Cortical Changes of Dual Cognitive-Task Balance Training in Patients with Chronic Ankle Instability: A Randomized Trial

Context: Researchers have shown that patients with chronic ankle instability (CAI) have deficits in memory and attention allocation. This functional deficit affects the lower extremity performance. Motor-cognitive dual-task training may improve lower limb dysfunction caused by central nervous system injury. Whether dual-task training is more favorable than single-task training for neuromuscular control in patients with single-task training still needs to be further proven. Objective: To determine whether balance-cognitive dual-task training can influence cortical activity and has more effective treatment effects than balance single-task training. Design: Randomized controlled clinical trial (Clinical Trials: XXX). Setting: Rehabilitation training room. Patients or Other Participants: After recruitment, twenty-four patients with CAI (age=22.33±2.43 years, height=175.62±7.7 cm, mass=70.63±14.59 kg) were block randomized into two groups. Intervention(s): Protocols were performed three times per week for six weeks. The single-task group underwent one-leg static balance training with and without vision and hopping balance training. The dual-task group underwent balance and cognitive training (backward counting task). Main Outcome Measure(s): The follow variables were assessed before and after the interventions: cortical activity, proprioception, muscle onset time, and dynamic balance. We performed MANOVAs to compare changes of main effects and interactions across groups and time. A post-hoc Bonferroni test was performed for pairwise comparisons when there were significant interactions with the MANOVAs. Results: Twenty-four participants successfully completed the six-week interventions. Proprioception, peroneus longus muscle onset time, and dynamic postural control improved significantly after the interventions in both groups (P<0.05). Dual-task training was superior to single-task training in improving JPS plantarflexion, shortening peroneus longus muscle onset time, and altering cortical activity(P<0.05). Conclusions: A six-week balance training program or balance combined with cognitive training could improve the functional deficits associated with CAI. Meanwhile, the dual-task training could improve cortical activity and lower extremity function.