Effects of Neurocognitive Training on Chronic Ankle Instability

NCT07004114 | Completed

• 1 other identifier: 2023/13
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

Aim: This study aimed to investigate the effects of neurocognitive training on pain, proprioception, injury-related fear, functional, and neurocognitive performance in athletes with chronic ankle instability (CAI). Materials and Methods: A total of 30 athletes with CAI, with a mean age of 11.10±1.06 years and residing in Balıkesir, were included in the study. Participants were randomly assigned into two groups using simple randomization: the intervention group (n=15) and the control group (n=15). Two participants from the control group were excluded from the final analyses due to missing post-intervention assessments. The intervention group received a neurocognitive training program conducted twice a week for four weeks, following an initial familiarization week. The training was progressively administered on flat ground, balance mat, BOSU, and inverted BOSU. Both groups were evaluated before and after the 4-week intervention using the following measures: the Identification of Functional Ankle Instability (IdFAI), the Cumberland Ankle Instability Tool (CAIT), pain intensity, proprioception, fear of re-injury, Y Balance Test (YBT), Side Hop Test, Reactive Balance Test (RBT), and Upper Extremity Choice Reaction Time Test. Results: The results were analyzed.

Conditions

Chronic Ankle Instability; Balance; Neurocognitive

Keywords

Cognitive Load; Ankle Instability; RBT

Outcome Measures

Primary Outcomes (3)

• Functional Ankle Instability Assessment Using the Identification of Functional Ankle Instability Questionnaire (IDFAI)

  The IDFAI is a self-reported questionnaire consisting of 9 items designed to identify the presence and severity of functional ankle instability. Scores range from 0 to 37, with higher scores indicating greater instability. A score above 11 suggests the presence of instability. Scores are unitless numeric values representing the severity of symptoms and frequency of ankle sprains.

  from the beginning of the study until the end of the 4th week

• Functional Ankle Instability Evaluation Using the Cumberland Ankle Instability Tool (CAIT)

  The CAIT is a self-assessment tool with 9 items measuring subjective ankle instability. Scores range from 0 (severe instability) to 30 (no instability). A score of 27 or below indicates functional ankle instability. The score is a unitless numeric value that reflects the level of perceived instability and risk of recurrent sprains.

  from the beginning of the study until the end of the 4th week

• Pain Severity Assessment-Visual Analog Scale (VAS)

  The Visual Analog Scale (VAS) is a 10 cm line ranging from "No pain" to "Worst imaginable pain." Participants mark their pain intensity on the line, which is measured in centimeters to quantify pain severity. This unitless numeric score reflects pain intensity at rest, during training, and post-training in ankles with instability history.

  from the beginning of the study until the end of the 4th week

Other Outcomes (7)

• Proprioception Assessment with Reposition Test (Ankle Dorsiflexion and Plantarflexion Angles)

  from the beginning of the study until the end of the 4th week

• The Sport Injury Anxiety Scale (SIAS)

  from the beginning of the study until the end of the 4th week

• Postural Stability Measurement Using Multireha Portable Balance Device (Sway in Millimeters During Single-Leg Stance)

  from the beginning of the study until the end of the 4th week

Study Arms (2)

Neurocognitive training group

EXPERIMENTAL

Neurocognitive training is a program developed by incorporating motor learning strategies and cognitive challenges into neuromuscular training. Cognitive challenges included tasks requiring quick reactions, motor-motor or cognitive-motor tasks (dual-task), congruent and incongruent tasks, exercises combined with mathematical calculations (working memory), and response inhibition tasks.

Other: Neurocognitive training group

Control group

NO INTERVENTION

The control group continued their training and no additional intervention was applied. Four weeks after their initial assessment, the same assessments were applied again with the study group.

Interventions

Neurocognitive training group OTHER

Neurocognitive training is a rehabilitation approach that, unlike traditional treatment methods which primarily focus on improving physical performance, emphasizes cognitive functions and psychometric skills. It is a program developed by integrating motor learning strategies and cognitive challenges into neuromuscular training. These cognitive challenges include tasks requiring quick reactions, motor-motor or cognitive-motor tasks (dual-task), congruent and incongruent tasks, exercises involving mathematical calculations (working memory), and response inhibition tasks.

Neurocognitive training group

Eligibility Criteria

• Age: 10 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Aged between 10 and 18 years
• At least 2 years of active athletic participation
• History of ankle sprain with at least 2 inflammatory symptoms (e.g., pain, swelling)
• The most recent sprain occurred at least 3 months prior to the study start date
• A score of 11 or above on the FABIT (Simon et al., 2012)
• A score of ≤27 on the CAIT (Yin et al., 2022)
• Willingness to participate in the study

You may not qualify if:

• History of hip/pelvis, knee, or ankle surgery within the past year
• History of ankle fracture
• Diagnosis of a neurological disorder
• Presence of vestibular disorders

Sponsors & Collaborators

• Balikesir University: lead

Study Sites (1)

Balikesir University

Balıkesir, Bigadiç, Turkey (Türkiye)

Location

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  BACKGROUND

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• 1) Akca NK, Aydın G, Gümüş K. Lomber disk hernili hastaların vücut mekanikleri bilgi düzeyleri ile ağrı şiddeti arasındaki ilişki. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2013;2(1):66-77.

  BACKGROUND

Study Design

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

Study Record Dates

• First Submitted: May 17, 2025
• First Posted: June 4, 2025
• Study Start: September 6, 2023
• Primary Completion: November 1, 2024
• Study Completion: March 3, 2025
• Last Updated: June 4, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)