The effect of center-based versus home-based training for rehabilitation of chronic ankle instability in recreational athletes

Abstract

Background: Ankle sprains are common in athletes and often progress to chronic ankle instability. Many individuals choose home-based (HB) training due to insufficient time, personal preferences, and accessibility. Therefore, the purpose of this study was to assess the effect of HB rehabilitation training. Methods: Forty adults (center-based (CB) group, n = 20; home-based (HB) group, n = 20) with chronic ankle instability were trained for 6 weeks and their data analyzed. For ankle strength training, tube bands or body weight, and dynamic balance exercises were used. The CB group trained 5 days/week at a center under physiotherapist monitoring; the HB group performed a self-monitored exercise program 4 days/week using their mobile device and a video-session program 1 day/week. Training intervention lasted 6 weeks; tests were conducted during weeks 1, 3, and 6. Ankle muscle strength was measured at an angular velocity of 30 degrees/s and 120 degrees/s using isokinetic equipment, and balance using the Y-balance test (YBT) including three direction; anterior, posteromedial, posterolateral. Hop tests- single, triple, crossover, and 6 m tests-were performed to evaluate lower extremity function, and subjective ankle evaluation using the foot and ankle outcome score (FAOS). Results: Ankle strength significantly improved with no between-group differences at 30 degrees/s; at 120 degrees/s, the CB group significantly improved compared to the HB group. The YBT and FAOS significantly improved in both groups at 6 weeks, with between-group differences. The hop test significantly improved in both groups. Single and triple hop test between-group differences were not significant; however, the CB group significantly improved in the crossover and 6 m tests compared to the HB group. Conclusions: The 6-week CB and HB rehabilitation programs improved muscle strength, balance, lower extremity function, and subjective ankle satisfaction in both groups. CB training showed a partially superior effect, although HB training recommended for participants who have difficulty visiting rehabilitation centers and may be an appropriate alternative.