Contralateral Balance Training Improves Postural Control and Functional Recovery After Arthroscopic Anterior...

Area of Science:

• Orthopedics and Sports Medicine
• Rehabilitation Science
• Biomechanics

Background:

• Chronic ankle instability (CAI) affects up to 40% of individuals post-ankle sprain.
• Arthroscopic anterior talofibular ligament (ATFL) repair is common, but early rehab is limited by weight-bearing restrictions.
• Contralateral limb training (cross-education) shows potential for improving balance but its postoperative use is unclear.

Purpose of the Study:

• To investigate if adding contralateral balance training to standard rehabilitation enhances functional recovery after ATFL repair.
• To evaluate the impact of supplemental contralateral training on postural control, sensory integration, and patient-reported outcomes.

Main Methods:

• Fifty-eight participants with unilateral CAI undergoing arthroscopic ATFL repair were randomized into an assisted rehabilitation group (ARG) or conventional rehabilitation group (CRG).
• The ARG received standard 6-week rehabilitation plus 3 weekly sessions of contralateral limb balance training for 6 weeks.
• Outcomes included static and dynamic balance tests (sway velocity, SEBT), sensory organization tests (SOT), and patient-reported functional scales (AOFAS, FAAM, TSK).

Main Results:

• The ARG showed significantly better static balance (lower eyes-closed sway velocity) and dynamic postural control (greater SEBT reach) compared to the CRG.
• Superior equilibrium scores were observed in the ARG during sensory conflict conditions (SOT-3, SOT-4).
• The ARG reported better functional outcomes (AOFAS, FAAM-ADL) and preserved sports function (FAAM-Sport) compared to the CRG's decline.

Conclusions:

• Supplemental contralateral balance training significantly improved postural control and sensory integration post-ATFL repair compared to conventional rehabilitation alone.
• This training approach appears safe and feasible in early rehabilitation, effectively attenuating the typical early postoperative decline in function.
• While statistically significant, improvements in sensory integration did not consistently reach minimal clinically important differences (MCIDs).