{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:21:25Z","timestamp":1793085685741,"version":"4.5.0"},"reference-count":56,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Repetitive ankle sprains lead to mechanical instability of the ankle. Patients with chronic ankle instability may experience decreased muscle strength and limited postural control. This study investigated the effects of a hip-strengthening exercise program on muscle strength, balance, and function in patients with chronic ankle instability. Materials and Methods: A total of 30 patients participated in the study and were randomly assigned to the two groups. Among the 30 participants, 14 were assigned to the hip joint-strengthening exercise group and 16 to the control group. The experimental group underwent a hip-strengthening exercise program and received training for 40 min per session twice a week for four weeks. The control group received the same frequency, duration, and number of sessions. Measurements were performed before and after the training period to assess changes in hip strength, balance, and function. Results: In the within-group and between-group comparisons, both groups showed significant differences in hip joint strength, static balance, dynamic balance, and function (FAAM; foot and ankle ability measures) (p &lt; 0.05). Statistically significant differences were observed in the time \u00d7 group interaction effects among the hip abductors and external rotation in hip joint strength, path length in static balance, posterolateral and posteromedial in dynamic balance, and FAAM-ADL and FAAM-SPORT functions (p &lt; 0.05). Conclusions: Accordingly, this study confirmed that hip joint-strengthening exercises have a positive effect on the strength, balance, and function of patients with chronic ankle instability, and we believe that hip joint-strengthening exercises will be recommended as an effective intervention method for patients suffering from chronic ankle instability.<\/jats:p>","DOI":"10.3390\/medicina60081199","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T14:55:47Z","timestamp":1721832947000},"page":"1199","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The Influence of Hip-Strengthening Program on Patients with Chronic Ankle Instability"],"prefix":"10.3390","volume":"60","author":[{"given":"Woo-Jin","family":"Yeum","sequence":"first","affiliation":[{"name":"Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3100-3995","authenticated-orcid":false,"given":"Mi-Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9766-6068","authenticated-orcid":false,"given":"Byoung-Hee","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1016\/j.apmr.2012.04.023","article-title":"Prevalence and impact of chronic musculoskeletal ankle disorders in the community","volume":"93","author":"Hiller","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/JSM.0b013e31827d21fe","article-title":"Epidemiology of U.S. high school sports-related ligamentous ankle injuries, 2005\/06-2010\/11","volume":"23","author":"Swenson","year":"2013","journal-title":"Clin. J. Sport Med."},{"key":"ref_3","first-page":"1876","article-title":"Evidence-based treatment choices for acute lateral ankle sprain: A comprehensive systematic review","volume":"26","author":"Altomare","year":"2022","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1123\/jsr.2016-0143","article-title":"Effects of Hip Strengthening on Neuromuscular Control, Hip Strength, and Self-Reported Functional Deficits in Individuals with Chronic Ankle Instability","volume":"27","author":"Smith","year":"2018","journal-title":"J. Sport Rehabil."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"CPG1","DOI":"10.2519\/jospt.2021.0302","article-title":"Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021","volume":"51","author":"Martin","year":"2021","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1080\/00913847.2018.1409604","article-title":"Acute lateral ankle sprain to chronic ankle instability: A pathway of dysfunction","volume":"46","author":"Miklovic","year":"2018","journal-title":"Phys. Sportsmed."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1152\/jn.00067.2019","article-title":"Age-related changes in leg proprioception: Implications for postural control","volume":"122","author":"Henry","year":"2019","journal-title":"J. Neurophysiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/B978-0-444-63916-5.00002-1","article-title":"Sensory integration for human balance control","volume":"159","author":"Peterka","year":"2018","journal-title":"Handb. Clin. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jshs.2020.09.014","article-title":"Chronic ankle instability is associated with proprioception deficits: A systematic review and meta-analysis","volume":"10","author":"Xue","year":"2021","journal-title":"J. Sport Health Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.4085\/1062-6050-52.11.16","article-title":"Proprioceptive Training for the Prevention of Ankle Sprains: An Evidence-Based Review","volume":"52","author":"Rivera","year":"2017","journal-title":"J. Athl. Train."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1177\/02692155211022009","article-title":"Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: Systematic review and meta-analysis","volume":"35","author":"Ingles","year":"2021","journal-title":"Clin. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4085\/1062-6050-363-18","article-title":"Ultrasound Imaging of the Gluteal Muscles During the Y-Balance Test in Individuals with or Without Chronic Ankle Instability","volume":"55","author":"DeJong","year":"2020","journal-title":"J. Athl. Train."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.gaitpost.2017.02.001","article-title":"Hip-ankle coordination during gait in individuals with chronic ankle instability","volume":"53","author":"Yen","year":"2017","journal-title":"Gait Posture"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ptsp.2013.02.005","article-title":"Gluteus medius strengthening and the use of the Donatelli Drop Leg Test in the athlete","volume":"15","author":"Gowda","year":"2014","journal-title":"Phys. Ther. Sport"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"572","DOI":"10.4085\/1062-6050-344-18","article-title":"An Updated Model of Chronic Ankle Instability","volume":"54","author":"Hertel","year":"2019","journal-title":"J. Athl. Train."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.gaitpost.2019.04.007","article-title":"Gluteus medius activity during gait is altered in individuals with chronic ankle instability: An ultrasound imaging study","volume":"71","author":"DeJong","year":"2019","journal-title":"Gait Posture"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Jaber, H., Lohman, E., Daher, N., Bains, G., Nagaraj, A., Mayekar, P., Shanbhag, M., and Alameri, M. (2018). Neuromuscular control of ankle and hip during performance of the star excursion balance test in subjects with and without chronic ankle instability. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201479"},{"key":"ref_18","first-page":"74","article-title":"Ipsilateral hip abductor weakness after inversion ankle sprain","volume":"41","author":"Friel","year":"2006","journal-title":"J. Athl. Train."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Martins, E.C., Steffen, L.B., Gomes, D., Herzog, W., Haupenthal, A., and de Brito Fontana, H. (2022). Looped Elastic Resistance during Squats: How Do Band Position and Stiffness Affect Hip Myoelectric Activity?. J. Funct. Morphol. Kinesiol., 7.","DOI":"10.3390\/jfmk7030060"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"756","DOI":"10.26603\/001c.23672","article-title":"Concentric and Eccentric Force Changes with Elastic Band and Isotonic Heavy Resistance Training: A Randomized Controlled Trial","volume":"16","author":"Folkins","year":"2021","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_21","first-page":"573","article-title":"An Examination of the Gluteal Muscle Activity Associated with Dynamic Hip Abduction and Hip External Rotation Exercise: A Systematic Review","volume":"10","author":"Macadam","year":"2015","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"585","DOI":"10.2519\/jospt.2013.0303","article-title":"Selection criteria for patients with chronic ankle instability in controlled research: A position statement of the International Ankle Consortium","volume":"43","author":"Gribble","year":"2013","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"22","DOI":"10.2519\/jospt.2012.3704","article-title":"The effects of isolated hip abductor and external rotator muscle strengthening on pain, health status, and hip strength in females with patellofemoral pain: A randomized controlled trial","volume":"42","author":"Khayambashi","year":"2012","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3189","DOI":"10.1589\/jpts.28.3189","article-title":"Effects of elastic-band resistance exercise on balance, mobility and gait function, flexibility and fall efficacy in elderly people","volume":"28","author":"Kwak","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Wang, H., Yu, H., Kim, Y.H., and Kan, W. (2021). Comparison of the Effect of Resistance and Balance Training on Isokinetic Eversion Strength, Dynamic Balance, Hop Test, and Ankle Score in Ankle Sprain. Life, 11.","DOI":"10.3390\/life11040307"},{"key":"ref_26","first-page":"388","article-title":"Ankle Joint Control during Single-Legged Balance Using Common Balance Training Devices\u2014Implications for Rehabilitation Strategies","volume":"11","author":"Strom","year":"2016","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"977","DOI":"10.26603\/ijspt20200977","article-title":"Balance Training: Does Anticipated Balance Confidence Correlate with Actual Balance Confidence for Different Unstable Objects?","volume":"15","author":"Cheatham","year":"2020","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/j.1600-0838.2009.00958.x","article-title":"Clinical assessment of hip strength using a hand-held dynamometer is reliable","volume":"20","author":"Thorborg","year":"2010","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.ejmhg.2013.02.002","article-title":"Effect of partial weight bearing program on functional ability and quadriceps muscle performance in hemophilic knee arthritis","volume":"14","author":"Zaky","year":"2013","journal-title":"Egypt. J. Med. Hum. Genet."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Mentiplay, B.F., Perraton, L.G., Bower, K.J., Adair, B., Pua, Y.H., Williams, G.P., McGaw, R., and Clark, R.A. (2015). Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0140822"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e42040","DOI":"10.5812\/asjsm.42040","article-title":"Reliability of Zebris Motion Analysis System in Healthy Athletes and Athletes with Anterior Cruciate Ligament Reconstruction","volume":"8","author":"Niknam","year":"2017","journal-title":"Asian J. Sports Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"343","DOI":"10.3113\/FAI.2007.0343","article-title":"Contributing factors to chronic ankle instability","volume":"28","author":"Hubbard","year":"2007","journal-title":"Foot Ankle Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"683","DOI":"10.26603\/ijspt20190683","article-title":"The Reliability of the Star Excursion Balance Test and Lower Quarter Y-Balance Test in Healthy Adults: A Systematic Review","volume":"14","author":"Powden","year":"2019","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1123\/jsr.2016-0187","article-title":"The Relationship Between Hip Strength and the Y Balance Test","volume":"27","author":"Wilson","year":"2018","journal-title":"J. Sport Rehabil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1007\/s00167-017-4748-7","article-title":"Measurement properties of the most commonly used Foot- and Ankle-Specific Questionnaires: The FFI, FAOS and FAAM. A systematic review","volume":"26","author":"Sierevelt","year":"2018","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1177\/1071100719884554","article-title":"Rasch Analysis of Reliability and Validity of Scores from the Foot and Ankle Ability Measure (FAAM)","volume":"41","author":"Matheny","year":"2020","journal-title":"Foot Ankle Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1177\/107110070502601113","article-title":"Evidence of validity for the Foot and Ankle Ability Measure (FAAM)","volume":"26","author":"Martin","year":"2005","journal-title":"Foot Ankle Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/23335432.2020.1728381","article-title":"An exploration of the differences in hip strength, gluteus medius activity, and trunk, pelvis, and lower-limb biomechanics during different functional tasks","volume":"7","author":"Sinsurin","year":"2020","journal-title":"Int. Biomech."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"672","DOI":"10.4085\/1062-6050-238-17","article-title":"Isometric Hip Strength and Dynamic Stability of Individuals with Chronic Ankle Instability","volume":"53","author":"McCann","year":"2018","journal-title":"J. Athl. Train."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3233\/WOR-210268","article-title":"Effect of Q-angle, lateral distal tibial angle and hip muscle torques on ankle injury","volume":"74","author":"Uludag","year":"2023","journal-title":"Work"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1186\/s13018-022-03061-0","article-title":"Sex differences in the relationship of hip strength and functional performance to chronic ankle instability scores","volume":"17","author":"Lu","year":"2022","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1177\/0363546516672650","article-title":"Hip Strength as an Intrinsic Risk Factor for Lateral Ankle Sprains in Youth Soccer Players: A 3-Season Prospective Study","volume":"45","author":"Witvrouw","year":"2017","journal-title":"Am. J. Sports Med."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Buehler, C., Koller, W., De Comtes, F., and Kainz, H. (2021). Quantifying Muscle Forces and Joint Loading During Hip Exercises Performed with and Without an Elastic Resistance Band. Front. Sports Act. Living, 3.","DOI":"10.3389\/fspor.2021.695383"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.jcm.2019.07.002","article-title":"Electromyographic Activity of Hip Musculature During Functional Exercises in Participants with and Without Chronic Ankle Instability","volume":"19","author":"Fatima","year":"2020","journal-title":"J. Chiropr. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e19775","DOI":"10.1097\/MD.0000000000019775","article-title":"Quantitative assessments of static and dynamic balance performance in patients with chronic ankle instability","volume":"99","author":"Zhang","year":"2020","journal-title":"Medicine"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"727","DOI":"10.4085\/1062-6050-450-17","article-title":"Cortical Measures of Motor Planning and Balance Training in Patients with Chronic Ankle Instability","volume":"54","author":"Burcal","year":"2019","journal-title":"J. Athl. Train."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1123\/jsr.2023-0024","article-title":"Effects of A Single Balance Training Session on Neural Excitability in Individuals With Chronic Ankle Instability","volume":"32","author":"Chung","year":"2023","journal-title":"J. Sport Rehabil."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1007\/s40279-017-0850-8","article-title":"Balance Training Does Not Alter Reliance on Visual Information during Static Stance in Those with Chronic Ankle Instability: A Systematic Review with Meta-Analysis","volume":"48","author":"Song","year":"2018","journal-title":"Sports Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1177\/1941738113481200","article-title":"Core stability training for injury prevention","volume":"5","author":"Anderson","year":"2013","journal-title":"Sports Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.bjpt.2019.07.011","article-title":"Lower limb kinematics and hip extensors strengths are associated with performance of runners at high risk of injury during the modified Star Excursion Balance Test","volume":"24","author":"Pinheiro","year":"2020","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"801","DOI":"10.4085\/1062-6050-41-19","article-title":"Four-Week Ankle-Rehabilitation Programs in Adolescent Athletes with Chronic Ankle Instability","volume":"55","author":"Cain","year":"2020","journal-title":"J. Athl. Train."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1123\/jsr.2015-0189","article-title":"A Randomized Controlled Trial Comparing Rehabilitation Efficacy in Chronic Ankle Instability","volume":"26","author":"Wright","year":"2017","journal-title":"J. Sport Rehabil."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s13018-022-02925-9","article-title":"Validation of Foot and Ankle Ability Measure (FAAM) and the Foot and Ankle Outcome Score (FAOS) in individuals with chronic ankle instability: A cross-sectional observational study","volume":"17","author":"Maffulli","year":"2022","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"297","DOI":"10.3113\/FAI.2009.0297","article-title":"Validity of the Foot and Ankle Ability Measure (FAAM) in Diabetes Mellitus","volume":"30","author":"Martin","year":"2009","journal-title":"Foot Ankle Int."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1123\/jsr.2021-0111","article-title":"Isometric Hip Strength and Patient-Reported Outcomes of Individuals with and Without Chronic Ankle Instability","volume":"31","author":"Bain","year":"2022","journal-title":"J. Sport Rehabil."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"662","DOI":"10.4085\/1062-6050-555-16","article-title":"Two 4-Week Balance-Training Programs for Chronic Ankle Instability","volume":"53","author":"Anguish","year":"2018","journal-title":"J. Athl. 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