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)
Pages (from-to)538-543
Number of pages6
JournalJournal of Science and Medicine in Sport
Volume22
Issue number5
DOIs
StatePublished - May 2019

Fingerprint

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, Vol. 22, No. 5, 05.2019, p. 538-543.

Research output: Contribution to journalArticle

Burcal, Christopher J. ; Sandrey, Michelle A. ; Hubbard-Turner, Tricia ; McKeon, Patrick O. ; Wikstrom, Erik A. / Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients. In: Journal of Science and Medicine in Sport. 2019 ; Vol. 22, No. 5. pp. 538-543.
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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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