Changes in Postural Control After a Ball-Kicking Balance Exercise in Individuals With Chronic Ankle Instability.
BACKGROUND
Rehabilitation programs for patients with chronic ankle instability (CAI) generally involve balance-perturbation training (BPT). Anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) are the primary strategies used to maintain equilibrium during body perturbations. Little is known, however, about how APAs and CPAs are modified to promote better postural control for individuals with CAI after BPT.


OBJECTIVE
To investigate the effect of BPT that involves kicking a ball on postural-control strategies in individuals with CAI.


METHODS
Randomized controlled clinical trial.


METHODS
Laboratory.


METHODS
We randomly assigned 44 volunteers with CAI to either a training group (TG; 11 women, 11 men; age = 24 ± 4 years, height = 173.0 ± 9.8 cm, mass = 72.64 ± 11.98 kg) or control group (CG; 11 women, 11 men; age = 22 ± 3 years, height = 171.0 ± 9.7 cm, mass = 70.00 ± 11.03 kg).


METHODS
The TG performed a single 30-minute training session that involved kicking a ball while standing on 1 foot. The CG received no intervention.


METHODS
The primary outcome was the sum of the integrated electromyographic activity (∑∫EMG) of the lower extremity muscles in the supporting limb that were calculated during typical intervals for APAs and CPAs. A secondary outcome was center-of-pressure displacement during similar intervals.


RESULTS
In the TG after training, the ∑∫EMG decreased in both dorsal and ventral muscles during compensatory adjustment (ie, the time interval that followed lower limb movement). During this interval, muscle activity (∑∫EMG) was less in the TG than in the CG. Consequently, center-of-pressure displacement increased during the task after training.


CONCLUSIONS
A single session of ball-kicking BPT promoted changes in postural-control strategies in individuals with CAI. These results should stimulate new and more comprehensive studies to investigate the effect of this and other BPT techniques on postural control in patients with CAI.
Department of Physical Therapy, Santa Catarina State University, Florianópolis, Brazil.
Josilene Souza
JS
Conceição
Department of Physical Therapy, Santa Catarina State University, Florianópolis, Brazil.
Felipe Gustavo
FG
Schaefer de Araújo
Department of Physical Therapy, Santa Catarina State University, Florianópolis, Brazil.
Gilmar Moraes
GM
Santos
Department of Biostatistics, University of Kansas Medical Center, Kansas City.
John
J
Keighley
Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City.
Marcio Jose
MJ
Dos Santos
D000328:Adult; D016512:Ankle Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D000843:Ankle Joint / Q000503:physiopathology*; D002908:Chronic Disease; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology* / Q000534:rehabilitation; D008297:Male; D009068:Movement / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology*; D011312:Pressure; D016037:Single-Blind Method; D055815:Young Adult
balance training; reactive responses; recurrent sprains