Evaluation of kinesthetic deficits indicative of balance control in gymnasts with unilateral chronic ankle sprains

Abstract

If ankle proprioception can be determined to be impaired, then treatment can be more specifically directed toward correcting the proprioceptive deficit, thereby improving functional ability. The purpose of this study was to determine if collegiate level gymnasts with unilateral, multiple ankle sprains (ie., chronic ankle sprains) had decreased ability to detect passive plantar flexion of the ankle (ie., decreased ankle proprioception) and to determine if balance deficits existed during one-legged stance. Eleven gymnasts participated in 30 passive movement trials (15 movement and 15 nonmovement) presented randomly on both the injured and noninjured sides. The nonmovement trials consisted of either no movement of the ankle or passive movement of the ankle into 5 degrees of plantar flexion. Luce's choice theory determined that subjects were not biased in responding to a "yes" in perceiving movement or no movement during the movement/nonmovement trials of passive plantar flexion. Subjects were better able to detect movement during movement trials with their uninjured ankles than their injured ankles. Subjects also performed single 30-second trials of one-legged standing on each leg, with eyes open and with eyes closed. Subjects reported better balance when standing on the uninjured ankle during the one-legged stance conditions. Although our results cannot be extrapolated to balance abilities during complex gymnastic routines, they do suggest that physical therapy assessment includes passive detection of joint position as well as single-legged stance tests, and that perhaps rehabilitation programs incorporate sports-specific balance activities for such injuries.