Abstract
Background: Chronic ankle instability (CAI) is a common sequela of lateral ankle sprains, characterized by recurrent instability, impaired neuromuscular control, and reduced functional performance. Although balance training is widely recommended, variability in intervention protocols and limited athlete-specific randomized trials restrict its clinical translation.
Objective: To evaluate the effectiveness of a standardized, progressive balance training program on dynamic postural control, self-reported instability, and functional performance in athletes with CAI.
Methods: A single-blinded, parallel-group randomized controlled trial was conducted in 60 athletes aged 18–35 years with CAI (Cumberland Ankle Instability Tool [CAIT] ≤24). Participants were randomly allocated to either a structured balance training group or a control group receiving strength-based rehabilitation. The intervention was delivered three times weekly for six weeks. The primary outcome is dynamic postural control assessed using the Star Excursion Balance Test (SEBT). Secondary outcomes include CAIT and Foot and Ankle Ability Measure (FAAM). Data were analyzed using linear mixed-effects models with intention-to-treat principles.
Results: The balance training group demonstrated significantly greater improvements in SEBT composite reach distance compared to the control group (mean difference = 6.8%, 95% CI: 4.2–9.4, p < 0.001, Cohen’s d = 0.88). Significant group × time interactions were observed for CAIT scores (mean increase: 7.5 points vs 3.2 points; p < 0.001) and FAAM-ADL (mean increase: 12.4% vs 6.1%; p = 0.002). Improvements exceeded minimal clinically important differences for all primary outcomes. No adverse events were reported.
Conclusion: A structured, progressive balance training program produced clinically meaningful improvements in dynamic postural control and functional outcomes in athletes with CAI compared to conventional rehabilitation. These findings support the integration of standardized balance protocols in sports rehabilitation settings.