To evaluate the effects of joint mobilization, in which movement is applied to the ankle's dorsiflexion range of motion, on dynamic postural control and on the self-reported instability of patients with chronic ankle instability (CAI). A double-blind, placebo-controlled, randomized trial with repeated measures and a follow-up period. Ninety patients with a history of recurrent ankle sprain, self-reported instability, and a limited dorsiflexion range of motion, were randomly assigned to either the intervention group (Joint Mobilizations, 3 weeks, two sessions per week) the placebo group (Sham Mobilizations, same duration as joint mobilization) or the control group, with a 6 months follow-up. Dorsiflexion Range of Motion (DFROM), Star Excursion Balance Test (SEBT) and CAI Tool (CAIT) were outcome measures. A separate 3 × 4 mixed model analysis of variance was performed to examine the effect of treatment conditions and time, and intention-to-treat (ITT) analysis was applied to evaluate the effect of the independent variable. The application of joint mobilization resulted in better scores of DFROM, CAIT, and SEBTs in the intervention group when compared with the placebo or the control groups (p < 0.001). The effect sizes of group-by-time interaction, measured with eta-squared, oscillated between 0.954 for DFROM and 0.288 for SEBT posteromedial distance. In within-group analysis, the manipulation group showed an improvement at 6 months follow-up in CAIT [mean = 5.23, CI 95% (4.63-5.84)], DFROM [mean = 6.77, CI 95% (6.45-7.08)], anterior SEBT [mean = 7.35, CI 95% (6.59-8.12)], posteromedial SEBT [mean = 3.32, CI 95% (0.95-5.69)], and posterolateral SEBT [mean = 2.55, CI 95% (2.20-2.89)]. Joint mobilization techniques applied to subjects suffering from CAI were able to improve ankle DFROM, postural control, and self-reported instability. These results suggest that joint mobilization could be applied to patients with recurrent ankle sprain to help restore their functional stability. Implications for Rehabilitation Functional instability is a very common sequela in patients with CAI, resulting in reduced quality of living due to the limitations it imposes on daily life activities. The mobilization with movement technique presented by Mulligan, and based on the joint mobilization accompanied by active movement, appears as a valuable tool to be employed by physical therapists to restore ankle function after a recurrent ankle sprain history. ROM restriction, subjective feeling of instability and dynamic postural control are benefiting from the joint mobilization application.

The purpose of this study was to determine the effects of a 12-week contrast training (CT) program (isometric + plyometric), with no external loads, on the vertical jump, kicking speed, sprinting, and agility skills of young soccer players. Thirty young soccer players (age, 15.9 ± 1.43 years; weight, 65.4 ± 10.84 kg; height, 171.0 ± 0.06 cm) were randomized in a control group (n = 13) and an experimental group (n = 17). The CT program was included in the experimental group's training sessions, who undertook it twice a week as a part of their usual weekly training regime. This program included 3 exercises: 1 isometric and 2 plyometric, without external loads. These exercises progressed in volume throughout the training program. Performance in countermovement jump (CMJ), Balsom agility test (BAT), 5-, 10-, 20-, and 30-m sprint, and soccer kick were assessed before and after the training program. A 2-factor (group and time) analysis of variance revealed significant improvements (p < 0.001) in CMJ, BAT, and kicking speed in the experimental group players. Control group remained unchanged in these variables. Both groups significantly reduced sprint times over 5, 10, 20, and 30 m (p ≤ 0.05). A significant correlation (r = 0.492, p < 0.001) was revealed between ΔBAT and Δaverage kicking speed. Results suggest that a specific CT program without external loads is effective for improving soccer-specific skills such as vertical jump, sprint, agility, and kicking speed in young soccer players.

The purpose of this study was to evaluate the effect of a 12-week-specific proprioceptive training program on postural stability, gait, balance, and fall prevention in adults older than 65 years. The present study was a controlled clinical trial. Forty-four community dwelling elderly subjects (61-90 years; mean age, 78.07 ± 5.7 years) divided into experimental (n = 20) and control (n = 24) groups. The participants performed the Berg balance test before and after the training program, and we assessed participants' gait, balance, and the risk of falling, using the Tinetti scale. Medial-lateral plane and anterior-posterior plane displacements of the center of pressure, Sway area, length and speed, and the Romberg quotient about surface, speed, and distance were calculated in static posturography analysis (EPS pressure platform) under 2 conditions: eyes open and eyes closed. After a first clinical evaluation, patients were submitted to 12 weeks proprioception training program, 2 sessions of 50 minutes every week. This program includes 6 exercises with the BOSU and Swiss ball as unstable training tools that were designed to program proprioceptive training. The training program improved postural balance of older adults in mediolateral plane with eyes open (p < 0.05) and anterior-posterior plane with eyes closed (p < 0.01). Significant improvements were observed in Romberg quotient about surface (p < 0.05) and speed (p < 0.01) but not about distance (p > 0.05). After proprioception training, gait (Tinetti), and balance (Berg) test scores improved 14.66% and 11.47% respectively. These results show that 12 weeks proprioception training program in older adults is effective in postural stability, static, and dynamic balance and could lead to an improvement in gait and balance capacity, and to a decrease in the risk of falling in adults aged 65 years and older.

The objective of the present study was to determine the effectiveness of a 6-week balance training program on patients with Chronic Ankle Instability (CAI) in relation to the results obtained in Dynamic Balance, subjective feeling of instability and pain using a single-blind randomized controlled trial. 70 athletes were randomly assigned to control or intervention group. The control group performed their usual training, and the intervention group was administered the same usual activity in addition to a balance program. The paired t-test was performed to evaluate the change scores in each group. The t-test for independent samples was performed to evaluate between-group differences in change scores. Significance level was assigned for p-values less than 0.05 for all analyses. There were significant differences between groups in change scores in CAIT and all of the SEBTs reach distances (p<0.001) but not in Pain (p=0.586). The effect sizes were larger for the outcomes measures that showed significant differences. In the within-group change, the experimental groups showed larger effect sizes in CAIT, SEBT posteromedial and SEBT posterolateral, and moderate effect sizes in SEBT anterior. Exercise therapy training based on multi-station balance tasks led to significant improvements in dynamic balance and self-reported sensation of instability in patients with CAI.