scholarly journals Ankle-Joint Self-Mobilization and CrossFit Training in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

2020 ◽  
Vol 55 (2) ◽  
pp. 159-168
Author(s):  
David Cruz-Díaz ◽  
Fidel Hita-Contreras ◽  
Antonio Martínez-Amat ◽  
Agustin Aibar-Almazán ◽  
Kyung-Min Kim
Keyword(s):  
Postural Control ◽  
Ankle Joint ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
The Self ◽  
Control Group ◽  
Subjective Feeling ◽  
Randomized Controlled ◽  
Crossfit Training ◽  
Cumberland Ankle Instability Tool

Context Ankle-joint mobilization and neuromuscular and strength training have been deemed beneficial in the management of patients with chronic ankle instability (CAI). CrossFit training is a sport modality that involves these techniques. Objective To determine and compare the influence of adding self-mobilization of the ankle joint to CrossFit training versus CrossFit alone or no intervention in patients with CAI. Design Randomized controlled clinical trial. Setting Research laboratory. Patients or Other Participants Seventy recreational athletes with CAI were randomly allocated to either self-mobilization plus CrossFit training, CrossFit training alone, or a control group. Intervention(s) Participants in the self-mobilization plus CrossFit group and the CrossFit training-alone group pursued a CrossFit training program twice a week for 12 weeks. The self-mobilization plus CrossFit group performed an ankle self-mobilization protocol before their CrossFit training, and the control group received no intervention. Main Outcome Measure(s) Ankle-dorsiflexion range of motion (DFROM), subjective feeling of instability, and dynamic postural control were assessed via the weight-bearing lunge test, Cumberland Ankle Instability Tool, and Star Excursion Balance Test (SEBT), respectively. Results After 12 weeks of the intervention, both the self-mobilization plus CrossFit and CrossFit training-alone groups improved compared with the control group (P < .001). The self-mobilization plus CrossFit intervention was superior to the CrossFit training-alone intervention regarding ankle DFROM as well as the posterolateral- and posteromedial-reach distances of the SEBT but not for the anterior-reach distance of the SEBT or the Cumberland Ankle Instability Tool. Conclusions Ankle-joint self-mobilization and CrossFit training were effective in improving ankle DFROM, dynamic postural control and self-reported instability in patients with CAI.

Effects of 12 Weeks of Tai Chi Intervention in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

2020 ◽  
Vol 29 (3) ◽  
pp. 326-331
Author(s):  
David Cruz-Díaz ◽  
Kyung-Min Kim ◽  
Fidel Hita-Contreras ◽  
Marco Bergamin ◽  
Agustin Aibar-Almazán ◽  
...  
Keyword(s):  
Postural Control ◽  
Tai Chi ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Intervention Group ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Balance Test ◽  
Randomized Controlled ◽  
Cumberland Ankle Instability Tool

Context: Tai Chi is a physical activity modality which is widely practiced over the world. The effectiveness of Tai Chi on postural control and balance has been described in older population, but until recently there are no studies that include patients with chronic ankle instability. Objectives: The aim of this study was to evaluate the effectiveness of 12 weeks of Tai Chi intervention on dynamic balance and self-reported instability in patients with chronic ankle instability. Study Design: A randomized controlled trial was carried out. Setting: University physical therapy facility. Participants: Fifty-two participants were allocated to an intervention group (n = 26) based on Tai Chi training or a control group (n = 26) who received no intervention. Intervention: The participants completed 12 weeks of Tai Chi intervention (1 h session/2 times per week) or no intervention in the control group. Main Outcome Measures: Outcome measures included postural control and self-reported instability feeling assessed by the Star Excursion Balance Test and the Cumberland Ankle Instability Tool, respectively. Results: There was observed significant improvement in all Star Excursion Balance Test reach distances (anterior [F = 6.26, P < .01]; posteromedial [F = 9.58, P < .01], and posterolateral [F = 8.42, P < .01]) in the Tai Chi group with no change in the control group (P < .01). The intervention group demonstrated significant improvement on self-reported instability feeling assessed by the Cumberland Ankle Instability Tool questionnaire (F = 21.36, P < .01). Conclusion: The obtained results suggested that 12 weeks of Tai Chi intervention have positive effects on postural control and self-reported instability feeling in patients with 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.

scholarly journals Effects of Dry Needling on Neuromuscular Control of Ankle Stabilizer Muscles and Center of Pressure Displacement in Basketball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial

2021 ◽  
Vol 18 (4) ◽  
pp. 2092
Author(s):  
Luis López-González ◽  
Deborah Falla ◽  
Irene Lázaro-Navas ◽  
Cristina Lorenzo-Sánchez-Aguilera ◽  
Isabel Rodríguez-Costa ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Postural Control ◽  
Center Of Pressure ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Neuromuscular Control ◽  
Chronic Ankle Instability ◽  
Dry Needling ◽  
Basketball Players ◽  
Randomized Controlled

This study aimed to compare the effects of dry needling (DN) versus placebo DN applied to the peroneus longus (PL) and tibialis anterior (TA) on neuromuscular control and static postural control in basketball players with chronic ankle instability (CAI). A single-blinded randomized controlled trial was conducted. Thirty-two male and female basketball players with CAI were randomly assigned to receive either DN (n = 16) or placebo DN (n = 16). Pre-activation amplitudes of PL and TA were assessed with surface electromyography (EMG) during a dynamic landing test. Center of pressure (CoP) displacement and sway variability in anterior-posterior (AP) and medio-lateral (ML) directions were measured with a force platform during a single leg balance test (SLBT). Measures were obtained prior to a single DN intervention, immediately after, at 48 h, and 1 month after. The DN group displayed a significant increase in PL and TA pre-activation values, which were maintained 1 month later. Significant reductions in the ML and AP displacements and sway variability of CoP were found for the DN group. These results showed improvements in feedback/feed-forward strategies following DN, including enhanced neuromuscular control and static postural control, with the potential to become a convenient and accessible preventive treatment in CAI subjects.

scholarly journals Bilateral Improvements in Lower Extremity Function After Unilateral Balance Training in Individuals With Chronic Ankle Instability

2014 ◽  
Vol 49 (2) ◽  
pp. 181-191 ◽  
Author(s):  
Sheri A. Hale ◽  
Andrea Fergus ◽  
Rachel Axmacher ◽  
Kimberly Kiser
Keyword(s):  
Lower Extremity ◽  
Postural Control ◽  
Ankle Instability ◽  
Balance Training ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Lower Extremity Function ◽  
Balance Test ◽  
Extremity Function ◽  
Star Excursion Balance Test

Context: Bilateral improvements in postural control have been reported among individuals with acute lateral ankle sprains and individuals with chronic ankle instability (CAI) when only the unstable ankle is rehabilitated. We do not know if training the stable ankle will improve function on the unstable side. Objective: To explore the effects of a unilateral balance-training program on bilateral lower extremity balance and function in individuals with CAI when only the stable limb is trained. Design: Cohort study. Setting: University clinical research laboratory. Patients or Other Participants: A total of 34 volunteers (8 men, 26 women; age = 24.32 ± 4.95 years, height = 167.01 ± 9.45 cm, mass = 77.54 ± 23.76 kg) with CAI were assigned to the rehabilitation (n = 17) or control (n = 17) group. Of those, 27 (13 rehabilitation group, 14 control group) completed the study. Intervention(s): Balance training twice weekly for 4 weeks. Main Outcome Measure(s): Foot and Ankle Disability Index (FADI), FADI Sport (FADI-S), Star Excursion Balance Test, and Balance Error Scoring System. Results: The rehabilitation and control groups differed in changes in FADI-S and Star Excursion Balance Test scores over time. Only the rehabilitation group improved in the FADI-S and in the posteromedial and anterior reaches of the Star Excursion Balance Test. Both groups demonstrated improvements in posterolateral reach; however, the rehabilitation group demonstrated greater improvement than the control group. When the groups were combined, participants reported improvements in FADI and FADI-S scores for the unstable ankle but not the stable ankle. Conclusions: Our data suggest training the stable ankle may result in improvements in balance and lower extremity function in the unstable ankle. This further supports the existence of a centrally mediated mechanism in the development of postural-control deficits after injury, as well as improved postural control after rehabilitation.

scholarly journals The Effect of Plantar Massage on Static Postural Control in Patients With Chronic Ankle Instability: A Critically Appraised Topic

2020 ◽  
pp. 1-5
Author(s):  
Katherine L. Helly ◽  
Katherine A. Bain ◽  
Phillip A. Gribble ◽  
Matthew C. Hoch
Keyword(s):  
Randomized Controlled Trial ◽  
Postural Control ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Somatosensory System ◽  
Chronic Ankle Instability ◽  
Future Research ◽  
Bottom Line ◽  
Randomized Controlled ◽  
Crossover Studies

Clinical Scenario: Patients with chronic ankle instability (CAI) demonstrate deficits in both sensory and motor function, which can be objectively evaluated through static postural control testing. One intervention that has been suggested to improve somatosensation and, in turn, static postural control is plantar massage. Clinical Question: Does plantar massage improve static postural control during single-limb stance in patients with CAI relative to baseline? Summary of Key Findings: A search was performed for articles exploring the effect of plantar massage on static postural control in individuals with CAI. Three articles were included in this critically appraised topic including 1 randomized controlled trial and 2 crossover studies. All studies supported the use of plantar massage to improve static postural control in patients with CAI. Clinical Bottom Line: There is currently good-quality and consistent evidence that supports the use of plantar massage as an intervention that targets the somatosensory system to improve static postural control in patients with CAI. Future research should focus on incorporating plantar massage as a treatment intervention during long-term rehabilitation protocols for individuals with CAI. Strength of Recommendation: In agreement with the Center of Evidence-Based Medicine, the consistent results from 2 crossover studies and 1 randomized controlled trial designate that there is level B evidence due to consistent, moderate- to high-quality evidence.

Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: Systematic review and meta-analysis

2021 ◽  
pp. 026921552110220
Author(s):  
Sara Mollà-Casanova ◽  
Marta Inglés ◽  
Pilar Serra-Añó
Keyword(s):  
Systematic Review ◽  
Strength Training ◽  
Randomized Controlled Trials ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Balance Training ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled

Aim: To identify the effects of balance and strength training on function, ankle instability and dynamic balance in people with chronic ankle instability. Method: The search was conducted on randomized controlled trials that investigated the effects of balance training or strength training in people with chronic ankle instability compared to a control group. Therefore, a systematic electronic search was performed until April 2021 in Pubmed/MEDLINE, Cochrane, and Embase databases. Moreover, an additional search was further performed checking the reference lists of the selected articles. The main outcomes were ankle instability, functionality, and dynamic balance. Finally, a qualitative and quantitative synthesis was performed. Results: Fifteen randomized controlled trials with 457 volunteers were included. Compared to regular exercise, balance training demonstrated to be more effective in terms of improving functionality (0.81 (0.48, 1.14)), ankle instability (0.77 (0.27, 1.26)), and dynamic balance (0.83 (0.57, 1.10)) outcomes. However, when compared to strength training, the effectiveness of balance training was only greater in terms of the functionality outcome (0.49 (0.06, 0.92)), since no differences were found for instability (0.43 (0.00, 0.85)) and dynamic balance (0.21 (−0.15, 0.58)). Conclusions: Based on fair-to-high quality evidence, balance training significantly improves functionality, instability, and dynamic balance outcomes in people with chronic ankle instability Moreover, results of the comparison between balance training versus strength training suggest that the former achieves greater benefits for functionality, but not for instability and dynamic balance. Systematic review registration number: CRD42021224179.

scholarly journals Changes in Dorsiflexion and Dynamic Postural Control After Mobilizations in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 54 (4) ◽  
pp. 403-417 ◽  
Author(s):  
Robert A. Vallandingham ◽  
Stacey L. Gaven ◽  
Cameron J. Powden
Keyword(s):  
Systematic Review ◽  
Postural Control ◽  
Ankle Instability ◽  
Meta Analysis ◽  
Intervention Group ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Quality Level ◽  
Methodologic Quality ◽  
Evidence Database

Objective To conduct a systematic review with meta-analysis assessing the effectiveness of joint mobilizations for improving dorsiflexion range of motion (DFROM) and dynamic postural control in individuals with chronic ankle instability. Data Sources Electronic databases (PubMed, MEDLINE, CINAHL, and SPORTDiscus) were searched from inception to January 2017. Study Selection Included studies examined the isolated effects of joint mobilizations to enhance DFROM and dynamic postural control in individuals with chronic ankle instability and provided adequate data to calculate effect sizes (ESs) and 95% confidence intervals (CIs). Data Extraction Two investigators independently assessed the methodologic quality, level of evidence, and strength of recommendation using the Physiotherapy Evidence Database scale and the Strength of Recommendation Taxonomy. We extracted the sample sizes, means, and standard deviations for DFROM and dynamic postural control and filtered the data based on control-to-intervention and preintervention-to-postintervention (pre-post) comparisons. Data Synthesis We included 7 level 1 and 3 level 2 studies that had a median Physiotherapy Evidence Database score of 60% (range = 40%–80%). The magnitudes of control-to-intervention and pre-post differences were examined using bias-corrected Hedges g ESs. Random-effects meta-analyses were conducted for each outcome measure and comparison. Positive ESs indicated better outcome scores in the intervention group than in the control group and at postintervention than at preintervention. The α level was set at .05. Meta-analysis revealed weak and moderate ESs for overall control-to-intervention (ES = 0.41; 95% CI = 0.14, 0.68; P = .003) and pre-post (ES = 0.34; 95% CI = 0.20, 0.48; P &lt; .001) DFROM analyses. Overall, dynamic postural control meta-analysis revealed moderate control-to-intervention (ES = 0.42; 95% CI = −0.14, 0.98; P = .14) and weak and moderate ESs for pre-post (ES = 0.37; 95% CI = −0.12, 0.87; P = .14) analyses. Conclusions We observed grade A evidence that joint mobilizations can mildly improve DFROM among individuals with chronic ankle instability compared with controls and preintervention. We observed grade B evidence that indicated conflicting effects of joint mobilizations on dynamic postural control compared with controls and preintervention.

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