Effects of an Instability Training Program Using Global Versus Selective Instability Devices

NCT ID: NCT06472648

Last Updated: 2024-06-27

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-11-18
• Study Completion Date: 2020-02-21

Brief Summary

The goal of this clinical trial was to compare the effects of a 4-week balance training programme using a GID or SID on functional dynamic balance and functional ankle stability in young healthy amateur soccer players.

The main question it aimed to answer are:

1. Are there differences between using GID or SID in improving dynamic balance according to the Modified Star Excursion Balance Test (mSEBT) and the Emery test, and in improving functional ankle stability according to the Side Hop Test?

Participants were randomly allocated into two groups: GID balance training (i.e., with a BOSU®) and SID balance training (i.e., with Blackboard). The randomization and allocation were performed using the sealed envelope method. Both groups performed on a 4-weeks balance training program with the assigned device.

Participants were asked to:

• Perform a 5-minute conventional warm-up (cycling and active anke mobility exercises)
• Perform four balance exercises with a 3-kg medicine ball, on the unstable surface device assigned to each group (explanation of the exercises in the detailed description)

Researchers compared the results of the GID group with those of the SID group to determine the differences between devices in the improvement of dynamic balance and functional stability of the foot and ankle.

Detailed Description

Sport injuries are one of the main concerns of soccer players and their coaching staff and ankle sprains are one of the most common injuries in this sport. Sprains have a high recurrence in soccer, leading to pathological laxity, residual pain, and sensorimotor deficits in the ankle which could cause stability alterations known as chronic ankle instability. In this sense, numerous efforts have been made to find alternatives to reduce the incidence and recurrence of ankle sprains, but the exercise protocols designed to date are still not completely effective. Therefore, studies that deal with exercises or devices that could produce changes in ankle stability and, consequently, can reduce injury rates, are still necessary.

Stability training programmes are generally performed on unstable surfaces such as Both Sides Utilized (BOSU®), balance boards, pads, soft mats, air cushions, or tilting platforms. These tools are generally considered global instability devices (GIDs) as the direction and intensity of the instability cannot be selected and adjusted by the user. Although not yet widely studied, a new device designed to overcome these limitations is the Blackboard Training, as selective instability device (SID). In a previous study, the investigators compared muscle activation of the peroneus longus during single-leg stance on the Blackboard Training and on other GIDs (including BOSU®), finding no differences between devices. These findings may suggest that the use of the SID to improve functional ankle balance in athlete's ankle sprain preventive programs could be effective, at least, as those produced by GID, but a clinical comparison has not yet been conducted.

Thus, the aim of this study was to compare the effects of a 4-week balance training programme using a GID or SID on functional dynamic balance and functional ankle stability in young healthy amateur soccer players.

A total number of 20 amateur soccer players were randomly allocated into two groups (GID and SID). Sociodemographic, anthropometric, dynamic balance (modified Star Excursion Balance Test and Emery Test) and ankle stability (Side Hop Test) data were collected.

After a 5-minute warm up, participants performed the same exercises on their assigned device (BOSU in its inverted position for the GID group, or Blackboard with the two slats placed centrally for the SID group), which was a modified version of a previously proposed plan for proprioception training in athletes. The exercises were the same for both groups and were performed with a 3-kg medicine ball, being the only difference the unstable surface device. These were the following:

1. A 30-second series of maintaining the single-leg stance position with extended knee and hip holding the ball with the arms stretched out above the head; the free leg was kept at 90º hip and knee flexion.

2. A series of 10 repetitions where the participant was asked to pass from the supporting-leg hip and knee starting position to a 90º knee flexion squat, keeping the ball above their heads and maintaining the other leg with the knee and hip about 90º flexed.

3. A single series of 10 repetitions where the participant started with full limb extension of the supporting member and the ball held with both hands at chest height; from this position subjects were asked to bring the free leg from 45º hip extension to 45º hip flexion.

4. 10 passes between the participant and a partner where the participants started with a total extension of the supporting limb and the ball held in both hands in front of them at chest height, and their free leg flexed 90º at the hip and the knee. A 2-minute rest between exercises was allowed.

The stability training programme was performed for a period of 4 weeks, with 3 weekly sessions using BOSU® or Blackboard at their soccer club before their usual training and under the supervision of a physical therapist. In all, 12 sessions were completed.

Conditions

Balance Instability Training

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: DOUBLE

Study Groups

GID group

GID: Global Instability Device. Out of the total sample, 10 subjects were randomly assigned to each group. The GID group consisted of 10 amateur soccer players, both men and women, who performed the intervention using the BOSU.

Group Type: EXPERIMENTAL

Proprioception training exercise plan with BOSU

Intervention Type: OTHER

A 5' conventional warm-up (stationary cycling and active ankle mobility exercises) was performed.

Ankle proprioception training exercise plan included:

1. A 30-second series of maintaining the single-leg stance position on the BOSU with extended knee and hip holding the ball with the arms stretched out above the head

2. A series of 10 reps on the BOSU where the subject was asked to pass from the supporting-leg hip and knee starting position to a 90º knee flexion squat, keeping the ball above their heads

3. A single series of 10 reps on the BOSU where the subject started with full limb extension of the supporting member and the ball held with both hands at chest height; from this position subjects were asked to bring the free leg from 45º hip extension to 45º hip flexion

4. 10 passes between the subject and a partner where the participants started with a total extension of the supporting limb on the BOSU and the ball held in both hands in front of them.

2' rest between exercises.

SID group

SID: Specific Instability Device. Out of the total sample, 10 subjects were randomly assigned to each group. The SID group consisted of 10 amateur soccer players, both men and women, who performed the intervention using the Blackboard.

Group Type: EXPERIMENTAL

Proprioception training exercise plan with Blackboard (BB)

Intervention Type: OTHER

A 5' conventional warm-up (stationary cycling and active ankle mobility exercises) was performed.

Ankle proprioception training exercise plan included:

1. A 30-second series of maintaining the single-leg stance position on the BB with extended knee and hip holding the ball with the arms stretched out above the head

2. A series of 10 reps on the BB where the subject was asked to pass from the supporting-leg hip and knee starting position to a 90º knee flexion squat, keeping the ball above their heads

3. A single series of 10 reps on the BB where the subject started with full limb extension of the supporting member and the ball held with both hands at chest height; from this position subjects were asked to bring the free leg from 45º hip extension to 45º hip flexion

4. 10 passes between the subject and a partner where the participants started with a total extension of the supporting limb on the BB and the ball held in both hands in front of them.

2' rest between exercises.

Interventions

Proprioception training exercise plan with BOSU

A 5' conventional warm-up (stationary cycling and active ankle mobility exercises) was performed.

Ankle proprioception training exercise plan included:

1. A 30-second series of maintaining the single-leg stance position on the BOSU with extended knee and hip holding the ball with the arms stretched out above the head

2. A series of 10 reps on the BOSU where the subject was asked to pass from the supporting-leg hip and knee starting position to a 90º knee flexion squat, keeping the ball above their heads

3. A single series of 10 reps on the BOSU where the subject started with full limb extension of the supporting member and the ball held with both hands at chest height; from this position subjects were asked to bring the free leg from 45º hip extension to 45º hip flexion

4. 10 passes between the subject and a partner where the participants started with a total extension of the supporting limb on the BOSU and the ball held in both hands in front of them.

2' rest between exercises.

Intervention Type: OTHER

Proprioception training exercise plan with Blackboard (BB)

A 5' conventional warm-up (stationary cycling and active ankle mobility exercises) was performed.

Ankle proprioception training exercise plan included:

1. A 30-second series of maintaining the single-leg stance position on the BB with extended knee and hip holding the ball with the arms stretched out above the head

2. A series of 10 reps on the BB where the subject was asked to pass from the supporting-leg hip and knee starting position to a 90º knee flexion squat, keeping the ball above their heads

3. A single series of 10 reps on the BB where the subject started with full limb extension of the supporting member and the ball held with both hands at chest height; from this position subjects were asked to bring the free leg from 45º hip extension to 45º hip flexion

4. 10 passes between the subject and a partner where the participants started with a total extension of the supporting limb on the BB and the ball held in both hands in front of them.

2' rest between exercises.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• No lower limb surgery during the last year prior to participation
• No history of pain in either ankles, knees or hips during the two months prior to participation
• Not having sprained either ankle for at least three months prior to participation

Exclusion Criteria

• Had participated in lower limb balance and proprioception programmes or had suffered balance alterations such as vertigo, vestibular or central disorders

• Minimum Eligible Age: 16 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Valencia

OTHER

Sponsor Role: lead

Responsible Party

Rodrigo Martín-San-Agustin

Assistant Professor of Physiotherapy

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Rodrigo Martín-San Agustín, Doctor

Role: PRINCIPAL_INVESTIGATOR

University of Valencia

Locations

Rodrigo Martin-San Agustin

Valencia, , Spain

Countries

Spain

Other Identifiers

1236358

Identifier Type: -

Identifier Source: org_study_id