title: Rehabilitation for Chronic Ankle Instability With or Without Destabilization Devices: A Randomized Controlled Trial.
abstract: BACKGROUND
  Individuals with chronic ankle instability (CAI) have deficits in neuromuscular control and altered movement patterns. Ankle-destabilization devices have been shown to increase lower extremity muscle activity during functional tasks and may be useful tools for improving common deficits and self-reported function.
  
  
  OBJECTIVE
  To determine whether a 4-week rehabilitation program that includes destabilization devices has greater effects on self-reported function, range of motion (ROM), strength, and balance than rehabilitation without devices in patients with CAI.
  
  
  METHODS
  Randomized controlled clinical trial.
  
  
  METHODS
  Laboratory.
  
  
  METHODS
  A total of 26 patients with CAI (7 men, 19 women; age = 21.34 ± 3.06 years, height = 168.96 ± 8.77 cm, mass = 70.73 ± 13.86 kg).
  
  
  METHODS
  Patients completed baseline measures and were randomized into no-device and device groups. Both groups completed 4 weeks of supervised, impairment-based progressive rehabilitation with or without devices and then repeated baseline measures.
  
  
  METHODS
  We assessed self-reported function using the Foot and Ankle Ability Measure. Ankle ROM was measured with an inclinometer. Ankle strength was assessed using a handheld dynamometer during maximal voluntary isometric contractions. Balance was measured using a composite score of 3 reach directions from the Star Excursion Balance Test and a force plate to calculate center of pressure during eyes-open and eyes-closed single-limb balance. We compared each dependent variable using a 2 × 2 (group × time) analysis of variance and post hoc tests as appropriate and set an a priori α level at .05. The Hedges g effect sizes and associated 95% confidence intervals were calculated.
  
  
  RESULTS
  We observed no differences between the no-device and device groups for any measure. However, both groups had large improvements in self-reported function and ankle strength.
  
  
  CONCLUSIONS
  Incorporating destabilization devices into rehabilitation did not improve ankle function more effectively than traditional rehabilitation tools because both interventions resulted in similar improvements. Impairment-based progressive rehabilitation improved clinical outcomes associated with CAI.
authors.affiliation: Department of Kinesiology, University of Toledo, OH; Departments of.
authors.forename: Luke
authors.initials: L
authors.lastname: Donovan
authors.affiliation: Kinesiology and.|Orthopaedic Surgery, The University of Virginia, Charlottesville;
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Hart
authors.affiliation: Kinesiology and.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Saliba
authors.affiliation: Orthopaedic Surgery, The University of Virginia, Charlottesville;
authors.forename: Joseph
authors.initials: J
authors.lastname: Park
authors.affiliation: Kinesiology and.
authors.forename: Mark Anthony
authors.initials: MA
authors.lastname: Feger
authors.affiliation: Department of Athletic Training & Nutrition, Weber State University, Ogden, UT.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Herb
authors.affiliation: Kinesiology and.
authors.forename: Jay
authors.initials: J
authors.lastname: Hertel
mesh_terms: D000842:Ankle / Q000503:physiopathology*; D016512:Ankle Injuries / Q000503:physiopathology / Q000534:rehabilitation; D002908:Chronic Disease; D005260:Female; D061826:Foot Orthoses; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000534:rehabilitation*; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D009068:Movement; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D057566:Self Report; D013180:Sprains and Strains / Q000503:physiopathology / Q000534:rehabilitation; D055815:Young Adult
keywords: ankle sprain; impairment-based progressive rehabilitation; postural control; strength