Background & Objectives: Balance control is a key factor in sports activities. The posture and balance control system is a complex and intricate mechanism in which the coordination of 3 balance systems, including the visual system, the vestibular system, and the somatosensory system, plays a very important role. Balance disorders in people with chronic ankle instability can result from dysfunction of one of the visual, somatosensory, or vestibular systems that maintain balance. Information obtained from weight can be united by all 3 systems in the CNS and create balance. People with chronic ankle instability rely on vision, and their somatosensory systems are weaker than those of healthy people. By challenging the vision, virtual reality forces the body to rely on other senses to maintain balance. In this research, conventional and virtual reality exercises are examined to evaluate their effectiveness. Therefore, this research aims to compare the effects of virtual reality and conventional exercises on lower–limb balance function in individuals with chronic ankle instability.

Methods: The present study employed an experimental study with a pretest–posttest design. The statistical population for this study included 40 patients aged 18 to 30 who were referred to the Shariati Physiotherapy Clinic for chronic ankle instability. The inclusion criteria were as follows: a history of an initial ankle sprain occurring at least 12 months before the commencement of testing and accompanied by inflammatory symptoms (pain and swelling); interruption of physical activity for at least one day following the injury; a history of recurrent uncontrolled or unpredictable episodes of ankle giving way; recurrent ankle sprains or a subjective feeling of ankle instability; and a score between 0 and 27 on the Cumberland Ankle Instability Tool (CAIT) (Hilleret al., 2006). The exclusion criteria included a history of surgery involving the musculoskeletal structures of the lower extremity, a history of lower–extremity fracture, and any acute musculoskeletal injury to the lower extremity within the previous 3 months that affected joint function and disrupted physical activity for at least one day. Participants with mechanical instability (ie, ligamentous laxity, arthrokinematic impairment, or degenerative joint changes), as determined by the Anterior Drawer Test, were also excluded. Subjects were randomly assigned to 4 groups: virtual reality exercises, conventional, combined, and control. The interventions included playing with virtual reality and conventional exercises focused mostly on balance. Balance was measured using the Y Balance Test at pretest and posttest. The modified Star Excursion Balance Test (Y–Balance Test) is a valid and reliable method for evaluating dynamic postural control, especially for detecting sensory–motor deficits related to chronic ankle instability (α=0.86–0.95). The maximum reach was measured in 3 directions, then the overall score was calculated and compared. Data analysis was performed in SPSS software version 27 in two sections: descriptive statistics and inferential statistics. In the descriptive statistics section, mean and standard deviation were used. In the inferential statistics section, an analysis of covariance test was used to examine significant differences in balance function between the research groups, and a Bonferroni post hoc test was used to compare the groups on the research variable. Also, a 1–way analysis of variance was used to examine differences between the research groups in anthropometric characteristics. The significance level for statistical tests was set at 0.05.

Results: The analysis of covariance showed a significant difference in the mean balance function scores at the posttest between the four research groups (p < 0.001). The results of the Bonferroni post–hoc test indicated that the mean balance function scores at the posttest in the virtual reality exercises group were significantly higher than those in the conventional exercises group (p = 0.019) and the control group (p < 0.001). Also, there was no significant difference in the mean balance function scores at the posttest between the virtual reality exercise groups with combined exercises (p = 0.178) and the conventional exercise groups with combined exercises (p = 0.999).

Conclusion: According to the findings, virtual reality and combined exercises are more effective than conventional exercises in improving balance in people with chronic ankle instability, and they should be used to improve this ability. Conventional exercises were also more effective than the control group.