Author(s): LAO, Y., Institution: TSINGHUA UNIVERSITY, Country: CHINA, Abstract-ID: 658

INTRODUCTION:
The objective of this trial was to observe the effect of uphill treadmill running and the combined effect of uphill running plus ankle joint mobilizations on subjective feeling of instability, dynamic postural control and ankle dorsiflexion range of motion in young adults with chronic ankle instability(CAI).
METHODS:
A randomized, four-arm, pretest-posttest design was implemented. After screening, a total of 76 CAI patients were randomly allocated among four groups: the combined uphill running and joint mobilization group(URJM), the uphill running alone group(UR), the joint mobilization alone group(JM), and the control group. Participants in the URJM group and UR group received 20 minutes per session, three treadmill training sessions per week throughout a 4-week program. Ankle joint mobilizations were provided three sessions a week for 4 weeks for the participants in the URJM group and JM group. The outcome measures included the Cumberland Ankle Instability Tool (CAIT) assessing subjective feeling of instability; the Y-balance test (YBT) in anterior, posteromedial (PM), and posterolateral (PL) directions assessing dynamic postural control; the weight-bearing lunge test and non-weight-bearing ankle dorsiflexion degree in half circle goniometer (NWBG) assessing ankle dorsiflexion range of motion. Linear mixed models were used to test differences between groups, with baseline outcome values serving as a covariate for adjustment. The effect size (Cohen’s d) will be calculated to evaluate the magnitude of difference among groups.
RESULTS:
There were statistically significant effects after isolated UR, JM or URJM on CAIT compared with the control group(p<0.01). All the mean difference and the lower 95% CI were greater than the minimal clinically significant difference of CAIT(3 scores), supporting the clinical efficacy. For the outcomes of dynamic postural control, there were statistically significant effects after isolated UR, JM or URJM on YBT-PM and YBT-PL compared with the control group(p<0.01). For ankle dorsiflexion range of motion, participants in URJM group had a significantly greater improvement in NWBG than those in UR(p=0.021), JM(p=0.028) and the control group(p=0.000).
CONCLUSION:
A 4-week uphill treadmill running program can improve the subjective feeling of instability and dynamic postural control in young adults with CAI. Compared to uphill running alone or joint mobilization alone, their combined application can better improve non-weight-bearing ankle dorsiflexion range of motion. This effect may help improve inadequate ankle dorsiflexion preceding heel strike, a known risk factor for ankle sprains in CAI individuals. Clinical implications: The uphill running program mentioned in this study is a form of exercise therapy that can be autonomously undertaken by CAI patients. Clinicians and physical therapists may consider incorporating uphill running into the rehabilitation protocols for CAI patients.