Research article - (2025)24, 332 - 340
DOI:
https://doi.org/10.52082/jssm.2025.332
Effects of Different Intervention Methods on Postural Control in Athletes with Chronic Ankle Instability: A Randomized Controlled Trial
Xiaoya Zhang1,†, Jianxin Wu1,†, Dun Liang2, Bin Ruan1, Qi Gao1,
1School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
2Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, Guangdong Province, China
These authors are regarded as co-first authors.

Qi Gao
✉ No.48, Xinxi Road, Haidian District, Beijing, China 100084
Email: fevok@sina.com
Received: 27-02-2025 -- Accepted: 01-05-2025
Published (online): 01-06-2025

ABSTRACT

This study aimed to evaluate the impacts of a 4-week transcranial direct current stimulation (tDCS), balance training (BT), and an integrated program combining tDCS with BT on static and dynamic postural control in athletes suffering from chronic ankle instability (CAI); as well as to explore whether the combined program produces superior effects compared to either single intervention. Forty athletes with CAI were randomized into four groups: tDCS group, sham tDCS (s-tDCS) group, tDCS + BT group, and s-tDCS + BT group. Twenty minutes of 2 mA anodal or sham tDCS was applied either independently or in conjunction with a 20-minute progressive hop-to-stabilization balance (PHSB) training program over 12 supervised sessions spanning 4 weeks. Primary outcomes were the total score of the Balance Error Scoring System (BESS) and the composite reach distance (COMP) in the Y-Balance Test (YBT). Secondary outcome measures included error scores of single-limb and tandem stance on firm and foam surfaces, as well as mean normalized reach distances in the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions. Compared to baseline measures, the tDCS, tDCS + BT, and s-tDCS + BT groups scored fewer errors on posttest measures for single-leg stance on a firm surface (Sfi), single-leg stance on a foam surface (Sfo), tandem stance on a firm surface (Tfi), tandem stance on a foam surface (Tfo), and the total BESS (p < 0.05). Additionally, both the tDCS + BT and the s-tDCS + BT groups showed greater PM, PL, and COMP in posttest measures compared to pretest measures (p < 0.05). However, no significant differences were found among the tDCS group, the tDCS + BT group, and the s-tDCS + BT group in the posttest measures (p > 0.05). tDCS, BT, and the combination of these two interventions can significantly improve static postural stability in athletes with CAI. However, only intervention methods incorporating BT were effective in enhancing dynamic stability. The combined program offered no additional benefits.

Key words: Ankle injuries, postural balance, transcranial direct current stimulation, exercise therapy

Key Points
  • The total BESS score significantly decreased in the tDCS group, the tDCS + BT group, and the s-tDCS + BT group following four weeks of intervention. These findings suggest that both individual and combined interventions utilized in this study can significantly improve static postural stability in athletes with CAI.
  • The YBT composite reach distance showed a significant increase only after the implementation of the BT intervention. The application of tDCS alone did not influence the dynamic stability in athletes with CAI.
  • The integrated program combining tDCS with BT did not provide significant additional benefits compared to the individual interventions.








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