The Effects Of 6-week Balance Training on Corticospinal Excitability, Spinal Reflexive Excitability Modulation, and Balance Performance in Individuals with Chronic Ankle Instability: Randomized Controlled Trial.

BACKGROUND

Individuals with chronic ankle instability (CAI) exhibit central nervous system (CNS) changes and poor balance. Thus, balance training is essential in CAI rehabilitation, and assessing post-training CNS changes can reveal how recovery occurs.

OBJECTIVE

To examine the effects of a 6-week balance training program on spinal reflexive excitability modulation, corticospinal excitability, and balance performance in individuals with CAI.

METHODS

Thirty individuals with CAI were randomized to balance training (BAL) or control (CON) groups. Spinal reflexive excitability was assessed using H-reflex testing, and corticospinal excitability via transcranial magnetic stimulation (TMS). Static and dynamic balance were evaluated through the center of pressure and the start excursion balance tests (SEBT), respectively. The training group completed a 6-week progressive static and dynamic balance exercises.

RESULTS

Cortical silent period (CSP), which was a period of inhibition following TMS, was significantly shorter in BAL (72.40 ± 30.42) compared to CON (80.80 ± 40.48) at post-testing (d=1.12 [0.32, 1.85]). Spinal reflexive excitability modulation was significantly greater in BAL (43.90 ± 21.77) than CON (26.99 ± 15.84) at post-testing (d =0.88 [0.08, 1.63]). Static balance performance was significantly improved at post-testing (4.61 ± 1.53) when compared to baseline (6.36 ± 3.24) in BAL (d =0.69 [0.06, 1.41]).

CONCLUSION

6-weeks of balance training restored the neurosignature of individuals with CAI, leading to improvement in their balance performance. Name of the public trials registry and the registration number This study was pre-registered at Clinicaltrials.gov (Identifier: NCT05655143).