***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To examine the effects of coordination training with and without stochastic resonance ( SR ) stimulation on dynamic postural stability . Design Experimental with repeated measures . Setting Research Laboratory . Participants Thirty subjects with functional ankle instability ( FAI ) and 30 healthy subjects . Interventions Subjects were assigned to a conventional coordination training group , SR stimulation coordination training group , or control group . Training groups performed coordination exercises for 6 weeks . Single leg jump-l and ing tests were performed before training began ( pretest ) , and then once every 2 weeks . Jump-l and ing tests required subjects to l and on a single leg on a force plate and stabilize quickly . Main Outcome Measures Anterior/posterior ( A/P ) and medial/lateral ( M/L ) time-to-stabilization ( TTS ) . Results The FAI group improved their A/P TTS over their pretest by 16 % ( test 2 ) , 22 % ( test 3 ) , and 22 % ( posttest ) . They also improved their M/L TTS over their pretest by 16 % ( test 3 ) and 22 % ( posttest ) . Control groups did not improve their TTS ( P>0.05 ) . SR stimulation did not statistically influence TTS ( P>0.05 ) . Effect sizes ( ES ) , however , for our 3-way interaction analyses for A/P TTS ( ES=0.40 ) and M/L TTS ( ES=0.30 ) suggested that SR stimulation improved the FAI group 's M/L TTS after 2 weeks of training , and improved their A/P TTS and M/L TTS to a greater degree after 4 weeks than coordination training alone . Conclusion Coordination training can improve dynamic postural instabilities associated with FAI . SR stimulation might be an alternative therapy for FAI , as this stimulation might improve dynamic postural stability more quickly and to a greater extent than coordination training without SR stimulation UNLABELLED The efficacy of a 6-week rehabilitation program was evaluated in 100 consecutive patients , age 15 - 42 years , with acute anterior cruciate ligament ( ACL ) injury . Arthroscopy revealed associated lesions in 82 % of the patients . Except for resections on menisci with large and unstable lesions , no surgery was performed . The patients were r and omly assigned to supervised training or self-monitored training after instruction . RESULTS At the 6-week follow-up there was no difference between the groups with regard to pain at rest , pain during walking , or experience of giving-way episodes , Tegner activity level of Lysholm knee score . Only 2 of the 100 patients were observed without joint mobility restriction . The only significant difference between the groups was the improvement of muscle function in men in the supervised training group . CONCLUSION Six weeks ' rehabilitation is too short a time period from original injury to obtain normal mobility and restored knee function Background Training of neuromuscular control has become increasingly important and plays a major role in rehabilitation of subjects with an injury to the anterior cruciate ligament ( ACL ) . Little is known , however , of the influence of this training on knee stiffness during loading . Increased knee stiffness occurs as a loading strategy of ACL-injured subjects and is associated with increased joint contact forces . Increased or altered joint loads contribute to the development of osteoarthritis . The aim of the study was to determine if knee stiffness , defined by changes in knee kinetics and kinematics of gait , step activity and cross-over hop could be reduced through a knee-specific 12-week training programme . Methods A 3-dimensional motion analysis system ( VICON ) and a force plate ( AMTI ) were used to calculate knee kinetics and kinematics before and after 12 weeks of knee-specific training in 12 males recruited from a cohort with ACL injury 16 years earlier . Twelve uninjured males matched for age , sex , BMI and activity level served as a reference group . Self-reported patient-relevant data were obtained by the KOOS question naire . Results There were no significant changes in knee stiffness during gait and step activity after training . For the cross-over hop , increased peak knee flexion during l and ing ( from 44 to 48 degrees , p = 0.031 ) and increased internal knee extensor moment ( 1.28 to 1.55 Nm/kg , p = 0.017 ) were seen after training , indicating reduced knee stiffness . The KOOS sport and recreation score improved from 70 to 77 ( p = 0.005 ) and was significantly correlated with the changes in knee flexion during l and ing for the cross-over hop ( r = 0.6 , p = 0.039 ) . Conclusion Knee-specific training improved lower extremity kinetics and kinematics , indicating reduced knee stiffness during dem and ing hop activity . Self-reported sport and recreational function correlated positively with the biomechanical changes supporting a clinical importance of the findings . Further studies are needed to confirm these results in women and in other ACL injured population Improvement of ankle proprioception through physiotherapy ( a.k.a . proprioceptive training ) is a widely accepted conservative treatment modality of chronic functional lateral ankle instability . Clinical studies provided controversial data on its proprioceptive effect . Aim of this study was to gain evidence on the efficacy of proprioceptive training on ankle joint position sense .  Ten patients ( five males and five females , aged 23.3±5.4 years ) were treated conservatively for chronic lateral ankle instability with a special training programme over 6 weeks . For the assessment of joint position sense we used the slope-box test , first applied and described by Robbins et al. ( Br J Sports Med 29:242–247 , 1995 ) . The test was performed before the start and after the end of the training programme , measuring joint position sense on 11 different slope amplitudes in four directions ( anterior , posterior , lateral and medial ) in r and om order each on both ankles . Comparisons were made between pre- and post-training results as well as versus a control-group of ten healthy athletes . Overall the proprioceptive sensory function of the studied group has improved , but this improvement was not significant in all directions . Only two patients have shown significant improvement of joint position sense in all directions ( mean estimate error improvement : 2.47 ° ) , while conservative treatment was partially successful in five others ( mean estimate error improvement : 0.73 ° ) . The follow-up results of these seven patients were comparable with the values measured in the control-group . Three patients did not show any improvements ( mean estimate error improvement : −0.55 ° ) ( overall difference between improving and non-improving patients : P<0.0001 ) . Mean absolute estimate error profiles of the seven improving patients became similar to the profiles of healthy athletes , while these changes could not be observed in the case of the three non-improving participants . Proprioceptive rehabilitation programme can be an effective method in order to improve impaired joint position sense function . After 6 weeks non-responding patients can be well identified , and considered for other treatment modalities . The determination of the effective length of the programme however needs further evaluation . Still , changes in the proprioceptive sensory function of the ankle plantarflectors indicate the preventive effect of the training programme . Furthermore , our results support the theory of simultaneous function of different mechanoreceptor-systems STUDY DESIGN A nonr and omized 2-group pretest-posttest design . OBJECTIVES To determine the effects of a 4-week balance training program during stance on a single leg . BACKGROUND Individuals who have experienced multiple episodes of inversion ankle sprains often participate in balance training programs . Balance training is performed to treat existing proprioceptive deficits and to restore ankle joint stability , presumably by retraining altered afferent neuromuscular pathways . The effectiveness of such programs on individuals with functionally unstable ankles has yet to be established . METHODS AND MEASURES Prior to and following training , subjects with self-reported functionally unstable ankles ( 5 women and 8 men , mean age = 21.9 + /- 3.1 years ) and nonimpaired subjects ( 6 women and 7 men , mean age = 21.2 + /- 2.5 years ) completed a  static balance assessment  for both limbs as well as the  ankle joint functional assessment tool question naire ( AJFAT ) . The subjects from both groups participated in a unilateral , multilevel , static and dynamic balance training program 3 times a week for 4 weeks . Subjects from the experimental group trained only the involved limb , and the nonimpaired group  trained a r and omly selected limb . A stability index ( SI ) was calculated during the balance assessment to indicate the amount of platform motion . Compared to low stability indices , high stability indices indicate greater platform motion during stance and therefore less stability . RESULTS Following training , subjects from both groups demonstrated significant improvements in balance ability . When balance was assessed at a low resistance to platform tilt ( stability level 2 ) , the posttraining scores of both the subjects with unstable ankles ( mean SI = 2.63 + /- 1.92 ) and the nonimpaired subjects ( mean SI = 2.69 + /- 2.32 ) were significantly better than their pretraining scores ( mean SIs = 5.93 + /- 3.65 and 4.67 + /- 3.43 , respectively ) . Assessed at a high resistance to platform tilt ( stability level 6 ) , the posttraining scores of both subjects with unstable ankles ( mean SI = 1.27 + /- 0.66 ) and the nonimpaired subjects ( mean SI = 1.37 + /- 0.66 ) were significantly better than their pretraining scores ( mean SIs = 2.30 + /- 1.88 and 2.04 + /- 1.43 , respectively ) . Additionally , the posttraining AJFAT scores of subjects with unstable ankles ( 25.78 + /- 3.80 ) and the nonimpaired subjects ( 29.15 + /- 5.27 ) were significantly greater than their pretraining scores ( 17.11 + /- 3.44 and 22.92 + /- 5.22 , respectively ) , indicating an overall improvement in perceived ankle joint functional stability . CONCLUSIONS This study suggests that balance training is an effective means of improving joint proprioception and single-leg st and ing ability in subjects with unstable and nonimpaired ankles A bi-directional bicycle pedal that combines proprioceptive training and evertor strengthening has been developed for the treatment of residual instability after ankle sprains . A prospect i ve r and omized study was carried out on 19 subjects with recurrent ankle sprains and positive stress X-ray films . The subjects were r and omized to use either a bi-directional test pedal or a traditional uni-directional bicycle pedal and then completed a 6-week high-intensity training program on a cycle ergometer . Assessment of training intensity level was based on maximum oxygen uptake values , heart rate and lactate concentration in blood at various submaximal workloads . After completion of the training program , the subjects who had used the test pedal increased peak eversion torque at 180 degrees degrees s-1 by 14.2 % ( P = 0.020 ) , reduced figure-of-eight running time by 0.24 s ( P = 0.003 ) , improved single leg stance speed from 72.5 % to the maximum speed of 80 % ( P = 0.005 ) , and improved Karlsson functional score by 5.1 points ( P = 0.005 ) . In the control group , single leg stance improved from 56.1 to 67.8 % ( P = 0.018 ) , but otherwise no significant effects were found . This study indicates that short-term high-intensity training with a bi-directional pedal improves ankle performance and may be an option in the treatment of recurrent ankle sprains Objectives : To examine the effect of six weeks of strength and proprioception training on eversion to inversion isokinetic strength ratios ( E/I ratios ) in subjects with unilateral functional ankle instability . Methods : Thirty eight subjects were r and omly assigned to one of four treatment groups : strength training ( S ) ; proprioception training ( P ) ; strength + proprioception training ( B ) ; control ( C ) . Isokinetic strength was tested before and after training using a Kin Com 125 automatic positioning isokinetic dynamometer . Subtalar joint eversion and inversion motions  were tested both concentrically and eccentrically through a range of motion involving 40 ° . All peak torque and average torque values were normalised for body mass . E/I ratios were calculated from average torque and peak torque measures by taking the concentric eversion value and combining it with the eccentric inversion value . Data were analysed using a mixed model analysis of variance with repeated measures on the test factor . Average torque and peak torque E/I ratios at 30 and 120 ° /s were analysed separately . Results : There were no significant differences in average torque and peak torque E/I ratios of the functionally unstable ankle for any of the groups after training compared with before . Conclusions : Six weeks of strength and proprioception training ( either alone or combined ) had no effect on isokinetic measures of strength in subjects with self reported unilateral functional instability . Further studies examining this agonist ( concentric ) to antagonist ( eccentric ) muscle group strength ratio are needed Background and Purpose The purpose of this study was to determine the effect of a 6-month neuromuscular training ( NT ) program versus a traditional strength training ( ST ) program following anterior cruciate ligament ( ACL ) reconstruction . Subjects Seventy-four subjects with ACL reconstruction participated in the study . Methods The study was a r and omized , single-blinded , controlled trial . The NT and ST groups were tested preoperatively and at 3 and 6 months . The main outcome measure was the Cincinnati Knee Score . Secondary outcome measures were visual analog scales ( VASs ) for pain and function , the 36 
    Output:
    
PT/NT was effective at increasing functionality as well as at decreasing the incidence of recurrent injuries and " giving way " episodes after ankle sprains and in conservative treatment of anterior cruciate ligament injuries .
However , conflicting results or no efficacy of training were reported for static postural control , joint position sense , neuromuscular control , joint laxity , and lower extremity strength .
From this review , it can be concluded that proprioceptive and neuromuscular interventions after ankle and knee joint injuries can be effective for the prevention of recurrent injuries and the improvement of joint functionality