Comparison of Kinetic Adaptations in Gait Initiation Following Exergaming and Balance Training in Athletes With Chronic Ankle Instability Publisher Pubmed



Sarkhosh SS ; Khanmohammadi R
Source: Scientific Reports Published:2026

Abstract

Gait initiation (GI) requires coordinated postural control and is often impaired in athletes with chronic ankle instability (CAI). Exergaming has been proposed as an innovative rehabilitation strategy, but its effects on GI kinetics compared with conventional balance training remain unclear. Thirty-four athletes with CAI were assigned to either an exergaming intervention or a balance training control group. Both groups underwent a 12-session intervention, with sessions held three times per week and each session lasting 60 minutes. Kinetic measures, including center of pressure (COP) displacement and velocity in both anterior–posterior (AP) and medio-lateral (ML) directions, were assessed across the anticipatory, weight transition, and locomotor phases of GI at pre-intervention, post-intervention, and one-month follow-up. During the anticipatory phase, the exergaming group demonstrated significantly higher AP COP velocities post-intervention compared with the control group (p = 0.001, η2 = 0.257), although this effect was not maintained at follow-up. In the weight transition phase, both groups exhibited significant forward displacement of COP from pre- to post-intervention (p = 0.018, η2 = 0.024), with partial retention at follow-up. In the locomotor phase, ML COP displacement toward the step-initiating limb decreased significantly from pre- to post-intervention in both groups (p = 0.022, η2 = 0.024) and remained stable at one-month follow-up (p = 0.009, η2 = 0.028). All other kinetic parameters showed no significant changes. The pooled effect size across GI variables was small but significant (Weighted Mean dppc2 = 0.20, SE = 0.10, 95% CI [0.01, 0.40]), indicating modest but measurable benefits of exergaming on GI performance. Exergaming appears to produce improvements in anticipatory postural adjustments during GI in athletes with CAI, while effects on other phases of GI were comparable to balance training. These findings suggest that exergaming may be a useful rehabilitation tool for enhancing certain aspects of postural control. However, the retention of anticipatory gains over time was limited, indicating that further research is needed to confirm the durability and generalizability of these effects. © The Author(s) 2026.