Effects of Different Intervention Methods on Postural Control in Athletes with Chronic Ankle Instability: A...

Area of Science:

• Neuroscience and Sports Medicine
• Rehabilitation and Biomechanics

Background:

• Chronic ankle instability (CAI) significantly impairs postural control in athletes.
• Current interventions for CAI often focus on balance training (BT), but efficacy of neurostimulation like transcranial direct current stimulation (tDCS) remains under investigation.
• Optimizing interventions for CAI requires understanding the distinct and combined effects of tDCS and BT on both static and dynamic postural stability.

Purpose of the Study:

• To evaluate the impact of 4-week transcranial direct current stimulation (tDCS), balance training (BT), and a combined tDCS + BT program on static and dynamic postural control in athletes with chronic ankle instability (CAI).
• To determine if the combined program offers superior benefits over individual interventions.
• To assess the effects on specific measures of static and dynamic postural stability.

Main Methods:

• Forty athletes with CAI were randomly assigned to four groups: tDCS, sham tDCS (s-tDCS), tDCS + BT, and s-tDCS + BT.
• Interventions involved 20 minutes of 2 mA anodal or sham tDCS, applied independently or with a 20-minute progressive hop-to-stabilization balance (PHSB) training program.
• Interventions were administered over 12 supervised sessions across 4 weeks, with outcomes measured using the Balance Error Scoring System (BESS) and Y-Balance Test (YBT).

Main Results:

• Significant improvements in static postural control were observed across tDCS, tDCS + BT, and s-tDCS + BT groups compared to baseline, indicated by fewer errors in single-leg and tandem stance tests (firm and foam surfaces) and lower total BESS scores.
• The tDCS + BT and s-tDCS + BT groups demonstrated significant enhancements in dynamic postural control, specifically in posteromedial (PM), posterolateral (PL) reach, and composite reach distance (COMP) on the YBT.
• No significant differences were found between the tDCS, tDCS + BT, and s-tDCS + BT groups in posttest measures, and the combined program did not yield additional benefits over BT alone.

Conclusions:

• Both transcranial direct current stimulation (tDCS) and balance training (BT), individually or combined, effectively improve static postural stability in athletes with chronic ankle instability (CAI).
• Only interventions incorporating balance training (BT) proved effective in enhancing dynamic postural control.
• Combining tDCS with BT does not provide superior outcomes for postural control compared to BT alone in this population.