Details

Autor(en) / Beteiligte

• Wong, Natalie
• Choi, Daniel

Titel

Comparing the Efficacy of Dynamic Neuromuscular Stabilization and Plyometric Training in Improving Dynamic Ankle Stability and Power Production in Chronic Ankle Sprain Patients

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2021

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Background. Ankle sprains are one of the most common musculoskeletal injuries, with a reinjury rate as high as 70% to 80%. The likelihood of developing chronic ankle instability (CAI), a condition characterized through the recurrence of ankle sprains, increases by 30% with a single ankle sprain. The systematic review (SR) sought to evaluate the effectiveness in improving power production and dynamic stability for individuals with CAI through the specific positions of dynamic neuromuscular stabilization (DNS) between 10 and 13 months. The critically appraised topic (CAT) sought to compare the improvement of dynamic balance on the Star Excursion Balance Test (SEBT) between plyometric training and general balance training in individuals with CAI. Methods. Two independent reviewers conducted the SR through a comprehensive computer search over seven databases from May 2020 to January 2021. The inclusion criteria consisted of full-text articles written in English between 2005 and January 2021 that pertained to CAI, DNS, plyometrics, power production, and dynamic stability. Articles not associated with these criteria were excluded. A similar process was performed for the CAT over three databases in January 2021. The inclusion criteria consisted of full-text articles written in English between 2011 to 2021 that pertained to CAI, plyometrics, general balance training, and SEBT. Articles that were not associated were excluded. Both raters individually assessed each article’s internal validity to limit the risk for bias by utilizing the Physiotherapy Evidence Database (PEDro) and National Institute of Health-National Heart, Lung, and Blood Institute (NIH-NHLBI) quality appraisals. The differences between their grading were discussed, and the appropriate assessment for the final score was identified after the appraisals were completed. For both the SR and the CAT, no statistical analysis of data was performed, but the confidence intervals (CI) and p values were collected for each article that was assessed. Results. In the SR, 14 research studies were assessed, including eight randomized-controlled trials, one controlled intervention study, two observational studies, and three pre-post studies with no control. Current research reported that plyometric training enhanced dynamic ankle stability and power production. According to the limited number of studies about it, DNS was seen to improve gross motor function. As for the CAT, the researchers reviewed five randomized-controlled trials to answer their PICO question. Based on the findings, both general balance and plyometrics displayed enhancements in dynamic ankle stability as subjects improved muscular strength and sensory processing throughout balance tests. Conclusion. The clinical bottom line of the SR stated plyometric training enhanced CAI patients’ dynamic stability and power production. Current research on DNS reported improvements in gross motor function, but more studies will be necessary to support the effectiveness of DNS as an intervention, especially for CAI patients. Limitations included a limited amount of research in DNS, especially with CAI patients. Similarly, the CAT’s clinical bottom line supported the use of general balance and plyometric training to enhance dynamic ankle stability, which implied an increase in SEBT scores in chronic ankle sprain patients. A limitation for the CAT included poor generalizability of the population without chronic ankle instability. Both the SR and the CAT utilized studies with at least a quality of evidence of level 3 or higher.