Effects of Closed Chain Exercise Versus Neuromuscular Training on Chronic Ankle Sprain in Football Players

Study Overview
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Brief Summary
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A current study will be conducted to determine the effects of closed-chain exercise versus neuromuscular training on pain, range of motion, and functional performance in football players with a chronic ankle sprain. This study will be a clinical trial conducted at the Pakistan sports board in the Lahore district. The study will be completed within the time duration of Six months. Non-probability convenient sampling technique will be used to collect the data. The sample size of 17 participants in each group will be taken in this study to find the effects of closed-chain exercise versus neuromuscular training on pain, range of motion, and functional performance in football players with a chronic ankle sprain. Athletes will be divided into two groups. Group A will be treated with closed-chain exercises and Group B will be with neuromuscular training. Pain (Numeric pain rating scale NPRS), Proprioceptive (balancing on a single leg with the eyes closed, balancing on a wobble board, Dynamic balance (Star Excursion Balance test and Y Balance Test), Functional Ankle Instability (Greek version of the Identification functional ankle instability questionnaire IdFAI), Cumberland Ankle Instability Tool (CHRONIC ANKLE INSTABILITY) and Ankle Instability Instrument (AII), Foot and Ankle Ability Measure (FAAM)-Sport Subscale, Range of Motion ROM (measure Goniometer) will be used as Data collecting tools. Three sessions of treatment per week for 4 weeks will be given. Data will be analyzed on SPSS version 22. In descriptive statistics Frequency tables, pie charts, and bar charts will be used to show the summary of group measurements measured over time.

Detailed Description
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To determine the effects of closed-chain exercise versus neuromuscular training on pain, range of motion, and functional performance in football players with a chronic ankle sprain. The study design will be a Randomized Clinical trial. Non-Probability Convenient Sampling will be used. the sample size of 34 subjects is calculated. TOOLS: Pain (Numeric pain rating scale NPRS) Range of Motion ROM (measure Goniometer) Proprioceptive (balancing on a single leg with the eyes closed, balancing on a wobble board) Dynamic balance (Star Excursion Balance test and Y Balance Test) Functional Ankle Instability (Greek version of the Identification functional ankle instability questionnaire IdFAI) Ankle Instability Instrument (AII) Foot and Ankle Ability Measure (FAAM)-Sport Subscale The data will be analyzed using SPSS for Windows software, version 25. Statistical significance will be set at P= 0.05. After assessing the normality of the data by Shapiro wilk test it will be decided whether parametric or non-parametric test will be used within a group or between two groups.

Official Title
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Effects of Closed Chain Exercise Versus Neuromuscular Training on Pain, Range of Motion, and Functional Performance in Football Players With Chronic Ankle Sprain

Conditions
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Ankle Sprains, Chronic Pain

Intervention / Treatment
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* Other: Group A - Closed Chain Exercise
* Other: Group B - Neuromuscular Training Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Both male and female Age 18-35 (3) Grade 1, 2 Ankle Sprain Recurrent ankle Sprains (3) Ankle Sprain Special Tests (Squeeze Test, Talar Tilt Test) Exclusion Criteria: • Traumatic history or Ankle fracture (6 months) any vestibular or balance disorders (1) athletes who had suffered a sprain in the month prior to the start of the study(3) who were taking anti-inflammatory drugs (3) Poor physical fitness Co-morbidities

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Closed Chain Exercise<br>closed chain exercise plan given to the participant of this group | Other: Group A - Closed Chain Exercise<br>* 17 participants were in experimental group giving them closed chain exercise plan of 5 exercises, 10reps x 3sets each, on alternate 3 days per week for duration of 4-weeks, all values measured before and after 4-weeks<br>|
| Experimental: Neuromuscular Training Exercise<br>Neuromuscular training plan given to the participants of this group | Other: Group B - Neuromuscular Training Exercise<br>* 17 participants were in experimental group giving them neuromuscular training plan of 5 exercises, 10reps x 3sets each, on alternate 3 days per week for duration of 4-weeks, all values measured before and after 4-weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain (NPRS Scale) | The Numeric Pain Rating Scale (NPRS) is a widely used tool for measuring and assessing pain intensity. It is a simple and subjective rating scale that allows individuals to quantify and communicate their level of pain on a numerical scale. The NPRS typically consists of a horizontal or vertical line with numbers ranging from 0 to 10. The numbers represent a continuum of pain intensity, where 0 represents no pain and 10 represents the worst possible pain. The individual is asked to select the number that best corresponds to their current level of pain, with 0 indicating no pain and 10 indicating the most severe pain imaginable. | 4 weeks | 
| Range of Motion (Goniometer) | A goniometer is a measuring tool commonly used in healthcare and physical therapy to assess and quantify the range of motion (ROM) in joints. It consists of a stationary arm, a movable arm, and a protractor or scale to measure angles. To measure range of motion with a goniometer, the stationary arm is aligned with a fixed point on the body, typically an anatomical landmark associated with the joint being assessed. The movable arm is aligned with a second anatomical landmark, which moves as the joint is flexed or extended. | 4 weeks | 
| Functional Performance (Special Tests) | Functional performance refers to an individual's ability to perform everyday tasks and activities effectively and independently. It encompasses the physical, cognitive, and emotional skills required to carry out various activities that are necessary for daily living, work, leisure, and social participation. Functional performance is closely tied to an individual's overall functional capacity, which involves the integration of physical abilities, such as strength, endurance, balance, and coordination, with cognitive and emotional factors, including problem-solving, decision-making, attention, and motivation. The concept of functional performance extends beyond isolated movements or specific skills and focuses on how individuals function within their unique environments and roles. | 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ankle Sprain, Chronic Ankle Instability, Exercise programs, Neuromuscular Training, Sports Injuries