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Comparative Analysis Through Plantar Pressure System Between Open Kinetic Chain & Close Kinetic Chain Exercise In Ankle Rehabilitation For Athletes To Improve Recovery And Injury Prevention

Palak Vijayvergiya, JAFAR KHAN, Dr. Suhani Bhatnagar, Dr. Sujay Gupta, Dr. Farukh Mohammad, Renuka Pal · PAIN JOINTS SPINE · 2026

Researchers compared two ankle rehab approaches in 30 athletes (ages 18-35) recovering from ankle soft-tissue injuries: open kinetic chain exercises (non-weight-bearing, like resistance band ankle moves) versus closed kinetic chain exercises (weight-bearing, foot planted), done five times a week for six weeks. Both groups significantly improved foot/ankle function scores and plantar pressure distribution, but the closed kinetic chain group showed larger gains across most measures, including balance and gait stability.
Takeaway: Prioritize weight-bearing (closed kinetic chain) ankle exercises during rehab to better restore balance and gait, while still including non-weight-bearing work.
Abstract (source)

Background: Ankle injuries are the most common sports trauma, accounting for 10–30% of all sports injuries. As most ankle sprains occur during plantar flexion, supination, and inversion, they are most common in all sports. The majority of patients who experience ankle sprains have persistent symptoms, which include pain, difficulty when walking or during activity, decreased or lost proprioception, loss of neuromuscular control, and re-injury. Plantar pressure guided rehabilitation exercises may enhance postural stability, foot biomechanics, and pain reduction during recovery.

Objective: To investigate the relationship between the effects of Open Kinetic Chain Exercises and Closed Kinetic Chain Exercises on plantar pressure parameters.The study seeks to determine which exercise approach produces more favorable pressure distribution patterns.

Methods: A Comparative study was conducted with 30 athletes aged 18-35 years, affected with ankle related soft tissue injury. Participants were recruited from the Department of Orthopedics (OPD) & Physiotherapy (OPD), Pacific Medical College and Hospital, Udaipur. Patients performed a six-week supervised rehabilitation program, including OKC (open kinetic chain exercises), CKC (closed kinetic chain exercises), five times per week. Outcome measures included theFoot and ankle ability measure (FAAM) for Activities of Daily Living and Sports activities and Plantar Pressure System (load distribution, mean pressure, peak pressure, foot and body barycenter, C.O.P. distance) for functional assessment. Pre- and post-intervention scores were analyzed using paired t-tests, with

Significance: set at p < 0.05.

Results: Post-intervention, FAAM scores significantly Improved from52.73 ± 3.55 to 58.60 ± 4.06 ADL and 22.40 ± 2.38 to 26.20 ± 2.30 Sports (OKC), 55.40 ± 4.25 to 72.66 ± 5.77 ADL and 21.33 ± 2.74 to 29.40 ± 2.75 Sports (CKC) (p < 0.001), indicating substantial pain reduction. Plantar pressure system analysis demonstrated significant improvements infoot barycenter (OKC 112.9 ± 22.07 to 119.1 ± 14.1, CKC 103.6 ± 11.63 to 151.4 ± 7.73 mm2) and center of pressure (OKC 715.1 ± 264.3 to 581.2 ± 295.3, CKC 289.9 ± 74.1 to 1101.8 ± 205.0). The changes may indicate the enhancement of body weight distribution during gait, which is essential to decrease the risk of falls and improve mobility in general.

Conclusion: Both OKC and CKC exercise programmesis statistically significant improvements over a 6-week intervention period in terms of balance, gait parameters, and overall functional performance. However, CKC exercises consistently demonstrated greater improvements across most primary and secondary outcome measures. Particularly, the CKC group showed superior reductions in postural sway, center of pressure (COP) velocity, and enhanced cadence, reflecting better dynamic stability and gait efficiency.

Primary studyOpen accessInjury Prevention & Rehab
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