Balance training for persons with functionally unstable ankles

Study Design: A nonrandomized 2-group pretest-posttest design. Objectives: To determine the effects of a 4-week balance training program d uring stance on a single leg. Background: Individuals who have experienced multiple episodes of inversion ankle sprains often participate in balance training programs Balance train ing is performed to treat existing proprioceptive deficits and to restore a nkle joint stability, presumably by retraining altered afferent neuromuscul ar pathways. The effectiveness of such programs on individuals with functio nally unstable ankles has yet to be established. Methods and Measures: Prior to and following training, subjects with self-r eported functionally unstable ankles (5 women and 8 men, mean age = 21.9 +/ - 3.7 years) and nonimpaired subjects (6 women and 7 men, mean age = 21.2 /- 2.5 years) completed a static balance assessment for both limbs as well as the ankle joint functional assessment tool questionnaire (AJFAT). The su bjects from both groups participated in a unilateral, multilevel, static an d dynamic balance training program 3 times a week for 4 weeks. Subjects fro m the experimental group trained only the involved limb, and the nonimpaire d group trained a randomly selected limb. A stability index (SI) was calcul ated during the balance assessment to indicate the amount of platform motio n. Compared to low stability indices, high stability indices indicate great er platform motion during stance and therefore less stability. Results: Following training, subjects from both groups demonstrated signifi cant improvements in balance ability. When balance was assessed at a low re sistance to platform tilt (stability level 2), the posttraining scores of b oth the subjects with unstable ankles (mean SI = 2.63 +/- 1.92) and the non impaired subjects (mean SI = 2.69 +/- 2.32) were significantly better than their pretraining scores (mean Sls = 5.93 +/- 3.65 and 4.67 +/- 3.43, respe ctively). Assessed at a high resistance to platform tilt (stability level 6 ) the posttraining scores of both subjects with unstable ankles (mean SI = 1.27 +/- 0.66) and the nonimpaired subjects (mean SI = 1.37 +/- 0.66) were significantly better than their pretraining scores (mean Sls = 2.30 +/- 1.8 8 and 2.04 +/- 1.43, respectively). Additionally, the posttraining AJFAT sc ores of subjects with unstable ankles (25.78 +/- 3.80)and the nonimpaired s ubjects (29.15 +/- 5.27) were significantly greater than their pretraining scores (17.11 +/- 3.44 and 22.92 +/- 5.22, respectively), indicating an ove rall improvement in perceived ankle joint functional stability Conclusions: This study suggests that balance training is an effective mean s of improving joint proprioception and single-leg standing ability in subj ects with unstable and nonimpaired ankles.