Comparative Effects of Neuromuscular Training and Mobilization With Movement in Professional Athletes With Ankle Sprain

NCT06303141 | Completed

• 1 other identifier: LUC/CPGS/PGS/20230405/001
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The study aims to compare the effects of neuromuscular training and mobilization with movement on pain, range of motion, function, and disability in professional athletes with ankle sprain. Neuromuscular training focuses on improving neuromuscular control and stability, while mobilization with movement aims to restore joint mobility and function. By investigating the outcomes of these two interventions, the study seeks to provide insights into their effectiveness for managing ankle sprains in professional athletes.

Conditions

Ankle Injuries; Musculoskeletal Manipulations

Keywords

NEUROMUSCULAR TRAINING; MOBILIZATION WITH MOVEMENT; Professional Athletes; Ankle Sprain

Outcome Measures

Primary Outcomes (5)

• Numerical Pain Rating Scale for Pain

  The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an elevenpoint numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain).

  4 weeks

• Goniometer for Range of Motion

  A goniometer is a device that measures an angle or permits the rotation of an object to a definite position

  4 weeks

• Star balance excursion test for Balance

  The Star Excursion Balance Test is a reliable measure and a valid dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with lower extremity conditions, and to be responsive to training programs in healthy participants and those with lower extremity conditions.

  4 weeks

• Foot and ankle ability Measure for Functional Performance

  The FAAM is a self-report measure that assesses physical function of individuals with lower leg, foot, and ankle musculoskeletal disorders. 2) Sports subscale of 8 items. For each subscale patients are asked to answer each question with a single response that most clearly describes their condition within the past week.

  4 weeks

• Cumberland Ankle Instability

  The Cumberland Ankle Instability Tool (CAIT) is a self-report questionnaire used to assess the severity of chronic ankle instability (CAI). It consists of nine items designed to evaluate functional ankle instability, including symptoms of giving way, recurrent sprains, and perceived ankle function during daily activities. Each item is scored on a 0 to 30 scale, with higher scores indicating better ankle stability

  4 weeks

Secondary Outcomes (2)

• Agility T-test

  4 weeks

• Speed (20m sprint test)

  4 weeks

Study Arms (3)

Closed Chain Exercises

OTHER

Group A, serving as the control group, will undergo a structured rehabilitation regimen comprising closed chain exercises, icing, and bracing. The exercise component will focus on enhancing proprioception and strengthening the ankle joint. Participants will perform exercises including open eyes and closed eyes across arm movements for three sets lasting 60 seconds each, lateral step down exercises for three sets of 6-12 repetitions, semi-squat exercises for three sets of 6-12 repetitions, and Thera-band isometric exercises for three sets of 10-15 seconds each. These exercises are designed to promote ankle stability, improve range of motion, and enhance muscle strength. Additionally, icing and bracing will be utilized to reduce inflammation and provide external support to the injured ankle.

Other: Closed Chain exercises

Neuromuscular training

EXPERIMENTAL

Group B, designated as the experimental group, will undergo a comprehensive rehabilitation protocol combining neuromuscular training with closed chain exercises, icing, and bracing. The exercise regimen will target proprioception, neuromuscular control, and ankle stability. Participants will engage in a series of exercises including single leg raises for three sets lasting 30 seconds each, ankle eversion/inversion exercises for three sets of 25 repetitions, double hopping in place then out of place for three sets of 30 seconds, reaching exercises with feet and hands for three sets lasting 30-60 seconds each, and wobble board exercises for three sets lasting 30-60 seconds each. These exercises are aimed at improving balance, coordination, and muscle strength around the ankle joint. The addition of neuromuscular training enhances the proprioceptive feedback and control, which is crucial for injury prevention and functional recovery in athletes with ankle sprains.

Other: Neuromuscular Training

Mobilization with movement

EXPERIMENTAL

Group C, designated as an experimental group, will undergo a unique intervention combining mobilization with movement techniques, closed chain exercises, icing, and bracing. The focus of this intervention is to address joint dysfunctions and pain modulation while improving range of motion (ROM) in athletes with ankle sprains. Participants will receive joint mobilization with movement techniques, following the Mulligan approach, aimed at restoring normal joint mechanics and function. The protocol will involve three sets of six oscillations or glides each, targeting specific joint restrictions and impairments associated with ankle sprains. By integrating manual therapy with exercise and adjunct modalities like icing and bracing, this comprehensive approach aims to optimize joint function, reduce pain, and enhance overall rehabilitation outcomes in professional athletes with ankle injuries.

Other: Mobilization with Movement

Interventions

Closed Chain exercises OTHER

Open eyes and closed eyes across arm" (3 sets x 60 sec) Lateral step down (3 sets x 6-12 reps) Semi-Squat Exercise (3sets x 6-12 reps) Thera-band isometric (3 sets x 10 -15sec each)

Closed Chain Exercises

Neuromuscular Training OTHER

Neuromuscular Training Exercise: * Single Leg Raise (3 sec x 30sec each) * Ankle eversion/inversion (3 sets x 25 reps) * Double Hopping in place then out of place (3 sets 30 sec) * Reach with feet (3 sets x 30-60 sec each) * Reach with hands (3 sets x 30-60 sec each) * Wobble board Exercise (3sets x 30-60sec each

Neuromuscular training

Mobilization with Movement OTHER

Joint mobilization with movement (by Mulligan) refers to manual therapy techniques that are used to modulate pain and treat joint dysfunctions that limit the range of motion (ROM). (3 sets x 6 oscillation/glide each)

Mobilization with movement

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Athletes will be included:
• Rackets player,
• Basketball players
• Runners
• Foot-ballers players
• Soccer players,
• and Volley-ball players
• Gender: both male and female
• Age: 18 to 35 years old
• Training: 15-20/ week
• Sustained an ankle sprain grade II and III
• With no Functional Ankle Instability (Greek version of the Identification functional ankle instability questionnaire IdFAI, score \< 10) will be used in order to identify athletes with FAI

You may not qualify if:

• Any vestibular or balance disorders (1)
• History of surgery and trauma of a lower limb since last 6 months
• Athletes with pain related to calf muscles and achillies tendon
• Co-morbidities: Diabetes, Hypertension, etc

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Pakistan Sports Board

Lahore, Punjab Province, Pakistan

Location

MeSH Terms

Conditions

Ankle Injuries

Interventions

Movement

Condition Hierarchy (Ancestors)

Leg Injuries; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Aamir Gul Memon, PhD Scholar

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: the assessor who take the reading is blind
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 4, 2024
• First Posted: March 12, 2024
• Study Start: April 5, 2023
• Primary Completion: September 5, 2023
• Study Completion: September 10, 2023
• Last Updated: March 12, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)