Objectives: To determine the effects of a 4-week balance training program during stance on a single leg. Background: Individuals who have experienced multiple episodes of inversion ankle sprains often participate in balance training programs. Balance training is performed to treat existing proprioceptive deficits and to restore ankle joint stability, presumably by retraining altered afferent neuromuscular pathways. The effectiveness of such programs on individuals with functionally unstable ankles has yet to be established.Methods and Measures: Prior to and following training, subjects with self-reported functionally unstable ankles (5 women and 8 men, mean age = 21.9 t 3.1 years) and nonimpaired subjects (6 women and 7 men, mean age = 212 t 2.5 years) completed a static balance assessment for both limbs as well as the ankle joint functional assessment tool questionnaire (AJFAT). The subjects from both groups participated in a unilateral, multilevel, static and dynamic balance training program 3 times a week for 4 weeks. Subjects from the experimental group trained only the involved limb, and the nonimpaired group trained a randomly selected limb. A stability index (SI) was calculated during the balance assessment to indicate the amount of platform motion. Compared to low stability indices, high stability indices indicate greater platform motion during stance and therefore l ess stability. Results: Following training, subjects from both groups demonstrated significant improvements in balance ability. When balance was assessed at a low resistance to platform tilt (stability level 21, the posttraining scores of both the subjects with unstable ankles (mean SI = 2.63 t 1.92) and the nonimpaired subjects (mean SI = 2.69 2 2.32) were significantly better than their pretraining scores (mean Sl s = 5.93 2 3.65 and 4.67 2 3.43, respectively). Assessed at a high resistance to platform tilt (stability level 6), the posttraining scores of both subjects with unstable ankles (mean SI = 1.27 t 0.66) and the nonimpaired subjects (mean SI = 1.37 + 0.66) were significantly better than their pretraining scores (mean Sl s = 2.30 + 1.88 and 2.04 + 1.43, respectively). Additionally, the posttraining AJFAT scores of subjects with unstable ankles (25.78 + 3.80) Functional instability of the ankle joint has been defined by Freeman7 as "a tendency for the foot to give way after an ankle sprain." Three factors thought to cause functional instability of the ankle joint are anatomic or mechanical instability, muscle weakness, and deficits in joint proprio~eption.'~ At this time, there are no objective data that conclusively show that muscle weakness is a viable explanation for functional ankle instability. However, the combination of mechanical instability and decreased neuromuscular control resulting from deficits in joint propriocep tion may result in functional instability of the ankle j~i n t .~J " J~J~ Deficits in ankle joint proprie ception with diminished neuromuscular control have been documented following ankle joint ligamentous ...
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