Trial Outcomes & Findings for The Effect of Additional Neurodynamic Intervention in Patients With Chronic Ankle Instability (NCT NCT05090423)

NCT ID: NCT05090423

Last Updated: 2026-01-15

Results Overview

The subjects sat on the edge of the bed without touching the ground with their feet. The physical therapist assisted the subjects in maintaining a neutral pelvis position. First, the subjects were asked to flex the neck, trunk, and finally the lumbar to tighten the back. Second, while the subjects plantarflexed and inverted the ankle, they performed the knee extension movement, and the angle of knee motion was recorded. Participants performed three practice trials followed by three test trials and averaged the three tests.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 36 participants
• Primary outcome timeframe: Within one week after 12 treatment session
• Results posted on: 2026-01-15

Participant Flow

In this study, participants with chronic ankle instability were recruited from Yang Ming Chiao Tung University and various orthopedic and rehabilitation clinics in Taipei. Potential participants were first contacted to confirm preliminary eligibility. During the initial meeting, the study process and relevant details were explained. Eligibility was further verified based on inclusion and exclusion criteria. Upon confirmation, participants provided informed consent to participate in the study.

In this study, 59 participants were initially recruited to meet the inclusion criteria. Among them, 36 participants (14 males and 22 females) were confirmed to meet the eligibility requirements. Due to others not meeting inclusion criteria or falling under exclusion criteria.

Participant milestones

Measure	Exercise Group The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Overall Study STARTED	18	18
Overall Study COMPLETED	15	15
Overall Study NOT COMPLETED	3	3

Reasons for withdrawal

Measure	Exercise Group The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Overall Study Because of the covid-19	3	2
Overall Study repeated ankle sprain in daily of life	0	1

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.	Total n=36 Participants Total of all reporting groups
Age, Continuous	24 years STANDARD_DEVIATION 4.84 • n=18 Participants	25 years STANDARD_DEVIATION 4.62 • n=18 Participants	24.64 years STANDARD_DEVIATION 4.7 • n=36 Participants
Sex: Female, Male Female	11 Participants n=18 Participants	11 Participants n=18 Participants	22 Participants n=36 Participants
Sex: Female, Male Male	7 Participants n=18 Participants	7 Participants n=18 Participants	14 Participants n=36 Participants
Race and Ethnicity Not Collected	—	—	0 Participants Race and Ethnicity were not collected from any participant.
Region of Enrollment Taiwan	18 participants n=18 Participants	18 participants n=18 Participants	36 participants n=36 Participants
Pressure pain threshold-anterior talofibular ligament	3.6 kg/ cm² STANDARD_DEVIATION 1.29 • n=18 Participants	3.38 kg/ cm² STANDARD_DEVIATION 0.85 • n=18 Participants	3.5 kg/ cm² STANDARD_DEVIATION 1.09 • n=36 Participants
Pressure pain threshold-calcaneofibular ligament	4.72 kg/ cm² STANDARD_DEVIATION 1.37 • n=18 Participants	4.14 kg/ cm² STANDARD_DEVIATION 0.1 • n=18 Participants	4.43 kg/ cm² STANDARD_DEVIATION 1.22 • n=36 Participants
Pressure pain threshold-peroneal brevis muscle	4.48 kg/ cm² STANDARD_DEVIATION 1.41 • n=18 Participants	3.73 kg/ cm² STANDARD_DEVIATION 1.16 • n=18 Participants	4.11 kg/ cm² STANDARD_DEVIATION 1.33 • n=36 Participants
Pressure pain threshold-peroneal longus muscle	6.39 kg/ cm² STANDARD_DEVIATION 1.59 • n=18 Participants	5.27 kg/ cm² STANDARD_DEVIATION 1.35 • n=18 Participants	5.83 kg/ cm² STANDARD_DEVIATION 1.56 • n=36 Participants
Pressure pain threshold-common peroneal nerve	5.28 kg/ cm² STANDARD_DEVIATION 1.49 • n=18 Participants	4.21 kg/ cm² STANDARD_DEVIATION 1.34 • n=18 Participants	4.74 kg/ cm² STANDARD_DEVIATION 1.5 • n=36 Participants
Active knee extension range of motion during slump test in ankle plantar flexion with inversion	34.19 degree STANDARD_DEVIATION 3.39 • n=18 Participants	36.39 degree STANDARD_DEVIATION 3.39 • n=18 Participants	35.29 degree STANDARD_DEVIATION 14.22 • n=36 Participants
Hamstring flexibility	40.63 degree STANDARD_DEVIATION 2.61 • n=18 Participants	41.02 degree STANDARD_DEVIATION 2.61 • n=18 Participants	40.83 degree STANDARD_DEVIATION 10.93 • n=36 Participants
Weight-bearing lunge test	44.87 degree STANDARD_DEVIATION 7.89 • n=18 Participants	43.96 degree STANDARD_DEVIATION 5.36 • n=18 Participants	44.42 degree STANDARD_DEVIATION 6.66 • n=36 Participants
Y balance test-anterior direction	55.1 % STANDARD_DEVIATION 5.28 • n=18 Participants	53.05 % STANDARD_DEVIATION 5.79 • n=18 Participants	54.09 % STANDARD_DEVIATION 5.51 • n=36 Participants
Y balance test-posterolateral direction	94.2 % STANDARD_DEVIATION 8.86 • n=18 Participants	88.27 % STANDARD_DEVIATION 10.75 • n=18 Participants	91.22 % STANDARD_DEVIATION 10.2 • n=36 Participants
Y balance test-posteromedial direction	85.09 % STANDARD_DEVIATION 7.94 • n=18 Participants	84.3 % STANDARD_DEVIATION 9.67 • n=18 Participants	84.71 % STANDARD_DEVIATION 8.7 • n=36 Participants
Foot and ankle ability measure-Activity of Life	92.99 % STANDARD_DEVIATION 7.19 • n=18 Participants	91.6 % STANDARD_DEVIATION 7.81 • n=18 Participants	92.29 % STANDARD_DEVIATION 7.47 • n=36 Participants
Foot and ankle ability measure- Activity of Life (Self- Awareness Score)	84.56 units on a scale STANDARD_DEVIATION 7.59 • n=18 Participants	82.5 units on a scale STANDARD_DEVIATION 15.46 • n=18 Participants	83.53 units on a scale STANDARD_DEVIATION 12.05 • n=36 Participants
Foot and ankle ability measure-sports	81.15 % STANDARD_DEVIATION 13.52 • n=18 Participants	81.94 % STANDARD_DEVIATION 14.57 • n=18 Participants	81.54 % STANDARD_DEVIATION 13.81 • n=36 Participants
Foot and ankle ability measure- Sports (Self- Awareness Score)	75.56 units on a scale STANDARD_DEVIATION 11.87 • n=18 Participants	72.39 units on a scale STANDARD_DEVIATION 20 • n=18 Participants	73.97 units on a scale STANDARD_DEVIATION 16.28 • n=36 Participants

PRIMARY outcome

Timeframe: Within one week after 12 treatment sessions

Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the anterior talofibular ligament. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Pressure Pain Threshold- Anterior Talofibular Ligament	4.19 kg/ cm² Standard Deviation 1.3	3.98 kg/ cm² Standard Deviation 1.29

PRIMARY outcome

Timeframe: Within one week after 12 treatment sessions

Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the calcaneofibular ligament. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Pressure Pain Threshold- Calcaneofibular Ligament	4.98 kg/ cm² Standard Deviation 1.62	4.67 kg/ cm² Standard Deviation 1.43

PRIMARY outcome

Timeframe: Within one week after 12 treatment session

The subjects sat on the edge of the bed without touching the ground with their feet. The physical therapist assisted the subjects in maintaining a neutral pelvis position. First, the subjects were asked to flex the neck, trunk, and finally the lumbar to tighten the back. Second, while the subjects plantarflexed and inverted the ankle, they performed the knee extension movement, and the angle of knee motion was recorded. Participants performed three practice trials followed by three test trials and averaged the three tests.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Active Knee Extension Range of Motion During Slump Test in Ankle Plantar Flexion With Inversion	24.53 degree Standard Deviation 1.9	17.8 degree Standard Deviation 1.9

PRIMARY outcome

Timeframe: Within one week after 12 treatment sessions

Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the peroneal brevis muscle. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Pressure Pain Threshold- Peroneal Brevis Muscle	4.66 kg/ cm² Standard Deviation 1.36	4.27 kg/ cm² Standard Deviation 1.19

PRIMARY outcome

Timeframe: Within one week after 12 treatment sessions

Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the peroneal longus muscle. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Pressure Pain Threshold- Peroneal Longus Muscle	6.3 kg/ cm² Standard Deviation 2	5.93 kg/ cm² Standard Deviation 1.5

PRIMARY outcome

Timeframe: Within one week after 12 treatment sessions

Using the PainTestTM FDX algometer, apply vertical contact and average force to measure pressure pain thresholds at the common peroneal nerve. The point is tested three times with a 30-second interval between tests, and the average of the three measurements is recorded.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Pressure Pain Threshold- Common Peroneal Nerve	5.47 kg/ cm² Standard Deviation 1.58	4.89 kg/ cm² Standard Deviation 1.39

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

Participants stood on the Y-Balance Test device and reached with the non-stance leg in the anterior, posterolateral, and posteromedial directions, starting with the dominant leg, in sequence. Each participant performed six practice trials to become familiar with the procedure. For data collection, three final trials in each direction were recorded. Leg length was measured from the anterior superior iliac spine to the distal tip of the medial malleolus. Reach distance in centimeters was normalized to leg length by dividing the reach distance by leg length and multiplying by 100 to obtain the percentage of leg length for statistical analysis.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Y Balance Test- Anterior Direction	61.18 % of leg length Standard Deviation 5.87	59.22 % of leg length Standard Deviation 4.01

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

The Foot and Ankle Ability Measure (FAAM) Sports Subscale is a self-reported questionnaire consisting of 8 items that assess the participant's perceived ability to perform sports-related activities. Each item is rated on a 5-point scale (0 = unable to do, 1 = extreme difficulty, 2 = moderate difficulty, 3 = slight difficulty, 4 = no difficulty). If an item is not applicable, the participant marks "N/A."

Raw scores are summed and converted to a percentage score using the following formula: (raw score ÷ maximum possible score) × 100, with higher scores indicating better functional ability.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
The Foot and Ankle Ability Measures- Sports	93.35 percentage Standard Deviation 4.22	93.55 percentage Standard Deviation 9.58

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

The Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) subscale is a self-reported questionnaire consisting of 21 items that assess the participant's perceived difficulty in performing activities of daily living. Each item is rated on a 5-point scale (0 = unable to do, 1 = extreme difficulty, 2 = moderate difficulty, 3 = slight difficulty, 4 = no difficulty). If an item is not applicable, the participant marks "N/A."

Raw scores are summed and converted to a percentage score using the following formula: (raw score ÷ maximum possible score) × 100, with higher scores indicating better functional ability.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
The Foot and Ankle Ability Measures- Activity of Life	98.13 percentage Standard Deviation 1.65	97.86 percentage Standard Deviation 3.32

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

Asked the person to face the wall and placed the tested foot in front, with the second toe and heel in a line perpendicular to the wall. The contralateral limb was positioned behind the testing limb in a comfortable position, and hands were placed on the wall in front to maintain stability. The gravity inclinometer was placed at the tibial tuberosity to measure the angle. The subjects lunged forward, trying to touch a vertical line on the wall with their knee, while keeping their heel in contact with the ground.

Participants performed three practice trials followed by three test trials and averaged the three tests.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Weight Bearing Lunge Test	41.27 degree Standard Deviation 6.66	40.38 degree Standard Deviation 5.09

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

Measured hamstring flexibility using the 90-90 passive knee extension test. The subject lay flat on their back on the bed and straps were used to secure the pelvis. The test leg was positioned with the hip and knee at 90 degrees, while the other leg remained straight on the bed. The subject's knee was then passively extended. The goniometer's stationary arm was attached to the middle of the thigh, the axis was aligned with the lateral epicondyle of the femur, and the moving arm was positioned to the lateral malleolus. The knee extension angle was measured. The value recorded was the angle between the lower leg and the vertical line.

Participants performed three practice trials followed by three test trials and averaged the three tests.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Hamstring Flexibility	38.07 degree Standard Deviation 2.7	30.78 degree Standard Deviation 2.7

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

The Activities of Daily Living (self-awareness score) is a self-reported measure in which the participant rates the functional status of the involved (patient) foot relative to the uninvolved (healthy) foot. The uninvolved foot is assigned a reference value of 100 points. The participant then rates the involved foot on a scale ranging from 0 to 100, with higher scores indicating better self-perceived functional ability in daily life.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
The Foot and Ankle Ability Measures- Activity of Life (Self- Awareness Score)	92.27 score on a scale Standard Deviation 6.27	93.73 score on a scale Standard Deviation 4.26

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

The Sports (self-awareness score) is a self-reported measure in which the participant rates the perceived functional ability of the involved (patient) foot during sports-related activities relative to the uninvolved (healthy) foot. The uninvolved foot is assigned a reference value of 100 points. The participant then rates the involved foot on a scale ranging from 0 to 100, with higher scores indicating better self-perceived sports-related functional ability.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
The Foot and Ankle Ability Measures- Sports (Self- Awareness Score)	86.67 score on a scale Standard Deviation 5.27	88.13 score on a scale Standard Deviation 11.79

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

Participants stood on the Y-Balance Test device and reached with the non-stance leg in the anterior, posterolateral, and posteromedial directions, starting with the dominant leg, in sequence. Each participant performed six practice trials to become familiar with the procedure. For data collection, three final trials in each direction were recorded. Leg length was measured from the anterior superior iliac spine to the distal tip of the medial malleolus. Reach distance in centimeters was normalized to leg length by dividing the reach distance by leg length and multiplying by 100 to obtain the percentage of leg length for statistical analysis.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Y Balance- Posterolateral Direction	103.17 % of leg length Standard Deviation 6.77	97.19 % of leg length Standard Deviation 6.13

SECONDARY outcome

Timeframe: Within one week after 12 treatment sessions

Participants stood on the Y-Balance Test device and reached with the non-stance leg in the anterior, posterolateral, and posteromedial directions, starting with the dominant leg, in sequence. Each participant performed six practice trials to become familiar with the procedure. For data collection, three final trials in each direction were recorded. Leg length was measured from the anterior superior iliac spine to the distal tip of the medial malleolus. Reach distance in centimeters was normalized to leg length by dividing the reach distance by leg length and multiplying by 100 to obtain the percentage of leg length for statistical analysis.

Outcome measures

Measure	Exercise Group n=18 Participants The exercise group receives 12 treatment interventions over six to eight weeks, with each session lasting approximately 20 minutes. First, 5-minute warm-up and stretching session, followed by foot core exercises and instruction on foot stability movements. The 12 treatment sessions were divided into three stages based on difficulty.	Neurodynamic Group n=18 Participants The exercise group underwent 12 treatment sessions over a period of six to eight weeks, each lasting about 20 minutes. Initially, the treatment involved peroneal nerve sliding techniques: movements were executed every two seconds for 30 seconds, repeated four times. Between each session, there was a one-minute rest, totaling five minutes. The 12 sessions of neurodynamic interventions were categorized into three progressive stages. Following this, participants engaged in foot core exercises and received instructions on foot stability movements, also organized into three stages based on difficulty.
Y Balance- Posteromedial Direction	98.13 % of leg length Standard Deviation 6.32	94.62 % of leg length Standard Deviation 6.35

Adverse Events

Exercise Group

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Neurodynamic Group

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Chen Hsin-I, Physical Therapist

National Yang Ming Chiao Tung University

Phone: +886-982-641-541

Email: hsini0329@gmail.com

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place