title: Effects of balance training on gait parameters in patients with chronic ankle instability: a randomized controlled trial.
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.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Laboratory.
  
  
  METHODS
  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.
  
  
  METHODS
  Four weeks of supervised rehabilitation that emphasized dynamic balance stabilization in single-limb stance. The control group received no intervention.
  
  
  METHODS
  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 degrees +/- 6.2 degrees , balance training pretest: 16.2 degrees +/- 3.3 degrees , P = 0.03), indicating improved shank/rearfoot coupling stability. The control group did not significantly change. (posttest: 16.30 degrees +/- 4.4 degrees , pretest: 18.6 degrees +/- 7.1 degrees , 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.
authors.affiliation: Division of Athletic Training, Department of Rehabilitation Sciences, University of Kentucky, College of Health Sciences, Wethington Building, Room 206C, 900 South Limestone, Lexington, KY 40536-0200, USA. Patrick.McKeon@uky.edu
authors.forename: Patrick O
authors.initials: PO
authors.lastname: McKeon
authors.forename: Gabriele
authors.initials: G
authors.lastname: Paolini
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Ingersoll
authors.forename: D Casey
authors.initials: DC
authors.lastname: Kerrigan
authors.forename: Ethan N
authors.initials: EN
authors.lastname: Saliba
authors.forename: Bradford C
authors.initials: BC
authors.lastname: Bennett
authors.forename: Jay
authors.initials: J
authors.lastname: Hertel
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena / Q000502:physiology; D002908:Chronic Disease; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007590:Jogging / Q000502:physiology; D007593:Joint Instability / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D016138:Walking / Q000502:physiology; D055815:Young Adult