The Effect of Additional Neurodynamic Intervention in Patients With Chronic Ankle Instability

NCT05090423 | Completed Results

• 1 other identifier: YM110112F
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Approximately 40% of acute ankle sprain would develop into chronic ankle instability (CAI). Chronic ankle instability is characterized by pain, repeated sprains and giving way. Recently, the pathomechanical impairment, sensory-perceptual impairment and motor-behavioral impairment have been documented in the chronic ankle instability model. Previous research revealed that compared to the control subjects, people with CAI had lower pressure pain threshold (PPT). This increased mechanosensitivity of the neural tissues around the ankle might account for pain and dysfunction in people with CAI. Also, the other study indicated that in subjects following ankle inversion sprain there is greater restriction of knee extension on the injured side compared to non-injured side in the slump test with the ankle plantar flexion and inversion, which may suggest the restriction in mobility of the common peroneal tract. However, the effects of neurodynamic intervention, which addresses the mechanosensitivity problems, in people with CAI are still unclear. Therefore, the aim of the study is to investigate the effect of additional neurodynamic intervention on the ankle range of motion, mechanosensitivity, balance performance and self-reported function.

Conditions

Ankle Sprains

Keywords

Chronic ankle instability; Neurodynamics; Mechanosensitivity

Outcome Measures

Primary Outcomes (6)

• Pressure Pain Threshold- Anterior Talofibular Ligament

  Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the anterior talofibular ligament. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

  Within one week after 12 treatment sessions

• Pressure Pain Threshold- Calcaneofibular Ligament

  Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the calcaneofibular ligament. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

  Within one week after 12 treatment sessions

• Active Knee Extension Range of Motion During Slump Test in Ankle Plantar Flexion With Inversion

  The subjects sat on the edge of the bed without touching the ground with their feet. The physical therapist assisted the subjects in maintaining a neutral pelvis position. First, the subjects were asked to flex the neck, trunk, and finally the lumbar to tighten the back. Second, while the subjects plantarflexed and inverted the ankle, they performed the knee extension movement, and the angle of knee motion was recorded. Participants performed three practice trials followed by three test trials and averaged the three tests.

  Within one week after 12 treatment session

• Pressure Pain Threshold- Peroneal Brevis Muscle

  Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the peroneal brevis muscle. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

  Within one week after 12 treatment sessions

• Pressure Pain Threshold- Peroneal Longus Muscle

  Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the peroneal longus muscle. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

  Within one week after 12 treatment sessions

• Pressure Pain Threshold- Common Peroneal Nerve

  Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the common peroneal nerve. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

  Within one week after 12 treatment sessions

Secondary Outcomes (9)

• Y Balance Test- Anterior Direction

  Within one week after 12 treatment sessions

• The Foot and Ankle Ability Measures- Sports

  Within one week after 12 treatment sessions

• The Foot and Ankle Ability Measures- Activity of Life

  Within one week after 12 treatment sessions

• Weight Bearing Lunge Test

  Within one week after 12 treatment sessions

• Hamstring Flexibility

  Within one week after 12 treatment sessions

Study Arms (2)

Experimental: balance training alone

EXPERIMENTAL

The subjects will receive 12 sessions of balance training over six to eight weeks.

Other: balance training alone

Experimental: balance training and neurodynamic intervention for the common peroneal nerve

EXPERIMENTAL

The subjects will receive the 12 sessions of balance training and neurodynamic intervention for the common peroneal nerve over six to eight weeks.

Other: balance training and neurodynamic intervention for the common peroneal nerve

Interventions

balance training alone OTHER

The subjects will warm up to stretch the lower extremity for 5 minutes. The physical therapist will instruct the patient how to use the foot tripod within 5 minutes. And then, giving him or her balance training. At the first, the patient double legs stand on the ground to throw and catch a ball for 30 seconds, and then one leg stand on the ground to throw and catch a ball for 30 seconds. When finished, the patient can take 1 minutes rest. Second, the patient will finish the prescribed the task stand on different materials, which included the exercise mat, dynair, bosu and foam roller.

Experimental: balance training alone

balance training and neurodynamic intervention for the common peroneal nerve OTHER

The physical therapist will give the patient neurodynamic intervention for the common peroneal nerve, which is performed slider the nerve 2 seconds. The slider technique is repeated 30 seconds for 4 times, each time can be take a rest 1 minutes. The physical therapist will instruct the patient how to use the foot tripod within 5 minutes. And then, giving him or her balance training. At the first, the patient double legs stand on the ground to throw and catch a ball for 30 seconds, and then one leg stand on the ground to throw and catch a ball for 30 seconds. When finished, the patient can take 1 minutes rest. Second, the patient will finish the prescribed the task stand on different materials, which included the exercise mat, dynair, bosu and foam roller.

Experimental: balance training and neurodynamic intervention for the common peroneal nerve

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• History of at least two ankle sprains in the same leg, of which the first sprain is more than one year
• Leading to at least one interrupted day of desired physical activity
• The Cumberland Ankle Instability Tool (CAIT) ≦ 24
• Slump test in ankle plantar flexion with inversion: positive

You may not qualify if:

• Pregnancy
• Surgical treatments
• Previous fractures in either lower extremity
• Any concomitant lower extremity pathology, for example, vascular disease, osteoarthritis and rheumatoid arthritis
• Significant pain or injury to the lumbar or cervical spine
• Regular use of medication: anti-inflammatory drugs, painkiller, steroid or muscle relaxants
• Previous manual therapy or exercise interventions received on the lower extremity within the previous 3 months

Sponsors & Collaborators

• National Yang Ming Chiao Tung University: lead

Study Sites (1)

National Yang Ming University

Taipei, 11221, Taiwan

Location

MeSH Terms

Conditions

Ankle Injuries

Condition Hierarchy (Ancestors)

Leg Injuries; Wounds and Injuries

Results Point of Contact

• Title: Chen Hsin-I, Physical Therapist
• Organization: National Yang Ming Chiao Tung University

hsini0329@gmail.com

+886-982-641-541

Study Officials

• Shih Yi-Fen, Ph.D

  Department of Physical Therapy and Assistive Technology, National Yang-Ming

  STUDY DIRECTOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: September 27, 2021
• First Posted: October 22, 2021
• Study Start: January 5, 2022
• Primary Completion: June 30, 2024
• Study Completion: June 30, 2024
• Last Updated: January 15, 2026
• Results First Posted: January 15, 2026

Record last verified: 2025-12

Locations

TW (1)