Context: Although lateral ankle sprains are common in athletes and can lead to chronic ankle instability (CAI), strengthtraining 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-bandprotocol group (n ¼ 13 [33%] age ¼ 19.7 6 2.2 years, height ¼ 172.9 6 12.8 cm, weight ¼ 69.1 6 13.5 kg), a proprioceptive neuromuscular facilitation strength-protocol group (n ¼ 13 [33%], age ¼ 18.9 6 1.3 years, height ¼ 172.5 6 5.9 cm, weight ¼ 72.7 6 14.6 kg), or a control group (n ¼ 13 [33%], age ¼ 20.5 6 2.1 years, height ¼ 175.2 6 8.1 cm, weight ¼ 70.2 6 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, repeatedmeasures 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 , .05); the proprioceptive neuromuscular facilitation group improved in strength (inversion and eversion) and on the visual analog scale (P , .05) as well. No improvements were seen in the triple-crossover hop or the YBalance tests for either intervention group or in the control group for any dependent variable (P . .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.Key Words: functional ankle instability, functional performance, rehabilitation, Star Excursion Balance Test Key PointsProprioceptive neuromuscular facilitation is an alternate strength-training protocol that was effective in enhancing ankle strength in those with chronic ankle instability. Neither the resistance-band protocol nor the proprioceptive neuromuscular facilitation protocol improved dyn...

IMPORTANCE A report by the Institute of Medicine called for comprehensive nationwide concussion incidence data across the spectrum of athletes aged 5 to 23 years. OBJECTIVE To describe the incidence of concussion in athletes participating in youth, high school, and collegiate American football.

Findings of this study revealed differences in the distribution of chronic ankle instability that warrant further study.

Sports encourage physical activity, which help promote a healthy lifestyle. Moderate activity and exercise should be encouraged. However, the demands of Division I athletics may result in injuries that linger into adulthood and possibly make participants incapable of staying active as they age, thereby lowering their HRQoL.

Context: Although strength training is commonly used to rehabilitate ankle injuries, studies investigating the effects of strength training on proprioception have shown conflicting results.Objective: To determine the effects of a 6-week strengthtraining protocol on force sense and strength development in participants with functional ankle instability.Design: Randomized controlled clinical trial. Setting: University athletic training research laboratory. Patients or Other Participants: A total of 40 participants with functional ankle instability were recruited. They were randomly placed into a training group (10 men, 10 women: age 5 20.9 6 2.2 years, height 5 76.4 6 16.1 cm, mass 5 173.0 6 7.9 kg) or control group (10 men, 10 women: age 5 20.2 6 2.1 years, height 5 78.8 6 24.5 cm, mass 5 173.7 6 8.2 kg).Intervention(s): Participants in the training group performed strength exercises with the injured ankle 3 times per week for 6 weeks. The protocol consisted of a combination of rubber exercise bands and the Multiaxial Ankle Exerciser, both clinically accepted strengthening methods for ankle rehabilitation. The progression of this protocol provided increasingly resistive exercise as participants changed either the number of sets or resistance of the Thera-Band or Multiaxial Ankle Exerciser.Main Outcome Measure(s): A load cell was used to measure strength and force sense. Inversion and eversion strength was recorded to the nearest 0.01 N. Force-sense reproduction was measured at 2 loads: 20% and 30% of maximal voluntary isometric contraction.Results: Increases in inversion (F 1,38 5 11.59, P , 0.01, g p 2 5 0.23, power 5 0.91) and eversion (F 1,38 5 57.68, P , .01, g p 2 5 0.60, power 5 0.99) strength were found in the training group at the posttest when compared with the control group. No significant improvements were noted in force-sense reproduction for either group. Conclusions: Strength training at the ankle increased strength but did not improve force sense.