Table 2 The balance training protocol

Single-legged stance

Performed up to 60s per repetition for up to 3 repetitions.

Performed with eyes opened and eyes closed

Progressed when participants could complete a 60-s trial without a loss of balance.

Increased no. of repetitions by 1

Changed surface from floor to using the Dyna-Disc^a.

Wobble board

Slowly moved the board in the plantar- flexion/dorsiflexion and inversion/eversion directions without letting the board contact the floor.

Performed up to 10 repetitions in each direction.

Progressed when participant could complete the task without upper extremity support.

Added rotational directions.

Steamboats

Tied a 48-in Thera-band around the unstable ankle.

Positioned stance foot 27-in from where Thera-band was tied.

Performed up to 3 sets of 15 repetitions in each direction (hip flexion, extension, abduction, adduction).

Progressed when participants could complete the repetitions without a loss of balance or fatigue.

Increased no. of repetitions from 10 to 15.

Progressed to next level of resistance with the Thera-band.

Single-legged hop

Hopped as far as comfortable in the anterior direction.

Performed up to 15 repetitions.

Progressed when participants could perform the task with minimal ankle and hip motion and no loss of balance on landing.

Increased no. of repetitions from 5 to 10 to 15.

Encouraged increased distance to participants’ tolerance.

Progressed to medial, lateral, and posterior directions.

Quadrant hop

Hopped in numbered squares clockwise and counterclockwise while maintaining single-legged stance.

Progressed when participants could complete 2 sets of 5 hops without a loss of balance or fatigue

Made unanticipated directional changes where investigator randomly called out numbers.

Single-legged ball catch

Performed up to 3 sets of 20 tosses

Progressed when participants could perform 20 tosses without a loss of balance.

Tossed ball outside participants base of support.

Performed during stance on a DynaDisc.

Toe touch down

Maintained single-legged stance on a step while lowering the unstable ankle in the anterior, posterior, medial, and lateral directions until the foot contacted floor.

Performed up to 3 sets of 10 repetitions.

Progressed when participants could complete all trials without a loss of balance and with good lower extremity alignment (no eversion collapse)

Increased no. of repetitions from 5 to 10.

Increased height of step from 4 in to 12 in in 2-in increments

Hop ups and downs

Hop off step and landed in single-legged stance on floor.

Performed up to 3 sets of 10 repetitions.

Progressed when participants could complete all hops without a loss of balance or fatigue.

Increased no. of repetitions from 5 to 10.

Increased height of step from 4 in to 12 in in 2-in increments

Changed direction of hop.

Hopped up onto step.