Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients

Balance training typically features as a central component of exercise-based rehabilitation programs for patients with lateral ankle sprain and chronic ankle instability (CAI). The purpose of this study was to conduct a responder/non-responder analysis using existing data to identify factors associated with improvements in dynamic balance performance in CAI patients.

Secondary data analysis.

Data was used from 73 CAI patients who participated in 6 previous investigations that used the same balance training program. We defined treatment success as a patient exceeding the minimal detectable change score (8.15%) for the posteriomedial direction of the Star Excursion Balance Test (SEBT-PM). Baseline measures of participant and injury demographics, patient-reported function, and dynamic balance were entered into a step-wise logistic regression model to determine the best set of predictors of treatment success.

Only 28 out of 73 patients (38.4%) demonstrated a successful improvement in SEBT-PM reach after balance training. Of the variables assessed, SEBT-PM reach distance ≤85.18% and self-reported function activities of daily living score ≤92.55% were significant predictors of treatment success (p<0.001). If a patient met both these criteria there was a 70% probability of a successful treatment, indicating a 31.6% increase in the probability of a meaningful balance improvement after completing balance training.

Without screening, less than 40% of CAI patients experience a meaningful improvement in SEBT-PM following balance training. Completing a brief pre-treatment assessment of a patient- and clinician-oriented outcome can significantly improve the probability of determining patients with CAI who may improve dynamic balance after balance training.