The Effect of a 4-Week Comprehensive Rehabilitation Program on Postural Control and Lower Extremity Function in Individuals With Chronic Ankle Instability

Sheri A. Hale, Jay Hertel, Lauren C. Olmsted-Kramer

DOI: 10.2519/jospt.2007.2322

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 in the involved limb compared to the uninvolved limb and reported functional deficits on 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 CAI. 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.

J Orthop Sports Phys Ther. 2007;37(6):303-311, Epub 16 April 2007. doi:10.2519/jospt.2007.2322

KEY WORDS: ankle sprain, balance, Foot and Ankle Disability Index, star excursion balance test 

The results of this study demonstrate that postural control and functional limitations exist in individuals with chronic ankle instability (CAI). However, rehabilitation appears to improve these functional limitations.  There is also evidence to suggest the star excursion balance test may be a good functional measure to monitor change after rehabilitation for CAI.

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