CONTEXT: Deficits in ankle and hip strength and lower extremity postural control are associated with chronic ankle instability (CAI). Following strength training, muscle groups demonstrate increased strength. This change is partially credited to improved neuromuscular control and many studies have investigated ankle protocols for subjects with CAI. The effects of isolating hip musculature in strength training protocols in this population is not well understood. OBJECTIVE: Examine the effects of hip strengthening on clinical and self-reported outcomes in patients with CAI. STUDY DESIGN: Prospective randomized controlled clinical trial. SETTING: Athletic Training facility. PARTICIPANTS: Twenty-six participants with CAI (12 males and 14 females, 20.9 +/- 1.5 years, 170.0 +/- 12.7 cm, 77.5 +/- 17.5 kg) were randomly assigned to training or control groups. INTERVENTION: The participants completed either four weeks of supervised hip strengthening (resistance bands 3x/week) or no intervention. MAIN OUTCOME MEASURES: Participants were assessed on four clinical measures (Star Excursion Balance Test (SEBT) in the anterior, posteromedial and posterolateral directions, Balance Error Scoring System (BESS), hip external rotation strength, hip abduction strength) and a patient reported measure (the Foot and Ankle Ability Measure (FAAM) activities of daily living and sports subscales) before and after the four-week training period. RESULTS: The training group displayed significantly improved post-test measures compared with the control group for: hip abduction strength (training 446.3 +/- 77.4 N, control 314.7 +/- 49.6 N, p < 0.01), hip external rotation strength (training 222.1 +/- 48.7 N, control 169.4 +/- 34.6 N, p < 0.01); SEBT reach in the anterior (training 93.1 +/- 7.4%, control 90.2 +/- 7.9%, p < 0.01), posteromedial (training 96.3 +/- 8.9%, control 88.0 +/- 8.8%, p < 0.01) and posterolateral (training 95.4 +/- 11.1%, control 86.6 +/- 9.6%, p < 0.01) directions; BESS total errors (training 9.9 +/- 6.3 errors, control 21.2 +/- 6.3 errors, p < 0.01); and FAAM-sports score (training 88.0 +/- 12.6, control 84.8 +/- 10.9, p < 0.01). CONCLUSION: Improved clinical and patient-reported outcomes in the training group suggest hip strengthening is beneficial in the management and prevention of recurrent symptoms associated with CAI.
Copyright Human Kinetics. Reprinted with permission from Human Kinetics (Champaign, IL).

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