Clinical Research Directory

The Effect of Cognitive Dual-Task on Athletic Performance Parameters in Volleyball Players With and Without Chronic Ankle Instability

The aim of this study is to investigate the effect of the cognitive dual-task on athletic performance parameters in volleyball players with and without chronic ankle instability. In addition, it will examine how a pathology in the lower extremity affects upper extremity function.

Postural Control in Amateur Footballers With Chronic Ankle Instability

This study will investigate static and dynamic postural control characteristics in male amateur football players with chronic ankle instability (CAI) compared with football players without ankle instability. Participants will undergo standardized biomechanical assessments using a force-platform-based postural analysis system to quantify postural sway under eyes-open and eyes-closed conditions and to evaluate direction-specific limits of stability performance. In addition to conventional between-group comparisons, objective balance and stabilization variables will be used to develop supervised machine-learning classification models. These models will examine whether athletes demonstrating CAI-like functional patterns can be identified based solely on biomechanical performance data, independent of self-reported instability questionnaires. The results are expected to enhance understanding of neuromuscular control deficits associated with chronic ankle instability and to support the development of objective, performance-based assessment approaches for football players. The aim of this study is to determine the differences in static and dynamic postural control between amateur football players with and without chronic ankle instability and to evaluate whether multidimensional biomechanical balance parameters can be used to objectively characterize CAI-related functional profiles using machine-learning-based analysis.

fMRI Study on Cerebral Localization and Network Mechanisms of rTMS in Chronic Ankle Instability Treatment

Chronic ankle instability (CAI) is a common sports injury that often leads to recurrent injuries and functional deficits. While conventional rehabilitation can restore ankle stability, the underlying neurophysiological mechanisms remain poorly understood, and the long-term efficacy of current treatments is limited. This study aims to investigate the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) in combination with conventional ankle stability training for CAI and to evaluate its impact on ankle-stabilizing muscle activation and cerebral cortex excitability. The study design is a single-center, randomized, single-blind, parallel-controlled trial. Participants with CAI will be randomly assigned to either an ankle stability training plus real rTMS group or an ankle stability training plus sham rTMS group. The primary outcome measure is the Cumberland Ankle Instability Tool (CAIT) score, which assesses the severity of ankle instability. Secondary outcomes include the Karlsson-Peterson Ankle Function Score (KPAFS), American Orthopedic Foot and Ankle Society Score (AOFAS), surface electromyography (sEMG) data, and task-based functional magnetic resonance imaging (fMRI) data. These secondary outcomes will provide a comprehensive evaluation of ankle function, muscle activation patterns, and neural activity changes. The intervention will consist of a 4-week program, with participants receiving rTMS sessions three times per week. Each rTMS session will target key brain regions. The ankle stability training will include exercises designed to improve strength, balance, and proprioception. The sham rTMS group will receive identical ankle stability training but with a placebo rTMS protocol to ensure blinding. Data will be collected at baseline, 2 weeks, and 4 weeks. The primary outcome, CAIT score, will be used to assess the overall improvement in ankle stability. The KPAFS and AOFAS scores will provide additional measures of ankle function and pain. sEMG data will be collected during specific functional tasks to evaluate the activation patterns of the tibialis anterior, peroneus longus, and other relevant muscles. Task-based fMRI will be used to assess changes in brain activity in motor and sensory areas before and after the intervention. Statistical analyses will be performed using SPSS 22.0. Data will be presented as mean ± standard deviation. Between-group differences will be compared using independent samples t-tests, and overall differences across time points will be assessed via two-way repeated-measures ANOVA or mixed-effects models. Post-hoc analyses will be conducted to identify specific time points and conditions where significant differences occur. The study timeline spans from March 2025 to December 2026, including participant recruitment, intervention implementation, data collection, and analysis, as well as manuscript drafting. This research aims to provide new insights into the neurophysiological mechanisms of CAI and to offer a novel, evidence-based approach to the rehabilitation of CAI, potentially improving long-term outcomes and reducing the risk of recurrent injuries.

Effects of Ankle Evertor Fatigue on Perturbed Gait

This study will investigate the effects of ankle evertor muscle fatigue on gait stability during treadmill walking with mechanical perturbations. Participants will walk at two speeds (0.4 m/s and 1.0 m/s) while random medial and lateral perturbations (\<10% body weight) are applied to the pelvis. Surface EMG from ankle muscles and center of pressure (COP)-based gait parameters (e.g., step length, step width, single support duration, COP trajectory) will be analyzed before and immediately after an isotonic fatigue protocol of the ankle evertors.

Effects of Pilates Training on Ankle Proprioception, Postural Control and Performance in Footballers With Chronic Ankle Instability

This study aims to contribute to the effects of Pilates training on ankle proprioception, postural control, and performance in football players with chronic ankle instability. Eighty eight participants will be randomly allocated into two groups and will receive both Pilates and balance training for eight weeks. it is hypothesized that the group that will receive Pilates taring will produce greater improvements as compared to other group.

Effects of Ankle Evertor Fatigue on Force Sense and Neuromuscular Activation in Subjects With Chronic Ankle Instability

The goal of this observational study is to investigate whether ankle evertor muscle fatigue impairs force perception and alters neuromuscular activation patterns during submaximal isometric contractions, and whether these effects differ between individuals with chronic ankle instability (CAI) and individuals without CAI.

Validation of a Portable Ankle Arthrometer

The purpose of this study is to assess the validity and reliability of a prototype portable ankle arthrometer in various populations. There are two aims to this study. Aim 1 will look to determine the reliability and validity of a prototype portable ankle arthrometer on young adults with no history of ankle sprain, copers, and young adults with chronic ankle instability. It is hypothesized that the prototype portable ankle arthrometer will be a valid and reliable tool to assess joint laxity across the three different populations. Aim 2 will look to determine the validity of a prototype portable ankle arthrometer in young adults with an acute ankle sprain across multiple timepoints in their first month post injury. It is hypothesized that the prototype portable ankle arthrometer will be a valid tool to assess joint laxity at three different timepoints for the same individual.

Extracorporeal Shock Wave Versus Photobiomodulation Therapy for Chronic Ankle Instability

PURPOSE: To Compare between the effect of extra corporeal shock wave and Photobiomodulation on pain level, ROM, muscle strength, function level, dynamic balance and thickness of ligament in patients with chronic ankle instability. BACKGROUND: Lateral ankle sprains are the most common lower limb musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities Approximately 40% of individuals who sustain a LAS develop a condition known as chronic ankle instability (CAI) (Miklovic et al., 2018), The lateral ligamentous complex is the main structure affected in 80-85% of these injuries, which are originated from a sudden inversion or supination trauma (Mansur et al., 2021). The ligament system plays a fundamental role in the ankle's stability and includes a talocrural complex and a subtalar complex that are functionally related. For the talocrural joint, three lateral collateral ligaments are present and one medial collateral ligament (Bonnel et al., 2010). Physical examination is mostly the first diagnostic step in the assessment of ankle injuries. Imaging modalities such as ultrasonography (US) and magnetic resonance imaging (MRI) play a major role in providing a detailed depiction of ankle tendons and ligaments (Hosseinian et al., 2022). The effect of ESWT is Higher multiplication of collagen fibers; faster organization of muscle fibers and vascularization by treatment with radial shockwaves (Schnurrer-Luke-Vrbanic et al., 2018), ESWT could improve pain, ankle instability, ankle function, dorsiflexion ROM, and dynamic balance in patients with CAI (Le et al., 2022). Photobiomodulation Therapy (PBMT) is effective for patients with an ankle sprain. PBMT showed high effect size with a moderate level of evidence on pain intensity and is related to the PBMT intensity and frequency (Alayat et al., 2024). HYPOTHESES: There is no statistically significant effect of extra corporeal shock wave versus photobiomodulation on level of pain, ROM, muscle strength, function level, dynamic balance and thickness of ligament in patients with chronic ankle instability. RESEARCH QUESTION: Is there any effect of extra corporeal shock wave versus Photobiomodulation on pain level, ROM, muscle strength, function level, dynamic balance and thickness of ligament in patients with chronic ankle instability?

MOTOR TRAINING VERSUS MOTOR COGNITIVE TRAINING IN ATHLETES WITH CHRONIC ANKLE INSTABILITY

This study aims to evaluate the effect of one-leg balance activity (OLBA) combined with visual feedback using BlazePod™ as a dual motor-cognitive rehabilitation task in basketball players with Chronic Ankle Instability (CAI). The intervention will be compared to OLBA alone as a motor task. Outcomes measured include dynamic balance, sense of instability, response time, athletic performance, and self-reported physical function. This study will help improve rehabilitation strategies for athletes suffering from ankle instability.

Radiological and Clinical Measures as Predictors of Dynamic Postural Control Deficits in Chronic Ankle Instability

The purpose of this study is to investigate the association between dynamic postural control and clinical measures of (ankle and hip strength, ankle DFROM and position sense) and radiological measures in patients with unilateral CAI.