Effect of Coordination Training on Proprioception of the Functionally Unstable Ankle

Abstract

Abstract:Exercises to improve joint proprioception and coordination of the functionally unstable ankle are advocated throughout the literature, yet there is little evidence that these exercises have any effect on proprioception and balance. The purpose of this study was to determine the effects of a 6-week coordination and balance training program on proprioception of subjects with functional ankle instability. Forty-five subjects (age = 22.53 ± 3.95 years, height = 172.04 ± 10.0 cm, weight = 71.72 ± 15.7 kg) were randomly placed into a control (Group 1), sham (Group 2), or experimental (Group 3) group. The experimental group trained 3 days per week, 10 minutes each day, performing various balance and proprioception exercises. Postural sway and active and passive joint position sense were assessed. Analysis of variance for postural sway modified equilibrium score for anterior and posterior sway, as well as medial and lateral sway revealed significant four-way interactions. Tukey post hoc analyses revealed that Group 3 performed significantly better (p < .05) than Group 1 and Group 2 on the posttests. There were no significant differences for joint position sense or postural sway index. Results suggest that balance and coordination training can improve some measures of postural sway. It is still unclear if joint position sense can be improved in the functionally unstable ankle. Article:Inversion ankle sprains are among the most common injuries in sports (22,39,70). Often, recurrent injury ensues, and functional instability (1517) becomes evident in as many as 33 (3) to 42% (18) of the patients suffering from an acute ankle injury. Contributing factors to functional ankle instability are decreased range of motion (4), decreased strength of ankle evertors (3,60,66), and a decrease in joint proprioception (8,18,21,25,43,61,66,67). Some authors reported symptoms of functional instability in the absence of mechanical instability (14,16,66).The ability to detect motion in the foot and make postural adjustments in response to these detected motions is crucial in the prevention of ankle injury. Similarly, the ability of an individual to sense the position of the foot prior to heel strike is of the utmost importance. Studies have shown that functional ankle instability results in a decreased ability to maintain balance (16,69) and a decrease in joint position sense (25).Freeman et al (18) proposed that ankle injury may cause disruption of joint afferents located in the supporting ligaments and capsule, leading to an impairment of the postural control system. Using a modified Rom-berg's test, they found a decrease in the ability to maintain static balance on the injured limb when compared to the uninjured limb of patients with unilateral ankle injury. From their finding of decreased postural control, they proposed a partial deafferentation of joint mechanoreceptors in the functionally unstable ankle, which contributed to symptoms of functional instability (18).

Ankle proprioception is not targeted by exercises on an unstable surface

“…Ashton-Miller et al (2001) conclude that central mechanisms could explain how training might modify proprioception. While several studies have reported positive effects of training on position sense (Kynsburg et al 2006;Lee and Lin 2008), Bernier and Perrin (1998) found improvements in position sense after an exercise program, but these improvements did not differ significantly from the control groups. Recently, in a critical evaluation of the available literature, Hupperets et al (2009a) concluded that the aforementioned effects on postural sway and joint position sense are not necessarily a consequence of the exercises, but may be due to a learning effect created by the repeated measurements.…”

Análise do COP e sentido de posição em jogadores universitários de futebol com e sem instabilidade de tornozelo

“…In order to diagnose the instability 47 and to prevent ankle sprains, evaluate the position sense and the joint movement, both passively or actively, seems to be crucial [48][49] . Despite of di erences between studies' protocols, our results demonstrated a greater error in the joint reposition sense in individuals with ankle instability.…”

The Effect of Aquatic Exercise on the Peak Torque and Stability of Knee Joints of Elderly Women

“…This reinforces the fact that the improvement of muscular strength and muscular endurance positively affects the maintenance of balance and prevents falls. Moreover, an improvement in the ability to control balance was considered to be obtained through the training aimed at improving the somatic sense, vestibular sensation and proprioceptive sensational functions 17) , and that the improvement of muscular strength was the result of muscular nerve adaptation and muscular responses, since muscular contractions in response to resistance increase the stimulation of the cerebral cortex making them the most effective promotion factor 18) . We consider the significant improvement in stability which was seen in the present study, was the result of improvement in knee joint muscular function and the balance control system.…”