Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
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©Journal of Sports Science and Medicine (2024) 23, 593 - 602   DOI: https://doi.org/10.52082/jssm.2024.593

Research article
The Effect of Strength and Balance Training on Kinesiophobia, Ankle Instability, Function, and Performance in Elite Adolescent Soccer Players with Functional Ankle Instability: A Prospective Cluster Randomized Controlled Trial
Han Soo Park, Jae Keun Oh, Jun Young Kim, Jin Ho Yoon 
Author Information
Sports Medicine Laboratory, Korea National Sport University, Seoul 05541, Republic of Korea
The authors contributed equally to this work.

Jin Ho Yoon
✉ Korean National Sports University, 1239, Yangjae-daero, Songpa-gu, Seoul 05541, Republic of Korea
Email: tkd97@knsu.ac.kr
Publish Date
Received: 08-04-2024
Accepted: 09-07-2024
Published (online): 01-09-2024
 
 
ABSTRACT

We aimed to implement strength and balance training for elite adolescent male soccer players with functional ankle instability (FAI) to assess kinesiophobia, ankle instability, ankle function, and performance. This cluster randomized controlled trial comprised 51 elite adolescent male soccer players with FAI recruited from six different teams, divided into strength, balance, and control groups (SG, n = 17; BG, n = 17; and CG, n = 17, respectively). The SG and BG underwent strength and balance training sessions three times per week for 6 weeks. Primary outcomes were the Tampa scale for kinesiophobia-17 (TSK) and Cumberland ankle instability tool (CAIT) scores to assess kinesiophobia and FAI, respectively. Secondary outcomes were ankle strength (four directions), dynamic balance, static balance (ellipse, displacement, velocity), and performance (figure 8 and side-hop tests). A significant interaction effect was observed for both TSK and CAIT post-intervention (both, P < 0.01). In post hoc analyses, the BG had significantly better outcomes in reducing TSK. The SG and BG showed greater improvements in CAIT scores. Regression analysis indicated that CAIT severity correlated significantly with TSK (P = 0.039, R = 0.289). For secondary outcomes, the SG and BG were superior in terms of ankle dorsiflexion/inversion strength, static balance displacement, and figure-8 and side-hop tests (all, P < 0.05). The BG showed significantly better static balance ellipse results (P < 0.05). The 6-week intervention significantly enhanced kinesiophobia management, ankle stability, and performance. Balance training effectively mitigated kinesiophobia and improved balance, compared with strength training alone. Even small variations in CAIT severity can influence kinesiophobia, highlighting the potential benefits of balance training. Integrating balance training into training programs can address both physical and psychological aspects of ankle instability. Research is recommended to explore the longitudinal effects of these interventions and their potential to prevent injury recurrence.

Key words: Ankle strength, chronic ankle instability, injury prevention


           Key Points
  • The results support the integration of balance training in rehabilitation programs for athletes with FAI. Balance training not only aids in improving physical ankle stability but also contributes to reducing psychological barriers such as kinesiophobia.
  • The study suggests that consistent and targeted balance and strength training improves FAI and enhances overall athletic performance and readiness, potentially reducing the risk of future ankle injuries.
  • Through providing evidence-based recommendations for incorporating specific types of training to address both the physical and psychological aspects of FAI in athletes, the findings suggest that such interventions can be immediately applicable in clinical settings.
 
 
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