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First published on March 29, 2007, doi:10.1177/0363546507300059
This version was published on August 1, 2007
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The American Journal of Sports Medicine 35:1289-1294 (2007)
© 2007 American Orthopaedic Society for Sports Medicine

The Effectiveness of a Balance Training Intervention in Reducing the Incidence of Noncontact Ankle Sprains in High School Football Players

Malachy P. McHugh, PhD{dagger},*, Timothy F. Tyler, MSPT{dagger},{ddagger}, Michael R. Mirabella, ATC{ddagger}, Michael J. Mullaney, DPT{dagger} and Stephen J. Nicholas, MD{dagger}

From the {dagger} Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York, and {ddagger} Pro Sports Physical Therapy of Westchester, Scarsdale, New York

* Address correspondence to Malachy P. McHugh, PhD, Nicholas Institute of Sports Medicine and Athletic Trauma, 130 East 77th Street, 10th Floor, New York, NY 10021 (e-mail: mchugh{at}nismat.org).

Background: A high body mass index and previous ankle sprains have been shown to increase the risk of sustaining noncontact inversion ankle sprains in high school football players.

Hypothesis: Stability pad balance training reduces the incidence of noncontact inversion ankle sprains in football players with increased risk.

Study Design: Cohort study; Level of evidence, 2.

Methods: Height, body mass, history of previous ankle sprains, and current ankle brace/tape use were documented at the beginning of preseason training in 2 high school varsity football teams for 3 consecutive years (175 player-seasons). Players were categorized as minimal risk, low risk, moderate risk, and high risk based on the history of previous ankle sprain and body mass index. Players in the low-, moderate-, and high-risk groups (ie, any player with a high body mass index and/or a previous ankle sprain) were placed on a balance training intervention on a foam stability pad. Players balanced for 5 minutes on each leg, 5 days per week, for 4 weeks in preseason and twice per week during the season. Postintervention injury incidence was compared with preintervention incidence (107 players-seasons) for players with increased risk.

Results: Injury incidence for players with increased risk was 2.2 injuries per 1000 exposures (95% confidence interval, 1.1–3.8) before the intervention and 0.5 (95% confidence interval, 0.2–1.3) after the intervention (P < .01). This represents a 77% reduction in injury incidence (95% confidence interval, 31%–92%).

Conclusion: The increased risk of a noncontact inversion ankle sprain associated with a high body mass index and a previous ankle sprain was eliminated by the balance training intervention.

Key Words: inversion injury • proprioception • stability pad • body mass index (BMI)







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