Top

Sports Medicine

Published in:

01-07-2008 | Review Article

The Effectiveness of Active Exercise as an Intervention for Functional Ankle Instability

A Systematic Review

Authors: Dr Janice K. Loudon, Marcio J. Santos, Leah Franks, Wen Liu

Published in: Sports Medicine | Issue 7/2008

Abstract

Functional ankle instability (FAI) is a term used to describe an ankle that easily ‘gives way’ with activity. There have been many proposed causes of FAI including joint proprioceptive deficiency, muscle weakness, balance control impairments, and delayed muscle reaction time, none of which has proven to be the exclusive cause of FAI. Treatment becomes difficult when the causative factor of the injury is obscure. This systematic review evaluates the clinical trials involving conservative exercise interventions in FAI and examines the changes induced by the exercise treatments to the various potential FAI factors. Sixteen articles describing the active exercise treatment of FAI were analysed using Sackett’s levels of evidence and were examined for scientific rigor. From this review, it can be concluded that conservative treatment interventions including balance, proprioceptive and muscle strengthening exercises are effective for patients with FAI in decreasing the incidence of giving-way episodes, improving balance stability, and improving function.

Smith RW, Reischl SF. Treatment of ankle sprains in young athletes. Am J Sports Med 1986; 14: 465–71PubMedCrossRef

Garrick JG. The frequency of injury mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med 1977; 5: 241–2PubMedCrossRef

Kern-Steiner R, Washecheck HS, Kelsey DD. Strategy of exercise prescription using an unloading technique for functional rehabilitation of an athlete with an inversion ankle sprain. J Orthop Sports Phys Ther 1999; 29 (5): 282–7PubMed

Safran MR, Benedetti RS, Bartolozzi III AR, et al. Lateral ankle sprains: a comprehensive review, part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. Med Sci Sports Exerc 1999; 31 (7 Suppl.): S429–37PubMed

Hertel J. Functional instability following lateral ankle sprain. Sports Med 2000; 29: 361–71PubMedCrossRef

Taga I, Shino K, Inoue M. Articular cartilage lesions in ankles with lateral ligament injury: an arthroscopic study. Am J Sports Med 1993; 21: 120–7PubMedCrossRef

Hintermann B, Boss A, Schafer D. Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med 2002; 30 (3): 402–9PubMed

Freeman MA, Dean MR, Hanham IW. The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 1965; 47: 678–85PubMed

Forkin DM, Koczur C, Battle R, et al. Evaluation of kinesthetic deficits indicative of balance control in gymnasts with unilateral chronic ankle sprains. J Orthop Sports Phys Ther 1996; 23: 245–50PubMed

10.

Refshauge KM, Kilbreath SL, Raymond J. Deficits in detection of inversion and eversion movements among subjects with recurrent ankle sprains. J Orthop Sports Phys Ther 2003; 33: 166–73PubMed

11.

Rozzi SL, Lephart SM, Sterner R, et al. Balance training for persons with functionally unstable ankles. J Orthop Sports Phys Ther 1999; 29: 478–86PubMed

12.

Tropp H, Ekstrand J, Gillquist J. Stabilometry in functional instability of the ankle and its value in predicting injury. Med Sci Sports Exerc 1984; 16: 64–6PubMed

13.

Tropp H, Odenrick P, Gillquist J. Stabilometry recordings in functional and mechanical instability of the ankle joint. Int J Sports Med 1985; 6: 180–2PubMedCrossRef

14.

Tropp H. Pronator muscle weakness in functional instability of the ankle joint. Int J Sports Med 1986; 7: 291–4PubMedCrossRef

15.

Tropp H, Odenrick P. Postural control in single–limb stance. J Orthop Res 1988; 6: 833–9PubMedCrossRef

16.

Vaes P, Vanghelluwe B, Duquet W. Control of acceleration during sudden ankle supination in people with unstable ankles. J Orthop Sports Phys Ther 2001; 31: 741–52PubMed

17.

Eils E, Rosenbaum D. A multi–station proprioceptive exercise program in patients with ankle instability. Med Sci Sports Exerc 2001; 33: 1991–8PubMedCrossRef

18.

Willems TE, Witvrouw E, Verstuyft J, et al. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 2002; 37 (4): 487–93PubMed

19.

Willems TME, Witvrouw E, Delbaerek K, et al. Intrinsic risk factors for inversion ankle sprains in male subjects: a prospective study. Am J Sports Med 2005; 33 (3): 415–23PubMedCrossRef

20.

Mortenson PA, Eng JJ. The use of casts in the management of joint mobility and hypertonia following brain injury in adults: a systematic review. Phys Ther 2003; 83: 648–58PubMed

21.

Sackett DL. Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 1989; 95 Suppl. 2: 2S–3S

22.

Butler C, Campbell S. Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy: AACPDM Treatment Outcomes Committee Review Panel. Dev Med Child Neurol 2000; 42: 634–45PubMedCrossRef

23.

Gauffin H, Tropp H, Odenrick P. Effect of ankle disk training on postural control in patients with functional instability of the ankle joint. Int J Sports Med 1988; 9: 141–4PubMedCrossRef

24.

Bernier JN, Perrin DH. Effect of coordination training on proprioception of functionally unstable ankle. J Orthop Sports Phys Ther 1998; 27: 264–75PubMed

25.

Docherty CL, Moore JH, Arnold BL. Effects of strength training on strength development and joint position sense in functionally unstable ankles. J Athl Train 1998; 33: 310–4PubMed

26.

Hess DM, Joyce CJ, Arnold BL, et al. Effect of a 4–week agility training program on postural sway in the functionally unstable ankle. J Sports Rehab 2001; 10: 24–35

27.

Matsusaka N, Yokoyama S, Tsurusaki T, et al. Effect of ankle disk training combined with tactile stimulation to the leg and foot on functional instability of the ankle. Am J Sports Med 2001; 29: 25–30PubMed

28.

Hoiness P, Glott T, Ingjer F. High–intensity training with a bidirectional bicycle pedal improves performance in mechanically unstable ankles: a prospective randomized study of 19 subjects. Scand J Med Sci Sports 2003; 13: 266–71PubMedCrossRef

29.

Kaminski TW, Buckley BD, Powers ME, et al. Effect of strength and propioception training on eversion to inversion strength ratios in subjects with unilateral functional ankle instability. Br J Sports Med 2003; 37: 410–5PubMedCrossRef

30.

Powers ME, Buckley BD, Kaminski TW, et al. Six weeks of strength and proprioception training does not affect muscle fatigue and static balance in functional ankle instability. J Sports Rehab 2004; 13: 201–27

31.

Clark VM, Burden AM. A 4–week wobble board exercise programme improved muscle onset latency and perceived stability in individuals with a functionally unstable ankle. Phys Ther Sport 2005; 6: 181–7CrossRef

32.

Kynsburg A, Halasi T, Tallay A, et al. Changes in joint position sense after conservatively treated chronic lateral ankle instability. Knee Surg Sports Traumatol Arthrosc 2006; 14: 1299–306PubMedCrossRef

33.

Ross SE, Guskiewicz KM. Effect of coordination training with and without stochastic resonance stimulation on dynamic postural stability of subjects with functional ankle instability and subjects with stable ankles. Clin J Sport Med 2006; 16: 323–8PubMedCrossRef

34.

Michell TB, Ross SE, Blackburn JT, et al. Functional balance training, with or without exercise sandals, for subjects with stable or unstable ankles. J Athl Train 2006; 41 (4): 393–8PubMed

35.

Sekir U, Yildiz Y, Hazneci B, et al. Effect of isokinetic training on strength, functionality and proprioception in athletes with functional ankle instability. Knee Surg Sports Traumatol Arthrosc 2007; 15: 654–64PubMedCrossRef

36.

Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4–week comprehensive rehabilitation program on postural control and lower extremity function in individuals with chronic ankle instability. J Orthop Sports Phys Ther 2007; 37: 303–11PubMed

37.

Glencross D, Thornton E. Position sense following joint injury. Am J Sports Med 1981; 21: 23–7

Title: The Effectiveness of Active Exercise as an Intervention for Functional Ankle Instability
A Systematic Review
Authors: Dr Janice K. Loudon
Marcio J. Santos
Leah Franks
Wen Liu
Publication date: 01-07-2008
Publisher: Springer International Publishing
Published in: Sports Medicine / Issue 7/2008
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI: https://doi.org/10.2165/00007256-200838070-00003

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Effectiveness of Active Exercise as an Intervention for Functional Ankle Instability

A Systematic Review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 7/2008

Design and Interpretation of Anthropometric and Fitness Testing of Basketball Players

Echocardiography and Circulatory Response to Progressive Endurance Exercise

Physical Activity and Epilepsy

The Effect of Muscle-Damaging Exercise on Blood and Skeletal Muscle Oxidative Stress

Resistance Exercise Biology