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Balance training and center-of-pressure location in participants with chronic ankle instability [with consumer summary]
Mettler A, Chinn L, Saliba SA, McKeon PO, Hertel J
Journal of Athletic Training 2015 Apr;50(4):343-349
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

CONTEXT: Chronic ankle instability (CAI) occurs in some people after a lateral ankle sprain and often results in residual feelings of instability and episodes of the ankle's giving way. Compared with healthy people, patients with CAI demonstrated poor postural control and used a more anteriorly and laterally positioned center of pressure (COP) during a single-limb static-balance task on a force plate. Balance training is an effective means of altering traditional COP measures; however, whether the overall location of the COP distribution under the foot also changes is unknown. OBJECTIVE: To determine if the spatial locations of COP data points in participants with CAI change after a 4-week balance-training program. DESIGN: Randomized controlled trial. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Thirty-one persons with self-reported CAI. MAIN OUTCOME MEASURE(S): We collected a total of 500 COP data points while participants balanced using a single limb on a force plate during a 10-second trial. The location of each COP data point relative to the geometric center of the foot was determined, and the frequency count in 4 sections (anteromedial, anterolateral, posteromedial, posterolateral) was analyzed for differences between groups. RESULTS: Overall, COP position in the balance-training group shifted from being more anterior to less anterior in both eyes-open trials (before trial 319.1 +/- 165.4, after trial 160.5 +/- 149.5; p = 0.006) and eyes-closed trials (before trial 387.9 +/- 123.8, after trial 189.4 +/- 102.9; p < 0.001). The COP for the group that did not perform balance training remained the same in the eyes-open trials (before trial 214.1 +/- 193.3, after trial 230.0 +/- 176.3; p = 0.54) and eyes-closed trials (before trial 326.9 +/- 134.3, after trial 338.2 +/- 126.1; p = 0.69). CONCLUSIONS: In participants with CAI, the balance-training program shifted the COP location from anterolateral to posterolateral. The program may have repaired some of the damaged sensorimotor system pathways, resulting in a more optimally functioning and less constrained system.

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