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Balance Training Improves Function and Postural Control in Those with Chronic Ankle Instability

MCKEON, PATRICK O.1; INGERSOLL, CHRISTOPHER D.2; KERRIGAN, D. CASEY2; SALIBA, ETHAN2; BENNETT, BRADFORD C.2; HERTEL, JAY2

Medicine & Science in Sports & Exercise: October 2008 - Volume 40 - Issue 10 - p 1810-1819
doi: 10.1249/MSS.0b013e31817e0f92
APPLIED SCIENCES: Biodynamics

Purpose: The purpose of this randomized controlled trial was to determine the effect of a 4-wk balance training program on static and dynamic postural control and self-reported functional outcomes in those with chronic ankle instability (CAI).

Methods: Thirty-one young adults with self-reported CAI were randomly assigned to an intervention group (six males and 10 females) or a control group (six males and nine females). The intervention consisted of a 4-wk supervised balance training program that emphasized dynamic stabilization in single-limb stance. Main outcome measures included the following: self-reported disability on the Foot and Ankle Disability Index (FADI) and the FADI Sport scales; summary center of pressure (COP) excursion measures including area of a 95% confidence ellipse, velocity, range, and SD; time-to-boundary (TTB) measures of postural control in single-limb stance including the absolute minimum TTB, mean of TTB minima, and SD of TTB minima in the anteroposterior and mediolateral directions with eyes open and closed; and reach distance in the anterior, posteromedial, and posterolateral directions of the Star Excursion Balance Test (SEBT).

Results: The balance training group had significant improvements in the FADI and the FADI Sport scores, in the magnitude and the variability of TTB measures with eyes closed, and in reach distances with the posteromedial and the posterolateral directions of the SEBT. Only one of the summary COP-based measures significantly changed after balance training.

Conclusions: Four weeks of balance training significantly improved self-reported function, static postural control as detected by TTB measures, and dynamic postural control as assessed with the SEBT. TTB measures were more sensitive at detecting improvements in static postural control compared with summary COP-based measures.

1University of Kentucky, Lexington, KY; and 2University of Virginia, Charlottesville, VA

Address for correspondence: Patrick O. McKeon, Ph.D., ATC, CSCS, Division of Athletic Training, College of Health Sciences, University of Kentucky, Wethington Building, Room 206C, 900 S Limestone, Lexington, KY 40536-0200; E-mail: Patrick.McKeon@uky.edu.

Submitted for publication September 2007.

Accepted for publication April 2008.

©2008The American College of Sports Medicine