Electrical Stimulation Combined with Exercise Therapy for Chronic Ankle Instability: A Case Report

Abstract

Background: Chronic ankle instability (CAI) is associated with recurrent ankle giving-way, pain, muscle weakness, impaired range of motion, balance deficits, and functional limitations. 
Objective: To describe changes in pain, muscle strength, ankle range of motion (ROM), balance, and functional ability following electrical stimulation (ES) combined with therapeutic exercise in a patient with CAI. 
Methods: This descriptive case report involved a 17-year-old female volleyball athlete with recurrent lateral ankle sprains and right-sided CAI. The patient completed four physiotherapy treatment sessions combining ES with strengthening, proprioceptive, balance, and functional exercises. Outcomes were assessed before and after the intervention using the Numeric Rating Scale (NRS), Manual Muscle Testing (MMT), goniometric ROM, Single Leg Stance (SLS), Y-Balance Test, and Foot and Ankle Outcome Score (FAOS). 
Results: Pain during movement decreased from 4/10 to 1/10, and tenderness decreased from 2/10 to 0/10. Dorsiflexor and invertor strength improved from grade 3+ to 4, while plantarflexor strength improved from grade 3 to 3+. Ankle dorsiflexion increased from 15° to 20°, plantarflexion from 30° to 35°, and inversion from 15° to 20°. Right SLS increased from 10 to 35 seconds, and the right Y-Balance composite score increased from 69.9% to 79.7%. The FAOS increased from 73.97% to 92.64%. 
Conclusion: Four sessions of ES combined with therapeutic exercise were associated with improvements across pain, ankle ROM, muscle strength, balance, and self-reported function in this patient with CAI. The findings should be interpreted as descriptive clinical observations because of the single-case design and absence of a comparison condition.