Dynamic Balance, Hop Training and Preventing Recurrent Sprains

The Star Excursion Balance Test is usually done in three directions: anterior, posteromedial and posterolateral. Gribble and colleagues recommend four practice trials per direction, hands on hips and the stance heel kept down. Reach is normalized to leg length; expect around 60 to 70% anteriorly and over 100% in the posterior directions. A reactive version with colored lights adds a cognitive challenge. The McKeon protocol uses hops in anterior-posterior, medial-lateral and diagonal directions, hop to stabilization and reach, and unanticipated hops to a called number. People with chronic ankle instability improved their FAAM scores and posterior reach distances with large effect sizes, while the control group did not. Hupperets and colleagues tested an eight-week home program of six exercises, three times a week. Recurrent sprains occurred in 35% of controls and 21% of the intervention group, a relative risk of 0.6, an absolute risk reduction of 14% and a number needed to treat of 7.