Tdcs Combined With Bbt Outperforms Bbt-alonein Reducing Injury For Individuals With Chronic Ankle Instability

PURPOSE: Transcranial direct current stimulation (tDCS) is regarded as a leading approach for central nervous system (CNS) intervention, however, its effects on injury risks and movement performance in individuals with CAI remain unclear. The purpose of this study was to investigate the additional effects of transcranial direct current stimulation (tDCS) combined with Bosu ball training (BBT) on the injury potential during side-cutting in individuals with chronic ankle instability (CAI). METHODS: Forty participants with CAI were recruited and randomly assigned to either the tDCS+BBT group (n = 20, 21.5 ± 1.5 years, 177.7 ± 7.6 cm, 72.4 ± 10.2 kg) or BBT group (n = 20, 22.1 ± 1.3 years, 176.8 ± 6.7 cm, 73.1 ± 11.3 kg). The tDCS+BBT group received concurrent tDCS therapy with BBT, and the BBT group received BBT with sham tDCS for 6 weeks with three 20-minute sessions per week. The maximum inversion and internal rotation angle of the ankle during side-cutting were measured before and after the intervention using a twelve-camera motion capture system. Two-way ANOVA with repeated measures were used to analyze the data. RESULTS: Significant group-by-intervention interactions were detected in the ankle inversion (p = 0.018, η2p = 0.162) and internal rotation (p = 0.023, η2p = 0.151) angles. Post hoc comparisons showed that compared with week0, the ankle inversion (tDCS+BBT group: week0 = 31.29 ± 5.67°, week7 = 27.45 ± 5.10°, p < 0.001, d = 0.710; BBT group: week0 = 31.87 ± 5.34°, week7 = 30.23 ± 5.62°, p = 0.016, d = 0.299) and the internal rotation angle (tDCS+BBT group: week0 = 10.09 ± 2.61°, week7 = 6.50 ± 1.59°, p < 0.001, d = 1.576; BBT group: week0 = 10.12 ± 2.48°, week7 = 8.47 ± 2.11°, p = 0.001, d = 0.712) were decreased in both group in week7. The internal rotation angle of the tDCS+BBT group was smaller than that of the BBT group at week7 (tDCS+BBT group: week7 = 6.50 ± 1.59°, BBT group: week7 = 8.47 ± 2.11°, p = 0.004, d = 1.035). CONCLUSION: Compared to the BBT alone, tDCS combined with BBT intervention has additional effects in reducing injury potential during side-cutting in individuals with CAI.