Changes in Neural Excitability Following 6-Week of Balance Training in Individuals with Chronic Ankle Instability

Document Type

Abstract

Publication Date

2024

Publication Title

Clinical Practice in Athletic Training

Volume

7

Issue

3

Pages

7

Abstract

Context: Individuals with chronic ankle instability (CAI) often struggle with balance issues due to changes in the central nervous system (CNS). Specifically, difficulties in modulating spinal reflexive excitability and enhancing corticospinal excitability contribute to poor balance, indicating challenges in transferring control to supraspinal centers. A recent study found that a single session of balance training could positively impact the CNS, improving spinal reflexive excitability modulation and corticospinal excitability in CAI patients. However, there is limited research on the effects of long-term balance training on neural excitability in CAI individuals. Therefore, this study aimed to investigate the effects of a 6-week balance training program on spinal reflexive excitability modulation, corticospinal excitability, and balance performance in CAI individuals. Methods: 28 participants with CAI (F:16, M:12, 22.5±2.8yrs, 171.1±9.0cm, 77.3±19.6kg) were randomly assigned to the balance training group (BAL) or control group (CON). We assessed their spinal reflexive excitability modulation using Hoffmann-reflex (H-reflex) testing in prone and single-limb stance positions. Corticospinal excitability was measured during single-leg balance using transcranial magnetic stimulation (TMS), assessing motor evoked potential (MEP), active motor threshold (AMT), and cortical silent period (CSP). Balance function was evaluated by performing single-leg balance on a force plate to measure center of pressure (COP) variables. The BAL group underwent a 6-week progressive balance training program, engaging in sessions three times a week for 20-30 minutes each. Training comprised static (single-leg stance with eyes open and closed) and dynamic exercises (hop and stabilization, hop and reaching). Statistical analysis utilized separate 2x2 mixed-model analysis of variances (ANOVA) to examine the interaction effect of group (BAL and CON) x time (baseline and post-training) on each variable. Cohen's d effect sizes were calculated to determine the significance of differences, with significance set at P<0.05. Results: There was a significant group x time interaction in CSP (F=19.63, P=0.01). A large effect size (d=0.49[0.25, 1.20]) suggested that CSP was significantly shorter at post-testing (72.4±30.4) in BAL when compared to baseline (100.7±38.8). Furthermore, a significant group x time interaction was present for modulation of spinal reflexive excitability (F=8.06, P = 0.01). There was a moderate effect size (d =.88, [0.08, 1.63]) indicating that post-testing (44.0±21.8) spinal reflexive excitability modulation was greater than the result of baseline (29.5±35.2) in BAL. Conclusions: Balance training resulted in a decrease in cortical silent period (CSP), indicating enhanced corticospinal excitability among individuals with CAI. It was also observed that spinal reflexive excitability modulation was improved after balance training. The balance-related neurosignature of individuals with CAI might be restored with 6-week of balance training. Clinically, these alterations following balance training could suggest why balance training has been successful in preventing recurrent ankle sprains as well as improving balance performance in individuals with CAI.

Rights

© 2024 Sycamore Scholars, All rights reserved

The following uses are always permitted to the author(s) and do not require further permission from Sycamore Scholars provided the author does not alter the format or content of the articles, including the copyright notification:

Posting of the article on the internet as part of a non-commercial open access institutional repository or other non-commercial open access publication site affiliated with the author(s)'s place of employment (e.g., a Phrenology professor at the University of Southern North Dakota can have her article appear in the University of Southern North Dakota's Department of Phrenology online publication series)

Original Publication Citation

Chung, SH; Freeman, J; and McCann, RS (2024) "Changes in Neural Excitability Following 6-week of Balance Training in Individuals with Chronic Ankle Instability," Clinical Practice in Athletic Training: Vol. 7: Iss. 3, Article 7. Available at: https://scholars.indianastate.edu/clinat/vol7/iss3/7

Link to Full Text

Share

COinS