Background: Ankle sprain is one of the most common musculoskeletal injuries in the sports population or during usual daily life activities. The sprain can cause functional ankle instability (FAI), and it is very important to treat FAI. However, the optimum intervention method for FAI has yet to be determined. Objects: This study investigated the impact that virtual reality (VR) training program on balance with ankle kinesio taping for FAI. Methods: Twenty-two people were selected for the study and randomly divided into the experimental (n = 11) and the control group (n = 11). The experimental group had attached kinesio taping on the ankle and then implemented a virtual reality exercise program for 30 minutes a day. Nintendo Wii Fit Plus was used for the VR intervention three times a week for four weeks. The control group performed only two measurements without intervention. Results: There were no statistically significant differences in overall, anterior-posterior (AP), medial-lateral (ML) index of the static balance, and significant differences in overall, AP, ML index of the dynamic balance when taping and VR exercise were applied at the same time (p < 0.05). There were no significant differences in overall and ML index of static and dynamic balance compared with before and after assessment between the experimental and the control group, and found differences in AP index of static and dynamic balance (p < 0.05). Conclusion: Kinesio taping may not influence the balance of FAI as great as people expected. VR approach does not affect the static balance of FAI, but it influences dynamic balance in overall, AP, ML index. The authors suggest that VR-based exercises can be used as an additional concept in clinicians for FAI or as part of a home program because the exercises still have limitations.

Background: Functional ankle instability (FAI) indicating a decrease in muscle strength, proprioception, neuromuscular control, balance and postural control function. Objective: To investigate the effect of jumping exercise on the supporting surface on the ankle muscle thickness, proprioceptive sensation, and balance in adults with FAI. Design: Randomized Controlled Trial. Methods: Twenty young people with FAI were randomly assigned to the unstable supporting surface jump group (N=10) and the stable supporting surface jump group (N=10). The intervention was conducted three times a week for eight weeks, and for 30 minutes per session. Trampoline was used as an unstable support surface and the stable support surface was carried out on a regular floor. The thickness of the tibialis anterior muscle and medial gastrocnemius muscle was measured by ultrasonography, and the proprioception of dorsiflexion and plantarflexion was measured using an electrogoniometer. The dynamic balance was also measured with a balance meter. Results: The the muscle thickness of the medial gastrocnemius muscle was significantly higher in the stable supporting surface jump group than in the unstable supporting surface jump group (p<.05). Furthermore, the plantar flexion proprioception and dynamic balance were significantly improved in the unstable supporting surface jump group than in the stable supporting surface jump group in the intergroup comparison (p<.05). Conclusions: The conclusion has been reached in this study that the jumping exercise on the unstable supporting surface could be a more effective in improving FAI than the regular surface.

The purpose of this study was to investigate the complex ankle exercises on balance. 22 participants (male: 14, female: 8) with functional ankle instability were participated. Functional ankle instability was selected to be less than 24 points using the Cumberland ankle instability tool (CAIT) with people who had severe ankle sprain and then experiencing ankle giving way. A total of 20 minutes performed three times a week for four weeks with muscle strength and balance exercises. Muscle strengthening exercise was performed with Theraband, and balance exercise was performed with unstable support plates. Biodex balance systemⓇ was used to measure static and dynamic balance. The dynamic balance was selected in grade 2, 4, and 8. The static and dynamic balance (grade: 2, 4,and 8) balance was significantly decreased in anterior-posterior, and medial-lateral directions (p<.05). The instability was significantly increased after exercise (p<.05). These results suggest that complex exercises are beneficial to decreasing the functional ankle instability.

Background: The multiple hop test is an active performance test that has been commonly used to assess individuals with functional ankle instability. Previous studies have suggested that insufficiency of dynamic postural stability and passive stability during dynamic activities can have an influence on performance in the multiple hop test. However, no study has investigated the effects of dynamic postural stability training and ankle bracing on multiple hop test performance in individuals with functional ankle instability. Objects: The purpose of this study was to compare the immediate effects of dynamic postural stability training versus ankle bracing in the performance of the multiple hop test for participants with functional ankle instability. Methods: Twenty-nine participants with functional ankle instability who scored below 24 in the Cumberland Ankle Instability Tool were selected. The participants were randomly divided into two groups: a dynamic postural stability training group (n1=14) and an ankle bracing control group (n2=15). The multiple hop tests were performed before and after applying each intervention. Dynamic postural stability training was performed using visual-feedback-based balance-training equipment; participants in this group were asked to perform a heel raise in a standing position while watching the centering of their forefoot pressure to prevent excessive ankle inversion. Ankle bracing was applied in the control group. Results: When comparing the pre- and post-intervention period for both groups, both methods significantly improved the results of the multiple hop test (p<.05). However, no significant differences were shown between the dynamic postural stability training and ankle bracing groups (p>.05). Conclusion: Both dynamic postural stability training and ankle bracing showed significant improvement (2.85 seconds and 2.05 seconds, respectively) in test performance. Further study is needed to determine the long-term effects of dynamic postural stability training and to determine whether insufficient dynamic postural stability is a causative factor for functional ankle instability.

We investigated the effects of a Virtual reality(VR) program on the proprioception and instability of functional ankle instability(FAI) patients. Among the 20s old individuals who lived in Republic of Korea; 20 people were selected through a public participation process. The 20 participants were then randomly divided into two groups, one of strength exercise(n=10) and one of balance exercise(n=10). Of the patients who had experienced an ankle sprain in the past and currently felt ankle instability, those who recorded 24 points or less on the Cumberland ankle instability tool(CAIT) were determined to have FAI. We selected the strength exercise and balance exercise in the Nintendo Wii Fit Plus as a VR program. The subjects used the program on the Wii Balance Board three times per week for 20 minutes and total 10-minute warm-up and down for four weeks. Proprioception and CAIT of the balance exercise group were improved significantly after the exercise compared to before the exercise(p<.05). Authors recommend that the balance exercise in the VR program be used as an aid for physical therapeutic intervention.

The purpose of this study was to compare the change in electromyography (EMG) activity in the gluteus maximus (G-max) and the gluteus medius (G-med) in subjects with and without chronic ankle instability (CAI) during three functional postures. Twenty four females were recruited for this study. Subjects were assigned into two groups: with CAI (n1=12) and without CAI (n2=12). The assessment postures were rotational squat, one leg stand above a gradient and crossed leg-sway. Electromyographic activities of the G-max and the G-med were recorded using surface EMG and was normalized using the maximal voluntary isometric contraction elicited using a manual muscle testing. Independent t-test was used to determine the statistical differences between two groups during the three functional postures. The comparisons of the three posture between two groups were performed using a one-way repeated analysis of variance. A Bonferroni adjustment used for post hoc analysis. The activation of EMG on G-max performing the one leg stand above a gradient and crossed leg-sway in subjects with CAI is significantly higher than normal group (p<.05). The activation of EMG on the G-max during the rotational squat was significantly increased, compared to those of the one leg stand above a gradient and crossed leg-sway (p<.05). The activation of EMG on G-med performing three exercise at CAI is significantly higher than normal group (p<.05). The activation of EMG on the G-med during the crossed leg-sway was significantly increased, compared to the rotational squat (p<.05). This study provides valuable information for clinician who research CAI.

The purpose of this study was to implement a program of combined muscle stregth and proprioceptive exercises and to examine the impacts of these exercises on functional ankle instability(FAI). Experiments were conducted with 30 adult males and females in their 20s, and the exercise programs were implemented three days per week for four weeks. FAI was defined as a feeling of giving way after an ankle sprain and having a Cumberland ankle instability tool score of 24 points or less. The study subjects were randomly assigned to either a control group, a muscle-strengthening exercise group, or a combined muscle-strengthening and proprioceptive exercise group consisting of 10 subjects each. A Biodex isokinetic dynamometer was used to assess the subjects’ankle strength at selected speeds of 60°/sec and 120°/sec. The peak torque % body weight showed significant differences in plantar flexion, dorsiflexion, inversion, and eversion. There were also significant differences in proprioception. The results suggest that applying combined muscle-strength and proprioceptive exercises to subjects with FAI is a more effective intervention than applying only muscle-strengthening exercises.

The purpose of this study was to examine the differentiation of proprioception, invertor and evertor muscle strength, and time to peak torque at a velocity of 300 °/sec of the ankle joint in people with or without functional ankle instability (FAI). Nineteen subjects with a history of ankle sprain participated. All subjects were divided into FAI group (n1=9, Cumberland ankle instability tool (CAIT)≤24) and a control group (n2=10) based on their CAIT scores. Isokinetic dynamometer was used to measure the sense of active joint position of the ankle at mid-range and end-range of an inversion motion and invertor as well as the evertor muscle strength and time to peak torque at 300 °/s. The FAI group showed a statistically reduction in invertor and evertor muscle strength and time to peak torque when compared to the control group (p<.05). Muscle strength and time to peak torque of the invertor and evertor, as well as the sense of active joint position at end-range were also lower in the FAI group than in the control (p<.05). Correlations between CAIT score and position sense at end-range (r=-.577) and invertor muscle strength (r=.554) were statistically significant (p<.05). Individuals with FAI showed reduction in invertor and evertor muscle strength and recruitment time as well as in proprioception of the ankle joint. Thus, proprioception and invertor and evertor muscle strength of the ankle joint at fast angular velocity may be investigated when examining and planning care for individuals with FAI.

The present study was aimed at investigating the postural control ability of volleyball players with functional ankle instability. The subjects were 26 male volleyball players were divided into 2 groups (13 subjects with functional ankle instability and 13 subjects with ankle stability) who could evaluate Questionnaire. All the male participants were tested by a Balance Master System. This study were to measure of static balance ability, dynamic balance ability, motor function the difference between functional ankle instability group and control group. Ankle instability group and stable group in postural sway (°/sec) on film surface with eye closed in modified clinical test sensory interaction on balance, and left unilateral stance with eye opened and closed were significantly different (p<.05). The ankle instability group and stable group in limit of stability were significantly different (p<.05). The ankle instability group and stable group in left/right rhythmic weight shirt were significantly different (p<.05). The ankle instability group and stable group in turn time (sec) & turn sway (°) during step/quick turn and end sway (°/sec) in tandem walk were significantly different (p<.05). This study showed that volleyball players with functional ankle in stability were effected postural control ability by static balance & dynamic balance ability. Further study is needed to measure various athletic with functional ankle instability for clinical application.