Reliability and usefulness of the single leg heel raise balance test in patients with chronic ankle instability

Woo Young Jang,Taek Sung Jung,Hae Woon Jung,Jin Hyuck Lee

doi:10.1038/s41598-021-99466-8

Abstract

We aimed to analyze the differences in static (including conventional and modified [single-leg heel-raise balance]) and dynamic postural stability and muscle endurance between patients with chronic ankle instability (CAI) and healthy controls, and to determine the reliability and usefulness of the single-leg heel-raise balance test in patients with CAI. In total, 26 patients with CAI and 26 healthy controls were enrolled. Postural stability was assessed using a postural stabilometry system. Muscle endurance was measured in dorsiflexion and plantarflexion using an isokinetic device. Modified static postural stability (P < 0.001) and dynamic postural stability (P < 0.001) were significantly poorer in the affected ankles of patients with CAI than in the controls. Plantarflexion endurance was significantly lower in the affected ankles of the patients with CAI than in the controls (P = 0.023). Modified static postural stability significantly correlated with plantarflexion endurance in both groups (CAI group: r = − 0.470, P = 0.015; healthy controls group: r = − 0.413, P = 0.036). Plantarflexion endurance was a significant risk factor for modified static postural stability in both the CAI group (R2 = 0.221, P = 0.015) and healthy controls (R2 = 0.170, P = 0.036). Given the reliability of the modified static postural stability test, clinicians and therapists should consider using it to assess improvements in postural stability and muscle endurance in patients with CAI before and after rehabilitation.

Highlights

We aimed to analyze the differences in static and dynamic postural stability and muscle endurance between patients with chronic ankle instability (CAI) and healthy controls, and to determine the reliability and usefulness of the single-leg heel-raise balance test in patients with CAI
We hypothesized that static and dynamic postural stability and muscle endurance were poorer in patients with CAI than in healthy controls, and that modified static postural stability may be significantly correlated with muscle endurance
Demographic data of the enrolled patients and healthy controls are summarized in Table 1; there were no significant differences between the two groups

Summary

Introduction

We aimed to analyze the differences in static (including conventional and modified [single-leg heelraise balance]) and dynamic postural stability and muscle endurance between patients with chronic ankle instability (CAI) and healthy controls, and to determine the reliability and usefulness of the single-leg heel-raise balance test in patients with CAI. As most previous studies have reported a lack of proprioception in patients with CAI4,5,7–10, the single-leg balance test has been used to determine the prognosis of functional recovery, including proprioception, before and after treatment such as surgery and conservative rehabilitation in patients with CAI This balance test comprises static and dynamic postural stability tests[8,11,12]. We hypothesized that static and dynamic postural stability and muscle endurance were poorer in patients with CAI than in healthy controls, and that modified static postural stability may be significantly correlated with muscle endurance

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Conclusion