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

Introduction: While the majority of patients recover from an initial lateral ankle sprain and become copers, approximately 40% develop chronic ankle instability (CAI), which includes a recurrent feeling of giving way1. Central adaptations have been suggested to partly explain the aetiology and chronic character of CAI2. Consequently, deficits in neurocognitive ability may impact musculoskeletal injury incidence rates3. Balance tests, which are routinely utilised in clinical practice for injury prevention and return to sport decision-making, lack neurocognitive load seen in the sports context. Therefore, the primary aim was to assess neurocognitive function and balancing ability using the reactive balance test (RBT)4.
Methods: Patients and healthy controls in this study visited the lab twice. During the first visit, they familiarized themselves with the Y-balance test (YBT) and RBT test procedures. During the second visit, the YBT and RBT were performed on each leg using the same procedures as the first visit. The randomisation used for the Fitlight colours and inter-stimulus time during the RBT differed between the two trials to avoid recall bias and minimise possible learning effects. The inclusion criteria followed the IAC recommendations5.
Results: This study included 27 patients with CAI and 22 healthy controls. Patients with CAI had similar YBT test scores regardless of stance limb or axis tested compared to healthy controls (p = 0.455; composite scores; CAI – most affected side: 87.23cm, CAI – contralateral side: 87.86cm, CON: 84.00cm). The RBT revealed deficits in accuracy in the patient group. However, there were no side-to-side differences for either RBT outcomes (accuracy and visuomotor reaction time) in the patient group (p = 0.538; most affected side: 83.12% ± 8.04%, contralateral side: 81.48% ± 8.65%). There were no significant changes between groups for VMRT (CAI - CON: 776.03ms ± 107.77ms, 739.47ms ± 98.43ms, p = 0.584).
Conclusion: This study found that patients with CAI performed less accurately than healthy controls during a neurocognitive balance task but maintained similar VMRTs. Also, in this study, patients performed the YBT as well as healthy controls. Based on these findings, neurocognitive stimuli should be added to rehabilitation programs for patients with CAI.