Title: The Effect of a 4-Week Comprehensive Rehabilitation Program on Postural Control and Lower Extremity Function in Individuals With Chronic Ankle Instability
Authors: Sheri A. Hale, PT, PhD, ATC, Jay Hertel, PhD, ATC, Lauren C. Olmsted-Kramer, PhD, ATC
Source: Journal of Orthopaedic & Sports Physical Therapy Volume 37 Number 6 June 2007 303-311
PODIATRIC RELEVANCE:
Chronic ankle instability (CAI) is a common problem that is encountered in podiatric practice. Following lateral ankle sprain 10-30% of patients report persistent problems. Physical therapy has been shown to play a major role in the rehabilitation process. Despite many reports of improvement following physical therapy treatment there is little evidence to support that balance training reduces the number of subsequent ankle sprains. Also much of the research explores the efficacy of a specific treatment strategy such as balance training or strengthening in isolation. The purpose of this study was to examine the efficacy of a four week comprehensive rehabilitation program that included range of motion, muscle performance, and neuromuscular control.
METHODS:
In this article the subjects with unilateral CAI were assigned to rehabilitation or control groups. Subjects without CAI were assigned to a healthy group. Initial examinations consisted of center of pressure velocity (COPV), star excursion balance test (SEBT), and foot and ankle disability index (FADI) with the FADI-Sports subscale (FADI-Sport). The rehab group completed 4 weeks of rehabilitation including range of motion, strength, neuromuscular control and function tasks. After four weeks all subjects were tested again.
RESULTS:
Subjects with CAI displayed deficits in postural control and SEBT reach tasks of the involved limb compared to the uninvolved limb. They also reported functional deficits of the involved limb compared to healthy subjects. Following the course of rehabilitation the CAI-rehab group had increased SEBT reach improvements of the involved limb compared to the other groups as well as greater improvements in FADI and FADI-Sports.
COMMENTS:
The authors concluded from the information they gathered, that postural control and functional limitations exist in individuals with CAI. They also show that a comprehensive rehabilitation program greatly improves these function limitations. Longer study length may be required to demonstrate a decrease in the recurrence of injury.
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Disclaimer:
Scientific Abstract Monthly postings are submitted by podiatric surgical residents. The ideas presented are not the opinions of the American College of Foot and Ankle Surgeons (ACFAS), nor are they presented as facts. ACFAS presents this information without any warranty of any kind, expressed or implied, and is not liable for its accuracy nor for any loss or damage caused by the user's reliance on information obtained in these areas.