Neurocognitive Exercises for Ankle Instability

Istanbul University - Cerrahpasa

Status: Not yet enrolling

Conditions: Ankle Sprains

Treatments: Other: Multimodal Exercise; Other: Neurocognitive Enriched Exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT06567847

2024_AE_Tez

Details and patient eligibility

About

In the general population, 19.0-26.6 per 1000 cases of ankle instability have been reported, while in the athletic population, the rate is 11.3 per 1000. Ankle instability also predisposes individuals to recurrent instability, leading to persistent symptoms. After ankle injuries, temporary increases in afferent activity, along with long-term deficits in somatosensory information from ligaments, may cause central neuroplasticity that affects sensorimotor function. This central neuroplasticity can lead to permanent dysfunctions in the affected limb, thereby increasing the likelihood of developing and maintaining chronic ankle instability (CAI). In addition to the association between impaired balance and reduced proprioception with CAI, it has been reported that the central nervous system may fail to manage joint stress due to its inability to discern load on the ligaments.

Impaired neurocognition has been linked to decreased performance and higher rates of re-injury. Deficiencies in neuromuscular control, motor learning, or other neurocognitive components related to an individual's performance and safety may affect the ability to respond appropriately in a dynamic environment. Any deficiencies in these neurocognitive processes can hinder the successful completion of tasks.

The aim of this study is to comparatively examine the effects of neurocognitively enriched rehabilitation versus traditional rehabilitation on re-injury risk, balance, and proprioception in individuals with a history of ankle instability.

Full description

Voluntary participants who have been diagnosed with lateral ankle instability will be included in the study. Signed voluntary consent will be obtained from participants. Participants will be divided into two groups. Study groups will be as follows: a) Neurocognitive Enriched Exercise, b) Multimodal Exercise.

Enrollment: 36 estimated patients

Sex: All

Ages: 18 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The documented unilateral ankle instability confirmed through clinical examinations (drawer test, talar tilt test) and MRI in cases requiring differential diagnosis.
• A history of an initial ankle sprain occurring at least 6 months ago.
• The presence of a recurrent sense of giving way that started at least 6 months ago and has been intermittently persistent.

Exclusion criteria

• Presence of a history of previous surgery in the lower extremity.
• Identification of organic and non-organic lesions such as cartilage injuries, periarticular tendon tears, and impingement syndromes.
• The existence of a fracture accompanying instability in the foot-ankle.
• Presence of congenital deformities in the foot-ankle.
• Diagnosis of talus osteochondral lesion.
• Diagnosis of ankle arthritis.
• Presence of medial ligament lesion.
• Existence of peripheral neuropathy.
• Presence of additional rheumatological diseases.
• Regular moderate-level exercise for at least 3 days a week in the last 6 months.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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36 participants in 2 patient groups

Neurocognitive Enriched Exercise

Active Comparator group

Description:

Individuals with a diagnosis of lateral ankle instability who underwent supervised neurocognitive enriched exercise under the guidance of a physiotherapist for 8 weeks, 2 days a week.

Treatment:

Other: Neurocognitive Enriched Exercise

Multimodal Exercise

Active Comparator group

Description:

Individuals with a diagnosis of lateral ankle instability who underwent supervised routine exercise under the guidance of a physiotherapist for 8 weeks, 2 days a week.

Treatment:

Other: Multimodal Exercise