[RESEARCH] Strength and Balance Training for Chronic Ankle Instability | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

[RESEARCH] Strength and Balance Training for Chronic Ankle Instability

[RESEARCH] Strength and Balance Training for Chronic Ankle Instability - themanualtherapist.com

Balance & Strength Training to Improve Chronic Ankle Instability

Lateral ankle sprains most prevalent musculoskeletal injuries in sport.

Without appropriate rehab, risk increases for chronic ankle instability (CAI), and osteoarthritis (OA).

Prolonged symptoms of CAI include pain, weakness, or instability, which can lead to range-of-motion (ROM), strength, balance, and functional performance deficits.

Hall et al. (2018) determined if balance- and strength-training protocols would improve the strength, balance, and functional performance deficits associated with CAI.

  • 39 volunteers with CAI, 3 groups, all completed 20-minute sessions, 3x/week, for 6 weeks:
  • Balance-training protocol
  • Strength-training protocol
  • Control

  • Time-by-group interactions were found in:
  • Concentric & eccentric inversion
  • Eccentric eversion
  • Concentric & eccentric plantar flexion
  • Balance Error Scoring System (BESS)
  • Star Excusrion Balance Test (SEBT)
  • Side hops

Improvements in the balance- and strength-training protocol groups in concentric and eccentric inversion and concentric and eccentric plantar flexion and the BESS, SEBT, and side hop. Only the strength-training protocol group improved in eccentric eversion. The control group did not improve in any dependent variable


  • The balance- and strength-training groups improved their strength, balance, and functional performance.
  • The control group did not improve, suggesting that bicycling alone or increasing passive motion did not improve strength, balance, and functional performance.
  • Combining resistance-band and proprioceptive neuromuscular facilitation strength training was an effective intervention.
  • More clinicians should incorporate hop-to-stabilization exercises into their rehabilitation protocols to improve the deficits associated with chronic ankle instability.

Hall et al. 2018. Balance- and Strength-Training Protocols to Improve CAI. Journal of Athletic Training 2018;53(6):568–577

Dalton Urrutia, MSc PT

Dalton is a Physical Therapist from Oregon, currently living and running the performance physiotherapy clinic he founded in London for Grapplers and Strength & Conditioning athletes. Dalton runs the popular instagram account @physicaltherapyresearch, where he posts easy summaries of current and relevant research on health, fitness, and rehab topics. 
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