Balance Training Versus Balance Training With STARS in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

Burcal, Christopher J.; Trier, Alejandra Y.; Wikstrom, Erik A.

doi:10.1123/jsr.2016-0018

Cited by 34 publications

(55 citation statements)

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“…For example, improvements were noted after 4-week interventions that included hop-stabilization exercises. 14,15,19 Additionally, the magnitude of the improvements we found were consistent with, if not larger than, those reported previously. The magnitudes of improvement on the FAAM and FAAM-S were also larger than previously established 22 minimal clinically important difference scores (8% and 9%, respectively) for these questionnaires in patients with CAI.…”

Section: Discussionsupporting

confidence: 92%

“…These impairments decrease the adaptability for coordinating movements during changing task and environmental demands, resulting in a continuum of disability. 29 Research 11,14,15,17 has consistently shown that coordination training improved a variety of outcomes in those with CAI.…”

Section: Discussionmentioning

confidence: 99%

“…13 Training programs that emphasize hop stabilization enhance function and postural control in individuals with CAI. 14,15 In addition, plyometric-training programs that included a variety of hopping exercises improved lower extremity biomechanics in healthy control participants. 16 Despite this evidence, it remains unclear how a hop-stabilization intervention would affect lower extremity jump-landing biomechanics in individuals with CAI.…”

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confidence: 99%

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Hop-Stabilization Training and Landing Biomechanics in Athletes With Chronic Ankle Instability: A Randomized Controlled Trial

Ardakani

Wikstrom

Minoonejad

et al. 2019

Journal of Athletic Training

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Context Hopping exercises are recommended as a functional training tool to prevent lower limb injury, but their effects on lower extremity biomechanics in those with chronic ankle instability (CAI) are unclear. Objective To determine if jump-landing biomechanics change after a hop-stabilization intervention. Design Randomized controlled clinical trial. Setting Research laboratory. Patients or Other Participants Twenty-eight male collegiate basketball players with CAI were divided into 2 groups: hop-training group (age = 22.78 ± 3.09 years, mass = 82.59 ± 9.51 kg, height = 187.96 ± 7.93 cm) and control group (age = 22.57 ± 2.76 years, mass = 78.35 ± 7.02 kg, height = 185.69 ± 7.28 cm). Intervention(s) A 6-week supervised hop-stabilization training program that consisted of 18 training sessions. Main Outcome Measure(s) Lower extremity kinetics and kinematics during a jump-landing task and self-reported function were assessed before and after the 6-week training program. Results The hop-stabilization program resulted in improved self-reported function (P < .05), larger sagittal-plane hip- and knee-flexion angles, and greater ankle dorsiflexion (P < .05) relative to the control group. Reduced frontal-plane joint angles at the hip, knee, and ankle as well as decreased ground reaction forces and a longer time to peak ground reaction forces were observed in the hopping group compared with the control group after the intervention (P < .05). Conclusions The 6-week hop-stabilization training program altered jump-landing biomechanics in male collegiate basketball players with CAI. These results may provide a potential mechanistic explanation for improvements in patient-reported outcomes and reductions in injury risk after ankle-sprain rehabilitation programs that incorporate hop-stabilization exercises.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Hop-Stabilization Training and Landing Biomechanics in Athletes With Chronic Ankle Instability: A Randomized Controlled Trial

Ardakani

Wikstrom

Minoonejad

et al. 2019

Journal of Athletic Training

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“…14 Impaired balance in patients with CAI can be improved after balance training. 6,[15][16][17] Whereas multiple balancetraining programs have been developed, researchers have recommended that the sensorimotor system be progressively challenged to develop motor ''solutions'' to new motor ''problems'' by increasing the difficulty of motor tasks after movement proficiency is demonstrated. 15,18 Progressively increasing the difficulty of hopping and balance exercises may be beneficial, as it may allow the sensorimotor system time to adapt to more challenging tasks.…”

mentioning

confidence: 99%

Cortical Measures of Motor Planning and Balance Training in Patients With Chronic Ankle Instability

Burcal

Jeon

Gonzales

et al. 2019

Journal of Athletic Training

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Context Motor planning, a prerequisite for goal-driven movement, is a complex process that occurs in the cortex. Evidence has suggested that motor planning is altered in patients with chronic ankle instability (CAI). We know balance training can improve balance, but we do not know if it also improves motor planning. Such changes in cortical activity can be assessed using electroencephalography. Objective To evaluate changes in cortical measures of motor planning after balance training in patients with CAI. Design Controlled laboratory study. Setting Research laboratory. Patients or Other Participants Fifteen patients with CAI (age = 20.80 ± 2.37 years, height = 169.47 ± 7.95 cm, mass = 70.45 ± 19.25 kg). Intervention(s) A 4-week progression-based balance-training program. Main Outcome Measure(s) Motor planning was assessed via electroencephalography before a lateral-stepping task. We calculated event-related spectral perturbations in the θ (4–8 Hz), α (8–12 Hz), β (14–25 Hz), and γ (30–50 Hz) bands. The change in power (in decibels) was calculated in each band for the 500 milliseconds before the onset of the lateral-stepping movement. Additional outcomes were the Foot and Ankle Ability Measure (FAAM)–Activities of Daily Living and Sport subscales; the anterior-, posteromedial-, and posterolateral-reach directions of the Star Excursion Balance Test; and static balance. Patients completed 3 test sessions: baseline, 24- to 48-hour posttest, and 1-week posttest. Repeated-measures analyses of variance were used to assess changes over time. The α level was set at .05. Results The FAAM–Activities of Daily Living subscale score was improved at both posttests (P < .05), and the FAAM-Sport subscale score was improved at the 1-week posttest (P = .008). Balance was better in all 3 directions of the Star Excursion Balance Test at both posttest sessions (P < .001). After balance training, no differences were identified in cortical activity at either posttest session (P > .05). Conclusions No improvements were identified in electroencephalography measures of motor planning during lateral stepping in patients with CAI. Improved balance suggested that sensorimotor adaptations occurred, but they may not have transferred to the lateral-stepping task or they may have been mediated via other processes in patients with CAI.

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“…13,14 Similarly, combining balance training with STARS may further enhance the individual benefits of both treatments as highlighted in a preliminary investigation. 31 …”

Section: Discussionmentioning

confidence: 99%

Predicting balance improvements following STARS treatments in chronic ankle instability participants

Wikstrom

2017

Journal of Science and Medicine in Sport

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Objectives Sensory Targeted Ankle Rehabilitation Strategies that stimulate sensory receptors improve postural control in chronic ankle instability participants. However, not all participants have equal responses. Therefore, identifying predictors of treatment success is needed to improve clinician efficiency when treating chronic ankle instability. Therefore, the purpose was to identify predictors of successfully improving postural control in chronic ankle instability participants. Design Secondary data analysis Methods Fifty-nine participants with self-reported chronic ankle instability participated. The condition was defined as a history of at least two episodes of “giving way” within the past 6 months; and limitations in self-reported function as measured by the Foot and Ankle Ability Measure. Participants were randomized into three treatment groups (plantar massage, ankle joint mobilization, calf stretching) that received 6, 5-minute treatment sessions over a 2-week period. The main outcome measure was treatment success, defined as a participant exceeding the minimal detectable change score for a clinician-oriented single limb balance test. Results Participants with ≥3 balance test errors had a 73% probability of treatment success following ankle joint mobilizations. Participants with a self-reported function between limb difference <16.07% and who made >2.5 errors had a 99% probability of treatment success following plantar massage. Those who sustained ≥11 ankle sprains had a 94% treatment success probability following calf stretching. Conclusions Self-reported functional deficits, worse single limb balance, and number of previous ankle sprains are important characteristics when determining if chronic ankle instability participants will have an increased probability of treatment success.

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Balance Training Versus Balance Training With STARS in Patients With Chronic Ankle Instability: A Randomized Controlled Trial

Abstract: While statistically no more effective, exceeding minimal detectable change scores and favorable effect sizes suggest that a 4-week progressive BTS program may be more effective at improving self-assessed disability and postural control in CAI patients than balance training in isolation.

Cited by 34 publications

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Hop-Stabilization Training and Landing Biomechanics in Athletes With Chronic Ankle Instability: A Randomized Controlled Trial

Hop-Stabilization Training and Landing Biomechanics in Athletes With Chronic Ankle Instability: A Randomized Controlled Trial

Cortical Measures of Motor Planning and Balance Training in Patients With Chronic Ankle Instability

Predicting balance improvements following STARS treatments in chronic ankle instability participants

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