Effects of Gait Retraining With Auditory Feedback

Study Overview
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Brief Summary
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There is evidence to support individuals with chronic ankle instability (CAI) have altered gait biomechanics which may lead to re-injury and poor patient outcomes. Currently, there are no interventions specifically targeting these abnormal gait biomechanics. Evidence supports the use of an external focus of attention feedback to promote motor learning and retention. The overall purpose of randomized clinical trial is to determine the effects of a 2-week (8 session) gait retraining protocol using an auditory external feedback instrument can (1) alter biomechanics during functional tasks (walking, step-down, lunge, lateral hops, and balance) (2) improve ankle cartilage measures and (3) improve patient-reported outcome measures.

Official Title
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Effects of Gait Retraining With Auditory Feedback on Biomechanics and Ankle Joint Health in Individuals With Chronic Ankle Instability

Conditions
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Ankle Injuries, Ankle Inversion Sprain

Intervention / Treatment
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* Other: Auditory Feedback
* Other: No Feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of at least one ankle sprain Index ankle sprain > 12 months prior to study enrollment Most recent ankle sprain > 12 weeks prior to study enrollment Score >10 on the Identification of Functional Ankle Instability (IdFAI) survey. Score <95% on the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living and a <85% on the Sport subscales Be physically active by participating in some form of physical activity for at least 20 min per day, three times per week. Exclusion Criteria: History of ankle surgery History of other musculoskeletal injuries within the past 6 weeks Any condition affecting plantar pressure distribution Neurological or vestibular disorders affecting balance Current/previous self-reported disability due to lower extremity pathology that may adversely affect neuromuscular function

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Auditory Feedback<br>Participants will complete 8 sessions over a 2-week period of walking gait retraining on a treadmill while receiving auditory feedback. | Other: Auditory Feedback<br>* Participants will complete 8 sessions over a 2-week period of walking gait retraining on a treadmill while receiving no feedback. Participants will be instructed to walk on a treadmill at their desired pace in a manner that does not cause the auditory tool to elicit a noise.<br>|
| Active Comparator: No Feedback<br>Participants will complete 8 sessions over a 2-week period of walking on a treadmill without receiving feedback. | Other: No Feedback<br>* Participants will complete 8 sessions over a 2-week period of walking gait retraining on a treadmill while receiving no feedback. Participants will be instructed to walk on a treadmill at their desired pace in a manner that they perceive to be their normal walking speed and mechanics.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from baseline in lower extremity kinetics during walking | Plantar pressure and center of pressure trajectory measured with an in-shoe plantar pressure system | Immediate post-intervention, 1-week post-intervention | 
| Changes from baseline in talar cartilage deformation before and after walking | Talar cartilage thickness and cross-sectional area will be measured with an diagnostic ultrasound imaging system | Immediate post-intervention, 1-week post-intervention | 
| Changes from baseline in self-reported ankle function | Changes from baseline in self-reported function as measured by the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living and Sport questionnaire. Scores range from 100% (no decrease in function) to 0% (complete loss of function). | Immediate post-intervention, 1-week post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes from baseline in static balance | Static balance will be measured via a force plate | Immediate post-intervention, 1-week post-intervention | 
| 2. Changes from baseline in plantar pressure during forward lunges, lateral hops, and a step-down | Plantar pressure during forward lunges, lateral hops, and a step-down will be recorded with an in-shoe insole system. | Immediate post-intervention, 1-week post-intervention |