Ankle InjuriesNCT06303141
Comparative Effects of Neuromuscular Training and Mobilization With Movement in Professional Athletes With Ankle Sprain
A study testing Closed Chain exercises, Neuromuscular Training and Mobilization with Movement in people with Ankle Injuries and Musculoskeletal Manipulations, run by Riphah International University at 1 site in Pakistan.
Trial summary
The study aims to compare the effects of neuromuscular training and mobilization with movement on pain, range of motion, function, and disability in professional athletes with ankle sprain. Read more about this study
- Who is it for?
- Ages 18 to 30 years
- Conditions the study is for
- Ankle Injuries, Musculoskeletal Manipulations
- What is being tested?
- Closed Chain exercises, Neuromuscular Training and Mobilization with Movement
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 sitePakistan
- Study dates
- 5 Apr 2023to 10 Sep 2023
- 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 30 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- • Athletes will be included:
- Rackets player,
- Basketball players
- Runners
- Foot-ballers players
- Soccer players,
Show all 12Show fewer
- and Volley-ball players
- Gender: both male and female
- Age: 18 to 35 years old
- Training: 15-20/ week
- Sustained an ankle sprain grade II and III
- With no Functional Ankle Instability (Greek version of the Identification functional ankle instability questionnaire IdFAI, score < 10) will be used in order to identify athletes with FAI
Who cannot join
- • Any vestibular or balance disorders (1)
- History of surgery and trauma of a lower limb since last 6 months
- Athletes with pain related to calf muscles and achillies tendon
- Co-morbidities: Diabetes, Hypertension, etc
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparative Effects of Neuromuscular Training and Mobilization With Movement on Pain, Range of Motion, Function and Disability in Professional Athletes With Ankle Sprain
The study aims to compare the effects of neuromuscular training and mobilization with movement on pain, range of motion, function, and disability in professional athletes with ankle sprain. Neuromuscular training focuses on improving neuromuscular control and stability, while mobilization with movement aims to restore joint mobility and function. By investigating the outcomes of these two interventions, the study seeks to provide insights into their effectiveness for managing ankle sprains in professional athletes.
Read the detailed description
The comparative study on the effects of neuromuscular training and mobilization with movement on pain, range of motion, function, and disability in professional athletes with ankle sprain is designed to address the efficacy of these two interventions in managing ankle injuries among athletes. An ankle sprain is a common injury in sports, often resulting in pain, limited range of motion, functional impairment, and disability. Therefore, identifying the most effective treatment approaches is essential for promoting athletes' recovery and minimizing the impact of ankle sprains on their performance.
Neuromuscular training is a structured exercise program aimed at improving neuromuscular control, proprioception, balance, and strength around the ankle joint. It typically involves exercises targeting the muscles and ligaments involved in ankle stability, such as balance training, proprioceptive exercises, strength training, and functional rehabilitation exercises. The goal of neuromuscular training is to enhance joint stability, reduce the risk of re-injury, and improve functional outcomes in athletes with ankle sprains.
On the other hand, mobilization with movement is a manual therapy technique used to restore joint mobility and function through specific movements or mobilizations. This approach involves applying controlled and graded movements to the affected ankle joint while simultaneously mobilizing the surrounding soft tissues. Mobilization with movement aims to reduce pain, improve joint mobility, and restore normal movement patterns by addressing restrictions in joint mobility, muscle tightness, and soft tissue adhesions.
The comparative study will involve professional athletes who have sustained ankle sprains during sports participation. Participants will be randomly assigned to either the neuromuscular training group or the mobilization with movement group. Both groups will undergo a structured intervention program tailored to their respective treatment approach.
The neuromuscular training program will consist of a series of progressive exercises targeting ankle stability, balance, strength, and proprioception. These exercises may include single-leg balance exercises, resistance training using bands or weights, agility drills, plyometric exercises, and functional activities relevant to the athlete's sport.
Meanwhile, the mobilization with movement intervention will involve manual therapy techniques administered by a qualified physiotherapist or sports therapist. These techniques may include joint mobilizations, soft tissue mobilizations, and specific movement patterns designed to restore normal joint mechanics and improve ankle function.
Outcome measures will include pain levels, range of motion (assessed using goniometry), functional status (evaluated using standardized outcome measures such as the Foot and Ankle Ability Measure), and disability scores (measured using validated scales such as the Disability Rating Index). These measures will be assessed at baseline, post-intervention, and follow-up time points to evaluate the effectiveness of each intervention in improving ankle sprain outcomes.
The study's findings will provide valuable insights into the comparative effectiveness of neuromuscular training and mobilization with movement in professional athletes with ankle sprains. By identifying the most beneficial treatment approach, the study aims to optimize rehabilitation strategies for ankle injuries in athletes, ultimately supporting their return to sport and minimizing the risk of re-injury.
- Conditions
- Ankle Injuries, Musculoskeletal Manipulations
- Being tested
- Closed Chain exercises, Neuromuscular Training, Mobilization with Movement
- Keywords
- NEUROMUSCULAR TRAINING, MOBILIZATION WITH MOVEMENT, Professional Athletes, Ankle Sprain
- Medical subject headings
- Ankle Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Closed Chain exercisesOther
Open eyes and closed eyes across arm" (3 sets x 60 sec) Lateral step down (3 sets x 6-12 reps) Semi-Squat Exercise (3sets x 6-12 reps) Thera-band isometric (3 sets x 10 -15sec each)
Neuromuscular TrainingOther
Neuromuscular Training Exercise:
- Single Leg Raise (3 sec x 30sec each)
- Ankle eversion/inversion (3 sets x 25 reps)
- Double Hopping in place then out of place (3 sets 30 sec)
- Reach with feet (3 sets x 30-60 sec each)
- Reach with hands (3 sets x 30-60 sec each)
- Wobble board Exercise (3sets x 30-60sec each
Mobilization with MovementOther
Joint mobilization with movement (by Mulligan) refers to manual therapy techniques that are used to modulate pain and treat joint dysfunctions that limit the range of motion (ROM).
(3 sets x 6 oscillation/glide each)
| Study group | Role | What they receive |
|---|---|---|
| Closed Chain Exercises | Other | Group A, serving as the control group, will undergo a structured rehabilitation regimen comprising closed chain exercises, icing, and bracing. The exercise component will focus on enhancing proprioception and strengthening the ankle joint. Participants will perform exercises including open eyes and closed eyes across arm movements for three sets lasting 60 seconds each, lateral step down exercises for three sets of 6-12 repetitions, semi-squat exercises for three sets of 6-12 repetitions, and Thera-band isometric exercises for three sets of 10-15 seconds each. These exercises are designed to promote ankle stability, improve range of motion, and enhance muscle strength. Additionally, icing and bracing will be utilized to reduce inflammation and provide external support to the injured ankle. Receives: Other: Closed Chain exercises |
| Neuromuscular training | Experimental | Group B, designated as the experimental group, will undergo a comprehensive rehabilitation protocol combining neuromuscular training with closed chain exercises, icing, and bracing. The exercise regimen will target proprioception, neuromuscular control, and ankle stability. Participants will engage in a series of exercises including single leg raises for three sets lasting 30 seconds each, ankle eversion/inversion exercises for three sets of 25 repetitions, double hopping in place then out of place for three sets of 30 seconds, reaching exercises with feet and hands for three sets lasting 30-60 seconds each, and wobble board exercises for three sets lasting 30-60 seconds each. These exercises are aimed at improving balance, coordination, and muscle strength around the ankle joint. The addition of neuromuscular training enhances the proprioceptive feedback and control, which is crucial for injury prevention and functional recovery in athletes with ankle sprains. Receives: Other: Neuromuscular Training |
| Mobilization with movement | Experimental | Group C, designated as an experimental group, will undergo a unique intervention combining mobilization with movement techniques, closed chain exercises, icing, and bracing. The focus of this intervention is to address joint dysfunctions and pain modulation while improving range of motion (ROM) in athletes with ankle sprains. Participants will receive joint mobilization with movement techniques, following the Mulligan approach, aimed at restoring normal joint mechanics and function. The protocol will involve three sets of six oscillations or glides each, targeting specific joint restrictions and impairments associated with ankle sprains. By integrating manual therapy with exercise and adjunct modalities like icing and bracing, this comprehensive approach aims to optimize joint function, reduce pain, and enhance overall rehabilitation outcomes in professional athletes with ankle injuries. Receives: Other: Mobilization with Movement |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numerical Pain Rating Scale for Pain
The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an elevenpoint numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain).
Measured: 4 weeks
Goniometer for Range of Motion
A goniometer is a device that measures an angle or permits the rotation of an object to a definite position
Measured: 4 weeks
Star balance excursion test for Balance
The Star Excursion Balance Test is a reliable measure and a valid dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with lower extremity conditions, and to be responsive to training programs in healthy participants and those with lower extremity conditions.
Measured: 4 weeks
Foot and ankle ability Measure for Functional Performance
The FAAM is a self-report measure that assesses physical function of individuals with lower leg, foot, and ankle musculoskeletal disorders. 2) Sports subscale of 8 items. For each subscale patients are asked to answer each question with a single response that most clearly describes their condition within the past week.
Measured: 4 weeks
Cumberland Ankle Instability
The Cumberland Ankle Instability Tool (CAIT) is a self-report questionnaire used to assess the severity of chronic ankle instability (CAI). It consists of nine items designed to evaluate functional ankle instability, including symptoms of giving way, recurrent sprains, and perceived ankle function during daily activities. Each item is scored on a 0 to 30 scale, with higher scores indicating better ankle stability
Measured: 4 weeks
Secondary outcomes (2)
Agility T-test
The Agility T-Test is a widely used physical performance test designed to assess an individual's agility, speed, and quickness. It involves a series of directional changes and sprints around cones or markers arranged in a T-shape. The test measures the time taken by the individual to complete the course accurately. It requires rapid acceleration, deceleration, and changes of direction in multiple planes of movement, making it a comprehensive assessment of agility and dynamic balance. The Agility T-Test is commonly used in sports performance testing, fitness evaluations, and rehabilitation settings to assess an individual's agility and athletic ability.
Measured: 4 weeks
Speed (20m sprint test)
The 20-meter sprint test is a commonly used measure of an individual's speed and acceleration. In this test, the participant is required to sprint as fast as possible over a distance of 20 meters from a standing start. The time taken to complete the sprint is recorded using timing gates or a stopwatch, providing a measure of the participant's sprinting speed.
The 20-meter sprint test is often used in sports performance assessments, fitness testing, and research studies to evaluate an individual's anaerobic power and speed capabilities. It is particularly relevant for athletes competing in sports that require short bursts of maximal effort, such as sprinting, soccer, basketball, and rugby
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Mar 2024
- Study start5 Apr 2023
- Primary completion5 Sep 2023
- Study completion10 Sep 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Ankle InjuriesStudies of the same condition, open and under way.
- More trials run by Riphah International 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
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Aamir Gul Memon, PhD Scholar, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06303141
- Sponsor's protocol ID
- LUC/CPGS/PGS/20230405/001
- Status last verified
- Mar 2024
- First submitted
- 4 Mar 2024
- Last updated
- 12 Mar 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Mar 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Neuromuscular Training and Mobilization With Movement on Pain, Range of Motion, Function and Disability in Professional Athletes With Ankle Sprain
- ClinicalTrials.gov ID
- NCT06303141
- Acronym / sponsor ID
- LUC/CPGS/PGS/20230405/001
- Conditions
- Ankle Injuries, Musculoskeletal Manipulations
- Keywords
- NEUROMUSCULAR TRAINING, MOBILIZATION WITH MOVEMENT, Professional Athletes, Ankle Sprain
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 5 Apr 2023 (actual)
- Primary completion
- 5 Sep 2023 (actual)
- Study completion
- 10 Sep 2023 (actual)
- First posted
- 12 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 study aims to compare the effects of neuromuscular training and mobilization with movement on pain, range of motion, function, and disability in professional athletes with ankle sprain. Neuromuscular training focuses on improving neuromuscular control and stability, while mobilization with movement aims to restore joint mobility and function. By investigating the outcomes of these two interventions, the study seeks to provide insights into their effectiveness for managing ankle sprains in professional athletes.
Detailed description
The comparative study on the effects of neuromuscular training and mobilization with movement on pain, range of motion, function, and disability in professional athletes with ankle sprain is designed to address the efficacy of these two interventions in managing ankle injuries among athletes. An ankle sprain is a common injury in sports, often resulting in pain, limited range of motion, functional impairment, and disability. Therefore, identifying the most effective treatment approaches is essential for promoting athletes' recovery and minimizing the impact of ankle sprains on their performance.
Neuromuscular training is a structured exercise program aimed at improving neuromuscular control, proprioception, balance, and strength around the ankle joint. It typically involves exercises targeting the muscles and ligaments involved in ankle stability, such as balance training, proprioceptive exercises, strength training, and functional rehabilitation exercises. The goal of neuromuscular training is to enhance joint stability, reduce the risk of re-injury, and improve functional outcomes in athletes with ankle sprains.
On the other hand, mobilization with movement is a manual therapy technique used to restore joint mobility and function through specific movements or mobilizations. This approach involves applying controlled and graded movements to the affected ankle joint while simultaneously mobilizing the surrounding soft tissues. Mobilization with movement aims to reduce pain, improve joint mobility, and restore normal movement patterns by addressing restrictions in joint mobility, muscle tightness, and soft tissue adhesions.
The comparative study will involve professional athletes who have sustained ankle sprains during sports participation. Participants will be randomly assigned to either the neuromuscular training group or the mobilization with movement group. Both groups will undergo a structured intervention program tailored to their respective treatment approach.
The neuromuscular training program will consist of a series of progressive exercises targeting ankle stability, balance, strength, and proprioception. These exercises may include single-leg balance exercises, resistance training using bands or weights, agility drills, plyometric exercises, and functional activities relevant to the athlete's sport.
Meanwhile, the mobilization with movement intervention will involve manual therapy techniques administered by a qualified physiotherapist or sports therapist. These techniques may include joint mobilizations, soft tissue mobilizations, and specific movement patterns designed to restore normal joint mechanics and improve ankle function.
Outcome measures will include pain levels, range of motion (assessed using goniometry), functional status (evaluated using standardized outcome measures such as the Foot and Ankle Ability Measure), and disability scores (measured using validated scales such as the Disability Rating Index). These measures will be assessed at baseline, post-intervention, and follow-up time points to evaluate the effectiveness of each intervention in improving ankle sprain outcomes.
The study's findings will provide valuable insights into the comparative effectiveness of neuromuscular training and mobilization with movement in professional athletes with ankle sprains. By identifying the most beneficial treatment approach, the study aims to optimize rehabilitation strategies for ankle injuries in athletes, ultimately supporting their return to sport and minimizing the risk of re-injury.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Closed Chain Exercises | Other | Other: Closed Chain exercisesGroup A, serving as the control group, will undergo a structured rehabilitation regimen comprising closed chain exercises, icing, and bracing. The exercise component will focus on enhancing proprioception and strengthening the ankle joint. Participants will perform exercises including open eyes and closed eyes across arm movements for three sets lasting 60 seconds each, lateral step down exercises for three sets of 6-12 repetitions, semi-squat exercises for three sets of 6-12 repetitions, and Thera-band isometric exercises for three sets of 10-15 seconds each. These exercises are designed to promote ankle stability, improve range of motion, and enhance muscle strength. Additionally, icing and bracing will be utilized to reduce inflammation and provide external support to the injured ankle. |
| Neuromuscular training | Experimental | Other: Neuromuscular TrainingGroup B, designated as the experimental group, will undergo a comprehensive rehabilitation protocol combining neuromuscular training with closed chain exercises, icing, and bracing. The exercise regimen will target proprioception, neuromuscular control, and ankle stability. Participants will engage in a series of exercises including single leg raises for three sets lasting 30 seconds each, ankle eversion/inversion exercises for three sets of 25 repetitions, double hopping in place then out of place for three sets of 30 seconds, reaching exercises with feet and hands for three sets lasting 30-60 seconds each, and wobble board exercises for three sets lasting 30-60 seconds each. These exercises are aimed at improving balance, coordination, and muscle strength around the ankle joint. The addition of neuromuscular training enhances the proprioceptive feedback and control, which is crucial for injury prevention and functional recovery in athletes with ankle sprains. |
| Mobilization with movement | Experimental | Other: Mobilization with MovementGroup C, designated as an experimental group, will undergo a unique intervention combining mobilization with movement techniques, closed chain exercises, icing, and bracing. The focus of this intervention is to address joint dysfunctions and pain modulation while improving range of motion (ROM) in athletes with ankle sprains. Participants will receive joint mobilization with movement techniques, following the Mulligan approach, aimed at restoring normal joint mechanics and function. The protocol will involve three sets of six oscillations or glides each, targeting specific joint restrictions and impairments associated with ankle sprains. By integrating manual therapy with exercise and adjunct modalities like icing and bracing, this comprehensive approach aims to optimize joint function, reduce pain, and enhance overall rehabilitation outcomes in professional athletes with ankle injuries. |
Who may qualify
- Ages
- 18 to 30 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (12 listed)
- • Athletes will be included:
Key exclusion criteria (4 listed)
- • Any vestibular or balance disorders (1)
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 |
|---|---|---|
| Closed Chain exercisesOpen eyes and closed eyes across arm" (3 sets x 60 sec) Lateral step down (3 sets x 6-12 reps) Semi-Squat Exercise (3sets x 6-12 reps) Thera-band isometric (3 sets x 10 -15sec each) | Other | Closed Chain Exercises |
| Neuromuscular TrainingNeuromuscular Training Exercise: * Single Leg Raise (3 sec x 30sec each) * Ankle eversion/inversion (3 sets x 25 reps) * Double Hopping in place then out of place (3 sets 30 sec) * Reach with feet (3 sets x 30-60 sec each) * Reach with hands (3 sets x 30-60 sec each) * Wobble board Exercise (3sets x 30-60sec each | Other | Neuromuscular training |
| Mobilization with MovementJoint mobilization with movement (by Mulligan) refers to manual therapy techniques that are used to modulate pain and treat joint dysfunctions that limit the range of motion (ROM). (3 sets x 6 oscillation/glide each) | Other | Mobilization with movement |
Primary outcome
Numerical Pain Rating Scale for Pain
Time frame: 4 weeks
The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an elevenpoint numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain).
Goniometer for Range of Motion
Time frame: 4 weeks
A goniometer is a device that measures an angle or permits the rotation of an object to a definite position
Star balance excursion test for Balance
Time frame: 4 weeks
The Star Excursion Balance Test is a reliable measure and a valid dynamic test to predict risk of lower extremity injury, to identify dynamic balance deficits in patients with lower extremity conditions, and to be responsive to training programs in healthy participants and those with lower extremity conditions.
Foot and ankle ability Measure for Functional Performance
Time frame: 4 weeks
The FAAM is a self-report measure that assesses physical function of individuals with lower leg, foot, and ankle musculoskeletal disorders. 2) Sports subscale of 8 items. For each subscale patients are asked to answer each question with a single response that most clearly describes their condition within the past week.
Cumberland Ankle Instability
Time frame: 4 weeks
The Cumberland Ankle Instability Tool (CAIT) is a self-report questionnaire used to assess the severity of chronic ankle instability (CAI). It consists of nine items designed to evaluate functional ankle instability, including symptoms of giving way, recurrent sprains, and perceived ankle function during daily activities. Each item is scored on a 0 to 30 scale, with higher scores indicating better ankle stability
2 secondary outcomes
Agility T-test
Time frame: 4 weeks
Speed (20m sprint test)
Time frame: 4 weeks
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 12 Mar 2024.
- Individual participant dataSharing planned: No
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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.
Aamir Gul Memon, PhD Scholar principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Closed Chain exercises, Neuromuscular Training and Mobilization with Movement in people with Ankle Injuries and Musculoskeletal Manipulations, run by Riphah International University at 1 site in Pakistan.
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 12 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 12 Mar 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 Pakistan. 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?
Numerical Pain Rating Scale for Pain (time frame: 4 weeks). The study lists 5 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 12 Mar 2024.