Dynamic Neuromuscular Stability Exercises With and Without Rhythmic Auditory Stimulation in Lateral Ankle Sprain

NCT07726810 | Recruiting

• 1 other identifier: REC/RCR & AHS/25/0441
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

To examine the effects of Dynamic Neuromuscular Stability exercises with and without Rhythmic Auditory Stimulation on balance, proprioception, and functional performance in badminton players with lateral ankle sprain.

Conditions

Ankle Sprain; Lateral Ankle Sprain; Lateral Ankle Instability; Balance; Proprioception; Dynamic Neuromuscular Stabilization (DNS)

Keywords

Rhythmic Auditory Stimulation

Outcome Measures

Primary Outcomes (3)

• Joint Position Sense Test

  JPS evaluates proprioception by measuring a subject's ability to actively or passively reproduce a joint angle without visual input. It has shown moderate to high reliability (ICC = 0.70-0.93) and is a valid measure of sensorimotor deficits following lateral ankle injuries. Pre and post assessment will be done.

  6 weeks

• Star Excursion Balance Test

  The SEBT is a dynamic balance test that assesses neuromuscular control and postural stability during multi-directional reaching tasks while standing on one leg. It demonstrates high reliability (ICC = 0.85-0.96) and good validity in identifying lower limb deficits, especially following ankle sprains and in athletic populations. Pre and post assessment will be done.

  6 weeks

• Sports Ankle Rating Scale (SARS)

  The SARS is a subjective questionnaire designed to assess functional limitations, pain, and instability related to ankle injuries in athletic populations. It demonstrates good reliability (Cronbach's alpha \> 0.80) and acceptable validity when compared with clinical outcomes. The scale includes sections on pain, function during sports, and instability episodes to provide a comprehensive ankle health profile. Pre and post assessment will be done.

  6 weeks

Study Arms (2)

Dynamic Neuromuscular Stabilization with Rhythmic Auditory Stimulation

EXPERIMENTAL

The intervention was progressively advanced over six weeks. Baseline treatment included warm-up exercises, stretching, and basic balance training with rhythmic auditory cues. During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening. In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced with increased rhythmic cueing. By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements synchronized with rhythmic auditory stimulation to enhance neuromuscular control and functional performance.

Other: Dynamic Neuromuscular Stabilization with Rhythmic Auditory Stimulation

Dynamic Neuromuscular Stabilization Alone

ACTIVE COMPARATOR

The intervention was progressively advanced over six weeks. Baseline treatment included warm-up exercises, stretching, and basic balance training. During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening. In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced. By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements to enhance neuromuscular control, balance, and functional performance.

Other: Dynamic Neuromuscular Stabilization Alone

Interventions

Dynamic Neuromuscular Stabilization Alone OTHER

The intervention was progressively advanced over six weeks. Baseline treatment included warm-up exercises, stretching, and basic balance training. During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening. In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced. By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements to enhance neuromuscular control, balance, and functional performance.

Also known as: DNS

Dynamic Neuromuscular Stabilization Alone

Dynamic Neuromuscular Stabilization with Rhythmic Auditory Stimulation OTHER

The intervention was progressively advanced over six weeks. Baseline treatment included warm-up exercises, stretching, and basic balance training with rhythmic auditory cues. During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening. In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced with increased rhythmic cueing. By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements synchronized with rhythmic auditory stimulation to enhance neuromuscular control and functional performance.

Also known as: DNS, RAS

Dynamic Neuromuscular Stabilization with Rhythmic Auditory Stimulation

Eligibility Criteria

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

You may qualify if:

• Age 18-30 years
• Both male and female genders
• Diagnosed with Grade I or II lateral ankle sprain (subacute to chronic phase)
• Within 2-8 weeks post-injury

You may not qualify if:

• History of ankle surgery
• Vestibular, neurological, or hearing disorders
• Acute pain prevents participation
• Current involvement in other rehab programs
• Any fracture or other injury
• Any systemic illness
• Any inflammatory disease (Rheumatoid arthritis, gout)

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Sports Board of Punjab

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

Related Publications (10)

• Igusa T, Kobayashi T, Uchida H, Tsuchiya K, Akiba T, Sema S, Kaneko S, Yoshita T, Nagai S, Tanaka Y, Kikuchi S, Hirao K. Effect of gait training using rhythmic auditory stimulation on gait speed in older adults admitted to convalescent rehabilitation wards: A study protocol for a pilot randomized controlled clinical trial. Contemp Clin Trials Commun. 2023 Apr 1;33:101125. doi: 10.1016/j.conctc.2023.101125. eCollection 2023 Jun.

  PMID: 37091510 BACKGROUND

• Karami M, Jamehbozorgi A, Salemi P, Rezaei M. The Effect of 6 Weeks Neuromuscular Training On Muscle Strength, Balance, Range of Motion & Proprioception In Males With Lateral Ankle Sprain. Journal of Modern Rehabilitation. 2025.

  BACKGROUND

• Yesilkir S, Sahin GE. Dynamic neuromuscular stabilization training for chronic ankle instability: A randomized controlled trial in amateur athletes. J Back Musculoskelet Rehabil. 2026 Jul;39(4):1157-1169. doi: 10.1177/10538127251338170. Epub 2025 May 11.

  PMID: 40350619 BACKGROUND

• Meng L, Wang Y, Wang Z, Liu Y, Tan Y, Zhang Y, Wei X, Mao X, Zhang Q. Effects of auditory rhythmic adaptation on lower limb joint mechanics during single-leg drop landings in individuals with functional ankle instability. Front Hum Neurosci. 2025 Jul 2;19:1579260. doi: 10.3389/fnhum.2025.1579260. eCollection 2025.

  PMID: 40672743 BACKGROUND

• Mansouri M, Saki F. The Effectiveness of Neuromuscular Training With and Without Cognitive Intervention on Dynamic Balance and Proprioception of Female Athletes Prone to Ankle Sprain Injury: A Randomized Control Trial.

  BACKGROUND

• Kim KM, Kim JS, Needle AR. Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control. J Sport Health Sci. 2024 Jul;13(4):559-568. doi: 10.1016/j.jshs.2024.02.005. Epub 2024 Feb 28.

  PMID: 38428732 BACKGROUND

• Mansur H, Durigan JLQ, Contessoto S, Maranho DA, Nogueira-Barbosa MH. Evaluation of the Healing Status of Lateral Ankle Ligaments 6 Weeks After an Acute Ankle Sprain. J Foot Ankle Surg. 2024 Nov-Dec;63(6):637-645. doi: 10.1053/j.jfas.2024.07.004. Epub 2024 Jul 25.

  PMID: 39067610 BACKGROUND

• Taketomi S, Kawaguchi K, Mizutani Y, Takei S, Yamagami R, Kono K, Murakami R, Kage T, Arakawa T, Fujiwara S, Tanaka S, Ogata T. Factors Associated With a Lateral Ankle Sprain in Young Female Soccer Players: A Prospective Cohort Study. Orthop J Sports Med. 2024 Feb 26;12(2):23259671231221481. doi: 10.1177/23259671231221481. eCollection 2024 Feb.

  PMID: 38410169 BACKGROUND

• Liu Z, Yamaguchi R, Fu S, Zhao H, Li Y, Kobayashi Y, Gong Y, Kumai T. Epidemiology of ankle sprain and chronic ankle instability in elite adolescent dancesport athletes. Phys Sportsmed. 2025 Apr;53(2):119-128. doi: 10.1080/00913847.2024.2418283. Epub 2024 Oct 20.

  PMID: 39412831 BACKGROUND

• Wagemans J, Dingenen B, Clockaerts S, Bleakley C. Physiotherapists Approach in Lateral Ankle Sprain Rehabilitation: A Survey Study. J Sport Rehabil. 2025 Apr 4;35(1):31-38. doi: 10.1123/jsr.2024-0442. Print 2026 Jan 1.

  PMID: 40174890 BACKGROUND

MeSH Terms

Conditions

Ankle Injuries

Condition Hierarchy (Ancestors)

Leg Injuries; Wounds and Injuries

Study Officials

• Sidra Shafique, MS

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, PhD

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcome assessor will be blinded to avoid biasness.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Randomized Controlled trial study

Study Record Dates

• First Submitted: July 21, 2026
• First Posted: July 24, 2026
• Study Start: July 14, 2026
• Primary Completion (Estimated): August 14, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: July 24, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)