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Effects of balance training on gait parameters in patients with chronic ankle instability: a randomized controlled trial

Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA, Patrick.McKeon{at}uky.edu

Gabriele Paolini

Vicon, Oxford, UK

Christopher D Ingersoll

Department of Human Services, University of Virginia, Charlottesville, VA, USA

D Casey Kerrigan

Department of Physical Medicine and Rehabilitation, University of Virginia, Charlottesville, VA, USA

Ethan N Saliba

Department of Human Services, University of Virginia, Charlottesville, VA, USA

Bradford C Bennett

Department of Orthopedics, University of Virginia, Charlottesville, VA, USA

Jay Hertel

Department of Human Services, University of Virginia, Charlottesville, VA, USA

Objective: To examine the effects of a four-week balance training programme on ankle kinematics during walking and jogging in those with chronic ankle instability. A secondary objective was to evaluate the effect of balance training on the mechanical properties of the lateral ligaments in those with chronic ankle instability. Design: Randomized controlled trial.

Setting: Laboratory.

Subjects/patients: Twenty-nine participants (12 males, 17 females) with self-reported chronic ankle instability were randomly assigned to a balance training group or a control group.

Intervention: Four weeks of supervised rehabilitation that emphasized dynamic balance stabilization in single-limb stance. The control group received no intervention.

Main outcome measures: Kinematic measures of rearfoot inversion/eversion, shank rotation, and the coupling relationship between these two segments throughout the gait cycle during walking and jogging on a treadmill. Instrumented ankle arthrometer measures were taken to assess anterior drawer and inversion talar tilt laxity and stiffness.

Results: No significant alterations in the inversion/eversion or shank rotation kinematics were found during walking and jogging after balance training. There was, however, a significant decrease in the shank/rearfoot coupling variability during walking as measured by deviation phase after balance training (balance training posttest: 13.1°± 6.2°, balance training pretest: 16.2° ± 3.3°, P = 0.03), indicating improved shank/rearfoot coupling stability. The control group did not significantly change. (posttest: 16.30° ± 4.4°, pretest: 18.6° ± 7.1°, P40.05) There were no significant changes in laxity measures for either group.

Conclusions: Balance training significantly altered the relationship between shank rotation and rearfoot inversion/eversion in those with chronic ankle instability.

This version was published on July 1, 2009

Clinical Rehabilitation, Vol. 23, No. 7, 609-621 (2009)
DOI: 10.1177/0269215509102954


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