Balance Training vs. Balance Training w/ STARS

Not Applicable

Completed

Conditions: Ankle (Ligaments); Instability (Old Injury)

Interventions: Behavioral: Balance Training
Behavioral: STARS

Registration Number: NCT01790581

Lead Sponsor: University of North Carolina, Charlotte

Brief Summary: Chronic Ankle Instability (CAI) is a health condition that results in repeated ankle sprains and other residual impairments. CAI has been linked to many different causative factors including sensory and motor deficits that affect the global function of the sensorimotor system as well as the patient. Over the past 20 years, strong evidence has been generated to support balance training as an effective intervention strategy in the CAI population. Unfortunately, most investigations have focused solely on maximizing motor output through balance training, while ignoring the full spectrum of sensorimotor dysfunction associated with CAI. There may be advantageous sensory-targeted interventions that augment the effects of balance training and lead to greater enhancements of functional outcomes for CAI. However, this possibility has not been systematically explored. Sensory-targeted ankle rehabilitation strategies (STARS), such as joint mobilization and plantar massage have resulted in improved sensorimotor function in those with CAI. However, only a single STARS (i.e. stochastic resonance) has been investigated in combination with balance training. While the combined effects were greater than those of balance training alone, stochastic resonance requires relatively expensive equipment that is not commercially available. Thus, the purpose of this investigation is to test the hypothesis that combining low cost STARS (e.g. plantar massage and joint mobilizations) with balance training will result in greater sensorimotor and functional improvements in those with CAI than balance training alone.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 24

Inclusion Criteria

Males and females between the ages of 18 and 35.
A history of at least one episode of "giving way" within the past 3 months.
Answering 4 or more questions of "Yes" on the Ankle Instability Instrument (AII).
Score of <90% on the self-reported Foot and Ankle Ability Measure (FAAM).
Score of <80% on the FAAM Sport.

Exclusion Criteria

Failing to meet the inclusion criteria.
Known balance and vision problems.
Acute lower extremities and head injuries that occurred <6 weeks ago.
Chronic musculoskeletal conditions known to affect balance.
A history of ankle surgeries to fix internal derangements.

Study & Design

Study Type: INTERVENTIONAL

Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
Balance Training	Balance Training	-
Balance Training w/ STARS	Balance Training	-
Balance Training w/ STARS	STARS	-

Primary Outcome Measures

Name	Time	Method
Balance	Balance at 1-day post intervention	Dynamic balance will be assessed with the Star Excursion Balance Test (SEBT). This test requires a person to maintain their balance on a single limb while reaching as far as they can (with their other leg) in 3 different directions (forward, back-left, and back-right).
Self-assessed Disability	Disability to 1-day post intervention	2 questionnaires regarding self-assessed disability during activities of daily living and sport will be completed. The questionnaires will include the Foot and Ankle Ability Measure, and the Foot and Ankle Ability Measure-Sport. The FAAM contains 21 activity related items (max score of 84) while the FAAM-S contains 8 activity related items (max score of 32). Lower percentages (patient's score divided by max score) represent greater disability, and both FAAM and FAAM-S scores have been found to be reliable and precise (r=0.89, SEM= 2.1 and r=0.87, SEM= 4.5, respectively) in people with CAI.

Secondary Outcome Measures

Name	Time	Method
Balance	Change from baseline balance at 1-week post intervention	Dynamic balance will be assessed with the Star Excursion Balance Test (SEBT). This test requires a person to maintain their balance on a single limb while reaching as far as they can (with their other leg) in 3 different directions (forward, back-left, and back-right).
Self-assessed Disability	Change from baseline disability at 1-month post intervention	3 questionnaires regarding self-assessed disability during activities of daily living and sport will be completed. The questionnaires will include the Ankle Instability Instrument, the Foot and Ankle Ability Measure, and the Foot and Ankle Ability Measure-Sport.