scholarly journals The effects of a randomized four-week Graston Instrumented-Assisted Soft Tissue Mobilization (GISTM) dynamic balancing-training program on individuals with chronic ankle instability

2009 ◽  
Author(s):  
Jessica L. Schaefer
2012 ◽  
Vol 21 (4) ◽  
pp. 313-326 ◽  
Author(s):  
Jessica L. Schaefer ◽  
Michelle A. Sandrey

Context:A dynamic-balance-training (DBT) program supplemented with the Graston instrument-assisted soft-tissue mobilization (GISTM) technique has not been evaluated collectively as a treatment in subjects with chronic ankle instability (CAI).Objective:To examine the effects of GISTM in conjunction with a DBT program on outcomes associated with CAI, including pain and disability, range of motion (ROM), and dynamic postural control.Design:Pretest/posttest, repeated measures.Setting:High school and a Division I mid-Atlantic university.Participants:Thirty-six healthy, physically active individuals (5 female, 31 male; age 17.7 ± 1.9 y; height 175.3 ± 14.6 cm) with a history of CAI as determined by an ankle-instability questionnaire volunteered to be in this study.Interventions:Subjects were randomly assigned to 1 of 3 intervention groups: both treatments (DBT/GISTM, n = 13), DBT and a sham GISTM treatment (DBT/GISTM-S, n = 12), or DBT and control—no GISTM (DBT/C, n = 11). All groups participated in a 4-wk DBT program consisting of low-impact and dynamic activities that was progressed from week to week. The DBT/GISTM and DBT/GISTM-S groups received the GISTM treatment or sham treatment twice a week for 8 min before performing the DBT program. Pretest and posttest measurements included the Foot and Ankle Ability Measure (FAAM), FAAM Sport, the visual analog scale (VAS), ankle ROM in 4 directions, and the Star Excursion Balance Test (SEBT) in 3 directions.Main Outcome Measures:FAAM and FAAM-Sport scores, VAS, goniometric ROM (plantar flexion, dorsiflexion, inversion, eversion), and SEBT (anterior, posteromedial, posterolateral).Results:Subjects in all groups posttest demonstrated an increase in FAAM, FAAM Sport, ROM, and SEBT in all directions but not in VAS, which decreased. No other results were significant.Conclusion:For subjects with CAI, dynamic postural control, ROM, pain and disability improved pretest to posttest regardless of group membership, with the largest effects found in most measures in the DBT/GISTM group.


2017 ◽  
Vol 38 (06) ◽  
pp. 447-455 ◽  
Author(s):  
Rafael Sierra-Guzmán ◽  
Jose Jiménez ◽  
Carlos Ramírez ◽  
Paula Esteban ◽  
Javier Abián-Vicén

AbstractThe aim of this study was to evaluate the effects of a 6-week WBV training program, performed on a soft, unstable surface, on peak torque, reaction time and the electrical activity of ankle muscles in recreational athletes with chronic ankle instability (CAI). 50 recreational athletes with self-reported unilateral CAI were randomly assigned to a vibration group (VIB), non-vibration group (N-VIB) or control group. The VIB and N-VIB groups performed unilateral balance training on the unstable ankle on a BOSU® Balance Trainer 3 times weekly for 6 weeks. The VIB group trained on a vibration platform, and the N-VIB group trained on the floor. Muscle reaction times and electrical activity of the peroneus brevis (PB), peroneus longus (PL) and tibialis anterior (TA) muscles were assessed in response to sudden inversion, isokinetic peak torque and isokinetic strength ratios of the ankle evertor muscles. After 6 weeks of training, a significant improvement was shown in reaction times of the PB (Pre=60.99±9.17 ms, Post1=54.90±6.99 ms, p=0.003), PL (Pre=61.20±10.72 ms, Post1=55.21±9.04 ms, p=0.007) and TA (Pre=65.31±11.78 ms, Post1=59.07±9.99 ms, p=0.007) muscles in the VIB group, whereas no significant changes were found in the N-VIB group or the control group. There were no significant changes in electrical activity, peak torque and eccentric-concentric ratio for any of the groups after training. In conclusion, a 6-week WBV training program on a soft, unstable surface improves the reaction times of the PB, PL and TA muscles in recreational athletes with CAI. Trial registration: ClinicalTrials.gov NCT02794194


2015 ◽  
Vol 50 (4) ◽  
pp. 343-349 ◽  
Author(s):  
Abby Mettler ◽  
Lisa Chinn ◽  
Susan A. Saliba ◽  
Patrick O. McKeon ◽  
Jay Hertel

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. Intervention(s) Participants were randomly assigned to a 4-week balance-training program or no balance training. 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 = .006) and eyes-closed trials (before trial = 387.9 ± 123.8, after trial = 189.4 ± 102.9; P < .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 = .54) and eyes-closed trials (before trial = 326.9 ± 134.3, after trial = 338.2 ± 126.1; P = .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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