Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients

Christopher J Burcal, Michelle A. Sandrey, Tricia Hubbard-Turner, Patrick O. McKeon, Erik A. Wikstrom

Research output: Contribution to journalArticle

Abstract

Objectives: Balance training typically features as a central component of exercise-based rehabilitation programs for patients with lateral ankle sprain and chronic ankle instability (CAI). The purpose of this study was to conduct a responder/non-responder analysis using existing data to identify factors associated with improvements in dynamic balance performance in CAI patients. Design: Secondary data analysis. Methods: Data was used from 73 CAI patients who participated in 6 previous investigations that used the same balance training program. We defined treatment success as a patient exceeding the minimal detectable change score (8.15%) for the posteriomedial direction of the Star Excursion Balance Test (SEBT-PM). Baseline measures of participant and injury demographics, patient-reported function, and dynamic balance were entered into a step-wise logistic regression model to determine the best set of predictors of treatment success. Results: Only 28 out of 73 patients (38.4%) demonstrated a successful improvement in SEBT-PM reach after balance training. Of the variables assessed, SEBT-PM reach distance ≤85.18% and self-reported function activities of daily living score ≤92.55% were significant predictors of treatment success (p < 0.001). If a patient met both these criteria there was a 70% probability of a successful treatment, indicating a 31.6% increase in the probability of a meaningful balance improvement after completing balance training. Conclusions: Without screening, less than 40% of CAI patients experience a meaningful improvement in SEBT-PM following balance training. Completing a brief pre-treatment assessment of a patient- and clinician-oriented outcome can significantly improve the probability of determining patients with CAI who may improve dynamic balance after balance training.

Original languageEnglish (US)
JournalJournal of Science and Medicine in Sport
DOIs
StateAccepted/In press - Jan 1 2018

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Ankle
Logistic Models
Therapeutics
Ankle Injuries
Exercise Therapy
Activities of Daily Living
Demography
Education
Wounds and Injuries

Keywords

  • Clinical prediction rule
  • Postural control
  • Response analysis
  • Therapeutic intervention

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients. / Burcal, Christopher J; Sandrey, Michelle A.; Hubbard-Turner, Tricia; McKeon, Patrick O.; Wikstrom, Erik A.

In: Journal of Science and Medicine in Sport, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Objectives: Balance training typically features as a central component of exercise-based rehabilitation programs for patients with lateral ankle sprain and chronic ankle instability (CAI). The purpose of this study was to conduct a responder/non-responder analysis using existing data to identify factors associated with improvements in dynamic balance performance in CAI patients. Design: Secondary data analysis. Methods: Data was used from 73 CAI patients who participated in 6 previous investigations that used the same balance training program. We defined treatment success as a patient exceeding the minimal detectable change score (8.15{\%}) for the posteriomedial direction of the Star Excursion Balance Test (SEBT-PM). Baseline measures of participant and injury demographics, patient-reported function, and dynamic balance were entered into a step-wise logistic regression model to determine the best set of predictors of treatment success. Results: Only 28 out of 73 patients (38.4{\%}) demonstrated a successful improvement in SEBT-PM reach after balance training. Of the variables assessed, SEBT-PM reach distance ≤85.18{\%} and self-reported function activities of daily living score ≤92.55{\%} were significant predictors of treatment success (p < 0.001). If a patient met both these criteria there was a 70{\%} probability of a successful treatment, indicating a 31.6{\%} increase in the probability of a meaningful balance improvement after completing balance training. Conclusions: Without screening, less than 40{\%} of CAI patients experience a meaningful improvement in SEBT-PM following balance training. Completing a brief pre-treatment assessment of a patient- and clinician-oriented outcome can significantly improve the probability of determining patients with CAI who may improve dynamic balance after balance training.",
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AU - Wikstrom, Erik A.

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