Effects of a 4-Week Dynamic-Balance-Training Program Supplemented With Graston Instrument-Assisted Soft-Tissue Mobilization for Chronic Ankle Instability

2012 ◽  
Vol 21 (4) ◽  
pp. 313-326 ◽  
Author(s):  
Jessica L. Schaefer ◽  
Michelle A. Sandrey
Keyword(s):  
Soft Tissue ◽  
Postural Control ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Plantar Flexion ◽  
Balance Training ◽  
Chronic Ankle Instability ◽  
Soft Tissue Mobilization

Context:A dynamic-balance-training (DBT) program supplemented with the Graston instrument-assisted soft-tissue mobilization (GISTM) technique has not been evaluated collectively as a treatment in subjects with chronic ankle instability (CAI).Objective:To examine the effects of GISTM in conjunction with a DBT program on outcomes associated with CAI, including pain and disability, range of motion (ROM), and dynamic postural control.Design:Pretest/posttest, repeated measures.Setting:High school and a Division I mid-Atlantic university.Participants:Thirty-six healthy, physically active individuals (5 female, 31 male; age 17.7 ± 1.9 y; height 175.3 ± 14.6 cm) with a history of CAI as determined by an ankle-instability questionnaire volunteered to be in this study.Interventions:Subjects were randomly assigned to 1 of 3 intervention groups: both treatments (DBT/GISTM, n = 13), DBT and a sham GISTM treatment (DBT/GISTM-S, n = 12), or DBT and control—no GISTM (DBT/C, n = 11). All groups participated in a 4-wk DBT program consisting of low-impact and dynamic activities that was progressed from week to week. The DBT/GISTM and DBT/GISTM-S groups received the GISTM treatment or sham treatment twice a week for 8 min before performing the DBT program. Pretest and posttest measurements included the Foot and Ankle Ability Measure (FAAM), FAAM Sport, the visual analog scale (VAS), ankle ROM in 4 directions, and the Star Excursion Balance Test (SEBT) in 3 directions.Main Outcome Measures:FAAM and FAAM-Sport scores, VAS, goniometric ROM (plantar flexion, dorsiflexion, inversion, eversion), and SEBT (anterior, posteromedial, posterolateral).Results:Subjects in all groups posttest demonstrated an increase in FAAM, FAAM Sport, ROM, and SEBT in all directions but not in VAS, which decreased. No other results were significant.Conclusion:For subjects with CAI, dynamic postural control, ROM, pain and disability improved pretest to posttest regardless of group membership, with the largest effects found in most measures in the DBT/GISTM group.

Effect of a 2-Week Joint-Mobilization Intervention on Single-Limb Balance and Ankle Arthrokinematics in Those With Chronic Ankle Instability

2014 ◽  
Vol 23 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Matthew C. Hoch ◽  
David R. Mullineaux ◽  
Richard D. Andreatta ◽  
Robert A. English ◽  
Jennifer M. Medina-McKeon ◽  
...  
Keyword(s):  
Postural Control ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Center Of Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Talocrural Joint ◽  
Joint Mobilization ◽  
Multiple Treatment ◽  
Eyes Open

Context:A single talocrural joint-mobilization treatment has improved spatiotemporal measures of postural control but not ankle arthrokinematics in individuals with chronic ankle instability (CAI). However, the effects of multiple treatment sessions on these aspects of function have not been investigated.Objective:To examine the effect of a 2-wk anterior-to-posterior joint-mobilization intervention on instrumented measures of single-limb-stance static postural control and ankle arthrokinematics in adults with CAI.Design:Repeated measures.Setting:Research laboratory.Participants:12 individuals with CAI (6 male, 6 female; age 27.4 ± 4.3 y, height 175.4 ± 9.78 cm, mass 78.4 ± 11.0 kg).Intervention:Subjects received 6 treatments sessions of talocrural grade II joint traction and grade III anterior-to-posterior joint mobilization over 2 wk.Main Outcome Measures:Instrumented measures of single-limb-stance static postural control (eyes open and closed) and anterior and posterior talar displacement and stiffness were assessed 1 wk before the intervention (baseline), before the first treatment (preintervention), 24–48 h after the final treatment (postintervention), and 1 wk later (1-wk follow-up). Postural control was analyzed as center-of-pressure velocity, center-of-pressure range, the mean of time-to-boundary minima, and standard deviation of time-to-boundary minima in the anteroposterior and mediolateral directions for each visual condition.Results:No significant differences were identified in any measures of postural control (P > .08) or ankle arthrokinematics (P > .21).Conclusions:The 2-wk talocrural joint-mobilization intervention did not alter instrumented measures of single-limb-stance postural control or ankle arthrokinematics. Despite the absence of change in these measures, this study continues to clarify the role of talocrural joint mobilization as a rehabilitation strategy for patients with CAI.

scholarly journals Short-Term Effects of Balance Training with Stroboscopic Vision for Patients with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial

2021 ◽  
Vol 18 (10) ◽  
pp. 5364
Author(s):  
Kyung-Min Kim ◽  
María D. Estudillo-Martínez ◽  
Yolanda Castellote-Caballero ◽  
Alejandro Estepa-Gallego ◽  
David Cruz-Díaz
Keyword(s):  
Randomized Controlled Trial ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Balance Training ◽  
Chronic Ankle Instability ◽  
Balance Test ◽  
Training Groups ◽  
Randomized Controlled ◽  
Star Excursion Balance Test

Chronic Ankle Instability (CAI) is one of the most common musculoskeletal dysfunctions. Stroboscopic vision (SV) training has been deemed to enhance somatosensorial pathways in this population group; nevertheless, until recently no studies have addressed the additional effects of this treatment option to the traditional therapeutic approach. Methods: To evaluate the effectiveness of a partial visual deprivation training protocol in patients with CAI, a randomized controlled trial was carried out. Patients with CAI (n = 73) were randomized into either a balance training, SV training, or a control (no training) group. For participants assigned into training groups, they received 18 training sessions over 6 weeks. The primary outcome was dynamic balance as measured by the Star Excursion Balance Test assessed at baseline and after 6 weeks of intervention. Secondary outcome measures included ankle dorsiflexion range of motion, self-reported instability feeling, and ankle functional status. Results: Better scores in stroboscopic training and balance training groups in all outcome measures were observed in comparison with the control group with moderate to large effect sizes. Stroboscopic training was more effective than neuromuscular training in self-reported instability feeling (cohen’s d = 0.71; p = 0.042) and anterior reach distance of the star excursion balance test (cohen’s d = 1.23; p = 0.001). Conclusions: Preliminary findings from the effects of SV Stroboscopic training in patients with CAI, suggest that SV may be beneficial in CAI rehabilitation.

The Effect of 2 Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability

2017 ◽  
Vol 26 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Cameron J. Powden ◽  
Kathleen K. Hogan ◽  
Erik A. Wikstrom ◽  
Matthew C. Hoch
Keyword(s):  
Postural Control ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Weight Bearing ◽  
Chronic Ankle Instability ◽  
Physical Contact ◽  
Future Research ◽  
Talocrural Joint ◽  
Sham Condition

Context:Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI).Objective:Examine the immediate effects of talocrural joint traction in those with CAI.Design:Blinded, crossover.Setting:Laboratory.Participants:Twenty adults (14 females; age = 23.80 ± 4.02 y; height = 169.55 ± 12.38 cm; weight = 78.34 ± 16.32 kg) with self-reported CAI participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥2 episodes of giving way in the previous 3 mo, answering “yes” to ≥4 questions on the Ankle Instability Instrument, and ≤24 on the Cumberland Ankle Instability Tool.Intervention:Subjects participated in 3 sessions in which they received a single treatment session of sustained traction (ST), oscillatory traction (OT), or a sham condition in a randomized order. Interventions consisted of four 30-s sets of traction with 1 min of rest between sets. During ST and OT, the talus was distracted distally from the ankle mortise to the end-range of accessory motion. ST consisted of continuous distraction and OT involved 1-s oscillations between the mid and end-range of accessory motion. The sham condition consisted of physical contact without force application. Preintervention and postintervention measurements of weight-bearing dorsiflexion, dynamic balance, and static single-limb balance were collected.Main Outcome Measures:The independent variable was treatment (ST, OT, sham). The dependent variables included pre-to-posttreatment change scores for the WBLT (cm), normalized SEBTAR (%), and time-to-boundary (TTB) variables(s). Separate 1-way ANOVAs examined differences between treatments for each dependent variable. Alpha was set a priori at P < .05.Results:No significant treatment effects were identified for any variables.Conclusion:A single intervention of ST or OT did not produce significant changes in weight-bearing dorsiflexion range of motion or postural control in individuals with CAI. Future research should investigate the effects of repeated talocrural traction treatments and the effects of this technique when combined with other manual therapies.

Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients

2019 ◽  
Vol 22 (5) ◽  
pp. 538-543 ◽  
Author(s):  
Christopher J. Burcal ◽  
Michelle A. Sandrey ◽  
Tricia Hubbard-Turner ◽  
Patrick O. McKeon ◽  
Erik A. Wikstrom
Keyword(s):  
Ankle Instability ◽  
Dynamic Balance ◽  
Balance Training ◽  
Chronic Ankle Instability

Comparisons of Static and Dynamic Balance Following Training in Aquatic and Land Environments

2006 ◽  
Vol 15 (4) ◽  
pp. 299-311 ◽  
Author(s):  
Aimee E. Roth ◽  
Michael G. Miller ◽  
Marc Ricard ◽  
Donna Ritenour ◽  
Brenda L. Chapman
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Dynamic Balance ◽  
Balance Training ◽  
Aquatic Environments ◽  
Repeated Measures Design ◽  
Time Interaction ◽  
Type Design ◽  
Post Test

Context:It has been theorized that aquatic balance training differs from land balance training.Objective:To compare the effects of balance training in aquatic and land environments.Design:Between-groups, repeated-measures design.Setting:Biomechanics laboratory and pool.Participants:24 healthy subjects randomly assigned to aquatic (n = 8), land (n = 10), or control (n = 6) groups.Intervention:Four weeks of balance training.Main Outcome Measures:Balance was measured (pre, mid, post, follow-up). COP variables: radial area, y range, x range in single leg (SL), tandem (T), single leg foam (SLF), and tandem form (TF) stance.Results:A significant condition × time interaction for x range was found, with improvements for SL, SLF, and TF. Radial area improved, with post-test 1.01 ± .23 cm2and follow-up 1.06 ± .18 cm2significantly lower than pretest 1.18 ± .23 cm2. Y range significantly improved, with posttest (4.69 ± 1.02 cm2) lower than pretest (5.89 ± 1.26 cm2). The foam conditions (SLF & TF) were significantly different from non-foam conditions (SL & T) for all variables.Conclusions:Results of this study show that balance training can effectively be performed in both land and aquatic environments.

Effects of Balance Training with Stroboscopic Glasses on Postural Control in Chronic Ankle Instability Patients

2021 ◽  
Author(s):  
Hyunwook Lee ◽  
Seunguk Han ◽  
Garritt Page ◽  
Dustin A. Bruening ◽  
Matthew K. Seeley ◽  
...  
Keyword(s):  
Postural Control ◽  
Ankle Instability ◽  
Balance Training ◽  
Chronic Ankle Instability

The Immediate Effects of an Anterior-To-Posterior Talar Mobilization on Neural Excitability, Dorsiflexion Range of Motion, and Dynamic Balance in Patients With Chronic Ankle Instability

2014 ◽  
Vol 23 (4) ◽  
pp. 351-359 ◽  
Author(s):  
Matthew Harkey ◽  
Michelle McLeod ◽  
Ashley Van Scoit ◽  
Masafumi Terada ◽  
Michael Tevald ◽  
...  
Keyword(s):  
Postural Control ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Corticospinal Excitability ◽  
Spinal Reflex ◽  
Control Group ◽  
Joint Mobilization ◽  
Grade Iii

Context:Altered neuromuscular function and decreased dorsiflexion range of motion (DFROM) have been observed in patients with chronic ankle instability (CAI). Joint mobilizations are indicated for restoring DFROM and dynamic postural control, yet it remains unknown if a mobilization can alter neuromuscular excitability in muscles surrounding the ankle.Objective:To determine the immediate effects of a Maitland grade III anterior-to-posterior joint mobilization on spinal-reflex and corticospinal excitability in the fibularis longus (FL) and soleus (SOL), DFROM, and dynamic postural control.Design:Single-blinded randomized control trial.Setting:Research laboratory.Patients:30 patients with CAI randomized into a mobilization (n = 15) or control (n = 15) group.Intervention:Maitland grade III anterior-to-posterior joint mobilization.Main Outcome Measures:Spinal-reflex excitability was measured with the Hoffmann reflex, while corticospinal excitability was evaluated with transcranial magnetic stimulation. DFROM was measured seated with the knee extended, and dynamic postural control was quantified with the Star Excursion Balance Test. Separate 2 × 2 repeated-measures ANOVAs were performed for each outcome measure. Dependent t tests were used to evaluate individual differences within groups in the presence of significance.Results:Spinal-reflex and corticospinal excitability of the SOL and FL were not altered in the mobilization or control group (P > .05). DFROM increased immediately after the mobilization (P = .05) but not in the control group, while dynamic postural control was unchanged in both groups (P > .05).Conclusion:A single joint-mobilization treatment was efficacious at restoring DFROM in participants with CAI; however, excitability of spinal reflex and corticospinal pathways at the ankle and dynamic postural control were unaffected.

Comparison of the Effect of the Combined Mechanism Ankle Support on Static and Dynamic Postural Control of Chronic Ankle Instability Patients

2019 ◽  
Vol 40 (6) ◽  
pp. 702-709 ◽  
Author(s):  
Mohammad Hadadi ◽  
Faezeh Abbasi
Keyword(s):  
Postural Control ◽  
Center Of Pressure ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Level Of Evidence ◽  
Balance Test ◽  
Level Ii ◽  
Combined Mechanism ◽  
Ankle Support

Background: Chronic ankle instability (CAI) is associated with postural control impairment. Orthotic devices are routinely used to improve postural control of CAI patients and prevent recurrence of ankle sprain. This study aimed to evaluate and compare the effect of combined mechanism ankle support (CMAS) with soft ankle support (SAS) and custom-molded foot orthosis (CFO) on static and dynamic postural control in patients with CAI. Methods: Twenty-two patients with CAI and 22 matched healthy subjects were recruited. The participants were evaluated in four orthotic conditions (without orthosis and with the CMAS, SAS, and CFO). Static balance was investigated in single-limb stance on the force platform, and dynamic balance was assessed using the Star Excursion Balance Test (SEBT). Results: Statistically significant differences were found for the main effects of the groups in all center of pressure (COP) parameters and reach distances in medial (M), anteromedial (AM), and posteromedial (PM) directions of the SEBT ( P < .05). The main effect of the orthotics for all evaluated parameters, except reach distance in the PM direction, was statistically different. All COP parameters were significantly lower with the CMAS compared with other orthotic conditions in CAI patients. Also, the higher reach distances with the CMAS were obtained in the AM and M directions of the SEBT. Conclusion: The CMAS improved impaired postural control in static and dynamic stability tests, but no similar effect was found for SAS and CFO. This result may have implications for the best bracing for CAI. Level of Evidence: Level II, comparative study.

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