretest and posttest measurements were the Foot and Ankle Ability Measure (FAAM)-Activities of Daily Living subscale; FAAM-Sports subscale; Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions; and weight-bearing JPS blocks (dorsiflexion, plantar flexion, inversion, eversion).

Results: A significant main effect of time was present for the FAAM-Activities of Daily Living, FAAM-Sports, Star Excursion Balance Test (anterior, posteromedial, and posterolateral directions), and JPS (dorsiflexion, plantar flexion, inversion), as posttest results improved for the PHSB and SLB groups. The main effect of group was significant only for the FAAM-Sports, with the SLB group improving more than the PHSB group.

Conclusions: Either a 4-week PHSB or SLB can be used in athletes with CAI, as both programs resulted in similar gains.

Keywords: dynamic balance training; joint position sense; postural stability.

Figures

Figure 1

CONSORT flow diagram.

Figure 2

Slope surface board and angle wedges.

Figure 3

Time effect sizes for single-limb balance (SLB) and progressive hop-to-stabilization (PHSB) groups (95% confidence intervals). Effect size indicates an improvement from pretest to posttest for all dependent variables. Effect size = small (0.20), moderate (0.50), or large (0.80). Abbreviations: ADL, Activities of Daily Living; FAAM, Foot and Ankle Ability Measure.