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Ankle SprainsNCT01853462

Effects of Two Supervised Training Programs for the Rehabilitation of Ankle Sprains

A study testing PNF training and Balance training in people with Ankle Sprains, run by Lazaros Lazarou at 1 site in Greece.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study was to determine the effects of supervised balance and proprioceptive neuromuscular facilitation (PNF) training for the rehabilitation of ankle sprains Read more about this study

Who is it for?
Ages 18 to 40 years
Conditions the study is for
Ankle Sprains
What is being tested?
PNF training and Balance training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
22 participants
Where
1 siteGreece
Study dates
Dec 2014to Sep 2016
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Individuals with a symptomatic, conventionally treated, post acute (after 14 days) lateral ankle sprain, Grade I-II

Who cannot join

  • Individuals with lateral ankle sprains Grade III
  • Individuals with ankle sprain to the medial ligaments
  • Individuals with ankle sprain to the interosseous (syndesmotic) ligament
  • Individuals with concurrent fracture
  • Individuals with chronic ankle instability
  • Individuals with history of surgery to the ankles
Show all 9Show fewer
  • Individuals with history of lower limb nerve injuries
  • Individuals with history of further ankle injuries, after the sprain
  • Individuals with any injuries that hindered training participation

Trial locations and contacts

1 site in 1 country.

Greece1 site
  • Aristotle University

    Serres, Agios Ioannis, 62110

Other trials in Greece

About this study

Official title: Effects of Supervised Balance and Proprioceptive Neuromuscular Facilitation Training After Lateral Ligament Sprains of the Ankle

The purpose of this study was to determine the effects of supervised balance and proprioceptive neuromuscular facilitation (PNF) training for the rehabilitation of ankle sprains

Read the detailed description

Supervised proprioceptive training has been recommended by recently published guidelines for the rehabilitation of ankle sprains. However, research evidence on the efficacy of this type of training is still weak, mainly owing to the methodological limitations of relevant studies. In addition, there is paucity of evidence concerning the effects of such training for the outcomes of functional performance, pain, ankle range of motion, and contradictory results have been reported for postural control.

This study aimed to substantiate the benefits of supervised training for the rehabilitation of ankle sprains, and elucidate the effects of two different proprioceptive protocols on the above-mentioned outcomes.

Conditions
Ankle Sprains
Being tested
PNF training, Balance training
Medical subject headings
Ankle Injuries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PNF trainingOther

    Ten individual PNF sessions, supervised by a physical therapist, with 50-60 min duration per session, within a maximal five-week period

  • Balance trainingOther

    Ten individual balance sessions, supervised by a physical therapist, with 50-60 min duration per session, within a maximal five-week period

Study groups in NCT01853462
Study groupRoleWhat they receive
Proprioceptive Neuromuscular Facilitation (PNF)ExperimentalSupervised PNF training
Receives: Other: PNF training
BalanceExperimentalSupervised balance training
Receives: Other: Balance training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ankle Functional Stability, Via the Single-leg Hop for Distance Test

    Participants hopped, using the sprained leg, as far forward as possible, and remained in the landing position for 2sec. Three trials were performed, and the mean hopping distance was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  2. Ankle Functional Stability, Via the Single-leg Hops for Time Test

    Participants hopped, using the sprained leg, as fast as possible, a six-meter distance. Three trials were performed, and the mean hopping time was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  3. Endurance of Ankle Dorsiflexor Muscles

    The rising on heel test was used, and participants rose on the heel of the sprained leg, as many times as possible.

    Scoring:10 points for >40 rises, 5 points for 30-39 rises, 0 points for <30 rises.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  4. Endurance of Ankle Plantar Flexor Muscles

    The rising on toes test was used, and participants rose on the toes of the sprained leg, as many times as possible. Scoring:10 points for >40 rises, 5 points for 30-39 rises, 0 points for <30 rises.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

Secondary outcomes (27)
  1. Anterior-posterior Stability Index

    The Biodex Stability System, which is a dynamic tilting platform, was used for assessment. The anterior-posterior stability index corresponded to the variance of foot platform displacement in the sagittal plane, and it was measured in single-leg stance, for the sprained leg, without footwear. Three 20-sec trials were performed, with open eyes, and the mean score was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  2. Medial-lateral Stability Index

    The Biodex Stability System, which is a dynamic tilting platform, was used for assessment. The medial-lateral stability index corresponded to the variance of foot platform displacement in the frontal plane, and it was measured in single-leg stance, for the sprained leg, without footwear. Three 20-sec trials were performed, with open eyes, and the mean score was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  3. Overall Stability Index

    The Biodex Stability System, which is a dynamic tilting platform, was used for assessment. The overall stability index corresponded to the variance of foot platform overall displacement, and it was measured in single-leg stance, for the sprained leg, without footwear. Three 20-sec trials were performed, with open eyes, and the mean score was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  4. Ankle Dorsiflexion Range of Motion

    Assessement was performed with a goniometer. Participants actively dorsiflexed the sprained ankle, while being in long sitting, on a physical therapy table. The mean score of three measurements was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  5. Pain Sensation

    The main component of the Greek version of the short form of McGill Pain Questionnaire (GR-SFMPQ) was used for the assessment of pain sensation of the sprained ankle. This consists of 15 descriptive adjectives for the pain sensation (11 sensory and 4 affective), which are self-rated according to their intensity level on a 4-point rating scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). The total rating score (minimum = 0, maximum = 45) of the main component of the GR-SFMPQ was used for data analysis, with higher values representing a worse pain sensation.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  6. Pain Intensity During the Week Before Testing

    The second component of the Greek version of the short form of McGill Pain Questionnaire, which is a visual analogue scale (VAS), was used for the assessment. The VAS is a horizontal 10-cm line with clearly defined boundaries: 0 cm = 'No pain' and 10.0 cm = 'worst possible pain'. partipants made a mark on the line at the point that better described the average pain intensity for their sprained ankle, during the week before testing. The distance marked from the 'no pain' point was measured in mm and was used for data analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  7. Present Pain

    The third component of the Greek version of the short form of McGill Pain Questionnaire, which is a 6-point verbal rating scale, was used for the assessment. Participants noted what word at the time completing the questionnaire would best describe their pain sensation for the sprained ankle (scoring: no pain = 0, mild = 1, discomforting = 2, distressing = 3, horrible = 4, excruciating = 5). The score corresponding to the noted word was used for data analysis, with higher values representing a worse pain sensation.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  8. Ankle Joint Sense for 10° Dorsiflexion

    The Biodex isokinetic dynamometer was used for assessment. During testing, participants were blindfolded, in the seated position, with footwear on.The internal goniometer of Biodex recorded the degrees of error for the active repositioning of 10° dorsiflexion (non-weight-bearing) for the sprained ankle, and the mean of three trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  9. Ankle Joint Sense for 15° Plantar Flexion

    The Biodex isokinetic dynamometer was used for assessment. During testing, participants were blindfolded, in the seated position, with footwear on.The internal goniometer of Biodex recorded the degrees of error for the active repositioning of 15° plantar flexion (non-weight-bearing) for the sprained ankle, and the mean of three trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  10. Ankle Joint Sense for 30° Plantar Flexion

    The Biodex isokinetic dynamometer was used for assessment. During testing, participants were blindfolded, in the seated position, with footwear on.The internal goniometer of Biodex recorded the degrees of error for the active repositioning of 30° plantar flexion (non-weight-bearing) for the sprained ankle, and the mean of three trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  11. Peak Torque of Ankle Dorsiflexor Muscles at 30°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the ankle joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  12. Peak Torque of Ankle Dorsiflexor Muscles at 120°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the ankle joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  13. Peak Torque of Ankle Plantar Flexor Muscles at 30°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the ankle joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  14. Peak Torque of Ankle Plantar Flexor Muscles at 120°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the ankle joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  15. Peak Torque of Foot Evertor Muscles at 30°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the subtalar joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  16. Peak Torque of Foot Evertor Muscles at 120°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the subtalar joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  17. Peak Torque of Foot Invertor Muscles at 30°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the subtalar joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  18. Peak Torque of Foot Invertor Muscles at 120°/Sec Speed

    The Biodex isokinetic dynamometer was used for assessment. During isokinetic testing of the subtalar joint, participants were in the seated position, with footwear on. Measurements were taken for the sprained leg, and the mean of five maximal trials was used for analysis.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  19. Electromyographic Activity of Anterior Tibialis Muscle During Ankle Dorsiflexion at 30°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the ankle dorsiflexor muscles, at 30°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the anterior tibialis muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  20. Electromyographic Activity of Anterior Tibialis Muscle During Ankle Dorsiflexion at 120°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the ankle dorsiflexor muscles, at 120°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the anterior tibialis muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  21. Electromyographic Activity of Peroneus Longus Muscle During Ankle Plantar Flexion at 30°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the ankle plantar flexor muscles, at 30°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the peroneus longus muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  22. Electromyographic Activity of Peroneus Longus Muscle During Ankle Plantar Flexion at 120°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the ankle plantar flexor muscles, at 120°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the peroneus longus muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  23. Electromyographic Activity of Peroneus Longus Muscle During Foot Eversion at 30°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the foot evertor muscles, at 30°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the peroneus longus muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  24. Electromyographic Activity of Peroneus Longus Muscle During Foot Eversion at 120°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the foot evertor muscles, at 120°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the peroneus longus muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  25. Electromyographic Activity of Tibialis Anterior Muscle During Foot Inversion at 30°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the foot invertor muscles, at 30°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the anterior tibialis muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  26. Electromyographic Activity of Tibialis Anterior Muscle During Foot Inversion at 120°/Sec Speed

    Two surface electrodes and a ground electrode were used for assessment. Measurements were taken for the sprained leg, during isokinetic testing of the foot invertor muscles, at 120°/sec speed, with the Biodex dynamometer. Normalized values of the electromyographic (EMG) signals were used for analysis, and EMG activity during maximal voluntary isometric contraction of the anterior tibialis muscle was used as the reference value for normalization.

    Measured: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)

  27. Participants With Recurrent Ankle Sprain

    Measured: Twelve months after the completion of training

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 May 2013 (estimated)
  2. Study startDec 2014
  3. Primary completionNov 2015
  4. Study completionSep 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
22 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01853462
Sponsor's protocol ID
PNF-123-BAL-SPR
Status last verified
Mar 2018
First submitted
9 May 2013
Last updated
1 Nov 2018
Data monitoring committee
No
Individual data sharing
Undecided: Individual participant data will be available only if necessarily required

Questions about this trial

What is this clinical trial studying?

A study testing PNF training and Balance training in people with Ankle Sprains, run by Lazaros Lazarou at 1 site in Greece.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Nov 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Greece. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Nov 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ankle Functional Stability, Via the Single-leg Hop for Distance Test (time frame: Baseline, after the completion of training (follow-up 1), and eight weeks after the completion of training (follow-up 2)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Nov 2018; AzTrials last refreshed its copy on 1 Nov 2026.

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