Deficits in neurocognitive performance in patients with CAI performing a dynamic balance task.

Background
Lateral ankle sprains (LASs) are the most common ankle injury with high reinjury rates. While most patients recover and become copers, around 40% develop persisting dysfunctions, including a feeling of giving-way, known as chronic ankle instability (CAI). Neural adaptations are put forward to clarify the aetiology and the chronic nature of CAI. As such, deficiencies in neurocognitive performance may influence incidence rates in musculoskeletal injuries. However, balance tests commonly used in clinical practice with applications in injury prevention and return to sport decision-making to gauge injury risk lack neurocognitive load. Hence, why we used the reactive balance test (RBT) to evaluate neurocognitive performance and balance ability.
Objective
This study aimed to assess the baseline neurocognitive performance of patients suffering from CAI and LASs using the RBT.
Design
Case-control study
Patients
LAS and CAI
Main Outcome Measurements
Accuracy and visuomotor reaction time (VMRT)
Results
Patients with CAI had lower accuracy than healthy controls (CON: 91.80% ± 5.16%), independent of side (CAI: 83.12% ± 8.04%, contralateral side: 81.48% ± 8.65%). There were no left-right differences in both groups for accuracy and VMRT. For VMRT alone, there were no significant differences between groups (CAI - CON: 776.03ms ± 107.77ms, 739.47ms ± 98.43ms, p = 0.584).
Conclusions
The results of this study demonstrate that patients with CAI were significantly less accurate compared to healthy controls during a neurocognitive balance task. This accuracy reduction equates to a significantly lower neurocognitive performance whilst maintaining similar VMRTs. Based on these findings, neurocognitive stimuli should be added to rehabilitation programs for patients with CAI, as previous research has already demonstrated the added value of visuomotor training in injury prevention programmes for football players. Future research should investigate whether neurocognitive training can prevent ankle injuries in other sports where neurocognitive performance is relevant, such as table tennis, basketball or rugby.