The Impact of Mind–Body Interventions on Dynamic Postural Control in Chronic Ankle Instability Patients: A Critically Appraised Topic

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Abstract
Clinical Scenario: Although chronic ankle instability (CAI) and ankle sprains are highly prevalent, there has been little advancement in treatment strategies. A challenging aspect of CAI rehabilitation is the multifaceted nature of CAI. Sensorimotor deficits particularly dynamic postural control impairments, are well documented in those with CAI relative to uninjured controls and likely contribute to the high prevalence of CAI. Because CAI is associated with deficits in sensory pathways, mind–body interventions may help enhance a patient’s awareness and processing of sensory information (ie, proprioception). Improved proprioception may subsequently result in more confidence in bodily movements, which we hypothesize would manifest as improved dynamic postural control. Focused Clinical Question: Do mind–body interventions, relative to a control condition, improve dynamic postural control in patients with CAI? Summary of Key Findings: Two studies found that a 12-week Yang style Tai Chi resulted in significantly greater improvements in all Star Excursion Balance Test reach directions compared with the respective control groups. One study found that a 4-week walking meditation program (which entails the participant slowly walking back and forth while keeping their concentration on movements of the body) resulted in significant improvements on some Star Excursion Balance Test reach directions, but these changes were not different from the changes observed in the control group. Clinical Bottom Line: The results indicate that mind–body interventions, especially Tai Chi, can improve dynamic postural control in those with CAI. Strength of Recommendation: Overall consistent high-quality evidence was present in the 3 studies, suggesting grade A evidence for the use of mind–body interventions in the rehabilitation of patients with CAI.

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