Ankle Instability Is Associated with Balance Impairments
- 1 May 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Medicine & Science in Sports & Exercise
- Vol. 41 (5), 1048-1062
- https://doi.org/10.1249/mss.0b013e318192d044
Abstract
Our primary purpose was to determine whether balance impairments were associated with functional ankle instability (FAI). Our literature search consisted of four parts: 1) an electronic search of PubMed, CINAHL, pre-CINAHL, and SPORTDiscus; 2) a forward search of articles selected from the electronic search using the Science Citation Index; 3) a hand search of the previously selected articles; and 4) a direct contact with corresponding authors of the previously selected articles. We initially identified 145 articles and narrowed these to 23 for inclusion in the meta-analysis. Identified outcomes were categorized by measurement units and balance task type (i.e., dynamic or static). Each study was coded based on whether inclusion or exclusion criteria were identified. Our statistical analysis included fixed, random, or mixed effect analyses based on the presence of within study heterogeneity and whether categories were being compared. FAI was associated with poorer balance (standard difference of the mean [SDM] = 0.455, 95% confidence interval = 0.334-0.577, Z = 7.34, P < 0.001), but no difference existed between dynamic and static measure categories (Q = 3.44, P = 0.063). However, there was a significant difference between the dynamic measures (Q = 6.22, P = 0.013) with both time to stabilization and the Star Excursion Balance Test producing significant SDM and between static measures (Q = 13.00, P = 0.012) with the linear, time, velocity, and other measurement categories (but not area) producing significant SDM. Examination of individual outcomes revealed that time in balance and foot lifts produced very large SDM (3.3 and 4.8, respectively). FAI is associated with impaired balance. Due to the relatively large effect sizes and simplicity of use of time in balance and foot lifts, we recommend that further research should establish their clinical validity and clinical cutoff scores.Keywords
This publication has 29 references indexed in Scilit:
- The Effect of a 4-Week Comprehensive Rehabilitation Program on Postural Control and Lower Extremity Function in Individuals With Chronic Ankle InstabilityJournal of Orthopaedic & Sports Physical Therapy, 2007
- Postural Control Deficits in Participants with Functional Ankle Instability as Measured by the Balance Error Scoring SystemClinical Journal of Sport Medicine, 2006
- Simplifying the Star Excursion Balance Test: Analyses of Subjects With and Without Chronic Ankle InstabilityJournal of Orthopaedic & Sports Physical Therapy, 2006
- Assessing Functional Ankle Instability with Joint Position Sense, Time to Stabilization, and ElectromyographyJournal of Sport Rehabilitation, 2004
- Persistent Disability Associated with Ankle Sprains: A Prospective Examination of an Athletic PopulationFoot & Ankle International, 1998
- Ankle orthoses effect on single-limb standing balance in athletes with functional ankle instabilityArchives Of Physical Medicine and Rehabilitation, 1998
- Bias in meta-analysis detected by a simple, graphical testBMJ, 1997
- Single‐leg postural equilibrium testScandinavian Journal of Medicine & Science in Sports, 1991
- Effect of Ankle Disk Training on Postural Control in Patients with Functional Instability of the Ankle JointInternational Journal of Sports Medicine, 1988
- THE ETIOLOGY AND PREVENTION OF FUNCTIONAL INSTABILITY OF THE FOOTThe Journal of Bone and Joint Surgery. British volume, 1965