Effect of a Global Rehabilitation Program on Static Postural Control, Dynamic Stability and Functionality in Individuals with Lateral Ankle Instability - Randomized Clinical Trial

Research Type: Level 1 - Randomized controlled trial (RCT), Meta-analysis of randomized trials with homogeneous results Introduction/Purpose: Conventional treatment for LAI focuses on segmented ankle strengthening, but global exercises, which involve the entire kinetic chain, can be explored in its management. Objective: To compare global exercises with conventional exercises in LAI in postural control, dynamic balance, and functionality. Secondary objective: To evaluate the effects of these protocols on dorsiflexion range of motion (ROM), passive ankle stiffness, recurrence rate, and retention after six months of intervention. Methods: Forty-seven individuals with LAI were randomized into intervention (global exercises) and control (conventional exercises) groups. Intervention: Both groups received home exercise booklets for eight weeks. The intervention group performed multi-joint and bodyweight exercises. The control group performed segmented and equipment exercises for the ankle joint. Main Outcomes and Measure: mean velocity, area, and standard deviation of the center of pressure (COP) on a force platform; dynamic stability (Modified Star Excursion Balance Test), functionality (Foot and Ankle Ability Measure), dorsiflexion ROM and passive ankle stiffness were measured at baseline, four and eight weeks during intervention and after six months of intervention. Results: Increase in dynamic stability (p=0.001), mean velocity (p=0.001), standard deviation (p=0.002) and area (p=0.001) of the COP; functionality (p=0.001) and dorsiflexion ROM (p=0.001), maintained after 6 months except for the standard deviation of the COP in both groups. The recurrence rate of sprains was lower in the intervention group (88.2% without new sprains) compared to the control group (52.6%). Conclusion: After four weeks of rehabilitation, there were improvements in all outcomes, except for passive ankle stiffness, with effects amplified after eight weeks and maintained after six months. There was no superiority of the intervention group over the control group, but the intervention group achieved the minimum significant difference in functionality in daily activities and a lower rate of recurrence of sprains. Thus, global exercises may be an accessible alternative to reduce losses in the lives of people with LAI.