Abstract
BackgroundTo determine the effectiveness and sustainability of supervised balance training in people with chronic ankle instability (CAI) with grade III ligament injury.MethodsTwenty young adults (12 males and 8 females) diagnosed with CAI with grade III ligament injury underwent 3 months of supervised balance training. The self-reported functional questionnaire, plantar pressure (walking and single leg standing), and isokinetic ankle strength were consecutively evaluated at pre-training, 3 months, 6 months and one year. Paired T tests were used to explore changes in muscle strength and plantar pressures following the supervised balance training. According to whether the patient had sprain recurrence, the patients were divided into sprain recurrence group and control group. The risk factors of sprain recurrence were explored with univariate analysis and multivariable logistic regression.ResultsThe self-reported functional scores, the plantar pressure distribution and the muscle strength showed significant immediate improvements after 3 months of supervised balance training. At 6 months post-training, peak force under 2nd metatarsal, time to peak force under the medial hindfoot, time to boundary measurements and dorsiflexion, and eversion strength were partly declined to the pre-training level. 16 patients (80%) resumed the daily life and sports without sprain recurrence during the follow-up. Four patients (20%) reported ankle sprain during the follow-up, and the sprain recurrence group showed significantly higher Beighton scores (p = 0.012) and weaker initial inversion strength (p = 0.022) than the control group.ConclusionsThree months’ of supervised balance training could effectively improve postural control and muscle strength of CAI cases with grade III ligament injury, although these improvements would partially deceased over time. Additional strength exercises for dorsiflexion and eversion should be supplemented from 6 months. Higher Beighton score and initial inversion muscle strength weakness might increase the risk of sprain recurrence.Trial registrationChiCTR, ChiCTR1900023999, Registered 21 June 2019, https://www.chictr.org.cn/edit.aspx?pid=39984&htm=4
Highlights
Lateral ankle sprain is a common musculoskeletal injury in sports [1]
Most patients resume daily life after the primary sprain, about 34% of individuals can suffer from chronic ankle instability (CAI), which is characterized as recurrent sprain, episodes of giving-way of the ankle joint, pain, deficits of postural control and muscle strength [1]
Design From September 2018 to April 2019, 20 CAI patients who were diagnosed as grade III ligament injury and ready for rehabilitation were included in the study
Summary
Lateral ankle sprain is a common musculoskeletal injury in sports [1]. Treatment strategy includes conservative or operative solutions, mainly depending on the severity of ankle sprains, which are classified from grades I to III (mild, moderate, or severe) [2]. Conservative treatment is more effective for CAI patients with Grade I and Grade II ligament injuries while treatment for chronic ankle instability (CAI) with grade III injuries is controversial [3]. Considering the invasiveness and potential complications of the surgery, conservative treatment could be the first choice for CAI cases with isolated lateral ankle ligament but without intra-articular lesions. To determine the effectiveness and sustainability of supervised balance training in people with chronic ankle instability (CAI) with grade III ligament injury
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