Effects of two proprioceptive training programs on joint position sense, strength, activation and recurrent injuries after ankle sprains

BACKGROUND: After ankle sprains, therapists may use proprioceptive training programs to manage residual symptoms and reduce the risk for recurrent injuries. However, evidence on program effectiveness is limited. OBJECTIVE: To investigate effectiveness of balance and proprioceptive neuromuscular facilitation (PNF) programs in individuals with sprain. METHODS: Participants were recruited from a rehabilitation center and were randomly allocated to a balance or PNF group. Both groups received 10 training sessions, within a six-week period. Ankle position sense, isokinetic strength and EMG activity were assessed by a blinded investigator at baseline, at the end of training and eight weeks after training. Recurrent injuries were recorded 12 months after training. RESULTS: Twenty participants provided follow-up data. Eight weeks after training, significant (p < 0.017) gains were found in most strength measures for both groups, apart from dorsiflexion strength (p > 0.05). For the balance group, there were no recurrent injuries and for the PNF group the recurrent injury rate was 20%. Eight weeks after training, the balance group significantly (p < 0.017) improved plantar flexion position sense and EMG activity of peroneus longus muscle and the PNF group significantly (p < 0.017) improved EMG activity of tibialis anterior muscle. CONCLUSIONS: For individuals with sprain, balance and PNF programs are recommended for ankle strengthening. They may also be effective in reducing the risk for recurrent injuries.