scholarly journals The Cut-Off Score of Four Clinical Tests to Quantify Balance Impairment in Individuals with Chronic Ankle Instability

2021 ◽  
Vol 28 (4) ◽  
pp. 87-96
Author(s):  
Nontawit Udompanich ◽  
Kanok-on Thanasootr ◽  
Raoyrin Chanavirut ◽  
Uraiwan Chatchawan ◽  
Torkamol Hunsawong
Keyword(s):  
Roc Curve ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Youden Index ◽  
Clinical Tests ◽  
Balance Performance ◽  
Operating Characteristics ◽  
Balance Test ◽  
Balance Impairment ◽  
Hop Test

Background: Balance impairment is a common consequence of chronic ankle instability (CAI). This study aimed to assess the discriminative validity of four clinical tests for quantifying balance impairment in individuals with CAI. Methods: Participants were screened for their balance using the single-leg balance test (SLBT) and were assigned to either the positive or the negative SLBT groups. Fifty-four individuals with CAI (N = 27 per group) were recruited and completed four clinical tests including the foot-lift test (FLT), the time-in-balance test (TIBT), the modified star excursion balance test in the posteromedial (mSEBT-PM) direction and the side-hop test (SHT). The receiver operating characteristics (ROC) curve coupled with Youden index were calculated to determine the optimal cut-off scores of each test. Results: We found significant differences in balance between groups for all tests, with good to excellent values for the area under the ROC curve (AUC). All four tests reached good to excellent sensitivity and specificity values and had significant cut-off scores to discriminate balance performance among CAI participants. Conclusion: All four clinical tests can be conducted with their respective cut-off scores to quantify balance impairment in individuals with CAI.

The effect of combined mechanism ankle support on postural control of patients with chronic ankle instability

2016 ◽  
Vol 41 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Mohammad Hadadi ◽  
Ismaeil Ebrahimi ◽  
Mohammad Ebrahim Mousavi ◽  
Gholamreza Aminian ◽  
Ali Esteki ◽  
...  
Keyword(s):  
Postural Control ◽  
Postural Sway ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Foot And Ankle ◽  
Balance Performance ◽  
Balance Test ◽  
Combined Mechanism ◽  
Ankle Support ◽  
Healthy Participants

Background:Chronic ankle instability is associated with neuromechanical changes and poor postural stability. Despite variety of mechanisms of foot and ankle orthoses, almost none apply comprehensive mechanisms to improve postural control in all subgroups of chronic ankle instability patients.Objectives:The purpose of this study was to investigate the effect of an ankle support implementing combined mechanisms to improve postural control in chronic ankle instability patients.Study design:Cross-sectional study.Methods:An ankle support with combined mechanism was designed based on most effective action mechanisms of foot and ankle orthoses. The effect of this orthosis on postural control was evaluated in 20 participants with chronic ankle instability and 20 matched healthy participants. The single-limb stance balance test was measured in both groups with and without the new orthosis using a force platform.Results:The results showed that application of combined mechanism ankle support significantly improved all postural sway parameters in chronic ankle instability patients. There were no differences in means of investigated parameters with and without the orthosis in the healthy group. No statistically significant differences were found in postural sway between chronic ankle instability patients and healthy participants after applying the combined mechanism ankle support.Conclusion:The combined mechanism ankle support is effective in improving static postural control of chronic ankle instability patients to close to the postural sway of healthy individual. the orthosis had no adverse effects on balance performance of healthy individuals.Clinical relevanceApplication of the combined mechanism ankle support for patients with chronic ankle instability is effective in improving static balance. This may be helpful in reduction of recurrence of ankle sprain although further research about dynamic conditions is needed.

Effects of Kinesiotape vs Soft and Semirigid Ankle Orthoses on Balance in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

2020 ◽  
Vol 41 (7) ◽  
pp. 793-802 ◽  
Author(s):  
Mohammad Hadadi ◽  
Farzaneh Haghighat ◽  
Navid Mohammadpour ◽  
Sobhan Sobhani
Keyword(s):  
Randomized Controlled Trial ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Control Group ◽  
Balance Performance ◽  
Balance Test ◽  
Randomized Controlled ◽  
Single Leg Stance ◽  
Hop Test ◽  
Single Leg Hop Test

Background: Chronic ankle instability (CAI) is a frequent complication of ankle sprain that may be associated with long-term consequences. Although taping and bracing are common interventions that are widely used by clinicians and athletic trainers for patients with CAI, no studies have compared the effects of kinesiotaping and bracing on balance performance in these patients. The present study aimed to compare the effects of ankle kinesiotaping, a soft ankle orthosis, and a semirigid ankle orthosis on balance performance in patients with CAI. Methods: Sixty patients with CAI were randomly assigned to 4 groups that received kinesiotaping, a soft orthosis, a semirigid orthosis, or no treatment (control group). Dynamic and static balance were measured with the modified Star Excursion Balance Test, single leg hop test, and single leg stance test before and after a 4-week intervention period. Results: Significant between-group differences were seen in all evaluated outcomes ( P ≤ .003). The lowest reach distances in all directions in the modified Star Excursion Balance Test were found in the control group, and these patients also had a significantly shorter measured distance in the single leg hop test, and more errors in the single leg stance test compared with the 3 intervention groups. No significant differences were found among the 3 intervention groups. Conclusion: Use of kinesiotaping and a soft or a semirigid ankle brace for 4 weeks were all beneficial in improving static and dynamic balance in individuals with CAI. None of the interventions was superior to the other 2. Level of Evidence: Level I, randomized controlled trial.

scholarly journals Four-Week Ankle-Rehabilitation Programs in Adolescent Athletes With Chronic Ankle Instability

2020 ◽  
Vol 55 (8) ◽  
pp. 801-810
Author(s):  
M. Spencer Cain ◽  
Rebecca J. Ban ◽  
Yu-Ping Chen ◽  
Mark D. Geil ◽  
Benjamin M. Goerger ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Balance Test ◽  
Rehabilitation Programs ◽  
Patient Reported ◽  
Hop Test ◽  
Star Excursion Balance Test ◽  
Platform System ◽  
Clinical Measures

Context Researchers have shown that rehabilitation programs incorporating resistance-band and balance-board exercises are effective for improving clinical measures of function and patient-reported outcomes in individuals with chronic ankle instability (CAI). However, whether combining the 2 exercises increases improvement is unknown. Objective To determine the effectiveness of 3 rehabilitation programs on clinical measures of balance and self-reported function in adolescent patients with CAI. Design Randomized controlled clinical trial (Trail Registration Number: ClinicalTrails.gov: NCT03447652). Setting High school athletic training facilities. Patients or Other Participants Forty-three patients with CAI (age = 16.37 ± 1.00 years, height = 171.75 ± 12.05 cm, mass = 69.38 ± 18.36 kg) were block randomized into 4 rehabilitation groups. Intervention(s) Protocols were completed 3 times per week for 4 weeks. The resistance-band group performed 3 sets of 10 repetitions of ankle plantar flexion, dorsiflexion, inversion, and eversion with a resistance band. The Biomechanical Ankle Platform System group performed 5 trials of clockwise and counterclockwise rotations, changing direction every 10 seconds during each 40-second trial. The combination group completed resistance-band and Biomechanical Ankle Platform System programs during each session. The control group did not perform any exercises. Main Outcome Measure(s) Variables were assessed before and after the intervention: time-in-balance test, foot-lift test, Star Excursion Balance Test, side-hop test, figure-8 hop test, Foot and Ankle Ability Measure, and Cumberland Ankle Instability Tool. We conducted 4 separate multivariate repeated-measures analyses of variance, followed by univariate analyses for any findings that were different. Results Using the time-in-balance test, foot-lift test, Star Excursion Balance Test (medial, posteromedial, and posterolateral directions), and figure-8 hop test, we detected improvement for each rehabilitation group compared with the control group (P < .05). However, no intervention group was superior. Conclusions All 3 rehabilitation groups demonstrated improvement compared with the control group, yet the evidence was too limited to support a superior intervention. Over a 4-week period, either of the single-task interventions or the combination intervention can be used to combat the residual deficits associated with CAI in an adolescent patient population.

scholarly journals Balance Performance With and Without Visual Information: A Comparison of Elite Players With Chronic Ankle Instability

2019 ◽  
Vol 11 (2) ◽  
pp. 125-132
Author(s):  
Zahra Raeisi ◽  
◽  
Ali Yalfani ◽  
Keyword(s):  
Visual Information ◽  
Center Of Pressure ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Balance Performance ◽  
Balance Test ◽  
Eyes Closed ◽  
Significant Difference ◽  
Volleyball Players ◽  
Eyes Open

Introduction: This research was conducted to determine whether professional athletes with Chronic Ankle Instability (CAI) exhibit differences in maintaining balance under conditions of with and without visual information Materials and Methods: Forty-five elite players with CAI were classified into soccer, volleyball, and basketball groups (n=15 each). All participants performed a static single-leg balance test in conditions wherein visual information was provided and withheld. Also, their center of pressure (CoP) oscillation parameters was measured. The data were examined through an analysis of variance (ANOVA) and the Tukey test. Results: A significant difference was found between the soccer and volleyball players (P=0.034) in anteroposterior CoP displacement. Furthermore, there was a significant difference between soccer compared with volleyball (P=0.001) and basketball (P=0.02) groups regarding mediolateral sway and sway area (P=0.003 and P=0.03, respectively) when they performed the test with their eyes open. A significant difference occurred between the soccer and volleyball players concerning anteroposterior and mediolateral sway (P=0.002 and P=0.04, respectively) and sway area (P=0.004) when they performed the test with their eyes closed. Conclusion: Given the necessity of maintaining a good balance in sports, volleyball coaches should design practices that reduce players’ reliance on visual information. These practices should strengthen their proprioceptive abilities through an increased challenge to their proprioceptive senses.

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.

Comparison of the effect of foot orthoses on Star Excursion Balance Test performance in patients with chronic ankle instability

2018 ◽  
Vol 43 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Faezeh Abbasi ◽  
Mahmood bahramizadeh ◽  
Mohammad Hadadi
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Textured Surface ◽  
Foot Orthoses ◽  
Textured Surfaces ◽  
Balance Test ◽  
Star Excursion Balance Test ◽  
Foot Orthosis

Background: Chronic ankle instability as a prevalent consequence of ankle sprain causes various impairments such as balance and postural control deficits. Foot orthoses are one of the common interventions for rehabilitation of patients with chronic ankle instability. Objectives: To investigate the effect of custom-molded foot orthoses with textured surfaces on dynamic balance of chronic ankle instability patients and to compare their effects with other types of foot orthoses. Study design: This is a repeated measure design. Methods: A total of 30 participants were recruited based on the guideline introduced by the International Ankle Consortium. The effect of prefabricated, custom-molded, and custom-molded with textured surface foot orthoses was evaluated on dynamic balance by the Star Excursion Balance Test. Normalized reach distances in anteromedial, medial, and posteromedial directions of the test were computed to be used for statistical analysis. Results: The foot orthoses increased reach distances compared to the no-orthosis conditions in all three directions. The custom-molded with textured surface foot orthosis has significant differences compared with prefabricated foot orthosis ( p = 0.001) in all measured directions and with custom-molded foot orthosis ( p < 0.01) in medial and posteromedial directions. Conclusion: Foot orthoses improve reach distances in patients with chronic ankle instability. Custom-molded with textured surface foot orthosis has a more pronounced effect compared with other foot orthoses. Clinical relevance The custom-molded foot orthosis with textured surface could be an effective device to improve dynamic balance in chronic ankle instability (CAI) patients. It may be considered as an efficient intervention to reduce ankle sprain recurrence in these individuals, although further research should be conducted.

scholarly journals The Effects of Therapeutic Exercise With and Without Mobilization in Participants With Chronic Ankle Instability: A Randomized Controlled Trial

2020 ◽  
pp. 1-8
Author(s):  
Cameron Bolton ◽  
Sheri Hale ◽  
Todd Telemeco
Keyword(s):  
Randomized Controlled Trial ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Chronic Ankle Instability ◽  
Therapeutic Exercise ◽  
Convenience Sample ◽  
Randomized Controlled ◽  
Hop Test

Context: Manual therapy (MT) is reported to increase range of motion (ROM), improve balance, and decrease pain in individuals with chronic ankle instability (CAI). Additional literature is needed to examine the effectiveness of the addition of MT to a therapeutic exercise regimen in individuals with CAI. Objective: To examine the combined effects of thrust joint manipulation (TJM) and exercise on function in participants reporting CAI. Design: Randomized controlled trial. Setting: Research laboratory. Participants: A convenience sample of 30 participants (mean age 23.7 [3.65] y; mean height 169.50 [9.50] cm; mean mass 66.48 [10.64] kg). Intervention: Participants were randomly allocated to the exercise (n = 15) or exercise + TJM group (n = 20) and completed an exercise program. The exercise + TJM group also received MT at the talocrural, proximal, and distal tibiofibular joints in the first 3 sessions. Main Outcome Measures: Self-reported outcomes were recorded at baseline and follow-up using the Foot and Ankle Ability Measure (FAAM), the FAAM-Sport (FAAM-S) subscale, and the Ankle Joint Functional Assessment Tool (AJFAT). The side-hop test, figure-of-8 hop test, 3 directions of the Star Excursion Balance Test, and dorsiflexion ROM were also assessed at baseline and follow-up. Results: Only the exercise + TJM group demonstrated an improvement in weight-bearing dorsiflexion with the knee flexed following treatment (P = .02). For all outcome measures, except ROM, subjects improved significantly at follow-up regardless of group assignment (P ≤ .01). Conclusions: Our data suggest that rehabilitation of patients with CAI is related to improved ROM, function, and self-reported outcomes. This provides evidence that the addition of MT to exercise may enhance improvements in ROM as compared with exercise alone. Additional research is needed to identify optimal parameters to maximize therapeutic benefit.

Dynamic Leap and Balance Test: Ability to Discriminate Balance Deficits in Individuals With Chronic Ankle Instability

2020 ◽  
Vol 29 (3) ◽  
pp. 263-270 ◽  
Author(s):  
Abbis H. Jaffri ◽  
Thomas M. Newman ◽  
Brent I. Smith ◽  
Giampietro L. Vairo ◽  
Craig R. Denegar ◽  
...  
Keyword(s):  
Dynamic Stability ◽  
Healthy Subjects ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Chronic Ankle Instability ◽  
Assessment Tools ◽  
Balance Test ◽  
Balance Task ◽  
History Of ◽  
Base Of Support

Context: The Dynamic Leap Balance Test (DLBT) is a new dynamic balance task that requires serial changes in base of support with alternating limb support and recovery of dynamic stability, as compared with the Y modification of the Star Excursion Balance Test (Y-SEBT), which assesses dynamic stability over an unchanging base of support. Objectives: To assess the dynamic balance performance in 2 different types of dynamic balance tasks, the DLBT and the SEBT, in subjects with unilateral chronic ankle instability (CAI) when compared with matched controls. The authors hypothesized that the DLBT score would significantly differ between the CAI involved and uninvolved limbs (contralateral and healthy matched) and demonstrate a modest (r = .50) association with the SEBT scores. Design: Case-control. Setting: Controlled laboratory. Participants: A total of 36 physically active adults, 18 with history of unilateral CAI and 18 without history of ankle injury, were enrolled in the study. CAI subjects were identified using the Identification of Functional Ankle Instability questionnaire. Interventions: The DLBT and the SEBT were performed in a randomized order on a randomly selected limb in CAI and healthy subjects. Main Outcome Measures: Time taken to complete the DLBT and the reach distances performed on the SEBT were compared between the CAI and the healthy subjects. Results: There were no statistically significant differences (P < .05) in SEBT reach distances between groups. The DLBT time was greater (P < .01) for unstable ankles compared with the stable ankle. The authors found no correlation (P > .05) between DLBT time and any of the SEBT reach distances suggesting that the DLBT provides unique information in the assessment of patients with CAI. Conclusion: The DLBT challenges the ability to maintain postural control in CAI subjects differently than the SEBT. There is a need of more dynamic balance assessment tools that are functional and clinically relevant.

Examination of Y-Balance Performance in Chronic Ankle Instability

2017 ◽  
Vol 49 (5S) ◽  
pp. 122
Author(s):  
HYUNGPIL JUN ◽  
Russell Baker ◽  
Lindsay Warren ◽  
Young-min Chun ◽  
Jin-Ah Kim ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Balance Performance

scholarly journals Strength-Training Protocols to Improve Deficits in Participants With Chronic Ankle Instability: A Randomized Controlled Trial

2015 ◽  
Vol 50 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Emily A. Hall ◽  
Carrie L. Docherty ◽  
Janet Simon ◽  
Jackie J. Kingma ◽  
Joanne C. Klossner
Keyword(s):  
Strength Training ◽  
Visual Analog Scale ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Analog Scale ◽  
Protocol Group ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Hop Test

Context: Although lateral ankle sprains are common in athletes and can lead to chronic ankle instability (CAI), strength-training rehabilitation protocols may improve the deficits often associated with CAI. Objective: To determine whether strength-training protocols affect strength, dynamic balance, functional performance, and perceived instability in individuals with CAI. Design: Randomized controlled trial. Setting: Athletic training research laboratory. Patients or Other Participants: A total of 39 individuals with CAI (17 men [44%], 22 women [56%]) participated in this study. Chronic ankle instability was determined by the Identification of Functional Ankle Instability Questionnaire, and participants were randomly assigned to a resistance-band–protocol group (n = 13 [33%] age = 19.7 ± 2.2 years, height = 172.9 ± 12.8 cm, weight = 69.1 ± 13.5 kg), a proprioceptive neuromuscular facilitation strength-protocol group (n = 13 [33%], age = 18.9 ± 1.3 years, height = 172.5 ± 5.9 cm, weight = 72.7 ± 14.6 kg), or a control group (n = 13 [33%], age = 20.5 ± 2.1 years, height = 175.2 ± 8.1 cm, weight = 70.2 ± 11.1 kg). Intervention(s): Both rehabilitation groups completed their protocols 3 times/wk for 6 weeks. The control group did not attend rehabilitation sessions. Main Outcome Measure(s): Before the interventions, participants were pretested by completing the figure-8 hop test for time, the triple-crossover hop test for distance, isometric strength tests (dorsiflexion, plantar flexion, inversion, and eversion), the Y-Balance test, and the visual analog scale for perceived ankle instability. Participants were again tested 6 weeks later. We conducted 2 separate, multivariate, repeated-measures analyses of variance, followed by univariate analyses on any significant findings. Results: The resistance-band protocol group improved in strength (dorsiflexion, inversion, and eversion) and on the visual analog scale (P &lt; .05); the proprioceptive neuromuscular facilitation group improved in strength (inversion and eversion) and on the visual analog scale (P &lt; .05) as well. No improvements were seen in the triple-crossover hop or the Y-Balance tests for either intervention group or in the control group for any dependent variable (P &gt; .05). Conclusions: Although the resistance-band protocol is common in rehabilitation, the proprioceptive neuromuscular facilitation strength protocol is also an effective treatment to improve strength in individuals with CAI. Both protocols showed clinical benefits in strength and perceived instability. To improve functional outcomes, clinicians should consider using additional multiplanar and multijoint exercises.

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