Although altered biomechanics has been well documented as an impairment associated with chronic ankle instability (CAI), effective interventions targeting biomechanics with long-term outcomes measuring patient-reported outcomes (PROs) are absent. Evidence suggests that external focus of attention (ExFOCUS), internal focus of attention (InFOCUS) feedback, and auditory feedback during movement training can alter biomechanics in other patient populations, with ExFOCUS and auditory enhancing retention of learned biomechanics. Therefore, this randomized controlled trial will determine if a 4-week (12 session) impairment-based rehabilitation program that includes feedback (ExFOCUS or InFOCUS or Auditory) can (1) decrease ankle inversion kinematics and lateral plantar pressure during walking and (2) improve self-reported function.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
48
Patients will receive external focus of attention visual feedback during the impairment-based rehabilitation program.
Patients will receive external focus of attention auditory feedback during the impairment-based rehabilitation program.
Patients will receive internal focus of attention visual feedback during the impairment-based rehabilitation program.
Patients will receive no feedback during the impairment-based rehabilitation program.
UNC Charlotte
Charlotte, North Carolina, United States
Changes from baseline in lower extremity kinematics and kinetics during walking
Ankle, knee, and hip motion and moments during walking measured by a 3D motion capture system and in shoe plantar pressure system
Time frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
Changes from baseline in self-reported ankle function
Changes from baseline in self-reported function as measured by the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living and Sport questionnaire. Scores range from 100% (no decrease in function) to 0% (complete loss of function).
Time frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
Changes from baseline in ankle range of motion measured in degrees
Four different ankle ranges of motion will be measured
Time frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
Changes from baseline in ankle maximum voluntary isometric strength
Ankle maximum voluntary isometric strength will be measured during four different ankle positions using a hand-held dynamometer.
Time frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
Changes from baseline in static and dynamic balance
Static balance will be measured via a force plate and dynamic balance will be measured using the Star Excursion Balance Test
Time frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
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