Design, development, and feasibility of a stability-based training package for people with chronic ankle instability

Student thesis: Doctoral Thesis


Chronic ankle instability (CAI) is associated with recurrent ankle sprains, mechanical laxity, and/or perceived instability. Stability-based rehabilitative training has been found to prevent further injury, however poor programme compliance can hinder the programme's effectiveness. Providing feedback on performance allows progress to be monitored and encourages motivation. For this reason, the stimulating and motivational environment created using virtual reality (VR) systems may be more conducive to adherence. Visualisation is the connection of biomechanical analysis and VR. Visualisation produces real-time feedback and uses VR to create a diverse, challenging, and controllable environment, representative of real world situations. This study aimed to design, develop, and test the feasibility of a stability based training package for people with CAI.;The package designed a stability-based programme and developed the visualisation to provide accurate feedback of movement in a virtual environment using motion capture to supplement that of the clinician in practice. A feasibility randomised controlled trial was conducted for people with No-CAI and CAI to compare VIS and No-VIS groups across three sites in the UK and Australia. Outcomes at pre and post-training included participant retention, adherence, adverse events, and objective and subjective stability performance. Of the 28 randomised participants, 26 completed the feasibility study with two CAI participants withdrawing due to non-trial related matters. No adverse events occurred, and training was 100% adhered to.;The results of the stability-based training package were inconclusive for participants with no CAI. For people with CAI, training with visualisation did show significantly greater improvement for the Star Excursion Balance Test, but no conclusions can be drawn since the study was underpowered. All participants reported an enjoyable experience, and the visualisation did not elicit a greater change in results. To conclude, this study supports the feasibility of the stability-based training package for people with CAI and provides evidence for further development.
Date of Award10 May 2021
Original languageEnglish
Awarding Institution
  • University Of Strathclyde
SponsorsUniversity of Strathclyde
SupervisorCraig Childs (Supervisor) & Philip Rowe (Supervisor)

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