Effects of balance training on gait parameters in patients with chronic ankle instability: a randomized controlled trial.

摘要

OBJECTIVE: To examine the effects of a four-week balance training programme on ankle kinematics during walking and jogging in those with chronic ankle instability. A secondary objective was to evaluate the effect of balance training on the mechanical properties of the lateral ligaments in those with chronic ankle instability. DESIGN: Randomized controlled trial. SETTING: Laboratory. SUBJECTS/PATIENTS: Twenty-nine participants (12 males, 17 females) with self-reported chronic ankle instability were randomly assigned to a balance training group or a control group.Intervention: Four weeks of supervised rehabilitation that emphasized dynamic balance stabilization in single-limb stance. The control group received no intervention. MAIN OUTCOME MEASURES: Kinematic measures of rearfoot inversion/eversion, shank rotation, and the coupling relationship between these two segments throughout the gait cycle during walking and jogging on a treadmill. Instrumented ankle arthrometer measures were taken to assess anterior drawer and inversion talar tilt laxity and stiffness. RESULTS: No significant alterations in the inversion/eversion or shank rotation kinematics were found during walking and jogging after balance training. There was, however, a significant decrease in the shank/rearfoot coupling variability during walking as measured by deviation phase after balance training (balance training posttest: 13.1 degrees +/- 6.2 degrees , balance training pretest: 16.2 degrees +/- 3.3 degrees , P = 0.03), indicating improved shank/rearfoot coupling stability. The control group did not significantly change. (posttest: 16.30 degrees +/- 4.4 degrees , pretest: 18.6 degrees +/- 7.1 degrees , P40.05) There were no significant changes in laxity measures for either group. CONCLUSIONS: Balance training significantly altered the relationship between shank rotation and rearfoot inversion/eversion in those with chronic ankle instability.