Balance Training and Center-of-Pressure Location in Participants With Chronic Ankle Instability

Abstract

Context: Chronic ankle instability (CAI) occurs in some people after a lateral ankle sprain and often results in residual feelings of instability and episodes of the ankle's giving way. Compared with healthy people, patients with CAI demonstrated poor postural control and used a more anteriorly and laterally positioned center of pressure (COP) during a single-limb staticbalance task on a force plate. Balance training is an effective means of altering traditional COP measures; however, whether the overall location of the COP distribution under the foot also changes is unknown.Objective: To determine if the spatial locations of COP data points in participants with CAI change after a 4-week balancetraining program.Design: Randomized controlled trial. Setting: Laboratory.Patients or Other Participants: Thirty-one persons with self-reported CAI.Intervention(s): Participants were randomly assigned to a 4-week balance-training program or no balance training.Main Outcome Measure(s): We collected a total of 500 COP data points while participants balanced using a single limb on a force plate during a 10-second trial. The location of each COP data point relative to the geometric center of the foot was determined, and the frequency count in 4 sections (anteromedial, anterolateral, posteromedial, posterolateral) was analyzed for differences between groups.Results: Overall, COP position in the balance-training group shifted from being more anterior to less anterior in both eyes-open trials (before trial ¼ 319.1 6 165.4, after trial ¼ 160.5 6 149.5; P ¼ .006) and eyes-closed trials (before trial ¼ 387.9 6 123.8, after trial ¼ 189.4 6 102.9; P , .001). The COP for the group that did not perform balance training remained the same in the eyes-open trials (before trial ¼ 214.1 6 193.3, after trial ¼ 230.0 6 176.3; P ¼ .54) and eyes-closed trials (before trial ¼ 326.9 6 134.3, after trial ¼ 338.2 6 126.1; P ¼ .69).Conclusions: In participants with CAI, the balance-training program shifted the COP location from anterolateral to posterolateral. The program may have repaired some of the damaged sensorimotor system pathways, resulting in a more optimally functioning and less constrained system. Key Words: sprains, rehabilitation, postural control Key PointsA 4-week progressive balance-training program effectively altered the spatial locations of center-of-pressure data points in participants with chronic ankle instability. The alteration in the spatial locations of center-of-pressure data points may indicate a more optimally functioning sensorimotor system.

Balance- and Strength-Training Protocols to Improve Chronic Ankle Instability Deficits, Part I: Assessing Clinical Outcome Measures

“…These range from simple progressive strength [12][13][14][15] or balance [16][17][18][19] protocols to multicomponent (strength, balance, ROM) rehabilitation 20,21 approaches. These functional rehabilitation protocols effectively improve strength, balance, and self-reported function [12][13][14][15]19,[21][22][23][24][25] ; however, few researchers have assessed the improvements in functional performance that include power and agility. Functional activity is defined as dynamic, closed kinetic chain activity other than quiet standing.…”

“…13,25 Therefore, strength training alone may be insufficient to improve functional outcomes similar to the movements that occur more often during sport and physical activity. Balancetraining protocols (BTPs) 19,23 and resistance-band protocols (RBPs) have been shown to improve strength 12,13,15 and postural-control 18 variables, respectively; however, they have not been examined in the same study.…”

Does the Fatigue Index Induced in Athlete’s Affect Static Balance?

“…Several studies reported positive effects of balance training on static and dynamic balance (Granacher, Mueulbauer, Doerflinger, & Strohmeier, 2011;Yu & Yang, 2012;Mettler et al, 2015;Çankaya et al, 2015;Baccouch, Rebai, & Sahli, 2015;Zemkova et al, 2017;Hamed, Bohm, Mersmann, & Arampatzis, 2017;Simpson et al, 2017). More specifically, static balance exercises are suggested as more effective in balance performance than dynamic balance exercises (Erdoğan et al, 2017).…”

Trampoline Exercise Improves Functional Performance in Young Adults with Ankle Instability

“…(Kaminski et al, 2003;Kidgell et al, 2007;McKeon et al, 2008;Cha & Kim, 2009;Doherty et al, 2017). 여러 선행연구들은 불안정한 지면에 서의 균형 운동이 근력, 평형성, 자세 진동 등에 긍정적인 영향을 주어 근신경계의 통합에 효과적임을 보고하였다 (Richie, 2001;Mettler et al, 2015). Mckenzie et al(1985) (Schlosser, 1997).…”