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N. Kılıç1, E.T. Çil1, F. Subaşı1
1Yeditepe University, Physiotherapy and Rehabilitation, Istanbul, Turkey
Background: Ankle sprains, particularly injuries to the lateral ligament group of the ankle joint, are among the most common lower extremity injuries in athletes. The prevalence of chronic ankle instability (CAI) expected between %40 and 70% in the individuals having an acute ankle instability along with the general population after first lateral ankle sprain history due to recurrences.Conservative CAI treatment is widely accepted as the primary method of managing the condition and preventing re-injury.Although the literatüre suggested that comprehensive rehabilitation approaches (strength, balance, postural control, flexibilty and agility), there is only one study on vestibulo-ocular reflex training to the best of our knowledge.
Purpose: The aim of the study is to compare the effects of neromuscular exercise combined with vestibulo-ocular reflex training on balance and isokinetic muscle strength in subjects with chronic ankle instability.
Methods: This study was conducted in Sportomed Athlete Health and Orthopedic Rehabilitation clinic in February 2020, September 2022.A total of 20 participants aged 18-30 were included in the study on a voluntary basis. Participants were divided into two groups at random, the subjects in the first group were included in the vestibulo-ocular exercise program in addition to the neuromuscular exercise programs with the same physiotherapist. Subjects in the second group were included in neuromuscular training programs. The trainings were applied three days a week for four weeks and each training session lasted approximately 60 minutes. Functional limitations of the participants before and after the treatment were evaluated with the Foot and Ankle Ability Measure Daily Living Subscale (FAAM- ADL) and Sports Subscale (FAAM-S). Dynamic balance evaluation with star excursion balance test, proprioception evaluation by measuring joint position sense with goniometer, and ankle evertor and inverter concentric muscle strength were evaluated using isokinetic dynamometer at angular velocities of 60/s, 120/s and 180/s, and the results were recorded.
Results: According to statistical analysis,significant changes were observed in balance, muscle strength and proprioception before and after treatment in both groups (p<0.05).However, no superiority was found between the two treatment groups (p>0.05). Vestibulo-ocular reflex training with neuromuscular exercise group had superioty in terms of FAAM-ADL and FAAM-Sports scores at six months.
Conclusions: This is the second study in the literature to include vestibular-ocular reflex (VOR). Unlike the other study, we applied a more extended neuromuscular exercise training protocol and evaluated
different parameters. Additionally, the desired sample size was achieved in the power analysis. The combined neuromuscular and vestibulo-ocular reflex training program was more effective than only neuromuscular training for long term period. This study helps to understand the effects of these trainning protocols on balance, isokinetic muscle strength and proprioception. Both training protocols may be recommended at least fourth week treatment duration and their effects last at least six month. Since CAI can cause even after a simple injury long-term disability, understanding of effectiveness of rehabilitation protocols may help in prevention and provide the imanagement of patients with CAI.
different parameters. Additionally, the desired sample size was achieved in the power analysis. The combined neuromuscular and vestibulo-ocular reflex training program was more effective than only neuromuscular training for long term period. This study helps to understand the effects of these trainning protocols on balance, isokinetic muscle strength and proprioception. Both training protocols may be recommended at least fourth week treatment duration and their effects last at least six month. Since CAI can cause even after a simple injury long-term disability, understanding of effectiveness of rehabilitation protocols may help in prevention and provide the imanagement of patients with CAI.
Implications: It is implicated that vestibulo-ocular exercise training should be included in the treatment of people with chronic ankle instability.
Funding acknowledgements: There is no funding acknowledgement
Keywords:
Chronic ankle instability
Neuromuscular training
Vestibular-ocular reflex training
Chronic ankle instability
Neuromuscular training
Vestibular-ocular reflex training
Topics:
Disability & rehabilitation
Orthopaedics
Musculoskeletal: lower limb
Disability & rehabilitation
Orthopaedics
Musculoskeletal: lower limb
Did this work require ethics approval? Yes
Institution: Marmara University
Committee: Marmara University Ethical Commitee
Ethics number: 21
All authors, affiliations and abstracts have been published as submitted.
