Clinical trial NCT06898554: Spinal and Supraspinal Control in Chronic Ankle Instability
Official title: Cross-Education Effect of Structured Balance Training Program on Spinal and Supraspinal Control in Athletes With Chronic Ankle Instability
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Ankle Injuries
Ankle Sprains
Keywords: ankle, joint instability, cross-education, rehabilitation
Lead sponsor: Yeditepe University
Sponsor class: OTHER
Collaborators: name: Yeditepe University
name: Yeditepe University Hospital
First posted: 2025-03-27
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Maximum age (years): 25
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Ankle sprains are common sports injuries that often lead to chronic ankle instability (CAI). Patients with CAI experience deficits in neuromuscular control (NMC), including proprioception and strength. It is believed that damage to the ankle's ligament mechanoreceptors and the peroneal nerve after the initial ankle sprain can cause alterations in NMC, resulting in postural control and dynamic joint stability dysfunction. Inflammation related to recurrent ankle sprains may also contribute to neuromuscular impairments. Evidence suggests that bilateral postural control deficits occur after an ankle sprain, suggesting alterations in the central nervous system (CNS). Rehabilitation for CAI has been shown to lead to bilateral improvements in NMC, potentially due to neural alterations at both the spinal and supraspinal levels. Cross-education, which refers to the muscular crossed effect of unilateral training, has also been proposed as a mechanism for improving contralateral strength in neurologically healthy individuals. While the exact mechanisms underlying cross-education are not yet fully understood, evidence suggests that it involves neural adaptations at both spinal and supraspinal levels. This study aims to investigate the cross-education effect of a 6-week, unilateral balance training on corticomotor excitability, motor neuron pool excitability, and static and dynamic balance in athletes with chronic ankle instability.


Eligibility criteria: Inclusion Criteria:

* Volunteering to participate in the study,
* Being an athlete between the ages of 18-25,
* Being a player in a field team sport such as basketball, volleyball, and handball,
* Having a history of at least 2 significant grade II LAS diagnosed by a physician,
* Related inflammatory symptoms, "giving away" sensation, obtaining a score ≤25 from the Cumberland Ankle Instability Tool (CAIT),
* A score \<90% for the activities of daily living subscale and \<80% for the sport subscale from the Foot and Ankle Ability Measure,
* Recurrent episodes of LAS of the injured ankle which occurred within at least 12 months.

Exclusion Criteria:

* Acute injury of lower extremity musculoskeletal structures in the last three months,
* Orthopedic surgery in any of the lower extremities,
* Bilateral ankle instability,
* Vestibular or balance disorder

Primary outcomes:
measure: Proprioceptive-Stabilometric Assessment
timeFrame: at the baseline and end of the intervention, 8 weeks
measure: Transcranial Magnetic Stimulation
timeFrame: at the baseline and end of the intervention, 8 weeks
measure: Hoffman Reflex
timeFrame: at the baseline and end of the intervention, 8 weeks
Secondary outcomes:
measure: Cumberland Ankle Instability Tool
timeFrame: at the baseline and end of the intervention, 8 weeks
measure: Foot and Ankle Ability Measure (FAAM)
timeFrame: at the baseline and end of the intervention, 8 weeks
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Yeditepe University Koşuyolu Hospital
city: Istanbul
country: Turkey
facility: Yeditepe University
Study officials:
affiliation: Yeditepe University Hospital
name: Berrin Aktekin, MD, Professor
role: PRINCIPAL_INVESTIGATOR
affiliation: Yeditepe University
name: Feyza Şule Hantal, PHd
role: PRINCIPAL_INVESTIGATOR
References: