Ankle Inversion SprainNCT06296537
Effectiveness of Balance Training and Dynamic Neuromuscular Stabilization Training in Amateur Athletes with Chronic Ankle Instability
A study testing Dynamic Neuromuscular Stabilization Training (DNS), Balance Training and Conventional Training in people with Ankle Inversion Sprain and Chronic Instability of Joint, run by Medipol University at 1 site in Turkey (Türkiye).
Trial summary
The goal of this clinical trial is to determine and compare the effects of balance and dynamic neuromuscular stabilization training on ankle function ability, functional instability severity, physical activity level, muscle strength, proprioception, stabilization, balance, reaction time and performance of amateur… Read more about this study
- Who is it for?
- Ages 18 to 25 years
- Conditions the study is for
- Ankle Inversion Sprain, Chronic Instability of Joint, Chronic Pain
- What is being tested?
- Dynamic Neuromuscular Stabilization Training (DNS), Balance Training and Conventional Training
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Apr 2024to 16 Dec 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 25 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Being between the ages of 18-25
- Being a non-smoker
- Being an athlete at amateur level
- Score 25 or less on the Cumberland Ankle Instability Questionnaire
- At least 1 acute ankle inversion sprain resulting in swelling, pain, and dysfunction that occurred at least 12 months before the study
- Feeling of giving way in the ankle at least 2 times in the last 6 months
Who cannot join
- If the patient has any mental problems
- Neurological diseases
- Cerebellar, vestibular, cochlear and inner ear dysfunction
- Surgeries on musculoskeletal structures, chronic musculoskeletal disorders, severe acute lower extremity injuries or head trauma in the last 6 months
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparison of the Effectiveness of Balance Training and Dynamic Neuromuscular Stabilization Training in Amateur Athletes with Chronic Ankle Instability
The goal of this clinical trial is to determine and compare the effects of balance and dynamic neuromuscular stabilization training on ankle function ability, functional instability severity, physical activity level, muscle strength, proprioception, stabilization, balance, reaction time and performance of amateur athletes with chronic ankle instability. The main questions it aims to answer are:
- Do balance and dynamic neuromuscular stabilization training positively affect functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains?
- Does balance training or dynamic neuromuscular stabilization training have a more positive effect on functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains?
Read more
Participants will apply:
- a dynamic neuromuscular stabilization training program consisting of a series of special exercises based on the developmental kinesiology steps of a healthy baby.
- balance training which consist of an effective postural stability program.
- conventional training program which consist of stretching, joint range of motion, strengthening and postural control exercises.
Researchers will compare balance and dynamic neuromuscular stabilization training to see if effectiveness of ankle function ability, functional instability severity, physical activity level, muscle strength, proprioception, stabilization, balance, reaction time and performance.
Read the detailed description
Chronic ankle instability is a repetitive chronic ankle imbalance that leads to a high rate of ankle sprains. Ankle sprains remain the most common foot-ankle and sports injury for which individuals require medical care, including emergency room visits. It is known that 58.5% of professional basketball and football athletes experience ankle sprains. Approximately three-quarters of patients who sustain an ankle sprain have persistent symptoms 1.5 to 4 years after the injury.
The hallmark symptoms of chronic ankle instability are a history of recurrent sprains and/or repeated episodes of giving-way and/or a feeling of instability. Additionally, many permanent symptoms such as pain, structural changes, and adaptations in the sensorimotor and vestibular systems have also been reported. Both acute trauma and residual neuromuscular adaptations lead to biomechanical changes, resulting in chronic ankle instability. Chronic ankle instability generally occurs as a result of 2 deficiencies: functional instability caused by proprioceptive and neuromuscular deficiencies and mechanical instability caused by changes in joint structure and function.
Lateral ankle sprains and chronic ankle instability cause changes in feedback control, which regulates motor control through reflex loops, and in feedforward control, which plans the movement pattern based on especially past experience. Due to changes in neuromuscular control, kinematic and kinetic adaptations are also common in individuals with chronic ankle instability compared to uninjured individuals, and these adaptations may result in abnormal tension on the talar joint cartilage. Therefore, there is a need to identify therapeutic interventions that can restore appropriate neuromuscular control strategies.
Surgical and conservative treatment methods that assist in ankle-foot deformity recovery, return to social life activities and return to sports can provide even better results with in-depth knowledge of ankle anatomy, biomechanics and pathology. Anatomical repair, tendon augmentation, or both are the basic methods of surgical intervention, and today, arthroscopy treatment is becoming more and more common in the treatment of chronic ankle instability. Conservative treatments include the use of orthoses in the acute period and physical therapy modalities that can be applied in the acute/chronic period . Exercise therapy in physiotherapy is one of the most supported interventions in treating chronic ankle instability and significantly reduces the risk of re-injury. Strength training, balance and dual task training, and isokinetic exercises are effective in ankle instability. It has been reported that 6 weeks of dynamic neuromuscular exercise training leads to improvements in sensorimotor control of the ankle joint in athletes with chronic ankle instability. Moreover, balance training exercises based on multi-station tasks have been observed to significantly improve self-reported sense of instability and dynamic balance in individuals with chronic ankle instability. It has been reported that rehabilitation protocols focusing on balance training effectively improve health-related quality of life in individuals with chronic ankle instability. However, it is recommended that interventions include more open chain joint position sense training, multi-plane single limb challenges, and jumping and landing exercises. In addition, during rehabilitation, the focus should not only be on exercising the muscles in their dynamic anatomical functions, but their stabilizing functions should also be addressed. Therefore, dynamic neuromuscular stabilization (DNS) training has been developed, which optimizes the movement system based on the scientific principles of developmental kinesiology. DNS training aims to stimulate the natural movement control system in the brain to activate the body's stabilization system. In the literature, studies on the effects of DNS training on ankle sensorimotor control and ankle joint position are limited. Our aim in this study is to determine and compare the effects of balance and DNS training on ankle function adequacy, functional instability severity, physical activity level, muscle strength, proprioception, stabilization, balance, reaction time and performance of amateur athletes with chronic ankle instability.
Our hypothesis in this study:
H0: Balance and DNS training does not positively affect functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains.
H1: Balance and DNS training positively affects functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains. The effect of balance training is superior to DNS training.
H2: Balance and DNS training positively affects functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains. The effect of DNS training is superior to balance training.
- Being tested
- Dynamic Neuromuscular Stabilization Training (DNS), Balance Training, Conventional Training
- Keywords
- Chronic Ankle Instability, Dynamic Neuromuscular Stabilization Training, Balance Training, Amateur Athletes, Stabilization
- Medical subject headings
- Chronic Pain, Tinea Pedis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dynamic Neuromuscular Stabilization Training (DNS)Procedure or surgery
Dynamic neuromuscular stabilization training has been developed, which optimizes the movement system based on the scientific principles of developmental kinesiology. DNS training aims to stimulate the natural movement control system in the brain to activate the body's stabilization system. Supine, prone, oblique sitting, tripod, high kneeling, hanging stance-midstance faze, hanging stance- propulsion, bear, squat exercises will be applied.
Balance TrainingProcedure or surgery
Multi-plane single limb challenges, jumping and landing exercises, proprioceptive exercises, and perturbation exercises
Conventional TrainingProcedure or surgery
Education, electrotherapy, soft tissue fascia massage, stretching, range of motion, strengthening and postural control exercises
| Study group | Role | What they receive |
|---|---|---|
| Dynamic Neuromuscular Stabilization Training Group | Experimental | A dynamic neuromuscular stabilization training program consisting of a series of special exercises based on the developmental kinesiology steps of a healthy baby will be prepared and applied for athletes in the DNS group. As the sessions progress, elastic bands will be used to create resistance in the exercises as the participants gain stabilization. All exercises will start with 1 set of 3 repetitions and increase to 1 set of 20 repetitions. All exercises will be performed barefoot. Receives: Procedure: Dynamic Neuromuscular Stabilization Training (DNS) |
| Balance Training Group | Experimental | An intervention program will be prepared for balance training group in which balance training is added to an effective postural stability program. As the sessions progress, hand and ankle sandbags will be used together with the exercises. All exercises will start with 1 set of 10 repetitions and increase to 3 sets of 15 repetitions. Exercises will be performed barefoot. Receives: Procedure: Balance Training |
| Conventional Training Group | Active comparator | A program including stretching, joint range of motion, strengthening and postural control exercises will be prepared for athletes in the conventional group. As the sessions progress, hand and ankle sandbags will be used together with the exercises. All exercises will start with 1 set of 10 repetitions and increase to 3 sets of 15 repetitions. Exercises will be performed barefoot. Receives: Procedure: Conventional Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Star Excursion Balance Test
The star excursion balance test is a test used to evaluate dynamic balance and dynamic postural stability. A small number of material installations are required to perform the star balance test. Four strips of athletic tape will each need to be cut to lengths ranging from 182.88 cm to 243.84 cm. Two pieces will be used to form a "+", the other two will be placed on top to form an "x", creating a star shape. All lines will be separated from each other at a 45° angle. The participant will maintain balance on the one foot while using other foot to reach as far as possible in 8 different directions. The participant will reach with his feet in 8 different directions: anterior, anteromedial, medial, posteromedial, posterior, posterolateral, lateral and anterolateral.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Balance Error Scoring System (BESS)
BESS is a reliable and inexpensive tool to measure static balance in people with chronic foot instability. BESS consists of 6 tests that include both leg stance, one leg stance and tandem stance conditions, respectively, on both hard and foam surfaces with eyes closed. A stopwatch is used to determine participants' time during 20-second stance tests. The grading method is based on the score of the error table in the six tests. Errors include lifting the hip, walking, opening the eyes, grasping something, falling, leaving the test position after 5 seconds, flexion or abduction of the upper leg more than 30 degrees, and lifting the heel or front of the leg on the surface. If more than one mistake is made at the same time, they are counted as one mistake. The maximum total number of errors for any test is taken to be 10.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Secondary outcomes (9)
Foot and Ankle Ability Measurement (FAAM)
The foot and ankle ability measure was designed by R. Martin and colleagues in 2005 to detect changes in ankle function over time. It is a self-report questionnaire consisting of two subscales: activities of daily living (ADL) (FAAM, 21 items) and sports (FAAM-S, 8 items). ADL and Sports subscales are scored separately. The response to each item on the ADL subscale is scored from 4 to 0, with 4 meaning "no difficulty" and 0 meaning "cannot do." If the subject answers all 21 items, the highest potential score is 84. The sport subscale is scored in the same way, with 4 meaning 'no difficulty' and 0 meaning 'can't do'. If the subject answers all 8 items, the highest potential score is 32. The Turkish validity and reliability study of the Foot and Ankle Ability Measurement by Çelik et al. has been accepted.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Cumberland Ankle Instability Questionnaire
The CAIT, which includes a 9-item 30-point scale, is an effective tool for assessing the severity of functional instability, monitoring progress, and measuring treatment outcome. Participants with a score of 25 or higher are less likely to have functional instability, while participants with a score of 25 or lower are more likely to have functional instability. The Turkish validity and reliability study of the Cumberland Ankle Instability Questionnaire by Candeniz et al. has been accepted.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
International Physical Activity Questionnaire - Short Form
The International Physical Activity Questionnaire-Short Form assesses the number of days and time spent on moderate to vigorous physical activity, walking and sitting, performed for at least 10 minutes in the previous 7 days. The survey consists of 7 open-ended questions. The summary score is expressed in physical activity metabolic equivalent task-minutes (MET-min/week) per day or week. The scores are calculated as follows: Walking MET-min/week = 3.3 X walking minutes X number of walking days; moderate MET-min/week = 4.0 X minutes of moderate activity X number of days of moderate activity; vigorous MET-min/week = 8.0 X minutes of vigorous activity X number of days of vigorous activity. The short form is preferred because it is easy to administer and shows similar reliability and validity results compared to the long form. The validity and reliability study of the International Physical Activity Questionnaire- Short Form Turkish by Sağlam et al. has been accepted.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Manual Muscle Strength Test with Hand Dynamometer
A hand dynamometer is used to assess isometric muscle strength. Muscle forces are tested in four directions: dorsiflexion, plantar flexion, inversion and eversion. Participants are placed in the subtalar neutral position for all tests. The untested leg is stabilized with straps to stabilize and prevent any accessory movement. The hand dynamometer is calibrated and placed on the upper part of the metatarsal heads depending on the position of the foot. Participants are instructed to pull or push the device as hard as possible in each direction, and the researcher responds to this force with both hands for 3 seconds per trial. Three consecutive trials are performed with a 10-second rest between trials. Maximum force as the participant's highest force is used for analysis. All manual muscle testing movements and positions were consistent with the procedures outlined by Daniels and Worthingham
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Single Heel Lift Test
The test is a modification of the method described by Lunsford and Perry for assessing static ankle balance. Participants stand away from the researcher. They are asked to simply stand on their affected leg, then plantar flex the ankle and elevate on their toes. The test ends when the heel touches the ground. The time the heel touches the ground is recorded. The single heel lift test is the most reliable test reflecting the lack of inversion strength in chronic foot instability.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Joint Position Sense Test
Joint position sense is assessed by passively or actively placing the participant's ankle in three different degrees of inversion. These degrees are increments of 30, 60, and 90 percent of the participant's maximum ankle inversion active range of motion in the position where the ankle is at 42 degrees of plantarflexion. The participant is given three seconds to register the position before the ankle returns to the starting position. In the passive test, the ankle is passively moved into inversion at the same movement speed and the participant is asked to say "stop" when he perceives that the test position has been reached. If the participant feels that they are out of position, the ankle is passively rotated back to correct this. In active testing, the participant performs an active inversion movement aimed at stopping the movement in the test position. The order of the test, three different positions and two different methods, is chosen randomly.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Foot Lift Test
The participant performs a single-leg stance on the affected leg with eyes closed. The participant stands upright with his/her hands on the hips, spine erect, and head facing forward. The test is performed for 30 seconds and the number of foot lifts during each trial is recorded. Foot lift is defined as any part of the foot leaving the ground. Touching the ground with the opposite foot is recorded as an error. Participants are instructed not to take their hands off their hips, not to open their eyes, and not to touch their stance limb with the opposite foot; however, these actions are not recorded as errors. A single test trial is allowed for participants to acclimate before the test trials. The test is performed 3 times with a 30-second rest between trials. The trial with the most errors is used for analysis.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Blazepod Reaction Time
Blazepod reaction time, a new technology, is related to how quickly athletes react to a visual stimulus. The participant stands in the middle of the square shape placed on the ground. A blazepod is placed in each corner of the square. The distance between each blazepod will be equal to the length of the participant's lower extremity. The aim of this test is to reach as much light as possible with the affected foot for 30 seconds, with a one-legged balance activity. Three trials are performed and the best value obtained is recorded. A one-minute rest interval is given between all trials.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Side Hop Test
The side hop test is applied to evaluate the participant's functional performance. The participant performs 10 jumps medially and laterally over a 3 cm line on one foot. Ten jumps are performed as quickly as possible. The time to perform the test is measured using a handheld stopwatch. The test is performed twice on the affected limb, with a 60-second rest between trials. The shortest trial is used for analysis.
Measured: Beginning of the study, and 6th week and 12th week after beginning the study
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Mar 2024
- Study start1 Apr 2024
- Primary completion11 Nov 2024
- Study completion16 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Ankle Inversion SprainStudies of the same condition, open and under way.
- More trials run by Medipol UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- It is designed as a prospective, randomized, controlled study.
- Masking
- None (open label)
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- Medipol University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sevval Yesilkır, Medipol University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06296537
- Sponsor's protocol ID
- E-10840098-202.3.02-1434
- Status last verified
- Dec 2024
- First submitted
- 29 Feb 2024
- Last updated
- 19 Dec 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Yesilkir S, Ergezen Sahin G. Dynamic neuromuscular stabilization, balance, and conventional training for chronic ankle instability in amateur athletes: a randomised controlled trial. BMC Sports Sci Med Rehabil. 2025 Oct 1;17(1):286. doi: 10.1186/s13102-025-01319-8.
PubMed 41035081
Study at a glance
From the registry record, last updated by the sponsor on 19 Dec 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Effectiveness of Balance Training and Dynamic Neuromuscular Stabilization Training in Amateur Athletes with Chronic Ankle Instability
- ClinicalTrials.gov ID
- NCT06296537
- Acronym / sponsor ID
- E-10840098-202.3.02-1434
- Keywords
- Chronic Ankle Instability, Dynamic Neuromuscular Stabilization Training, Balance Training, Amateur Athletes, Stabilization
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- Medipol UniversityUniversity, hospital or other
- Study start
- 1 Apr 2024 (actual)
- Primary completion
- 11 Nov 2024 (actual)
- Study completion
- 16 Dec 2024 (actual)
- First posted
- 6 Mar 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to determine and compare the effects of balance and dynamic neuromuscular stabilization training on ankle function ability, functional instability severity, physical activity level, muscle strength, proprioception, stabilization, balance, reaction time and performance of amateur athletes with chronic ankle instability. The main questions it aims to answer are:
- Do balance and dynamic neuromuscular stabilization training positively affect functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains?
- Does balance training or dynamic neuromuscular stabilization training have a more positive effect on functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains?
Participants will apply:
- a dynamic neuromuscular stabilization training program consisting of a series of special exercises based on the developmental kinesiology steps of a healthy baby.
- balance training which consist of an effective postural stability program.
- conventional training program which consist of stretching, joint range of motion, strengthening and postural control exercises.
Researchers will compare balance and dynamic neuromuscular stabilization training to see if effectiveness of ankle function ability, functional instability severity, physical activity level, muscle strength, proprioception, stabilization, balance, reaction time and performance.
Detailed description
Chronic ankle instability is a repetitive chronic ankle imbalance that leads to a high rate of ankle sprains. Ankle sprains remain the most common foot-ankle and sports injury for which individuals require medical care, including emergency room visits. It is known that 58.5% of professional basketball and football athletes experience ankle sprains. Approximately three-quarters of patients who sustain an ankle sprain have persistent symptoms 1.5 to 4 years after the injury.
The hallmark symptoms of chronic ankle instability are a history of recurrent sprains and/or repeated episodes of giving-way and/or a feeling of instability. Additionally, many permanent symptoms such as pain, structural changes, and adaptations in the sensorimotor and vestibular systems have also been reported. Both acute trauma and residual neuromuscular adaptations lead to biomechanical changes, resulting in chronic ankle instability. Chronic ankle instability generally occurs as a result of 2 deficiencies: functional instability caused by proprioceptive and neuromuscular deficiencies and mechanical instability caused by changes in joint structure and function.
Lateral ankle sprains and chronic ankle instability cause changes in feedback control, which regulates motor control through reflex loops, and in feedforward control, which plans the movement pattern based on especially past experience. Due to changes in neuromuscular control, kinematic and kinetic adaptations are also common in individuals with chronic ankle instability compared to uninjured individuals, and these adaptations may result in abnormal tension on the talar joint cartilage. Therefore, there is a need to identify therapeutic interventions that can restore appropriate neuromuscular control strategies.
Surgical and conservative treatment methods that assist in ankle-foot deformity recovery, return to social life activities and return to sports can provide even better results with in-depth knowledge of ankle anatomy, biomechanics and pathology. Anatomical repair, tendon augmentation, or both are the basic methods of surgical intervention, and today, arthroscopy treatment is becoming more and more common in the treatment of chronic ankle instability. Conservative treatments include the use of orthoses in the acute period and physical therapy modalities that can be applied in the acute/chronic period . Exercise therapy in physiotherapy is one of the most supported interventions in treating chronic ankle instability and significantly reduces the risk of re-injury. Strength training, balance and dual task training, and isokinetic exercises are effective in ankle instability. It has been reported that 6 weeks of dynamic neuromuscular exercise training leads to improvements in sensorimotor control of the ankle joint in athletes with chronic ankle instability. Moreover, balance training exercises based on multi-station tasks have been observed to significantly improve self-reported sense of instability and dynamic balance in individuals with chronic ankle instability. It has been reported that rehabilitation protocols focusing on balance training effectively improve health-related quality of life in individuals with chronic ankle instability. However, it is recommended that interventions include more open chain joint position sense training, multi-plane single limb challenges, and jumping and landing exercises. In addition, during rehabilitation, the focus should not only be on exercising the muscles in their dynamic anatomical functions, but their stabilizing functions should also be addressed. Therefore, dynamic neuromuscular stabilization (DNS) training has been developed, which optimizes the movement system based on the scientific principles of developmental kinesiology. DNS training aims to stimulate the natural movement control system in the brain to activate the body's stabilization system. In the literature, studies on the effects of DNS training on ankle sensorimotor control and ankle joint position are limited. Our aim in this study is to determine and compare the effects of balance and DNS training on ankle function adequacy, functional instability severity, physical activity level, muscle strength, proprioception, stabilization, balance, reaction time and performance of amateur athletes with chronic ankle instability.
Our hypothesis in this study:
H0: Balance and DNS training does not positively affect functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains.
H1: Balance and DNS training positively affects functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains. The effect of balance training is superior to DNS training.
H2: Balance and DNS training positively affects functionality, balance, stabilization, proprioception and performance in amateur athletes with chronic ankle sprains. The effect of DNS training is superior to balance training.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- It is designed as a prospective, randomized, controlled study.
| Arm | Type | Receives |
|---|---|---|
| Dynamic Neuromuscular Stabilization Training Group | Experimental | Procedure: Dynamic Neuromuscular Stabilization Training (DNS)A dynamic neuromuscular stabilization training program consisting of a series of special exercises based on the developmental kinesiology steps of a healthy baby will be prepared and applied for athletes in the DNS group. As the sessions progress, elastic bands will be used to create resistance in the exercises as the participants gain stabilization. All exercises will start with 1 set of 3 repetitions and increase to 1 set of 20 repetitions. All exercises will be performed barefoot. |
| Balance Training Group | Experimental | Procedure: Balance TrainingAn intervention program will be prepared for balance training group in which balance training is added to an effective postural stability program. As the sessions progress, hand and ankle sandbags will be used together with the exercises. All exercises will start with 1 set of 10 repetitions and increase to 3 sets of 15 repetitions. Exercises will be performed barefoot. |
| Conventional Training Group | Active comparator | Procedure: Conventional TrainingA program including stretching, joint range of motion, strengthening and postural control exercises will be prepared for athletes in the conventional group. As the sessions progress, hand and ankle sandbags will be used together with the exercises. All exercises will start with 1 set of 10 repetitions and increase to 3 sets of 15 repetitions. Exercises will be performed barefoot. |
Who may qualify
- Ages
- 18 to 25 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Being between the ages of 18-25
- Being a non-smoker
- Being an athlete at amateur level
- Score 25 or less on the Cumberland Ankle Instability Questionnaire
- At least 1 acute ankle inversion sprain resulting in swelling, pain, and dysfunction that occurred at least 12 months before the study
Key exclusion criteria (4 listed)
- If the patient has any mental problems
- Neurological diseases
- Cerebellar, vestibular, cochlear and inner ear dysfunction
- Surgeries on musculoskeletal structures, chronic musculoskeletal disorders, severe acute lower extremity injuries or head trauma in the last 6 months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Dynamic Neuromuscular Stabilization Training (DNS)Dynamic neuromuscular stabilization training has been developed, which optimizes the movement system based on the scientific principles of developmental kinesiology. DNS training aims to stimulate the natural movement control system in the brain to activate the body's stabilization system. Supine, prone, oblique sitting, tripod, high kneeling, hanging stance-midstance faze, hanging stance- propulsion, bear, squat exercises will be applied. | Procedure or surgery | Dynamic Neuromuscular Stabilization Training Group |
| Balance TrainingMulti-plane single limb challenges, jumping and landing exercises, proprioceptive exercises, and perturbation exercises | Procedure or surgery | Balance Training Group |
| Conventional TrainingEducation, electrotherapy, soft tissue fascia massage, stretching, range of motion, strengthening and postural control exercises | Procedure or surgery | Conventional Training Group |
Primary outcome
Star Excursion Balance Test
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
The star excursion balance test is a test used to evaluate dynamic balance and dynamic postural stability. A small number of material installations are required to perform the star balance test. Four strips of athletic tape will each need to be cut to lengths ranging from 182.88 cm to 243.84 cm. Two pieces will be used to form a "+", the other two will be placed on top to form an "x", creating a star shape. All lines will be separated from each other at a 45° angle. The participant will maintain balance on the one foot while using other foot to reach as far as possible in 8 different directions. The participant will reach with his feet in 8 different directions: anterior, anteromedial, medial, posteromedial, posterior, posterolateral, lateral and anterolateral.
Balance Error Scoring System (BESS)
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
BESS is a reliable and inexpensive tool to measure static balance in people with chronic foot instability. BESS consists of 6 tests that include both leg stance, one leg stance and tandem stance conditions, respectively, on both hard and foam surfaces with eyes closed. A stopwatch is used to determine participants' time during 20-second stance tests. The grading method is based on the score of the error table in the six tests. Errors include lifting the hip, walking, opening the eyes, grasping something, falling, leaving the test position after 5 seconds, flexion or abduction of the upper leg more than 30 degrees, and lifting the heel or front of the leg on the surface. If more than one mistake is made at the same time, they are counted as one mistake. The maximum total number of errors for any test is taken to be 10.
9 secondary outcomes
Foot and Ankle Ability Measurement (FAAM)
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Cumberland Ankle Instability Questionnaire
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
International Physical Activity Questionnaire - Short Form
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Manual Muscle Strength Test with Hand Dynamometer
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Single Heel Lift Test
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Joint Position Sense Test
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Foot Lift Test
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Blazepod Reaction Time
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Side Hop Test
Time frame: Beginning of the study, and 6th week and 12th week after beginning the study
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Dec 2024.
- Derived from this study: PubMed 41035081Yesilkir S, Ergezen Sahin G. Dynamic neuromuscular stabilization, balance, and conventional training for chronic ankle instability in amateur athletes: a randomised controlled trial. BMC Sports Sci Med Rehabil. 2025 Oct 1;17(1):286. doi: 10.1186/s13102-025-01319-8.
- Individual participant dataSharing planned: No
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Ankle Sprains, Ankle Sprain Strain
Recruiting
A Mobile Recovery Guidance App for Children and Young Adults With Acute Ankle Inversion Injuries
Ankle Sprains
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Dynamic Neuromuscular Stabilization Training (DNS), Balance Training and Conventional Training in people with Ankle Inversion Sprain and Chronic Instability of Joint, run by Medipol University at 1 site in Turkey (Türkiye).
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 6 inclusion and 4 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 19 Dec 2024. 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 Turkey (Türkiye). 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Star Excursion Balance Test (time frame: Beginning of the study, and 6th week and 12th week after beginning the study). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06296537, which also lists 1 linked publication.
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 19 Dec 2024.