Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial

Abstract Objective To investigate the effects of a 12-week isokinetic eccentric training program on postural control and ankle muscle strength in individuals with functional ankle instability (FAI). Methods In this randomized controlled trial, 42 participants with unilateral FAI were randomly assign...

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Main Authors: Dunbing Huang, Wei Song, Yang Liu, Xiaohua Ke, Zhenhua Wu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-06194-0
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author Dunbing Huang
Wei Song
Yang Liu
Xiaohua Ke
Zhenhua Wu
author_facet Dunbing Huang
Wei Song
Yang Liu
Xiaohua Ke
Zhenhua Wu
author_sort Dunbing Huang
collection DOAJ
description Abstract Objective To investigate the effects of a 12-week isokinetic eccentric training program on postural control and ankle muscle strength in individuals with functional ankle instability (FAI). Methods In this randomized controlled trial, 42 participants with unilateral FAI were randomly assigned to either an experimental group (n = 21), receiving isokinetic eccentric training, or a control group (n = 21), receiving isokinetic concentric training. Both groups trained three times per week for 12 weeks. One participant from each group dropped out during the intervention, resulting in 20 participants per group included in the final analysis. Primary outcomes included static and dynamic postural control assessed using the Pro-Kin 254P platform. Secondary outcomes were ankle dorsiflexion and eversion strength, as well as dorsiflexion/plantarflexion (D/P) and eversion/inversion (E/I) torque ratios measured with a Biodex System 4 Pro® dynamometer at 60°/s and 180°/s. Between-group comparisons and effect sizes (Cohen’s d) with 95% confidence intervals (CI) were reported. Results After 12 weeks, the experimental group demonstrated significantly greater improvements in postural control and ankle strength outcomes compared to the control group (p < 0.01). For dynamic postural control, the total offset index decreased by 23.8% in the eccentric group, showed a significant improvement with a very large effect size (Cohen’s d = 2.06, 95% CI [1.29, 2.82], p < 0.001). Static postural control, measured by sway area, was reduced by 17.3% (Cohen’s d = 0.81, 95% CI [0.16, 1.45], p = 0.015), while sway length did not reach statistical significance (Cohen’s d = 0.55, 95% CI [–0.08, 1.18], p = 0.090). Regarding ankle strength, dorsiflexion relative peak torque (RPT) at 60°/s increased by 30.7% in the eccentric group (Cohen’s d = − 0.79, 95% CI [–1.44, − 0.15], p = 0.016), while eversion RPT at 180°/s improved by 75.7% (Cohen’s d = − 1.13, 95% CI [–1.79, − 0.46], p = 0.001). The D/P torque ratio at 180°/s exhibited a very large between-group difference (Cohen’s d = − 2.18, 95% CI [–2.96, − 1.39], p < 0.001), and the E/I torque ratio at 60°/s demonstrated an extremely large effect size (Cohen’s d = − 4.50, 95% CI [–5.67, − 3.34], p < 0.001). Conclusion Isokinetic eccentric training significantly enhances postural stability and ankle muscle strength in patients with FAI. These improvements in torque symmetry and balance support the inclusion of eccentric training as an effective rehabilitation strategy to reduce reinjury risk and restore neuromuscular function.
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spelling doaj-art-1ef98ce76c35460fbdca277dfc8266642025-08-24T11:40:38ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-08-0120111310.1186/s13018-025-06194-0Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trialDunbing Huang0Wei Song1Yang Liu2Xiaohua Ke3Zhenhua Wu4Encephalopathy and Rehabilitation Center, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Rehabilitation Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji UniversityDepartment of Rehabilitation Medicine, Zhejiang HospitalDepartment of Rehabilitation Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji UniversityEncephalopathy and Rehabilitation Center, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityAbstract Objective To investigate the effects of a 12-week isokinetic eccentric training program on postural control and ankle muscle strength in individuals with functional ankle instability (FAI). Methods In this randomized controlled trial, 42 participants with unilateral FAI were randomly assigned to either an experimental group (n = 21), receiving isokinetic eccentric training, or a control group (n = 21), receiving isokinetic concentric training. Both groups trained three times per week for 12 weeks. One participant from each group dropped out during the intervention, resulting in 20 participants per group included in the final analysis. Primary outcomes included static and dynamic postural control assessed using the Pro-Kin 254P platform. Secondary outcomes were ankle dorsiflexion and eversion strength, as well as dorsiflexion/plantarflexion (D/P) and eversion/inversion (E/I) torque ratios measured with a Biodex System 4 Pro® dynamometer at 60°/s and 180°/s. Between-group comparisons and effect sizes (Cohen’s d) with 95% confidence intervals (CI) were reported. Results After 12 weeks, the experimental group demonstrated significantly greater improvements in postural control and ankle strength outcomes compared to the control group (p < 0.01). For dynamic postural control, the total offset index decreased by 23.8% in the eccentric group, showed a significant improvement with a very large effect size (Cohen’s d = 2.06, 95% CI [1.29, 2.82], p < 0.001). Static postural control, measured by sway area, was reduced by 17.3% (Cohen’s d = 0.81, 95% CI [0.16, 1.45], p = 0.015), while sway length did not reach statistical significance (Cohen’s d = 0.55, 95% CI [–0.08, 1.18], p = 0.090). Regarding ankle strength, dorsiflexion relative peak torque (RPT) at 60°/s increased by 30.7% in the eccentric group (Cohen’s d = − 0.79, 95% CI [–1.44, − 0.15], p = 0.016), while eversion RPT at 180°/s improved by 75.7% (Cohen’s d = − 1.13, 95% CI [–1.79, − 0.46], p = 0.001). The D/P torque ratio at 180°/s exhibited a very large between-group difference (Cohen’s d = − 2.18, 95% CI [–2.96, − 1.39], p < 0.001), and the E/I torque ratio at 60°/s demonstrated an extremely large effect size (Cohen’s d = − 4.50, 95% CI [–5.67, − 3.34], p < 0.001). Conclusion Isokinetic eccentric training significantly enhances postural stability and ankle muscle strength in patients with FAI. These improvements in torque symmetry and balance support the inclusion of eccentric training as an effective rehabilitation strategy to reduce reinjury risk and restore neuromuscular function.https://doi.org/10.1186/s13018-025-06194-0Isokinetic eccentric trainingIsokinetic muscle strengthFunctional ankle instabilityPostural controlDorsiflexionEversion
spellingShingle Dunbing Huang
Wei Song
Yang Liu
Xiaohua Ke
Zhenhua Wu
Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial
Journal of Orthopaedic Surgery and Research
Isokinetic eccentric training
Isokinetic muscle strength
Functional ankle instability
Postural control
Dorsiflexion
Eversion
title Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial
title_full Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial
title_fullStr Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial
title_full_unstemmed Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial
title_short Isokinetic eccentric vs. concentric training for functional ankle instability: a randomized controlled trial
title_sort isokinetic eccentric vs concentric training for functional ankle instability a randomized controlled trial
topic Isokinetic eccentric training
Isokinetic muscle strength
Functional ankle instability
Postural control
Dorsiflexion
Eversion
url https://doi.org/10.1186/s13018-025-06194-0
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