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Ankle SprainNCT07760233

The Effects of Vestibulo-Ocular Reflex Exercises Added to Postural Stabilization Training in Amateur Athletes With Chronic Ankle Instability

A study testing Postural Stabilization Training and Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization Training in people with Ankle Sprain and Ankle Sprain Strain, run by Bahçeşehir University at 1 site in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Chronic ankle instability (CAI) is a common condition after lateral ankle sprain. CAI is characterized by mechanical and/or functional instability, or recurrent episodes of "giving way," persisting for at least 12 months after the initial injury, and is associated with limitations in activity and and participation. Read more about this study

Who is it for?
Ages 18 to 35 years
What is being tested?
Postural Stabilization Training and Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization Training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
32 participants
Where
1 siteTurkey (Türkiye)
Study dates
25 Jul 2026to 25 Jul 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 35 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Being between 18 and 35 years of age.
  • Being classified as a Tier 2 athlete according to the McKay et al. Participant Classification Framework (trained/developmental level).
  • Having a history of at least one lateral ankle sprain (LAS) occurring at least 12 months before enrollment, resulting in swelling, pain, and functional impairment, and followed by persistent instability.
  • Having the most recent ankle sprain at least 3 months before study enrollment.
  • Having a history of recurrent ankle sprains or episodes of "giving way."
  • Having a diagnosis of unilateral chronic ankle instability (CAI).
Show all 10Show fewer
  • Having a Cumberland Ankle Instability Tool - Turkish Version (CAIT-T) score of ≤24.
  • Having a Foot and Ankle Ability Measure (FAAM) score of <90%.
  • Having a Foot and Ankle Ability Measure Sports subscale (FAAM-S) score of <80%.
  • A side-to-side difference of ≥2.5 cm in Weight-Bearing Lunge Test distance, with the affected side demonstrating less dorsiflexion than the unaffected side.

Who cannot join

  • History of acute lateral ankle sprain within the last 3 months.
  • History of lower extremity surgery.
  • History of acute injury to other musculoskeletal structures of the lower extremity joints within the last 3 months that affected joint integrity and function and caused interruption of desired physical activity for at least one day.
  • History of balance or vestibular disorders, including cerebellar, vestibular, cochlear, or inner ear dysfunction.
  • Visual problems that may affect the administration or interpretation of the Dynamic Visual Acuity Test, including a history of amblyopia, diplopia, or significant visual loss.
  • Persistent symptoms related to a previous concussion or traumatic brain injury.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Mustafa Fatih Çetintaş, PT, PhD (c) contact

+905336654580

mfcetintas@gmail.com

Pelin Pişirici, PT, PhD contact

+905055016076

pelin.pisirici@bau.edu.tr

Turkey (Türkiye)1 site, 1 recruiting
  • Reset Fizyoterapi

    Istanbul, Turkey, 34728

    Mustafa F Çetintaş, PhD Candidate, +905336654580, mfcetintas@gmail.com

    İrem Ulkat, PT, +905386957456, iremulkat6@gmail.com

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Official title: The Effects of Vestibulo-Ocular Reflex Exercises Added to Postural Stabilization Training on Visuo-Motor Reaction Performance, Fear Avoidance Behaviors Related to Sports Injuries and Kinesiophobia in Amateur Athletes With Chronic Ankle Instability

Chronic ankle instability (CAI) is a common condition after lateral ankle sprain. CAI is characterized by mechanical and/or functional instability, or recurrent episodes of "giving way," persisting for at least 12 months after the initial injury, and is associated with limitations in activity and and participation. Contemporary theoretical models emphasize that CAI should not be explained solely by biomechanical or neuromuscular deficits, but rather as a dynamic condition shaped by the interaction of motor-behavioral, sensory-perceptual, psychological, and environmental factors.

Postural stabilization training is commonly used to improve balance and neuromuscular control in individuals with CAI. However, individuals with CAI may show increased reliance on visual information and altered visual-vestibular sensory reweighting during postural control tasks. The vestibulo-ocular reflex (VOR) contributes to gaze stability and visual clarity during head movements and may also be related to neurocognitive processes such as attention and processing speed. This study is designed as a randomized controlled, prospective, parallel-group, pretest-posttest design trial to investigate whether VOR exercises added to postural stabilization training improve visuo-motor reaction performance, fear avoidance behavior related to sports injuries and kinesiophobia in amateur athletes with CAI.

Read the detailed description

Chronic ankle instability (CAI) is a common condition following lateral ankle sprain and is characterized by mechanical and/or functional instability, recurrent episodes of "giving way," and activity limitations persisting for at least 12 months after the initial injury. Contemporary models suggest that CAI should not be explained only by biomechanical or neuromuscular deficits, but rather as a multidimensional condition influenced by motor-behavioral, sensory-perceptual, psychological, and environmental factors. In amateur athletes, CAI may be overlooked or undertreated despite the high sensorimotor and cognitive demands of sport-specific activities. During dynamic sport-related tasks, athletes must rapidly perceive visual information, select an appropriate motor response, and execute this response while maintaining postural control. Therefore, visuo-motor reaction performance assessed during dynamic balance may provide a meaningful functional outcome for evaluating sport-specific sensorimotor control in individuals with CAI.

Postural stabilization training is commonly used in CAI rehabilitation to improve balance, proprioceptive function, and neuromuscular control. However, individuals with CAI may demonstrate increased reliance on visual information and altered visual-vestibular sensory reweighting during postural control tasks. The vestibulo-ocular reflex (VOR) contributes to gaze stability and visual clarity during head movements. Therefore, integrating VOR exercises into postural stabilization training may support visual stabilization, sensory integration, and motor response performance during dynamic balance tasks.

Psychological factors may also influence functional performance and return-to-sport behavior after musculoskeletal injury. Fear-avoidance behavior related to sports injuries and kinesiophobia may lead individuals to avoid movement or sport-specific activities due to fear of reinjury. These factors may be associated not only with traditional motor performance outcomes, but also with visual attention strategies, attentional resource allocation, and reactive motor response processes.

This study is designed as a randomized controlled, prospective, parallel-group, pretest-posttest design trial to investigate whether VOR exercises added to postural stabilization training improve visuo-motor reaction performance, fear avoidance behavior related to sports injuries and kinesiophobia in amateur athletes with CAI. Visuo-motor reaction performance will be assessed using a Reactive Balance Test, Fear-avoidance behavior related to sports injuries will be evaluated through Athlete Fear Avoidance Questionnaire - Turkish Version and kinesiophobia will be assessed using Tampa Scale for Kinesiophobia - Turkish Version. Approximately 32 participants with CAI will participate in an exercise program for six weeks, three days a week. Each session will last approximately 45 minutes, including 40 minutes of exercise and 5 minutes of ankle mobilization. Participants will be randomized into either a Postural Stabilization Training Group or a Postural Stabilization Training plus Vestibulo-Ocular Reflex (VOR) Exercises Group. Outcomes will be assessed at baseline, at the end of the six week intervention and at 4-week follow-up.

Being tested
Postural Stabilization Training, Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization Training
Keywords
sprain, sensory reweighting, injury-related anxiety, psychological readiness, gaze stabilization
Medical subject headings
Ankle Injuries, Sprains and Strains

What participants receive

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

  • Postural Stabilization TrainingOther

    Also called Talocrural joint mobilization

    Participants in this group will receive ankle joint mobilization followed by a structured postural stabilization training program. The program will include single-leg stance progression, hop stabilization tasks and number-sequence hop tasks. Exercises will be progressed according to the participant's ability to complete each task without errors. Ankle joint mobilization will include talocrural anteroposterior mobilization and distal fibular mobilization with movement, applied before the exercise session for approximately 5 minutes. The total session will last approximately 45 minutes and will be performed 3 times per week for 6 weeks.

  • Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization TrainingOther

    Also called Talocrural joint mobilization

    Participants in this group will receive the same ankle joint mobilization and postural stabilization training program as the Postural Stabilization Training Group. In addition, vestibulo-ocular reflex (VOR) exercises involving fixation on a visual target during head movements will be implemented. VOR exercises will be structured to progressively increase postural demands and will include sitting, standing, walking, and single-leg stance positions. The total session will last approximately 45 minutes and will be performed 3 times per week for 6 weeks.

Study groups in NCT07760233
Study groupRoleWhat they receive
Postural Stabilization Training GroupActive comparatorParticipants in this group will receive ankle joint mobilization followed by a structured postural stabilization training program. The program will include single-leg stance progression, hop stabilization tasks, and number-sequence hop tasks. Exercises will be progressed according to the participant's ability to complete each task without errors. Ankle joint mobilization will include talocrural anteroposterior mobilization and distal fibular mobilization with movement, applied before the exercise session for approximately 5 minutes.
Receives: Other: Postural Stabilization Training
Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization Training GroupExperimentalParticipants in this group will receive the same ankle joint mobilization and postural stabilization training program as the Postural Stabilization Training Group. In addition, vestibulo-ocular reflex (VOR) exercises involving fixation on a visual target during head movements will be implemented. VOR exercises will be structured to progressively increase postural demands and will include sitting, standing, walking, and single-leg stance positions.
Receives: Other: Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization Training

What is being measured

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

  1. Reactive Balance Test

    This test will be used to assess visuo-motor reaction performance during dynamic postural control. The test will combine the Y-Balance Test setup with a smartphone-controlled LED light system (BlazePod). LED targets will be placed at 80% of each participant's maximum reach distance in the anterior, posteromedial, and posterolateral directions.

    Participants will stand in the standard Y-Balance Test position and will be instructed to touch the target LED stimulus as quickly as possible without losing balance. A total of 45 randomized visual stimuli will be presented, with inter-stimulus intervals ranging from 0.5 to 2.5 seconds.

    Visuo-motor reaction time will be recorded in milliseconds, and accuracy will be calculated based on missed stimuli, multiple attempts, and decision errors. The test will be performed twice on the limb with a history of instability; the first trial will be used for familiarization, and the second trial will be used for analysis.

    Measured: baseline, 6 weeks after baseline, and 10-week after baseline

Secondary outcomes (2)
  1. The Athlete Fear Avoidance Questionnaire - Turkish Version (AFAQ-TR)

    The questionnaire will be used to assess fear-avoidance behavior related to return to sport after injury. The questionnaire consists of 10 items scored on a 5-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree).

    The total score ranges from 0 to 40, with higher scores indicating greater fear-avoidance behavior.

    Measured: baseline, 6 weeks after baseline, and 10-week after baseline

  2. The Tampa Scale for Kinesiophobia - Turkish Version (TSK-TR)

    The scale will be used to assess fear of movement after musculoskeletal injury. The scale consists of 17 items scored on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree).

    After reverse scoring items 4, 8, 12, and 16, a total score will be calculated. The total score ranges from 17 to 68, with higher scores indicating greater kinesiophobia.

    Measured: baseline, 6 weeks after baseline, and 10-week after baseline

Timeline

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

  1. First posted12 Aug 2026
  2. Study start25 Jul 2026
  3. Primary completion25 Jul 2027 (estimated)
  4. Study completion25 Jul 2027 (estimated)

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
Model description
Participants who meet the inclusion criteria will be randomized into Participants will be randomly allocated to one of two groups two parallel groups: Postural Stabilization Training Group and Postural Stabilization Training plus Vestibulo-Ocular Reflex Exercises Group. Both groups will receive the ankle joint mobilization by the same physiotherapist. Assessments will be performed at baseline, at the end of week 6, and at 4-week follow-up.
Masking
None (open label)
Enrolment
32 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07760233
Sponsor's protocol ID
MFP-CAI-VOR-2027
Status last verified
Oct 2026
First submitted
7 Aug 2026
Last updated
28 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Postural Stabilization Training and Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization Training in people with Ankle Sprain and Ankle Sprain Strain, run by Bahçeşehir 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 10 inclusion and 6 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: looking for participants now, as of the sponsor's last update on 28 Oct 2026. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Mustafa Fatih Çetintaş, PT, PhD (c) (+905336654580, mfcetintas@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Reactive Balance Test (time frame: baseline, 6 weeks after baseline, and 10-week after baseline). 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 28 Oct 2026.

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