Background and purpose: Chronic ankle instability (CAI) are characterized by recurrent ankle sprains, impaired proprioception, reduced dynamic balance and fear of reinjury. This case report describes the use of vestibulo-ocular reflex (VOR) training combined with neuromuscular and conventional rehabilitation in an adolescent football player with CAI.

Case description: A 16-year-old male district-level football player with left-sided mixed (mechanical and functional) CAI completed a 4-week program (3 sessions/week) of conventional ankle rehabilitation, neuromuscular training and VOR exercises. Outcomes were the Foot and Ankle Ability Measure (FAAM), Cumberland Ankle Instability Tool (CAIT), Y-Balance Test (YBT), joint position sense (JPS) error and Tampa Scale of Kinesiophobia (TSK), measured at baseline, 4 weeks, 1 month and 3 months.

Outcomes: FAAM-Sports improved from 52% to 80% and CAIT from 17 to 25. The YBT composite reach improved from 58.7% to 72.0% (80.3% at 3 months), JPS error decreased from 5.8° to 3.2° (2.4° at 3 months), and TSK decreased from 44 to 30 (24 at 3 months). Changes in the YBT, JPS and TSK were maintained or further improved at 3 months. 

Discussion: In this patient, adding VOR training to neuromuscular training was associated with improved balance, proprioception, self-reported function and reduced kinesiophobia. As a single case without a control condition, causal effects cannot be established.