Abstract
The present study investigated that Headway (Isometric, Isotonic and Proprioception) exercises are effective for acute & chronic ankle sprain injury, which was observed through experimental research. Ninety-four amateur cricketers of age, 15-35 years (Control Injured, N=48; Headway Rehab Group N=46) with a confirmed acute or chronic ankle sprain, selected from four different cities of Punjab, Pakistan was evaluated through Star Excursion Balance Test (SEBT), Single Leg Balance test (SLB) and subject to a set of progressively increasing exercises on ground known as Headway rehab exercises which consisted of Isometric, Isotonic and proprioception protocols. Another group of the same level of cricketers (N=40) was managed parallel for comparisons. The Control Injured and Headway Rehab Group was left with 40 subjects each because during the course of Headway exercise eight and six subjects left the study due to their personal reasons. Comparisons of pre and post-exercise (Control Injured Group) values showed a significant increase (p<0.001) in Lateral direction reach and Posteromedial direction (p<0.05) while the rest of the six directions showed non-significant results. Headway Rehab Group showed an overall improvement of 5.2% and 7.5% with an increase (cm) of 3.4 and 4.9 for the non-injured and injured leg respectively. However, the range of improvement in percentage for all eight directions (anterior, anterolateral, lateral, posterolateral, posterior, posteromedial, medial, anteromedial) lies between 5.7-7.1(range) and 6.3-9.6 (range) for the non-injured and injured leg respectively. Similarly, the difference between pre and post-exercise difference of two positions of non-injured leg and injured leg (closed and open eyes) in seconds were 2.9, 12.1 and 4.1, 27.7 respectively. However, the improvement percentage of two directions (closed and open eyes) of Headway Rehab Group was 44.9 and 75.3 for non-injured and 12.7 and 51.6 per cent for injured group respectively. It was evaluated through the Single Leg Balance Test and analyzed by paired sample t-test found highly significant (p<0.001). The results indicated that Headway exercises improved isometric and isotonic muscular strength, proprioception and stability that ultimately helped to recover, regaining strength and reinstall proprioception. After completing the Headway Rehab plan the subjects were followed for four months to check the recurrence and found recurrence of Control Injured Group and Headway Rehab Group was 17.5% and 12.5% respectively.
Highlights
An acute ankle sprain is defined as “A traumatic injury to the overstretching of the ligament of the ankle joint as a result of inversion and eversion or a combined plantar flexion and adduction of the foot” [1]
The difference between pre and post-exercise results of non-injured leg of the Headway rehab group tested through Star Excursion Balance Test indicated that there was an improvement (2.5 ± 0.5)% in eight directions
Mean ± S.D. of subjects showed that their pre-exercise (N=46) and post-exercise (N=40) values changed from 66.1 ± 4.6 to 71.8 ± 4.9 with a difference of 5.8 ± 3.7 thereby showed percentage increases of 2.5 ± 1.6
Summary
An acute ankle sprain is defined as “A traumatic injury to the overstretching of the ligament of the ankle joint as a result of inversion and eversion or a combined plantar flexion and adduction of the foot” [1]. This commonly affects some initial deficits of function and disability [2,3,4,5]. SEBT is a simple, efficient, accurate and dynamic assessment during which the subject has to maintain his center of gravity without losing balance and it can differentiate subjects with lower extremity injuries It might be used as a baseline indication of normalization of neuromuscular control after ankle sprain injury. Both the test were discarded if the subject was unable to maintain his balance [17]
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