The effect of balance training on postural motor strategies of athletes with chronic ankle instability against manipulation of visual, vestibular, and proprioceptive information

Document Type : Research Paper

Authors

1 Associate Professor, Department of Sport and Health Sciences, Amirkabir University of Technology

2 PhD in Physical Education, Department of Sport and Health Sciences, Amirkabir University of Technology

3 PhD student in corrective exercise and sports pathology, University of Tehran

10.22038/mjms.2025.27114

Abstract

Introduction: The ankle joint plays a critical role in maintaining balance and postural control. Damage to the sensorimotor control system of the ankle has been identified as the primary cause of recurrent ankle instability. Impairments in proprioception and kinesthetic awareness are major contributors to decreased balance, increasing the likelihood of reinjury and often leading to prolonged absence of athletes from sports participation. This study aimed to examine the effect of balance training on postural motor strategies in athletes with chronic ankle instability when exposed to manipulated visual, vestibular, and proprioceptive inputs.
Methods: In this quasi-experimental study, 30 male athletes with chronic ankle instability were randomly assigned to an experimental group (n = 15) or a control group (n = 15). Assessments were conducted using a pretest–posttest design. The experimental group completed a six-week perturbation-based balance training program. Postural motor strategies were evaluated using the Sensory Organization Test (SOT) of a computerized dynamic posturography system. The system analyzed motor strategy use across six conditions: 1. all sensory inputs (visual, vestibular, and proprioceptive) available; 2. visual input removed; 3. vestibular input manipulated; 4. proprioceptive input manipulated; 5. combination of visual removal and proprioceptive manipulation; and 6. manipulation of both vestibular and proprioceptive inputs. Data were analyzed using one-way ANCOVA. Statistical analyses were performed in SPSS version 22 at a significance level of α = 0.05.
Results: Results indicated that participants in the experimental group demonstrated the highest motor strategy scores in condition one, relying primarily on the ankle strategy. Conversely, the lowest scores were observed in condition six, where both vestibular and proprioceptive inputs were manipulated, resulting in greater use of the hip strategy. Overall, posttest scores in all six conditions were superior in the experimental group compared with the control group.
Conclusion: The findings suggest that balance training can effectively enhance postural control. Training on unstable surfaces likely increases muscle activation and enables the central nervous system to receive more effective sensory input from various afferent receptors. These adaptations may lead to altered motor control patterns, improved sensory integration, faster sensory processing, and earlier muscle activation. Ultimately, such improvements promote the use of more stable motor strategies for postural control and contribute to greater overall stability.

Keywords

Medical Journal of Mashhad university of Medical Sciences
Volume 68, Issue 4
May and June 2025

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