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Kimmery Migel and Erik Wikstrom

gait in those with CAI. 6 These maladaptive gait biomechanics are thought to increase the risk of subsequent ankle sprains 8 and alter talar cartilage loading patterns leading to the development of posttraumatic osteoarthritis. 3 Neuromuscular control and balance training are frequently incorporated

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Fabiana Rodrigues Osti, Caroline Ribeiro de Souza and Luis Augusto Teixeira

over a series of exercising sessions. In young adults balance training on malleable devices has led to increased stance stability gains in comparison with balance training on a stable ground ( Lee et al., 2013 ; Nam et al., 2016 ). In older adults, similar results have been found. Hirase et al. ( 2015

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Han-Kyu Park, Dong-Woo Kim and Tae-Ho Kim

position than novice athletes. A good shooting performance requires the movements of the barrel and instability of the body to be minimized so that efficient shooting can be achieved. 2 , 6 , 8 To overcome these factors, shooting athletes should participate in a balance training program. 9 Balance

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Michael Wälchli, Jan Ruffieux,, Audrey Mouthon, Martin Keller and Wolfgang Taube

Balance training (BT) can improve postural control. This has recently been confirmed in systematic reviews for older adults ( 21 ) and healthy young adults ( 20 ). In addition, there are several studies demonstrating that BT interventions lead to improved postural control in children

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Christopher J. Burcal, Alejandra Y. Trier and Erik A. Wikstrom

Context:

Both balance training and selected interventions meant to target sensory structures (STARS) have been shown to be effective at restoring deficits associated with chronic ankle instability (CAI). Clinicians often use multiple treatment modalities in patients with CAI. However, evidence for combined intervention effectiveness in CAI patients remains limited.

Objective:

To determine if augmenting a balance-training protocol with STARS (BTS) results in greater improvements than balance training (BT) alone in those with CAI.

Design:

Randomized-controlled trial.

Setting:

Research laboratory.

Patients:

24 CAI participants (age 21.3 ± 2.0 y; height 169.8 ± 12.9 cm; mass 72.5 ± 22.2 kg) were randomized into 2 groups: BT and BTS.

Interventions:

Participants completed a 4-week progression-based balance-training protocol consisting of 3 20-min sessions per week. The experimental group also received a 5-min set of STARS treatments consisting of calf stretching, plantar massage, ankle joint mobilizations, and ankle joint traction before each balance-training session.

Main Outcome Measures:

Outcomes included self-assessed disability, Star Excursion Balance Test reach distance, and time-to-boundary calculated from static balance trials. All outcomes were assessed before, and 24-hours and 1-week after protocol completion. Self-assessed disability was also captured 1-month after the intervention.

Results:

No significant group differences were identified (P > .10). Both groups demonstrated improvements in all outcome categories after the interventions (P < .10), many of which were retained at 1-week posttest (P < .10). Although 90% CIs include zero, effect sizes favor BTS. Similarly, only the BTS group exceeded the minimal detectable change for time-to-boundary outcomes.

Conclusions:

While statistically no more effective, exceeding minimal detectable change scores and favorable effect sizes suggest that a 4-week progressive BTS program may be more effective at improving self-assessed disability and postural control in CAI patients than balance training in isolation.

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Sharon Hetherington, Paul Swinton, Tim Henwood, Justin Keogh, Paul Gardiner, Anthony Tuckett, Kevin Rouse and Tracy Comans

balance training has the potential to improve their physical function and physical capacity, as well as to promote independence ( Henwood, Riek, & Taaffe, 2008 ; Liu & Latham, 2011 ). However, a majority of research continues to focus on low-intensity activities that do not employ the technique of

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Monna Arvinen-Barrow, Nathan Maresh and Jennifer Earl-Boehm

participant reported moderate levels of pain and swelling, and progressed well through the acute care and strength-training phases of the rehabilitation. Her balance training phase began during week 2 following the injury. After 3 balance training sessions, she met the commonly used clinical guidelines for

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Kristen K. Maughan, Kristin A. Lowry, Warren D. Franke and Ann L. Smiley-Oyen

A 6-wk group balance-training program was conducted with physically active older adults (based on American College of Sports Medicine requirements) to investigate the effect of dose-related static and dynamic balance-specific training. All participants, age 60–87 yr, continued their regular exercise program while adding balance training in 1 of 3 doses: three 20-min sessions/wk (n = 20), one 20-min session/wk (n = 21), or no balance training (n = 19). Static balance (single-leg-stance, tandem), dynamic balance (alternate stepping, limits of stability), and balance confidence (ABC) were assessed pre- and posttraining. Significant interactions were observed for time in single-leg stance, excursion in limits of stability, and balance confidence, with the greatest increase observed in the group that completed 3 training sessions/wk. The results demonstrate a dose-response relationship indicating that those who are already physically active can improve balance performance with the addition of balance-specific training.

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Maraike Alice Wortmann and Carrie L. Docherty

The lateral ligament complex of the ankle is a frequently injured structure in sports and recreational activities, which often results in chronic ankle instability (CAI). Balance exercise training has become a common component of clinical rehabilitation for CAI to address postural deficits. To determine the effect of balance training on postural stability, this critically appraised topic presents a summary and analysis of 4 relevant studies that address the effectiveness of balance training in subjects with CAI. Information about the methods and sources used in the article is provided. The findings imply that there is moderate evidence that 4–6 wk of balance training can enhance static and dynamic postural stability in subjects with CAI.

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Emily D. Cox, Scott M. Lephart and James J. Irrgang

The purpose of this study was to provide normative data on postural sway by comparing the mean gain score between two balance training groups and a control group. Twenty-seven recreational collegiate athletes (14 females, 13 males, 18-36 years old) with no past documented lower extremity injury or lesion of the vestibular system were randomly placed into three groups: control (nontraining), foam surface training, or hard surface training. The Chattecx Dynamic Balance System (CDB) was utilized for objective post-and pretraining recordings. CDB tests were performed on the training and nontraining extremities with subjects' eyes open and eyes closed. Results revealed no significant post to pre mean gain score differences within any group, nor was any significance revealed between group differences. Although no significant differences were revealed, trends indicated specificity of training toward testing mode. These data should assist clinicians in preventing ankle injury or compensating for ankle instability with balance training.