Postural-Stability Tests That Identify Individuals With Chronic Ankle Instability

Abstract

Context: Chronic ankle instability (CAI) is characterized by repeated ankle sprains, which have been linked to postural instability. Therefore, it is important for clinicians to identify individuals with CAI who can benefit from rehabilitation.Objective: To assess the likelihood that CAI participants will exhibit impaired postural stability and that healthy control participants will exhibit better test performance values.Design: Case-control study. Setting: Laboratory.Patients or Other Participants: People with CAI (n ¼ 17, age ¼ 23 6 4 years, height ¼ 168 6 9 cm, weight ¼ 68 6 12 kg) who reported ankle ''giving-way'' sensations and healthy volunteers (n ¼ 17, age ¼ 23 6 3 years, height ¼ 168 6 8 cm, weight ¼ 66 6 12 kg).Intervention(s): Participants performed 7 balance tests: Balance Error Scoring System (BESS), time in balance, foot lift, single-legged stance on a force plate, Star Excursion Balance Test, side hop, and figure-of-8 hop.Main Outcome Measure(s): Balance was quantified with errors (score) for the BESS, length of time balancing (seconds) for time-in-balance test, frequency of foot lifts (score) for foot-lift test, velocity (cm/s) for all center-of-pressure velocity measures, excursion (cm) for center-of-pressure excursion measures, area (cm 2 ) for 95% confidence ellipse center-of-pressure area and center-of-pressure rectangular area, time (seconds) for anteriorposterior and medial-lateral time-to-boundary (TTB) measures, distance reached (cm) for Star Excursion Balance Test, and time (seconds) to complete side-hop and figure-of-8 hop tests. We calculated area-under-the-curve values and cutoff scores and used the odds ratio to determine if those with and without CAI could be distinguished using cutoff scores.Results: We found significant area-under-the-curve values for 4 static noninstrumented measures, 3 force-plate measures, and 3 functional measures. Significant cutoff scores were noted for the time-in-balance test (25.89 seconds), foot-lift test (5), single-legged stance on the firm surface (3 errors) and total (14 errors) on the BESS, center-of-pressure resultant velocity (1.56 cm/s), standard deviations for medial-lateral (1.56 seconds) time-to-boundary and anterior-posterior (3.78 seconds) time-to-boundary test, posteromedial direction on the Star Excursion Balance Test (0.91), side-hop test (12.88 seconds), and figure-of-8 hop test (17.36 seconds).Conclusions: Clinicians can use any of the 10 significant measures with their associated cutoff scores to identify those who could benefit from rehabilitation that reestablishes postural stability.

Extended Use of Kinesiology Tape and Balance in Participants With Chronic Ankle Instability

“…This criterion was based on 2 previous studies. 4,27 Confirming that participants had balance deficits when they began the study created the best environment to identify balance improvements.…”

Functional performance tests identify lateral ankle sprain risk: A prospective pilot study in adolescent soccer players

“…To the best of our knowledge, no study has investigated cutoff scores of FPTs for the future occurrence of lateral ankle sprain in an adolescent population. Thus, an a priori sample size calculation was performed (G*Power, Version 3.1.5, Kiel, Germany) with statistical power = 0.80, P ≤ 0.05, based on tabled data from a published FPT study with an adult population . For the SLHT, the necessary sample size for assessing the likelihood values was a total of 38 participants with effect size 0.65 .…”

“…Thus, an a priori sample size calculation was performed (G*Power, Version 3.1.5, Kiel, Germany) with statistical power = 0.80, P ≤ 0.05, based on tabled data from a published FPT study with an adult population . For the SLHT, the necessary sample size for assessing the likelihood values was a total of 38 participants with effect size 0.65 . For the PM reach direction of the SEBT, 38 participants with effect size 0.66 were necessary for the PM reach direction of the SEBT .…”

“…Additionally, the body mass index percentiles (BMI%), advocated by the American Academy of Pediatrics (AAP) and the Center for Disease Control (CDC) for applying in the adolescent population, were calculated based on participants' height and weight . The average of three test trials for the SEBT and the fastest completed time of two test trials for the SLHT were used for data analysis . The injured limb was utilized in the injured group for group comparison.…”

Comparison Kinematic Patterns between the Star Excursion Balance Test and Y-Balance Test in Elite Athletes

“…The SEBT and YBT have been commonly applied to assess dynamic postural stability deficits Linens, Ross, Arnold, Gayle, & Pidcoe, 2014;Plisky et al, 2006). In clinical and research settings, these two tests are utilized interchangeably.…”