EFFECTS OF CHRONIC ANKLE INSTABILITY AND REST INTERVALS ON PERFORMANCE, NEUROMUSCULAR FUNCTION, POSTURAL CONTROL, AND BIOMECHANICS DURING THE STAR EXCURSION BALANCE TEST

Abstract

Introduction: It has been proposed that inadequate rest intervals may contribute to decreased performance of activities. However, previous research has not investigated the effect of rest interval on performance of the Star Excursion Balance Test (SEBT) in individuals with and without chronic ankle instability. Objective: To determine whether rest interval affects performance of the SEBT associated with chronic ankle instability (CAI) and whether neuromuscular function, postural control or biomechanics can be associated factors which may help discriminate between healthy individuals and those with CAI during the SEBT. Design: 2-group counterbalanced study. Participants: Participants included 24 individuals with a history of at least one ankle sprain in the past year and at least 2 episodes of giving way in the past 6 month prior to study enrollment, and 24 individuals with no history of ankle sprain or instability in their lifetime. Methods: Subjects completed 3 trials in each of the 3 reach directions (anteromedial, medial, posteromedial) in random order. A total of three visits were required in order to complete the 3 rest intervals (10, 20, 40 seconds). Normalized maximum reach distance, electromyographic (EMG) activation of tibialis anterior, peroneus longus, and medial gastrocnemius muscles, multiplanar motion of the lower extremity, coupling angles (CA) of lower extremity segments and maximum lateral center of pressure velocity were calculated and compared between groups in each direction for each rest interval. Results: Rest interval did not influence differences of reach distance, EMG ankle muscle activation, kinematics and center of pressure velocity between healthy individuals and those with CAI during the SEBT. However, the rest interval of 20 seconds demonstrated differences in CAs of tibial internal rotation/dorsiflexion (TIR/DF) and tibial internal rotation/eversion (TIR/EV) between healthy individuals and those with CAI during the SEBT. Overall, reach distance, mean amplitude of EMG ankle muscles, kinematics and joint CAs were different between healthy individuals and those with CAI during the SEBT regardless of rest interval. Discussion: Based on these results, differences exist in neuromuscular functions and biomechanics between healthy individuals and those with CAI when performing the SEBT. A rest interval time of 20 seconds between trials during the SEBT is an appropriate time to discriminate joint CAs of TIR/DF and TIR/EV between healthy individuals and those with CAI during the SEBT. These findings have implications for treatment and possible prevention of CAI