Four-Week Ankle-Rehabilitation Programs in Adolescent Athletes With Chronic Ankle Instability

Context: Researchers have shown that rehabilitation programs incorporating resistance-band and balance-board exercises are effective for improving clinical measures of function and patient-reported outcomes in individuals with chronic ankle instability (CAI). However, whether combining the 2 exercises increases improvement is unknown. Objective: To determine the effectiveness of 3 rehabilitation programs on clinical measures of balance and self-reported function in adolescent patients with CAI. Design: Randomized controlled clinical trial (Trail Registration Number: ClinicalTrails.gov: NCT03447652). Setting: High school athletic training facilities.Patients or Other Participants: Forty-three patients with CAI (age ¼ 16.37 6 1.00 years, height ¼ 171.75 6 12.05 cm, mass ¼ 69.38 6 18.36 kg) were block randomized into 4 rehabilitation groups. Intervention(s): Protocols were completed 3 times per week for 4 weeks. The resistance-band group performed 3 sets of 10 repetitions of ankle plantar flexion, dorsiflexion, inversion, and eversion with a resistance band. The Biomechanical Ankle Platform System group performed 5 trials of clockwise and counterclockwise rotations, changing direction every 10 seconds during each 40-second trial. The combination group completed resistance-band and Biomechanical Ankle Platform System programs during each session. The control group did not perform any exercises.Main Outcome Measure(s): Variables were assessed before and after the intervention: time-in-balance test, foot-lift test, Star Excursion Balance Test, side-hop test, figure-8 hop test, Foot and Ankle Ability Measure, and Cumberland Ankle Instability Tool. We conducted 4 separate multivariate repeatedmeasures analyses of variance, followed by univariate analyses for any findings that were different. Results: Using the time-in-balance test, foot-lift test, Star Excursion Balance Test (medial, posteromedial, and posterolateral directions), and figure-8 hop test, we detected improvement for each rehabilitation group compared with the control group (P , .05). However, no intervention group was superior. Conclusions: All 3 rehabilitation groups demonstrated improvement compared with the control group, yet the evidence was too limited to support a superior intervention. Over a 4-weekperiod, either of the single-task interventions or the combination intervention can be used to combat the residual deficits associated with CAI in an adolescent patient population