NMES With PNF for Ankle Sprain Rehabilitation

NCT07190599 | Recruiting

• 1 other identifier: NCKU HREC-E-114-0093-2
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Ankle sprains are one of the most common sports injuries. In some people, they can lead to chronic ankle problems that affect daily life and sports performance. In this study, we want to see if combining neuromuscular electrical stimulation (NMES) with proprioceptive neuromuscular facilitation (PNF) can help improve these problems. We plan to recruit 60 participants, with 30 in the experimental group and 30 in the control group. The experimental group will receive PNF stretching with NMES, while the control group will only do PNF stretching. Both groups will have training three times a week for four weeks (12 sessions in total). We will test participants before and after the program, looking at pain, balance, range of motion, proprioception, strength, joint mobility, and functional limitations. We expect that 12 sessions will help improve chronic ankle problems, and that NMES combined with PNF will be more effective than PNF alone.

Conditions

Ankle Sprain

Keywords

Ankle sprain; Balance; Proprioception; Strength; Pain; Range of motion

Outcome Measures

Primary Outcomes (7)

• Star Excursion Balance Test, SEBT

  Balance ability will be assessed using the Star Excursion Balance Test (SEBT). Participants stand barefoot at the center of a grid with eight lines extending at 45° angles. They are instructed to reach with the distal part of the foot to touch the farthest point along each line while maintaining a standing position. The examiner recorded the reached distance in centimeters, measured from the center of the grid to the point touched by the participant's big toe.

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Proprioception - ankle dorsiflexion (degrees)

  Proprioception of the affected ankle will be measured using the Micro FET3 inclinometer. The examiner moves the foot to a target angle (hold for 10 seconds), and then returned to the starting position. Participants then actively reproduces the angle. The difference between the target and reproduced angles represented proprioceptive accuracy.

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Proprioception - ankle plantarflexion (degrees)

  Proprioception of the affected ankle will be measured using the Micro FET3 inclinometer. The examiner moves the foot to a target angle (hold for 10 seconds), and then returned to the starting position. Participants then actively reproduces the angle. The difference between the target and reproduced angles represented proprioceptive accuracy.

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Muscle strength - ankle dorsiflexors (kg)

  A dynamometer (Micro FET3) will be placed on the dorsal surfaces of the metatarsals to measure strength of dorsiflexors.

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Muscle strength - ankle plantarflexors (kg)

  A dynamometer (Micro FET3) will be placed on the plantar surfaces of the metatarsals to measure strength of plantarflexors.

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Range of motion - Ankle dorsiflexion (degrees)

  The axis of the goniometer was placed at the lateral malleolus, the stationary arm aligned with the lateral fibula, and the moving arm aligned with the fifth metatarsal. Participants will be instructed to actively move the ankle from 0° starting position to maximal dorsiflexion.

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Range of motion - Ankle plantarflexion (degrees)

  The axis of the goniometer was placed at the lateral malleolus, the stationary arm aligned with the lateral fibula, and the moving arm aligned with the fifth metatarsal. Participants will be instructed to actively move the ankle from 0° starting position to maximal plantarflexion

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

Secondary Outcomes (3)

• The Foot and Ankle Disability Index (FADI)

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Knee to wall test

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

• Visual analog scale (VAS)

  1. Baseline (Day 1, prior to intervention) 2. Post-intervention (after 12 sessions, Week 4)

Study Arms (2)

NMES with PNF

EXPERIMENTAL

The experimental group will receive proprioceptive neuromuscular facilitation (PNF) stretching combined with neuromuscular electrical stimulation (NMES)

Behavioral: Proprioceptive neuromuscular facilitation (PNF) with neuromuscular electrical stimulation (NMES)

PNF only

ACTIVE COMPARATOR

The control group will receive PNF stretching only.

Behavioral: Proprioceptive neuromuscular facilitation (PNF) only

Interventions

Proprioceptive neuromuscular facilitation (PNF) with neuromuscular electrical stimulation (NMES) BEHAVIORAL

The NMES was applied during the plantarflexor contraction phase of the PNF stretching (described as below). Two electrodes (4 × 8 cm) were used for stimulation, placed on the triceps surae of the affected side: one positioned 5 cm below the popliteal fossa, and the other placed 5 cm below the first electrode, directly over the triceps surae. The hold-relax technique of proprioceptive neuromuscular facilitation (PNF) will be applied to stretch the triceps surae muscle. It will be performed ten times on the affected limb during each treatment session, lasting approximately 10 minutes in total. Participants will receive interventions three times per week for four weeks, for a total of twelve sessions.

NMES with PNF

Proprioceptive neuromuscular facilitation (PNF) only BEHAVIORAL

The hold-relax technique will be applied to stretch the triceps surae muscle. It will be performed ten times on the affected limb during each treatment session, lasting approximately 10 minutes in total. Participants will receive interventions three times per week for four weeks, for a total of twelve sessions.

PNF only

Eligibility Criteria

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

You may qualify if:

• Aged 18-30 years
• Adults with a history of ankle sprain

You may not qualify if:

• Participants with ankle fractures, dislocations, grade III ankle sprains, bony restrictions, swelling, neuropathy, or any other neuromuscular disorders are excluded.

Sponsors & Collaborators

• Fooyin University: lead

Study Sites (1)

Fooyin University

Kaohsiung City, No. 151, Jinxue Road, Daliao District, Taiwan

RECRUITING

MeSH Terms

Conditions

Ankle Injuries; Pain

Interventions

Muscle Stretching Exercises; Single Person

Condition Hierarchy (Ancestors)

Leg Injuries; Wounds and Injuries; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Marital Status; Family Characteristics; Demography; Population Characteristics; Socioeconomic Factors

Central Study Contacts

I-Hsuan Chen

CONTACT

886-7-7811151 #7043; Y0894@fy.edu.tw

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 17, 2025
• First Posted: September 24, 2025
• Study Start: October 1, 2025
• Primary Completion: March 31, 2026
• Study Completion (Estimated): July 31, 2026
• Last Updated: November 17, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)