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Updated: Aug 9, 2025

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Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
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A 6-Week Nine-Square Exercise Programme for Collegiate Athletes with Chronic Ankle Instability: A Randomised
Kanok-On Thanasootr1,2, Torkamol Hunsawong1,2, Uraiwan Chatchawan1,2
1School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.
The Malaysian Journal of Medical Sciences : MJMS
|February 23, 2023
Summary
Nine-square exercise significantly improved postural control and self-reported outcomes in individuals with chronic ankle instability (CAI). This suggests it
Area of Science:
- Sports Medicine
- Rehabilitation Science
- Biomechanics
Background:
- Chronic ankle instability (CAI) is characterized by impaired postural stability, functional deficits, and reduced quality of life.
- While nine-square exercise shows potential for enhancing postural control, its efficacy as a standalone rehabilitation program for CAI requires further investigation.
- Limited evidence exists on the effectiveness of nine-square exercise for managing CAI symptoms and functional limitations.
Purpose of the Study:
- To evaluate the impact of a 6-week nine-square exercise program on postural stability in athletes with CAI.
- To assess the effects of nine-square exercise on self-reported ankle stability and functional ability in individuals with CAI.
- To compare the outcomes of nine-square exercise intervention against a control group for CAI management.
Main Methods:
- Eighteen male collegiate athletes diagnosed with CAI were recruited for a 6-week intervention.
- Participants were randomly assigned to either a nine-square exercise group (n=9) or a control group (n=9).
- Postural control (static and dynamic) and self-reported ankle function/stability were assessed at baseline and post-intervention.
Main Results:
- The nine-square exercise group demonstrated significant improvements in dynamic postural control (P=0.004), static postural control (P=0.001), and self-reported outcomes (P<0.05).
- The control group showed improvement only in static postural control (P=0.018).
- Post-intervention, the nine-square exercise group exhibited significantly greater improvements in dynamic postural control (P<0.001), ankle stability (P=0.002), and functional ability (P<0.05) compared to the control group.
Conclusions:
- Nine-square exercise is an effective intervention for enhancing postural control in individuals with CAI.
- The findings support nine-square exercise as a viable alternative rehabilitation strategy for improving self-perceived ankle stability and functional capacity in CAI.
- This exercise modality offers a promising approach to address key deficits associated with chronic ankle instability.

