The Effectiveness of Focus of Attention in Static Balance and Functional Ability of Chronic Ankle Instability: A Pilot Study

Objectives: The focus of patients’ attention during the physiotherapy program has been reported to affect the rehabilitation goals. The study aimed to investigate the effectiveness of an external focus of attention (EFA) on static balance and functional ability in individuals with chronic ankle instability (CAI). Methods: Fourteen subjects with CAI, aged from 19 to 25 years, were randomly assigned to two groups: external and internal focus of attention (IFA) group. The outcome measures of the study were static balance and functional ability. A pre-intervention evaluation was performed. Following instructions to an external or an IFA, subjects practiced on a balance board 3 times per week for 4 weeks. At the end of each week, they performed evaluation tests, including a time balance test, foot lift test, side hop test, figure-8 test, and star excursion balance test (SEBT). Parametric (mixed analysis of variance) and non-parametric analysis (the Mann–Whitney and Friedman tests) were performed between measurements and groups. Results: The intervention program showed a statistically significant improvement in static balance and functional ability in both groups. The results indicated the main effect of time (F(2.488, 29.855)=43.880, P<0.001). For the time in balance test, analysis of variance revealed a main effect of time (F(2.571, 30.855)=11.188, P<0.001). Regarding the SEBT, every direction indicated a main effect of time for both groups. No significant differences between the two groups were found in static balance and functional ability. Discussion: Even though there were no statistically significant differences between the two groups, both types of focus of attention contributed to the improvement of static balance and functional ability, which may reveal an increase in motor control and neuromuscular ability of the subjects with CAI.