Balance Training vs. Balance Training w/ STARS

Chronic Ankle Instability (CAI) is a health condition that results in repeated ankle sprains
and other residual impairments. CAI has been linked to many different causative factors
including sensory and motor deficits that affect the global function of the sensorimotor
system as well as the patient. Over the past 20 years, strong evidence has been generated
to support balance training as an effective intervention strategy in the CAI population.
Unfortunately, most investigations have focused solely on maximizing motor output through
balance training, while ignoring the full spectrum of sensorimotor dysfunction associated
with CAI. There may be advantageous sensory-targeted interventions that augment the effects
of balance training and lead to greater enhancements of functional outcomes for CAI.
However, this possibility has not been systematically explored. Sensory-targeted ankle
rehabilitation strategies (STARS), such as joint mobilization and plantar massage have
resulted in improved sensorimotor function in those with CAI. However, only a single STARS
(i.e. stochastic resonance) has been investigated in combination with balance training.
While the combined effects were greater than those of balance training alone, stochastic
resonance requires relatively expensive equipment that is not commercially available. Thus,
the purpose of this investigation is to test the hypothesis that combining low cost STARS
(e.g. plantar massage and joint mobilizations) with balance training will result in greater
sensorimotor and functional improvements in those with CAI than balance training alone.