Academy Blog » ankle

Balance exercises for chronic ankle sprains effective

Dr. Phil Page — Tue, 31 Aug 2010 12:12:58 +0000

Chronic ankle sprains have been attributed to poor sensorimotor control, resulting in “functional ankle instability.” First described in the 1960’s by Freeman and Wyke, functional ankle instability has been postulated to result from a lack of proprioceptive information from the ankle due to “deafferentation.” Functional ankle instability is associated with chronic ankle sprains; patients with functional ankle instability may have normal strength and ligament structure, yet continue to suffer ankles sprains. Progressive balance exercise programs have been shown effective at reducing functional instability and recurring ankle sprains. Sensorimotor training programs for ankle instability often include balance exercises that use foam pads such as Thera-Band® Stability Trainers.

Researchers at the University of Kentucky developed a progressive balance training program for patients with chronic ankle instability. The program lasted 4 weeks and focused on dynamic balance stabilization in single-leg stance. Exercises included progressions in hops and single-leg balance using foam pads and 6-pound medicine balls. The results of their first study, published in Medicine and Science in Sports and Exercise in 2008, found that their program significantly improved function and postural control in chronic ankle sprain patients. In their more recent study, 29 subjects with chronic ankle instability were randomly assigned to either an exercise group or control group. The authors reported improvements in gait kinematics, specifically the coupling of rearfoot and lower leg motion during walking. The researchers noted that the changes in gait kinematics following the exercise program were likely due to changes in sensorimotor function resulting from the 4- week balance training program, particularly since ligamentous laxity did not change.

In summary, a 4-week progressive balance training program implementing hops and single-leg balance exercises with Thera-Band Stability Trainers can help improve balance, function, and kinematics in patients with chronic ankle instability.

REFERENCES:

McKeon PO, et al. Effects of balance training on gait parameters in patients with chronic ankle instability: a randomized controlled trial. Clin Rehabil. 2009 Jul;23(7):609-21. Epub 2009 May 15.

McKeon PO, et al. Balance training improves function and postural control in those with chronic ankle instability. Med Sci Sports Exerc. 2008 Oct;40(10):1810-9.

Visit the Thera-Band Academy Stability Training Portal here

Functional rehabilitation of chronic ankle instability effective

Dr. Phil Page — Mon, 12 Jul 2010 22:29:51 +0000

It’s been reported that athletes suffering an ankle sprains re-injure their ankle 70% to 80% of the time. This leads to chronic ankle instability or ‘functional ankle instability’. Rehabilitation for chronic ankle sprains often includes functional exercises including dynamic closed-chain activities. Thera-Band® products such as elastic resistance bands, stability trainers and balance boards are used for functional rehabilitation.

Researchers at the University of Toledo performed a systematic review of functional exercise interventions for their effectiveness. They identified 6 studies that met their criteria for the review, including 4 that used balance boards and elastic resistance strengthening. The researchers concluded that functional rehabilitation improves dynamic balance and self-reported function in patients with chronic ankle sprains. The exercise programs from the reviewed studies generally lasted 4 to 6 weeks and were performed 3 to 5 times a week. Finally, they pointed out that wobble board training in rehabilitation programs is “supported by the literature”; therefore, Thera-Band balance boards should be a standard component of chronic ankle instability rehabilitation program.

REFERENCE Webster KA, Gribble PA. Functional rehabilitation interventions for chronic ankle instability: a systematic review. J Sport Rehabil. 2010 Feb;19(1):98-114.

Visit the Thera-Band Academy Ankle Sprain resource center here

Physical therapy with Thera-Band products effective after surgical repair of ankle fracture

Dr. Phil Page — Tue, 04 May 2010 09:00:57 +0000

After surgery to repair an ankle fracture, physical therapy exercise is usually prescribed; however, no randomized, controlled studies have evaluated the effectiveness of a rehabilitation program after removing the post-operative cast. A prospective, randomized, controlled trial (RCT) was published by researchers in Sweden to evaluate a standardized, but individually-suited training program supervised by a physiotherapist.

105 patients were randomly assigned to a control group or physical therapy group after an average of 6 weeks in a plaster cast. The control group received “usual care”: advice and self-directed exercise. While 76% of subjects in the control group also attended physical therapy sessions on their own, their exercises were not the standardized program of the experimental group.

The physical therapy program began 1 week after cast removal and lasted 12 weeks, with 2 sessions per week. Patients also performed exercises at home between physical therapy visits. The neuromuscular training program consisted of range of motion (ROM) exercises, strengthening, balance training, and closed-kinetic chain exercises. Patients used Thera-Band® resistance bands for ankle strengthening exercises as well as wobble board and mini-trampoline exercises for balance training. Download the article and exercise protocol from the Academy here.

After 12 weeks, the physical therapy group showed improved results compared to the control group in patients under 40 years old. The physical therapy group had significant improvements in subjective function and muscle strength, but not in other measures of physical function. There was no significant difference in radiologic outcomes at 12 months post. The lack of significance in several variables may be explained by the fact that 76% of the control group also received physical therapy. Interestingly, older patients (greater than 40 years old) did not benefit as much as younger patients; it’s possible that older patients need more time for rehabilitation and recovery following ankle fracture.

In conclusion, Thera-Band resistance bands and balance boards are effective for rehabilitation following surgery for ankle fracture.

REFERENCE: Nilsson GM, Jonsson K, Ekdahl CS, Eneroth M.Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial. BMC Musculoskelet Disord. 2009 Sep 25;10:118.

Visit the Thera-Band Academy Ankle Fracture Resource Center here

Balance Training Reduces Ankle Re-Injury

Dr. Phil Page — Thu, 03 Dec 2009 13:53:24 +0000

Approximately 23,000 ankle sprains occur daily in the United States, and about one half require some form of medical treatment. Research has shown that athletes are twice as likely to re-injure their ankle within one year. According to a study in the British Medical Journal, athletes with ankle sprains who receive additional proprioceptive training after ‘usual care’ are 35% less likely to suffer a recurrence over the next year. Over 500 athletes in the Netherlands were randomly assigned to usual care (the control group) or usual care plus 8 weeks of balance board exercises. The ankle exercises were performed 3 times per week, 30 minutes per session as part of normal warm-up before sports. The program gradually increased in difficulty.

Download the balance board ankle exercise program here.

The authors concluded that the 8 week balance training program would benefit both athletes and the general population after suffering an ankle sprain. The results of this study were similar to findings in a 2004 study where volleyball players in the Netherlands significantly reduced their risk of re-injury after a balance board training program. Another study on American high school football players with a history of ankle sprains reduced their risk of reinjury by 77% by training with the Thera-Band® Stability Trainer. The Thera-Band System of Progressive Balance Training, including Thera-Band Stability Trainers, Rocker Boards, and Wobble Boards can be part of a balance training program to help reduce the recurrence of ankle sprains.

Visit the Thera-Band Academy Ankle Sprain Center Here

Visit the Thera-Band Balance Board Center Here

Visit the Thera-Band Stability Trainer Center Here

Simple Exercises to Prevent Falls

Dr. Phil Page — Mon, 06 Apr 2009 15:14:23 +0000

Researchers in Portugal investigated the effects of 2 simple strengthening exercises using Thera-Band® resistance bands. The randomized, controlled study , published in Geriatrics and Gerontology International, included 48 institutionalized older adults. Subjects were tested before and after the program on ankle strength, functional mobility, and balance. The 2 exercises, ankle dorsiflexion and plantarflexion, were performed 3 times a week for 6 weeks, and gradually progressed by increasing the color level of the Thera-Band resistance.

Thera-Band Ankle Plantarflexion

After 6 weeks, the researchers found significant increases in ankle strength (dorsiflexion and plantarflexion), as well as significant increases in functional mobility and balance. The gain in ankle strength was significantly associated with improvement in dynamic balance. There was no significant change in the control group. The researchers concluded, the low cost strength training program may provide a ”modest degree of protection from injurious falls among these institutionalized older adults.”

Riberio et al. Impact of low cost strength training of dorsi- and plantar flexors on balance and functional mobility in institutionalized elderly people.Geriatr Gerontol Int. 2009 Mar;9(1):75-80.