## 4 Discussion
\begin{table}
\begin{tabular}{c c c c} \hline \hline
**Test Variables** & **Sobel Test** & **SE** & \(\mathbf{p}\)**-Value** \\ \hline Pain \(\times\) JPS \(-\)\(10^{\circ}\) of DF \(\times\) A-P sway (mm) & 0.34 & 0.04 & 0.040 \\ Pain \(\times\) JPS \(-\)\(15^{\circ}\) of DF \(\times\) A-P sway (mm) & 0.44 & 0.03 & 0.030 \\ Pain \(\times\) JPS \(-\)\(10^{\circ}\) of PF \(\times\) A-P sway (mm) & 0.26 & 0.02 & 0.028 \\ Pain \(\times\) JPS \(-\)\(15^{\circ}\) of PF \(\times\) A-P sway (mm) & 0.36 & 0.04 & 0.029 \\ Pain \(\times\) JPS \(-\)\(10^{\circ}\) of DF \(\times\) M-L sway (mm) & 0.44 & 0.10 & 0.020 \\ Pain \(\times\) JPS \(-\)\(15^{\circ}\) of DF \(\times\) M-L sway (mm) & 0.53 & 0.12 & 0.010 \\ Pain \(\times\) JPS \(-\)\(10^{\circ}\) of PF \(\times\) M-L sway (mm) & 0.35 & 0.11 & 0.030 \\ Pain \(\times\) JPS \(-\)\(15^{\circ}\) of PF \(\times\) M-L sway (mm) & 0.47 & 0.09 & 0.019 \\ Pain \(\times\) JPS \(-\)\(10^{\circ}\) of DF \(\times\) COP Ellipse area (mm\({}^{2}\)) & 0.26 & 0.02 & 0.028 \\ Pain \(\times\) JPS \(-\)\(15^{\circ}\) of DF \(\times\) COP Ellipse area (mm\({}^{2}\)) & 0.36 & 0.04 & 0.029 \\ Pain \(\times\) JPS \(-\)\(10^{\circ}\) of PF \(\times\) COP Ellipse area (mm\({}^{2}\)) & 0.44 & 0.10 & 0.020 \\ Pain \(\times\) JPS \(-\)\(15^{\circ}\) of PF \(\times\) COP Ellipse area (mm\({}^{2}\)) & 0.53 & 0.12 & 0.010 \\ \hline \hline \end{tabular} JPS = joint position sense, DF = dorsiflexion, PF = plantar flexion, A-P sway = anterior to posterior sway, M-L sway = medial to lateral sway, COP = center of pressure, and SE = standard error.  
\end{table} 
Table 4: Sobel test for the indirect effect of statistical significance. CAI showed a larger ellipse area, indicating greater oscillations in their postural sway. The impaired proprioception in patients with CAI may result from damage to the ligaments and sensory receptors in the ankle joint, leading to reduced sensitivity to the joint position and movement [8]. Furthermore, patients with CAI may exhibit altered muscle activation patterns and reduced ankle joint range of motion, further contributing to impaired proprioception and balance [8]. Interventions aimed at improving proprioception and balance in patients with CAI have been proposed as potential strategies to reduce the risk of future ankle injuries and improve functional outcomes [41]. For instance, proprioceptive training exercises, such as balance and stability exercises, have been shown to improve balance and reduce the risk of recurrent ankle sprains in patients with CAI [41; 42; 43]. Interventions aimed at improving proprioception and balance may be effective strategies to reduce the risk of recurrent ankle injuries and improve functional outcomes in this population. This study aimed to investigate the mediating role of pain in the association between ankle joint position sense (JPS) and balance in individuals with unilateral chronic ankle instability (CAI). Previous studies by [PERSON] et al. [44] and [PERSON] et al. [45] have demonstrated the mediating effects of pain on the relationship between kinesiophobia and joint position sense in chronic low back pain and fibromyalgia syndrome, respectively. In line with these findings, a study by [PERSON] [26] revealed impaired cervical proprioception in elderly individuals with chronic neck pain. Building upon this knowledge, our study aimed to examine the mediating effect of pain on the relationship between ankle JPS and balance impairments in individuals with CAI. Understanding this mediation effect may provide insights into targeted treatments and interventions to improve functional outcomes and reduce the risk of recurrent ankle injuries in this population. Pain is a complex phenomenon that can have a significant impact on an individual's ability to maintain balance [46]. Pain can affect the sensory and motor systems, leading to changes in proprioception, muscle activation patterns, and movement strategies [47].