Effectiveness of Motor Imagery Techniques in the Management of Acute Lateral Ankle Sprains in Soccer Players

To determine the effects of motor imagery techniques on pain, proprioception, instability and strength in acute lateral ankle sprains in soccer players

Football (Soccer) is very a popular game and is played for both leisure and professional occupation. Soccer that is one of the contact game and the main portion of the players life is mostly spend on the sport ground in circumstances where there is a great risk of physical injury. Soccer player requires to be fit physically and mentally in order to cater the outstanding demands of game and training which includes the exceptional levels of attention, memory, and planning, and other diverse mental roles though good proprioception is a vital prerequisite for a good game performance and locomotor system injuries and mild traumatic brain injury. The ankle is contemplated majorly susceptible joint to injure throughout games. About 30% of games injuries including running, contact, and jumping are ankle injuries, and ankle ligamentous injuries account for 77% of ankle injuries. Repetitive occurrence of ankle ligamentous injuries cause prolong injury in the sensory-motor function and proprioceptive, by creating a deficit in the Neuro-muscular reflex response time. In 20% of the cases, repeated ankle ligamentous events can result in unstableness of the ankle joints.

Motor imagery is an active procedure during which the representation of an exact action is internally reproduced within the working memory, deprived of any motor output. Evidence has been presented by Functional imaging studies that during motor imagery like anatomical substrates get activated as during motor performance and exercise, motor imagery has been indicated to boost motor performance and muscle potential. Imagery has also been mentioned to be an effectual adjunctive procedure to physiotherapy programs. The imagery program is utilized to assist members to control, see, and vividly construct an image with in the mind. Motor imagery method form a nerve network, hence motor images boost dynamic balancing capability by facilitation the coordination, proprioceptive sense, and kinesthesia capability. Besides, other researchers have described reduction in pain when imagery has been implemented to other medical disorders.

A study reported that a therapy plus imagery group had better functional retrieved than a control therapy group, during imagery there are extensive activation of neural and muscular mechanisms as if the arm were actually being utilized. Motor imagery was effectual by indicating slow down onset time of peroneal muscle in patients with functional ankle unstableness. MI may be effective for pain relief and development in range of motion among prolong musculoskeletal discomfort condition. MI protocol can be helpful to rehabilitation plans after total knee arthroplasty, as it mainly aids to reduce uneasiness and increase strength. For patients who have had arthroplasty, this pilot study advises that MI therapy should be comprised to the orthopedic treatment. We observed at a few developments brought about by MI on motor retrieval following peripheral injury, mostly in the initial postop phase. Plantar-flexor muscles' voluntary torque cohort was importantly increased by MI training of lower limb muscles, and this force surge was not the result of general motivational effects. When it comes to the rehabilitation of grade II ankle ligamentous tears, MI might be useful.

The management of MSK pain situations has seen a rise in the application of MI in modern years. This study aimed to relating the consequence of motor imagery as an adjunct to standard rehab (intervention) and with standard rehab only (comparison) on ankle pain, instability, strength, proprioception (outcomes) in soccer player with acute lateral ankle sprain (participants). This will help set the foundation for further study and designing treatment protocols of the said population.

Eligibility Criteria:
Inclusion Criteria:

* Active Male football player.
* Age among 18-30 years.
* Football players who had recent lateral ankle sprain allocation accomplished within 72 hours after the sprain.
* Participant had at least one of these symptoms: pain, inflammation, contusion or unable to perform physical activities for more than a day.
* Football players with a history of acute ankle sprains and a self-declared feeling of instability with a Cumberland ankle instability tool score of \<27.
* Players who were referred by Rheumatologist/Sports Physiatrist.

Exclusion Criteria:

* Ankle sprain related with lower extremity fracture.
* Other lower extremity injuries.
* Neurological/ Claudication or vascular abnormalities