STUDY DESIGN: Prospective, randomized controlled trial. OBJECTIVE: To examine the effects of a 4-week rehabilitation program for chronic ankle instability (CAI) on postural control and lower extremity function. BACKGROUND: CAI is associated with residual symptoms, performance deficits, and reinjury. Managing CAI is challenging and more evidence is needed to guide effective treatment. METHODS AND MEASURES: Subjects with unilateral CAI were randomly assigned to the rehabilitation (CAI-rehab, n=16) or control (CAI-control, n=13) group. Subjects without CAI were assigned to a healthy group (n=19). Baseline testing included the (1) center of pressure velocity (COPV), (2) star excursion balance test (SEBT), and (3) Foot and Ankle Disability index (FADI) and FADI-Sports Subscale (FADI-Sport). The CAI-rehab group completed 4 weeks of rehabilitation that addressed range of motion, strength, neuromuscular control, and functional tasks. After 4 weeks, all subjects were retested. Nonparametric analyses for group differences and between-group comparisons were performed. RESULTS: Subjects with CAI demonstrated deficits in postural control and SEBT reach tasks of the involved limb compared to the uninvolved limb and reported functional deficits of the involved limb compared to healthy subjects. Following rehabilitation, the CAI-rehab group had greater SEBT reach improvements on the involved limb than the other groups and greater improvements in FADi and FADI-Sport scores. CONCLUSIONS: These results demonstrate postural control and functional limitations exist in individuals with CAl. In addition, rehabilitation appears to improve these functional limitations. Finally, there is evidence to suggest the SEBT may be a good functional measure to monitor change after rehabilitation for CAI.
RCT Entities:
STUDY DESIGN: Prospective, randomized controlled trial. OBJECTIVE: To examine the effects of a 4-week rehabilitation program for chronic ankle instability (CAI) on postural control and lower extremity function. BACKGROUND: CAI is associated with residual symptoms, performance deficits, and reinjury. Managing CAI is challenging and more evidence is needed to guide effective treatment. METHODS AND MEASURES: Subjects with unilateral CAI were randomly assigned to the rehabilitation (CAI-rehab, n=16) or control (CAI-control, n=13) group. Subjects without CAI were assigned to a healthy group (n=19). Baseline testing included the (1) center of pressure velocity (COPV), (2) star excursion balance test (SEBT), and (3) Foot and Ankle Disability index (FADI) and FADI-Sports Subscale (FADI-Sport). The CAI-rehab group completed 4 weeks of rehabilitation that addressed range of motion, strength, neuromuscular control, and functional tasks. After 4 weeks, all subjects were retested. Nonparametric analyses for group differences and between-group comparisons were performed. RESULTS: Subjects with CAI demonstrated deficits in postural control and SEBT reach tasks of the involved limb compared to the uninvolved limb and reported functional deficits of the involved limb compared to healthy subjects. Following rehabilitation, the CAI-rehab group had greater SEBT reach improvements on the involved limb than the other groups and greater improvements in FADi and FADI-Sport scores. CONCLUSIONS: These results demonstrate postural control and functional limitations exist in individuals with CAl. In addition, rehabilitation appears to improve these functional limitations. Finally, there is evidence to suggest the SEBT may be a good functional measure to monitor change after rehabilitation for CAI.
Authors: Luis A Feigenbaum; Lee D Kaplan; Tony Musto; Ignacio A Gaunaurd; Robert S Gailey; William P Kelley; Timothy J Alemi; Braulio Espinosa; Eli Mandler; Vincent A Scavo; Dustin C West Journal: Int J Sports Phys Ther Date: 2016-06