A critical appraisal of “Effects of Hip Strengthening on Neuromuscular Control, Hip Strength, and Self-Reported Functional Deficits in Individuals With Chronic Ankle Instability”

Abstract

Chronic ankle Instability (CAI) is classified as the general ‘giving way’ of the lateral side of the ankle after numerous ankle sprains. A ‘gold standard’ of rehabilitation has yet to be established for CAI, but there are many articles showing that hip strengthening and balance/proprioception training can improve the joint stability and limit injuries. This background bridges into my clinical question, in which I asked, “In patients with CAI, will balance/proprioception or strength training more beneficial at improving joint stability?” Personal research has led me to an article by Smith et al., in which the authors emphasize the effects of hip strengthening on CAI in a college-aged population. This article succinctly covers strengthening with CAI, while implementing an intervention that included credible and reliable outcome measures such as the Balance Error Scoring System (BESS), Star Excursion Balance Test (SEBT), hip strength both in abduction and external rotation, and self-reported Foot and Ankle Ability Measure (FAAM). The authors describe their scientific method concisely, while providing an easily replicable study that could be implemented within a clinical setting. The study had minimal bias, as it was a single-blind randomized controlled trial with all of the assessments being performed by the same clinician. Furthermore, a ‘limitations’ and ‘future research’ section was provided in order to educate readers on what interventions could be implemented in future research. While checking a lot of my boxes, some changes could have been made in order to make this paper better. No MCID or NNT values were present, the introduction did not include a conclusion over their literature review, and the dependent variables were not described much in the introduction. Ultimately, while no ‘gold standard’ for rehabilitation is available for CAI, this well-written article provides a credible intervention that could aid in future rehabilitation efforts.