Comparative effectiveness of floss band-augmented perceptual balance training on balance, proprioception, and lower limb function in women with chronic ankle instability: Implications for injury prevention and rehabilitation in public health.

In this study, an assessor-blinded randomized trial with concealed allocation was conducted. Thirty women aged 25-35 years with chronic ankle instability (CAIT score ≤ 24 on the affected ankle) were randomly assigned (1:1) to perceptual balance (PB) training with floss bands (FB group, n = 15) or PB training alone (n = 15). Both groups completed a 6-week program (3 sessions/week), progressing from static to dynamic and plyometric tasks. FBs were applied at perceived occlusion pressure of 5-7/10 (0-10 scale); no adverse events occurred. Outcomes (assessed on the affected limb only) included static balance (single-leg stance time), dynamic balance (Y-balance test-normalized reaches in anterior, posteromedial, and posterolateral directions and composite score), ankle proprioception [joint position sense (JPS) error at 20° plantarflexion], and functional performance (single-leg hop and triple-hop for distance). A 2 × 2 mixed ANOVA (time × group) was used, with Bonferroni post hoc tests. Effect sizes were partial η² (ANOVA interactions) and Cohen's dz (repeated-measures within-group changes with 95% CI). Both groups improved significantly (p < 0.01). The FB group showed greater improvements in static balance (25.7 ± 2.9 s vs. 22.3 ± 2.8 s, p = 0.015), dynamic balance (composite and all directions, p < 0.015), JPS (4.2 ± 1.1° vs. 6.1 ± 1.3°, p = 0.022), single-leg hop (1.80 ± 0.15 m vs. 1.65 ± 0.18 m, p = 0.032), and triple-hop (5.10 ± 0.30 m vs. 4.70 ± 0.35 m, p = 0.039). Interaction effect sizes (dz) ranged from 0.143 to 0.234 (large). These findings suggest that floss band augmentation may provide additional short-term benefit to PB training in women with CAI, although mechanisms remain speculative, and larger, longitudinal trials are needed.