Balance Interventions vs. Strength Exercises for Chronic Ankle Instability
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Presenter(s)
Carlee Braun, Jaclyn Thomas, Miku Murayama
Abstract
Clinical Scenario: Recurrent ankle sprains and instability are common concerns, especially among physically active individuals. Without proper intervention and management, patients can develop chronic ankle instability (CAI), which is a condition of recurring “giving way” of the ankle that can negatively affect function and quality of life. Research currently suggests that CAI can be managed through rehabilitation. However, it is unclear what the most beneficial intervention is for reducing CAI symptoms and regaining function. The purpose of this critical appraisal is to investigate the difference between the impact of balance-based and strength-based interventions on the range of motion of patients with CAI.
Clinical Question: In patients with Chronic Ankle Instability what is the effect of balance interventions compared to strength-based exercises on increasing ROM?
Search Strategy and Evidence Quality: The database, PubMed, was used to find randomized control trials (RCT). The inclusion criteria were CAI, balance, strength, and physical activity. Elite and collegiate athletes were excluded. The search terms utilized were: CAI, ankle balance exercises, ankle strength exercises, improvement, ankle rehabilitation, and recurrent ankle sprains, (ROM). Seven qualifying scholarly articles were identified. An evidence quality assessment resulted in PEDro scores ranging between 4/10-9/10, Oxford Score was 2 for all the studies.
Results: The existing research shows consistent findings for increases in dorsiflexion and eversion with balance interventions. The use of strength interventions showed consistent increases in dorsiflexion, plantarflexion, and eversion. The research strengths are indicated by consistent measures of increased range of motion and function. The limitations were small subject pools, lack of standardized exercise programs, and limited long-term studies. Overall, the results of the existing literature show ankle ROM increases from both balance and strength interventions.
Clinical Bottom Line: Both interventions produce increases in dorsiflexion and eversion range of motion, with strength interventions also increasing plantarflexion of patients with CAI. To answer the proposed clinical question, it is suggested that balance interventions may produce more meaningful improvements, however, the use of a combination of intervention strategies is recommended to improve the range of motion, and therefore, the overall function of patients with CAI. (SORT score); A.
Implications: The findings of this critical appraisal may have practical implications for implementing a combination of interventions effective management strategies for symptoms and functional improvement for CAI. Educational implications suggest the consideration of the effects of using combined intervention strategies to maximize rehabilitative outcomes and patient quality of life. Further investigation is recommended to determine broader population and long-term outcomes.
College
College of Nursing & Health Sciences
Department
Health, Exercise & Rehabilitative Sciences
Campus
Winona
First Advisor/Mentor
Nora Kraemer, PhD, LAT, ATC, CSCS
Start Date
4-24-2025 12:00 AM
End Date
4-24-2025 12:00 AM
Presentation Type
Oral Presentation
Format of Presentation or Performance
Pre-Recorded Video
Metadata Creation Responsibility
Carlee Braun
Balance Interventions vs. Strength Exercises for Chronic Ankle Instability
Clinical Scenario: Recurrent ankle sprains and instability are common concerns, especially among physically active individuals. Without proper intervention and management, patients can develop chronic ankle instability (CAI), which is a condition of recurring “giving way” of the ankle that can negatively affect function and quality of life. Research currently suggests that CAI can be managed through rehabilitation. However, it is unclear what the most beneficial intervention is for reducing CAI symptoms and regaining function. The purpose of this critical appraisal is to investigate the difference between the impact of balance-based and strength-based interventions on the range of motion of patients with CAI.
Clinical Question: In patients with Chronic Ankle Instability what is the effect of balance interventions compared to strength-based exercises on increasing ROM?
Search Strategy and Evidence Quality: The database, PubMed, was used to find randomized control trials (RCT). The inclusion criteria were CAI, balance, strength, and physical activity. Elite and collegiate athletes were excluded. The search terms utilized were: CAI, ankle balance exercises, ankle strength exercises, improvement, ankle rehabilitation, and recurrent ankle sprains, (ROM). Seven qualifying scholarly articles were identified. An evidence quality assessment resulted in PEDro scores ranging between 4/10-9/10, Oxford Score was 2 for all the studies.
Results: The existing research shows consistent findings for increases in dorsiflexion and eversion with balance interventions. The use of strength interventions showed consistent increases in dorsiflexion, plantarflexion, and eversion. The research strengths are indicated by consistent measures of increased range of motion and function. The limitations were small subject pools, lack of standardized exercise programs, and limited long-term studies. Overall, the results of the existing literature show ankle ROM increases from both balance and strength interventions.
Clinical Bottom Line: Both interventions produce increases in dorsiflexion and eversion range of motion, with strength interventions also increasing plantarflexion of patients with CAI. To answer the proposed clinical question, it is suggested that balance interventions may produce more meaningful improvements, however, the use of a combination of intervention strategies is recommended to improve the range of motion, and therefore, the overall function of patients with CAI. (SORT score); A.
Implications: The findings of this critical appraisal may have practical implications for implementing a combination of interventions effective management strategies for symptoms and functional improvement for CAI. Educational implications suggest the consideration of the effects of using combined intervention strategies to maximize rehabilitative outcomes and patient quality of life. Further investigation is recommended to determine broader population and long-term outcomes.
