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.

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You can also view the video at the ATP website here: Agility Training for Tennis with Thera-Band Products

For more information on purchasing Thera-Band products, contact your local healthcare distributor or visit our “Where to Buy” website to find a practitioner in your area who sells the products.

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.

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Two groups of female basketball players were assigned to either a 6-week neuromuscular exercise program or a control group (the subjects weren’t randomized; they were assigned to a group based on their school). Athletes were tested for their static balance and dynamic balance; the static balance test (BESS) used foam pads to create an unstable surface to evaluate postural stability.

The exercise group completed a twice a week, 6-week program that included 4 training stations: functional strengthening, plyometrics, agility training, and balance training. Each session lasted about 1.5 hours. The functional training station utilized elastic band loops and exercise balls, and the balance station utilized foam rolls.

After analysis of the 50 athletes completing the study, the authors found significant improvements in both static and dynamic balance. While these results may sound intuitive, other studies have shown no increase in balance with more simple balance exercises, possibly due to a ceiling effect or lack of neuromuscular stimulus. This study, however, suggests a more robust neuromuscular “circuit” training program may be more effective. Unfortunately, the authors did not look at functional performance or subsequent injury rates, which may demonstrate more meaningful outcomes.

In summary, Thera-Band elastic loops, stability trainers, and exercise balls can be used as part of a neuromuscular circuit training program to improve balance in high school athletes.

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McLeod TC, et al. Balance improvements in female high school basketball players after a 6-week neuromuscular-training program.

A systematic review in the Journal of Strength and Conditioning Research provided a systematic review of balance training in healthy individuals. Using the PEDro scale for analyzing studies, the authors evaluated the quality and effect sizes of 16 articles involving healthy individuals. 2 types of balance training for postural stability were identified: static and dynamic balance. Static balance is defined as the ability to maintain the center of gravity within the base of support. Dynamic balance is defined as the transition from dynamic activity to a static position. The authors also identified 2 types of surfaces used in balance assessment to quantify postural stability. Stable surface assessments utilize force platforms or single-leg balance time, while unstable surface assessments utilize tilting platforms.

The reviewers suggested that specific exercises are more beneficial for improving specific balance performance. The chart below describes which exercises are best for improving specific balance tasks:

While balance training may improve balance, athletes may experience a ‘ceiling effect’ of training with stable surfaces as assessed on stable surfaces. Unfortunately, the results of this review don’t indicate the carry-over of balance training to enhancing functional performance; more research is needed.  This review was only limited to healthy individuals, so these findings may not be applicable to geriatric or patient populations.

The authors concluded that there is strong evidence for balance training to safely improve static and dynamic balance. Furthermore, balance training should be included in both rehabilitation and injury prevention programs. The authors added, “Progressive dynamic balance training appears to have the best results.” Based on their review, the authors recommend balance training at least 3 times per week for 4 weeks, at least 10 minutes a day for healthy athletes. They recommend progressing from 2-leg eyes open training on a stable surface, to 1-leg eyes closed on an unstable surface, to dynamic balance training.

The Thera-Band® system of progressive balance training, including Stability Trainers, Stability Discs, and Rocker and Wobble Boards offer the ability to progress individuals throughout the balance training spectrum.

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DiStefano LJ, et al. Evidence supporting balance training in healthy individuals: a systematic review. J Strength Cond Res. 2009 23(9):2718-31.