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Original Research

Open Access Special Issue

The effect of center-based versus home-based training for rehabilitation of chronic ankle instability in recreational athletes

  • Quan Jiang1
  • Yong Hwan Kim2,*,
  • Joung Kyue Han3,*,

1Department of Public Sports, Luoyang Normal University, 471934 Luoyang, Henan, China

2Department of Physical Education, Gangneung-Wonju National University, 25457 Gangneung, Republic of Korea

3College of Sports Science, Chung-ang University, 17546 Anseong, Republic of Korea

DOI: 10.31083/jomh.2021.142 Vol.18,Issue 1,January 2022 pp.1-9

Submitted: 07 August 2021 Accepted: 18 September 2021

Published: 31 January 2022

(This article belongs to the Special Issue Sports and physical activities for men’s health)

*Corresponding Author(s): Yong Hwan Kim E-mail:
*Corresponding Author(s): Joung Kyue Han E-mail:


Background: Ankle sprains are common in athletes and often progress to chronic ankle instability. Many individuals choose home-based (HB) training due to insufficient time, personal preferences, and accessibility. Therefore, the purpose of this study was to assess the effect of HB rehabilitation training.

Methods: Forty adults (center-based (CB) group, n = 20; home-based (HB) group, n = 20) with chronic ankle instability were trained for 6 weeks and their data analyzed. For ankle strength training, tube bands or body weight, and dynamic balance exercises were used. The CB group trained 5 days/week at a center under physiotherapist monitoring; the HB group performed a self-monitored exercise program 4 days/week using their mobile device and a video-session program 1 day/week. Training intervention lasted 6 weeks; tests were conducted during weeks 1, 3, and 6. Ankle muscle strength was measured at an angular velocity of 30◦/s and 120◦/s using isokinetic equipment, and balance using the Y-balance test (YBT) including three direction; anterior, posteromedial, posterolateral. Hop tests—single, triple, crossover, and 6 m tests—were performed to evaluate lower extremity function, and subjective ankle evaluation using the foot and ankle outcome score (FAOS).

Results: Ankle strength significantly improved with no between-group differences at 30◦/s; at 120◦/s, the CB group significantly improved compared to the HB group. The YBT and FAOS significantly improved in both groups at 6 weeks, with between-group differences. The hop test significantly improved in both groups. Single and triple hop test between-group differences were not significant; however, the CB group significantly improved in the crossover and 6 m tests compared to the HB group.

Conclusions: The 6-week CB and HB rehabilitation programs improved muscle strength, balance, lower extremity function, and subjective ankle satisfaction in both groups. CB training showed a partially superior effect, although HB training recommended for participants who have difficulty visiting rehabilitation centers and may be an appropriate alternative.


Home-based training; Rehabilitation; Center-based training; Strength; Balance; Chronic ankle instability

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Quan Jiang,Yong Hwan Kim,Joung Kyue Han. The effect of center-based versus home-based training for rehabilitation of chronic ankle instability in recreational athletes. Journal of Men's Health. 2022. 18(1);1-9.


[1] Halabchi F, Hassabi M. Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World Journal of Orthopedics. 2020; 11: 534–558.

[2] Yeung MS, Chan KM, So CH, Yuan WY. An epidemiological survey on ankle sprain. British Journal of Sports Medicine. 1994; 28: 112–116.

[3] Jagim AR, Luedke J, Fitzpatrick A, Winkelman G, Erickson JL, Askow AT, et al. The impact of COVID-19-related shutdown measures on the training habits and perceptions of Athletes in the United States: a brief research report. Frontiers in Sports and Active Living. 2020; 2: 208.

[4] Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty CL, Fourchet F, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. The Journal of Orthopaedic and Sports Physical Therapy. 2013; 43: 585–591.

[5] Herzog MM, Kerr ZY, Marshall SW, Wikstrom EA. Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training. 2019; 54: 603–610.

[6] Ajis A, Maffulli N. Conservative management of chronic ankle instability. Foot and Ankle Clinics. 2006; 11: 531–537.

[7] Emery CA, Meeuwisse WH. The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a cluster-randomised controlled trial. British Journal of Sports Medicine. 2010; 44: 555–562.

[8] Lazarou L, Kofotolis N, Pafis G, Kellis E. Effects of two proprioceptive training programs on ankle range of motion, pain, functional and balance performance in individuals with ankle sprain. Journal of Back and Musculoskeletal Rehabilitation. 2018; 31: 437–446.

[9] Tiemstra JD. Update on acute ankle sprains. American Family Physician. 2012; 85: 1170–1176.

[10] Hubbard-Turner T. Lack of Medical Treatment from a Medical Professional after an Ankle Sprain. Journal of Athletic Training. 2019; 54: 671–675.

[11] Steihaug S, Lippestad J, Werner A. Between ideals and reality in home-based rehabilitation. Scandinavian Journal of Primary Health Care. 2016; 34: 46–54.

[12] Ambrose A, Bartels M, Verghese T, Verghese J. Patient and caregiver guide to managing COVID-19 patients at home. The Journal of the International Society of Physical and Rehabilitation Medicine. 2020; 3: 53.

[13] Jamwal PK, Hussain S, Mir-Nasiri N, Ghayesh MH, Xie SQ. Tele-rehabilitation using in-house wearable ankle rehabilitation robot. Assistive Technology. 2018; 30: 24–33.

[14] Nilsson NC, Serafin S, Nordahl R. Gameplay as a Source of Intrinsic Motivation for Individuals in need of Ankle Training or Rehabilita-tion. Presence: Teleoperators and Virtual Environments. 2012; 21: 69–84.

[15] Simon J, Donahue M, Docherty C. Development of the Identification of Functional Ankle Instability (IdFAI). Foot & Ankle International. 2012; 33: 755–763.

[16] Tourné Y, Besse J, Mabit C. Chronic ankle instability. which tests to assess the lesions? Which therapeutic options? Orthopaedics & Traumatology, Surgery & Research. 2010; 96: 433–446.

[17] CSMi. Humac Norm Users Guide. Computer Sports Medicine, Inc.: Stoughton, MA. 2019.

[18] Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, et al. Y-balance test: a reliability study involving multiple raters. Military medicine. 2013; 178: 1264–1270.

[19] Haitz K, Shultz R, Hodgins M, Matheson GO. Test-retest and interrater reliability of the functional lower extremity evaluation. The Journal of Orthopaedic and Sports Physical Therapy. 2014; 44: 947–954.

[20] van den Akker-Scheek I, Seldentuis A, Reininga IHF, Stevens M. Reliability and validity of the Dutch version of the Foot and Ankle Outcome Score (FAOS). BMC Musculoskeletal Disorders. 2013; 14: 183.

[21] Nepocatych S, Ketcham CJ, Vallabhajosula S, Balilionis G. The effects of unstable surface balance training on postural sway, stability, functional ability and flexibility in women. The Journal of Sports Medicine and Physical Fitness. 2016; 58: 27–34.

[22] Cheatham SW, Chaparro G, Kolber MJ. Balance training: does an-ticipated balance confidence correlate with actual balance confidence for different unstable objects? International Journal of Sports Physical Therapy. 2020; 15: 977–984.

[23] Cleland JA, Mintken PE, McDevitt A, Bieniek ML, Carpenter KJ, Kulp K, et al. Manual physical therapy and exercise versus supervised home exercise in the management of patients with inversion ankle sprain: a multicenter randomized clinical trial. The Journal of Orthopaedic and Sports Physical Therapy. 2013; 43: 443–455.

[24] Feger MA, Herb CC, Fraser JJ, Glaviano N, Hertel J. Supervised rehabilitation versus home exercise in the treatment of acute ankle sprains: a systematic review. Clinics in Sports Medicine. 2015; 34: 329–346.

[25] Bassett SF, Prapavessis H. Home-based physical therapy intervention with adherence-enhancing strategies versus clinic-based management for patients with ankle sprains. Physical Therapy. 2007; 87: 1132–1143.

[26] De Ridder R, Willems TM, Vanrenterghem J, Roosen P. Effect of a Home-based Balance Training Protocol on Dynamic Postural Control in Subjects with Chronic Ankle Instability. International Journal of Sports Medicine. 2015; 36: 596–602.

[27] Hupperets MDW, Verhagen EALM, Mechelen WV. Effect of unsu-pervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial. British Medical Journal. 2009; 339: b2684–b2684.

[28] Stephenson S, Wiles R. Advantages and Disadvantages of the Home Setting for Therapy: Views of Patients and Therapists. British Journal of Occupational Therapy. 2000; 63: 59–64.

[29] Chin LC, Basah SN, Affandi M, Shah MN, Yaacob S, Juan, YE, et al. Home-based ankle rehabilitation system: Literature review and evaluation. Jurnal Teknologi. 2017; 79: 9–21.

[30] Punt IM, Ziltener J, Monnin D, Allet L. Wii FitTM exercise therapy for the rehabilitation of ankle sprains: its effect compared with physical therapy or no functional exercises at all. Scandinavian Journal of Medicine & Science in Sports. 2016; 26: 816–823.

[31] Wright CJ, Linens SW, Cain MS. A Randomized Controlled Trial Comparing Rehabilitation Efficacy in Chronic Ankle Instability. Journal of Sport Rehabilitation. 2017; 26: 238–249.

[32] Migel K, Wikstrom E. Gait Biomechanics Following Taping and Bracing in Patients with Chronic Ankle Instability: a Critically Appraised Topic. Journal of Sport Rehabilitation. 2020; 29: 373–376.

[33] Raymond J, Nicholson LL, Hiller CE, Refshauge KM. The effect of ankle taping or bracing on proprioception in functional ankle instability: a systematic review and meta-analysis. Journal of Science and Medicine in Sport. 2012; 15: 386–392.

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