TY - JOUR
T1 - Predicting dynamic balance improvements following 4-weeks of balance training in chronic ankle instability patients
AU - Burcal, Christopher J.
AU - Sandrey, Michelle A.
AU - Hubbard-Turner, Tricia
AU - McKeon, Patrick O.
AU - Wikstrom, Erik A.
N1 - Funding Information:
The original data analyzed in this manuscript was obtained through support from the NFL Charities , the National Athletic Trainers’ Association Research and Education Foundation , and the Mid-Atlantic Athletic Trainers’ Association .
Publisher Copyright:
© 2018
PY - 2019/5
Y1 - 2019/5
N2 - Objectives: 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. Design: Secondary data analysis. Methods: 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. Results: 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. Conclusions: 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.
AB - Objectives: 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. Design: Secondary data analysis. Methods: 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. Results: 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. Conclusions: 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.
KW - Clinical prediction rule
KW - Postural control
KW - Response analysis
KW - Therapeutic intervention
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U2 - 10.1016/j.jsams.2018.11.001
DO - 10.1016/j.jsams.2018.11.001
M3 - Article
C2 - 30501956
AN - SCOPUS:85057243051
VL - 22
SP - 538
EP - 543
JO - Australian Journal of Science and Medicine in Sport
JF - Australian Journal of Science and Medicine in Sport
SN - 1440-2440
IS - 5
ER -