Spinal and Supraspinal Control in Chronic Ankle Instability

Ayca Yagcioglu

Status: Enrolling

Conditions: Ankle Sprains; Ankle Injuries

Treatments: Other: The structured balance training protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT06898554

YeditepeU23

Details and patient eligibility

About

Ankle sprains are common sports injuries that often lead to chronic ankle instability (CAI). Patients with CAI experience deficits in neuromuscular control (NMC), including proprioception and strength. It is believed that damage to the ankle's ligament mechanoreceptors and the peroneal nerve after the initial ankle sprain can cause alterations in NMC, resulting in postural control and dynamic joint stability dysfunction. Inflammation related to recurrent ankle sprains may also contribute to neuromuscular impairments. Evidence suggests that bilateral postural control deficits occur after an ankle sprain, suggesting alterations in the central nervous system (CNS). Rehabilitation for CAI has been shown to lead to bilateral improvements in NMC, potentially due to neural alterations at both the spinal and supraspinal levels. Cross-education, which refers to the muscular crossed effect of unilateral training, has also been proposed as a mechanism for improving contralateral strength in neurologically healthy individuals. While the exact mechanisms underlying cross-education are not yet fully understood, evidence suggests that it involves neural adaptations at both spinal and supraspinal levels. This study aims to investigate the cross-education effect of a 6-week, unilateral balance training on corticomotor excitability, motor neuron pool excitability, and static and dynamic balance in athletes with chronic ankle instability.

Enrollment: 30 estimated patients

Sex: All

Ages: 18 to 25 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Volunteering to participate in the study,
• Being an athlete between the ages of 18-25,
• Being a player in a field team sport such as basketball, volleyball, and handball,
• Having a history of at least 2 significant grade II LAS diagnosed by a physician,
• Related inflammatory symptoms, "giving away" sensation, obtaining a score ≤25 from the Cumberland Ankle Instability Tool (CAIT),
• A score <90% for the activities of daily living subscale and <80% for the sport subscale from the Foot and Ankle Ability Measure,
• Recurrent episodes of LAS of the injured ankle which occurred within at least 12 months.

Exclusion criteria

• Acute injury of lower extremity musculoskeletal structures in the last three months,
• Orthopedic surgery in any of the lower extremities,
• Bilateral ankle instability,
• Vestibular or balance disorder

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 3 patient groups

Stable Group

Experimental group

Description:

The intervention will be applied to only the stable ankle of the athletes with unilateral chronic ankle instability.

Treatment:

Other: The structured balance training protocol

Unstable Group

Experimental group

Description:

The intervention will be applied to only the unstable ankle of the athletes with unilateral chronic ankle instability.

Treatment:

Other: The structured balance training protocol

Control Group

No Intervention group

Description:

No intervention will be applied.