Cortical Changes of Dual Cognitive-Task Balance Training in Patients With Chronic Ankle Instability: A Randomized Trial.

Abstract

Context: Researchers have shown that patients with chronic ankle instability (CAI) have deficits in memory and attention allocation. This functional deficit affects lower extremity performance. Motor-cognitive dual-task training may improve lower limb dysfunction caused by central nervous system injury. Further study is needed to determine whether dual-task training is more favorable than single-task training for improving neuromuscular control in patients with CAI.

Objective: To compare the effects of balance-cognition dual-task training and balance single-task training on lower limb function and electroencephalography changes during static postural control in patients with CAI.

Design: Randomized clinical trial (Chinese Clinical Trial Registry: ChiCTR2300073875).

Setting: Rehabilitation training room.

Patients or other participants: A total of 24 patients with CAI (age = 22.33 ± 2.43 years, height = 175.62 ± 7.7 cm, mass = 70.63 ± 14.59 kg) were block randomized into 2 groups.

Intervention(s): Protocols were performed 3 times per week for 6 weeks. The single-task group underwent 1-legged static balance training with eyes open and closed and hopping balance training. The dual-task group underwent balance and cognitive training (backward-counting task).

Main outcome measure(s): Cortical activity, proprioception, muscle onset time (difference between the muscle activation time and touchdown time), and dynamic balance were assessed before and after the interventions. We performed multivariate analyses of variance to identify main effects and interactions across groups and time. A post hoc Bonferroni test was performed for pairwise comparisons when interactions were present.

Results: All participants successfully completed the 6-week interventions. Proprioception, peroneus longus (PL) muscle onset time, and dynamic postural control improved after the interventions in both groups (P < .05). Dual-task training was superior to single-task training in improving joint position sense in plantar flexion, shortening PL muscle onset time, and altering cortical activity (P < .05).

Conclusions: A 6-week program of balance training or balance combined with cognitive training could improve the functional deficits associated with CAI. The dual-task training could also improve joint position sense in plantar flexion, PL muscle onset time, and cortical activity.