Rehabilitation Incorporating Gait Training Devices for Chronic Ankle Instability

Context: Individuals with chronic ankle instability (CAI) have deficits in neuromuscular control and altered movement patterns. Ankle destabilization devices have been shown to increase lower extremity muscle activity during functional tasks and may be a useful tool in improving common deficits and self-reported function. Objective: To determine whether a 4-week rehabilitation program that includes ankle destabilization devices (Device) has greater beneficial effects on self-reported function, ankle range of motion (ROM), ankle strength and balance compared to rehabilitation without destabilization devices (No Device) in CAI patients. Design: Single-blind randomized controlled trial. Setting: Athletic training laboratory. Patients or Other Participants: Twenty-six participants with CAI (age=21.34, sex=(M=7,F=19), height=168.96cm, weight=70.73kg). Interventions: Participants completed baseline self-reported function questionnaires, ROM, strength, balance measures and were randomized into no device and device groups. Both groups completed 4-weeks of supervised rehabilitation with or without destabilization devices and then repeated the questionnaires, ROM, strength, and balance measures. Main Outcome Measures: Self reported function, strength, static balance, and dynamic balance. All measures were compared using a mixed-model ANOVA and appropriate post-hoc tests with a priori significance level of P≤0.05. Results: There were no significant differences between the no device and device groups in self-reported function, ROM, strength or balance after rehabilitation. However, both groups had significant improvements in self-reported function, ROM, strength and balance after rehabilitation. Conclusion: Incorporating ankle destabilization devices into rehabilitation is not more effective at improving self-reported function, ROM, strength and balance when compared to traditional rehabilitation tools as both interventions resulted in similar improvements. Progressive impairment-based rehabilitation is effective at improving clinical outcomes associated with CAI and should be used when treating CAI.