The Effects of Augmenting Balance Training with Stroboscopic Goggles on Postural Control in Chronic Ankle Instability Patients: A Critically Appraised Topic.

CLINICAL SCENARIO: Individuals with chronic ankle instability (CAI) typically complete balance training protocols to improve postural control and reduce recurrent injury risk. However, the presence of CAI persists after traditional balance training protocols suggesting that such programs may be missing elements that could be beneficial to patients. Visual occlusion modalities, such as stroboscopic goggles, may be able to augment balance training exercises to further enhance postural control gains in those with CAI. However, a cumulative review of the existing evidence has yet to be conducted. FOCUSED CLINICAL QUESTION: Does wearing stroboscopic goggles during balance training result in greater improvements to postural control than balance training alone in those with CAI? SUMMARY OF KEY FINDINGS: All 3 studies indicated that the stroboscopic goggles group had statistically significant improvements in either a measure of static or dynamic postural control relative to the standard balance training group. However, significant improvements were not consistent across all postural control outcomes assessed in the included studies. CLINICAL BOTTOM LINE: Postural control may improve more in those with CAI when stroboscopic goggles were worn while completing balance training exercises relative to completing balance training exercises alone. STRENGTH OF RECOMMENDATION: Overall, consistent moderate- to high-quality evidence was present in the 3 studies, suggesting grade C evidence for the use of stroboscopic goggles during balance training in those with CAI.

Self-reported bio-psycho-social factors partially distinguish patellar tendinopathy from other knee problems and explain patellar tendinopathy severity in jumping athletes: A case-control study.

OBJECTIVE: To determine what combinations of self-reported factors distinguish patellar tendinopathy (PT) from other knee problems, and explain PT severity variance. DESIGN: Case-control study. SETTING: Social media, private practice and National Health Service. PARTICIPANTS: An international sample of jumping athletes diagnosed with either PT (n = 132; 30.7 ± 8.9 years; 80 males; VISA-P = 61.6 ± 16.0) or another musculoskeletal knee condition (n = 89; 31.8 ± 9.9 years; 47 males; VISA-P = 62.9 ± 21.2) by a clinician in the last 6 months. MAIN OUTCOME MEASURES: We considered clinical diagnosis (case = having PT vs control = having other knee problems) as the dependent variable. Severity and sporting impact were defined by VISA-P and availability, respectively. RESULTS: A model comprising seven factors distinguished PT from other knee problems; training duration (OR = 1.10), sport type (OR = 2.31), injured side (OR = 2.28), pain onset (OR = 1.97), morning pain (OR = 1.89), condition acceptability (OR = 0.39) and swelling (OR = 0.37). Sports-specific function (OR = 1.02) and player level (OR = 4.11) explained sporting availability. 44% of PT severity variance was explained by quality of life (ß = 0.32), sports-specific function (ß = 0.38) and age (ß = -0.17). CONCLUSION: Sports-specific, biomedical and psychological factors partially distinguish PT from other knee problems. Availability is mainly explained by sports-specific factors, while psychosocial factors impact on severity. Adding sports-specific and bio-psycho-social factors into assessments could help better identification and management of jumping athletes with PT.

The effects of stroboscopic balance training on cortical activities in athletes with chronic ankle instability.

OBJECTIVES: To investigate the effect of a 6-week stroboscopic balance training program on cortical activities in athletes with chronic ankle instability. DESIGN: Randomized controlled trial. SETTING: Single-center. PARTICIPANTS: Thirty-nine participants were assigned to the strobe group (SG, n = 13), non-strobe group (NSG, n = 13), and control group (CG, n = 13). MAIN OUTCOME MEASURES: Cortical activity and balance velocity were evaluated while the athletes were on the HUBER balance device. Electroencephalographic measurements of cortical activity were made at the transition from bipedal stance to single-leg stance. RESULTS: The SG showed significant increases in Cz theta and alpha values and COP-v (center of pressure velocity) between pretest and posttest (p < 0.001, p = 0.003, p < 0.001). Posttest Cz theta was significantly higher in the SG compared to the CG (p = 0.009) and posttest Cz alpha was significantly higher in the SG compared to the NSG (p = 0.039) and CG (p = 0.001). Posttest COP-v was significantly higher in the SG than in the CG (p = 0.031) and NSG (p = 0.03). CONCLUSIONS: Stroboscopic training may be clinically beneficial to improve balance parameters in athletes with CAI, and may have utility in sport-specific activity phases of rehabilitation to reduce visual input and increase motor control.