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.

A dynamic balance training program (DPT) and Graston Instrumented-Assisted Soft Tissue Mobilization (GISTM) technique are interventions that have been implemented as treatment options for chronic ankle instability (CAI). Although both have been evaluated individually, there are no published reports with the two treatments combined in a population with CAI. PURPOSE:To investigate the effects of a dynamic balance training program with GISTM technique on improving dynamic postural control, range of motion, pain and disability in subjects with CAI. METHODS:Thirty-six healthy, physically active individuals (5 female, 31 male; age= 17.7±1.9 yrs; ht=175.3±14.6 cm) with a history of CAI as determined by an Instability Questionnaire and orthopedic special tests volunteered to be in this study. Subjects were randomly assigned to three 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 4week 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 minutes before performing the DBT program. Pre-and Post-test measurements included the Foot and Ankle Ability Measures (FAAM), FAAM Sport, the Visual Analog Scale (VAS), ankle range of motion (ROM) in four movements, and the Star Excursion Balance Test (SEBT) in three directions. RESULTS:Subjects in all groups demonstrated differences between pre to post-test with post-test results showing improvement for disability (FAAM, P<0.001 and FAAM Sport, P<0.001) and pain (VAS, P<0.001). ROM improvements were noted for plantarflexion (P=0.001), inversion (P<0.001) and eversion (P<0.001) and SEBT in the direction of anterior (P<0.001), posteromedial (P<0.001) and posterolateral (P<0.001) pre to post-test as well. The ranges with percent change scores for groups were disability (10.4%-30.6%), pain (87.2%-100%), ROM (0% to 44.9%), and SEBT (5.7% to 17.4%). No other results were significant, especially differences between groups. CONCLUSIONS:Dynamic postural control, ROM, pain and disability improved pre to post-test for subjects with CAI following a 4-week dynamic balance-training program with GISTM.It has been shown that force platforms provide a quantitative, valid analysis of balance through measurements of center of pressure (CoP). However, these platforms are expensive and lack of portability limits their usefulness outside of laboratory settings. PURPOSE:To determine the validity and reliability of balance measures using the Nintendo Wii Balance Board. METHODS:Twenty-four male and female subjects participated in this study. The mean age, height, and weight of female subjects (n=4) was 20±0.8 years, 163.5±6.3 cm, and 60.3±12.3 kg, respectively. The mean age, height, and weight of male subjects (n=20) was 24.4±8.0 years, 178.7±7.9 cm, and 90.7±15.5 kg, respectively. Left-foot, right-foot and two-foot stances held for 30 seconds wer...

Context: Despite case reports and clinical studies, there have been no experimental studies conducted on Graston Instrumented-Assisted Soft Tissue Mobilization (GISTM) technique and the effects on chronic ankle instability. Most of the clinical studies and case reports that have been conducted have used animals and human subjects for lateral epicondylitis, and patellar, rotator cuff and achilles tendinopathy. Since only a case report exists in the literature for chronic ankle instability using GISTM, the intent of this study is to further evaluate the effects of GISTM and dynamic postural balance on improvements in healing and function. Objective: The present study aims to investigate the affects of GISTM technique and the influence on improving range of motion, neovascularization, collagen alignment, pain and disability in individuals experiencing chronic ankle instability. Design: Subjects were randomly assigned to the GISTM/ Dynamic Balance-Training (DBT), GISTM-S/DBT, or C/DBT group. All groups participated in a 4wk DBT program consisting of four exercises and a lower extremity dynamic stretching protocol using a Flex band twice a week throughout the training period. The GISTM/DBT and GISTM-S/DBT groups received the GISTM treatment of sham treatment twice a week before performing the DBT program throughout the training period. Setting: A AAA High School in North Central West Virginia. Patients or Other Participants: This study included 36 healthy, physically active individuals (5 female, 31 male; age= 17.771+1.972 years; ht=69.403+5.775; 30 right, 6 left foot; 28 six sessions, 8 seven sessions completed of rehab) with a history of CAI volunteered to be in this study from a North Central High School in WV and a DI Mid-Atlantic University. Interventions: The DBT program that was performed twice a week for 4-wks included a battery of exercises that was advanced from week to week for all three experimental groups. The 4-wk GISTM treatment protocol for the GISTM and GISTM-S groups also was performed twice a week. Pre-and Post-test measurements were taken using the Foot and Ankle Ability Measures (FAAM), FAAM Sport, the Visual Analog Scale (VAS), ankle range of motion (ROM) in four directions, ultrasonography (US), and the Star Excursion Balance Test (SEBT) in three directions. Outcomes Measures: A greater increase will be found in the talocrural range of motion, neovascularization, and collagen alignment between groups preand post-test. And also a decrease in the FAAM, FAAM Sport and VAS will be found; with a significant difference in pre-and post-test results between groups. Results: There was a significant difference for test with FAAM (