Effect Of Thoracic Mobility Versus Lumbopelvic Stabilization Exercises On Patients With Chronic Ankle Instability

Study Overview
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Brief Summary
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The aim of the study is to investigate the effectiveness of thoracic mobility versus lumbopelvic stabilization exercises combined with ankle strengthening exercises with resistive band on patients with chronic ankle instability in terms of lower extremity flexibility, proprioception and dynamic balance.The participants were divided into two group as Thoracic Mobility group (n=15) and Lumbopelvic Stability group (n=15). In addition their exercise programs (2 times/wk, 8 wk duration), both groups were given home exercise ankle strengthening exercises.(3 sets/ 10 reps, 3 times/wk.)

Detailed Description
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The aim of the study is to investigate the effectiveness of thoracic mobility versus lumbopelvic stabilization exercises combined with ankle strengthening exercises with resistive band on patients with chronic ankle instability in terms of lower extremity flexibility, proprioception and dynamic balance. The study were conducted in Noi Physio Pilates Studio in Istanbul between November 2022 - January 2023 during 8 weeks. 30 volunteers with chronic ankle instability were included according to Cumberland Ankle Instability Tool (CAIT). The cut off value for the CAIT test was determined as 27. Participants who received 27 or less than this value were included in the study. All participants were right dominant. Lower extremity flexibility was assessed with Active Straight Leg Raise Test, proprioception (hip, knee, ankle) was assessed with Joint Position Sense Test using electronic goniometer. Determined angles for joints; hip flexion angle as 75°, knee flexion angle as 50° and ankle dorsiflexion as 10° plantarflexion as 40°.Y Balance Test (anterior, posterolateral, posteromedial) was used for evaluating dynamic balance. 30 participants were divided into two groups as thoracic mobility and lumbopelvic stability group. Both groups were given ankle strengthening exercises (dorsiflexion, plantarflexion, inversion and eversion) with resistive band. Home exercises were performed 3 days a week for a total of 3 sets of 10 repetitions. Thoracic mobility group was given; thoracic extension on foam roller, sidelying thoracic rotation, quadruped thoracic rotation, squat with extension and rotation. Lumbopelvic stabilization group was prescribed; bridge with alternate leg, single leg bridge, four point kneeling with arm and leg extension, side plank on front arm with knee flexed (right, left), sitting on a Swiss Ball and hip flexion.Sessions took approximately 50 minutes and exercise program was planned twice a week for 8 weeks, 16 sessions total. Both groups were given ankle strengthening exercises (dorsiflexion, plantarflexion, inversion and eversion) with resistive band. Home exercises were performed 3 days a week for a total of 3 sets of 10 repetitions.

Official Title
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Effect Of Thoracic Mobility Versus Lumbopelvic Stabilization Exercises On Lower Extremity Flexibility, Dynamic Balance And Proprioception In Patients With Chronic Ankle Instability

Conditions
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Chronic Ankle Instability

Intervention / Treatment
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* Procedure: Thoracic Mobility Rehabilitation
* Procedure: Lumbopelvic Stability Rehabilitation
* Procedure: Ankle Strengthening Home Exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being older than 18 years Having at least two previous lateral ankle sprain of same ankle. At least one episode of giving way wtihin previous 6 months. Having persistent symptoms during functional activities and being free of. Symptoms from any previous lower limb injuries. No other lower extremity injuries. Exclusion Criteria: Having any systemic illness (eg. Rheumatoid arthritis, DM). Any surgery history related to fractures or disorders. Getting steroid injection or physiotherapy intervention previous 6 months. Being a pregnant and existence of tumor.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The sample of study consist of patients with chronic ankle instability who gets 27 and less point from Cumberland Ankle Instability Tool. The study was conducted between November 2022 - January 2023 in Noi Physio Pilates Studio in İstanbul.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Thoracic Mobility Group<br>Thoracic Mobility Exercises Ankle Strengthening Home Exercises with resistive band | Procedure: Thoracic Mobility Rehabilitation<br>* Thoracic mobility exercises: Thoracic extension on foam roller, Sidelying thoracic rotation, Quadruped thoracic rotation, Squat with extension and rotation ( 10 reps x 3 set - 2 times x wk - 8 wk)<br>Procedure: Ankle Strengthening Home Exercises<br>* Ankle Strengthening exercises with resistive band (dorsiflexion, plantarflexion, inversion, eversion) (10 reps x 3 set - 3 times/wk)<br>|
| Experimental: Lumbopelvic Stability Group<br>Lumbopelvic stabilization exercises Ankle Strengthening Home Exercises with resistive band | Procedure: Lumbopelvic Stability Rehabilitation<br>* Lumbopelvic Stabilization Exercises : Bridge with alternate leg, Single leg bridge, Four point kneeling with arm and leg extension, Side plank on front arm with knee flexed (right, left), Sitting on a Swiss Ball and hip flexion (10 reps x 3 set - 2times/wk - 8 wk)<br>Procedure: Ankle Strengthening Home Exercises<br>* Ankle Strengthening exercises with resistive band (dorsiflexion, plantarflexion, inversion, eversion) (10 reps x 3 set - 3 times/wk)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumberland Ankle Instability Tool (CAIT) | CAIT is questionnaire' has 9 items with scores ranging from 0 to 30, with lower scores indicating worse stability | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Active Straight Leg Raise Test | It is used for evaluation of lower extremity flexibility. | 8 weeks | 
| Y Balance Test | Dynamic balance test for right and left leg including three directions (anterior, posterolateral, posteromedial) | 8 weeks | 
| Joint Position Sense Test | It is a test for measuring proprioception of joints. (Hip, knee, ankle) | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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chronic ankle instability, dynamic balance, proprioception, flexibility, thoracic mobility, lumbopelvic stability