Mental Health Predictors of Dynamic Balance in Individuals With Chronic Ankle Instability

Chronic ankle instability (CAI) is linked to impaired dynamic balance and psychological deficits, potentially hindering optimal rehabilitation outcomes. However, the impact of psychological deficits on dynamic balance has not been explored before. Therefore, the aim of this study is to determine whether mental health factors predict dynamic balance performance in individuals with CAI using the Star Excursion Balance Test (SEBT).

This is a cross-sectional observational study performed in a university setting. Forty individuals with CAI (17 men, 23 women) participated in this study. Assessments included psychological profiles (kinesiophobia, self-reported mental health, self-efficacy, global mental health, and functional status via FAAM-Sport). Dynamic balance was evaluated using the SEBT composite and directional scores.

Multiple linear regression analyses indicated that the SEBT composite score was significantly predicted by self-efficacy, global mental health and TSK-11, explaining 40% of the variance (F-value = 7.82, p < 0.01). Further directional analysis revealed that posterior-medial reach was best predicted by self-efficacy, global mental health and TSK-11 (F-value = 9.05, p < 0.01; 44% variance), while posterior-lateral reach was similarly predicted by self-efficacy, and global mental health (F-value = 6.92, P = 0.003; 28% variance). Anterior reach performance was most strongly associated with self-efficacy and TSK-11 (F-value = 10.26, p < 0.01; 36% variance).

The findings underscore the importance of psychological factors as key predictors of dynamic balance in CAI. Incorporating mental health assessments into physical rehabilitation may enhance treatment outcomes for individuals with CAI.