O31 Effectiveness of balance training and strength training protocols to improve functional clinical and patient-reported outcomes

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Abstract

Study Design

Randomised Controlled Trial.

Objectives

Determine the effect of balance and strength training protocols on improving deficits in patients with chronic ankle instability (CAI).

Background

Functional deficits arise following a lateral ankle sprain and individuals with CAI can experience long-term disability. Healthcare practitioners should use functional rehabilitation to improve these deficits.

Methods and Measures

Thirty-nine participants with CAI volunteered for this study. Identification of Functional Ankle Instability Questionnaire(IdFAI) determined CAI status. Participants were randomly assigned to: Balance Training Protocol(BTP), Strength Training Protocol(STP), and Control Group(CON). The BTP group completed hop-to-stabilisation balance training, the STP group completed resistance band and PNF strength protocol, and the CON group completed a bike workout. Participants completed training 3x/week for six weeks. Clinical outcome (Balance Error Scoring System(BESS), Star Excursion Balance Test(SEBT), and Side Hop Test(SHT)) and patient-reported outcome measures (Foot and Ankle Ability Measure Sport(FAAM-Sport) and Disablement of Physical Activity(DPA)) were evaluated prior to and following the 6 week training. Two multivariate repeated measures ANOVAs were conducted with follow-up univariate analyses.

Results

The MANOVA yielded a significant time by group interaction for the clinical measures(p<0.01). Specifically, BTP and STP groups significantly improved from pre-test to posttest in each the BESS(BTP: mean difference=4.7, 95%CI=2.8–6.5 and STP: mean difference=3.3, 95%CI=1.5–5.2), SEBT(BTP: mean difference=4.98, 95%CI=2.9–7.04; STP: mean difference=4.1, 95%CI=2.04–6.2), and SHT(BTP: mean difference=1.8, 95%CI=0.8–2.7; STP: mean difference=2.4, 95%CI=1.5–3.4). The CON group did not significantly improve from pre to posttest (p>0.05) in any clinical outcome measure. No significant time-by-group interactions were identified when evaluating the MANOVA of the patient-reported outcomes(p=0.52). However, there was a significant main effect for time (p=0.001). Follow-up analyses revealed significant differences between the pre-test to posttest for the DPAS(p=0.02) and FAAM-Sport(p=0.001).

Conclusion

Both training protocols significantly improved balance and functional performance, but all groups improved patient-reported outcomes.

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