Effectiveness of Balance Training and Dynamic Neuromuscular Stabilization Training in Amateur Athletes with Chronic Ankle Instability
NCT ID: NCT06296537
Last Updated: 2024-12-19
Study Results
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Basic Information
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COMPLETED
NA
36 participants
INTERVENTIONAL
2024-04-01
2024-12-16
Brief Summary
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* 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
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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.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Dynamic Neuromuscular Stabilization Training Group
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.
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.
Balance Training Group
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.
Balance Training
Multi-plane single limb challenges, jumping and landing exercises, proprioceptive exercises, and perturbation exercises
Conventional Training Group
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.
Conventional Training
Education, electrotherapy, soft tissue fascia massage, stretching, range of motion, strengthening and postural control exercises
Interventions
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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.
Balance Training
Multi-plane single limb challenges, jumping and landing exercises, proprioceptive exercises, and perturbation exercises
Conventional Training
Education, electrotherapy, soft tissue fascia massage, stretching, range of motion, strengthening and postural control exercises
Eligibility Criteria
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Inclusion Criteria
* 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
Exclusion Criteria
* 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
18 Years
25 Years
ALL
No
Sponsors
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Medipol University
OTHER
Responsible Party
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Sevval Yesilkır
Physiotherapist
Locations
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Sevval Yeşilkır
Istanbul, Beşiktaş, Turkey (Türkiye)
Countries
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References
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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.
Other Identifiers
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E-10840098-202.3.02-1434
Identifier Type: -
Identifier Source: org_study_id