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

¹ Department of Rehabilitation Sciences, University of Kentucky, Lexington, USA
² Vicon, Oxford, UK
³ Department of Human Services, University of Virginia, Charlottesville, VA, USA
⁴ Department of Physical Medicine and Rehabilitation, University of Virginia, Charlottesville, VA, USA
⁵ Department of Orthopedics, University of Virginia, Charlottesville, VA, USA

^* To whom correspondence should be addressed. E-mail: Patrick.McKeon{at}uky.edu.

	Abstract

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°, P > 0.05) 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.

First published on May 15, 2009, doi:10.1177/0269215509102954

Clinical Rehabilitation 2009;23:609.

A more recent version of this article appeared on July 1, 2009


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