Effect of Stroboscopic Balance Training on Chronic Ankle Instability in Volleyball Players

NCT ID: NCT07255625

Last Updated: 2025-12-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-20

Study Completion Date

2026-03-01

Brief Summary

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Effect of Stroboscopic Balance Training on Chronic Ankle Instability in Volleyball Players

Detailed Description

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Ankle sprains are among the most common injuries in both athletes and the general population. A large-scale systematic review reported that ankle sprains account for approximately 80% of injuries occurring among athletes in most sports. Among volleyball players, ankle sprains are the most prevalent injury, constituting about 41% of all volleyball-related injuries. In athletes, performing certain technical or sport-specific tasks that require attention, such as running, sudden changes of direction, or landing, is associated with an increased risk of ankle sprain. Approximately 20% of acute ankle sprains progress to chronic conditions. Chronic ankle sprains lead to serious proprioceptive dysfunctions, including deficits in joint position sense and delayed peroneal muscle reaction time, resulting in significant ankle instability and balance impairment. Balance training in individuals with chronic ankle instability is concerned with improving postural control and has been recognized as an effective therapeutic approach for this population. Although there is evidence supporting the effectiveness of balance training in improving sensorimotor deficits in individuals with chronic ankle instability, including static and dynamic postural stability, muscle strength, and reinjury rates, reliance on visual information remains unchanged after conventional rehabilitation. The inability of visual input to utilize somatosensory feedback from the ankle joint has been identified as a factor contributing to recurrent ankle sprains in these individuals. Conventional interventions for chronic ankle instability do not address the need to correct altered somatosensory deficits following an ankle sprain. Therefore, a specific treatment option focusing on this neurophysiological dysfunction would be beneficial for these patients. Kim et al. reported the effect of stroboscopic vision in reactivating visual input in individuals with chronic ankle instability. Stroboscopic vision involves the use of special glasses in which the lenses alternate between transparent and opaque at intervals of 100 milliseconds, thereby reducing visual feedback. Balance training with stroboscopic glasses offers a different approach compared to conventional balance training. Stroboscopic balance training is a technique aimed at manipulating visual perception. In this method, the stroboscopic glasses intermittently block light, affecting the brain's processing of visual information. Consequently, the brain must process seen objects less continuously and less clearly. Stroboscopic glasses make rapid movements and changing situations more difficult to perceive, thereby challenging the balance system further. Conventional balance training, on the other hand, involves methods used to improve static and dynamic balance skills. This training approach aims to strengthen the balance mechanism through the use of specialized balance devices, exercises, and techniques. For example, balance boards, balance pads, trampolines, and various movement exercises are commonly used tools in conventional balance training. This method works on factors such as muscle strength, postural control, and coordination to improve static and dynamic balance control. The main difference between balance training with stroboscopic glasses and conventional balance training is the use of glasses that manipulate visual perception. These glasses challenge the brain's processing, thereby providing greater stimulation to the balance mechanism. In contrast, conventional balance training uses general exercises and tools to improve balance skills and does not focus on altering visual perception. Stroboscopic glasses have previously been used to improve sports performance in baseball players with positive results. They have also been incorporated into rehabilitation programs for individuals with chronic ankle instability, demonstrating beneficial outcomes. Although chronic ankle instability is a common problem among volleyball players, to our knowledge, no study has investigated a rehabilitation program using stroboscopic balance training in female volleyball players with chronic ankle instability.

Conditions

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Chronic Ankle Instability

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Stroboscopic Glassess Group

The athletes assigned to Group A underwent an eight-week balance training program using stroboscopic glasses, conducted twice a week under the supervision of a physiotherapist.

Group Type EXPERIMENTAL

Balance training with stroboscopic glasses

Intervention Type DEVICE

Participants in Group A completed a supervised, multi-modal balance training program while wearing Senaptec stroboscopic glasses (Beaverton, Oregon), set to a duty cycle of 100 ms transparent followed by 150 ms opaque. The glasses use liquid crystal lenses that alternate between clear and nearly opaque states when electrically activated and can operate in both binocular and monocular modes, with settings adjustable via a Bluetooth application. The program, targeting static and dynamic balance in individuals with chronic ankle instability, consisted of six progressively challenging exercises performed indoors, barefoot, in small groups, lasting approximately 20 minutes per session, twice weekly for eight weeks. Exercises were completed in two sets with 30-second rests between exercises and 2-minute rests between sets, and progression was adjusted based on participant performance.

Control Group

The athletes assigned to Group B underwent an eight-week traditional balance training program, conducted twice a week under the supervision of a physiotherapist.

Group Type ACTIVE_COMPARATOR

Traditional Balance Training

Intervention Type OTHER

The intervention consisted of a supervised, multi-modal balance training program targeting differentaspects of static and dynamic balance for participants with chronic ankle instability. The program included six progressively challenging exercises, administered under the supervision of a physiotherapist. Each session lasted approximately 20 minutes, and participants completed two sessions per week for eight weeks.

The training was conducted indoors, barefoot, in small groups, with exercises performed in two sets, including 30-second rests between exercises and 2-minute rests between sets. Progression was implemented according to participants' performance throughout the program.

Interventions

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Balance training with stroboscopic glasses

Participants in Group A completed a supervised, multi-modal balance training program while wearing Senaptec stroboscopic glasses (Beaverton, Oregon), set to a duty cycle of 100 ms transparent followed by 150 ms opaque. The glasses use liquid crystal lenses that alternate between clear and nearly opaque states when electrically activated and can operate in both binocular and monocular modes, with settings adjustable via a Bluetooth application. The program, targeting static and dynamic balance in individuals with chronic ankle instability, consisted of six progressively challenging exercises performed indoors, barefoot, in small groups, lasting approximately 20 minutes per session, twice weekly for eight weeks. Exercises were completed in two sets with 30-second rests between exercises and 2-minute rests between sets, and progression was adjusted based on participant performance.

Intervention Type DEVICE

Traditional Balance Training

The intervention consisted of a supervised, multi-modal balance training program targeting differentaspects of static and dynamic balance for participants with chronic ankle instability. The program included six progressively challenging exercises, administered under the supervision of a physiotherapist. Each session lasted approximately 20 minutes, and participants completed two sessions per week for eight weeks.

The training was conducted indoors, barefoot, in small groups, with exercises performed in two sets, including 30-second rests between exercises and 2-minute rests between sets. Progression was implemented according to participants' performance throughout the program.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Were professional female volleyball players.
* Had a history of at least two episodes of pain and swelling in the same ankle.
* Experienced at least one ankle sprain within the last six months.
* Exhibited persistent symptoms during functional activities and were free from symptoms related to any previous lower-extremity injuries.
* Reported a feeling of instability in the ankle joint.
* Had no other lower-extremity musculoskeletal injuries in the past six months.

Exclusion Criteria

* Reported any vestibular or balance-related dysfunction.
* Had any systemic disease.
* Experienced an acute ankle sprain within the past six weeks.
* Had a history of fractures in the lower extremities.
Minimum Eligible Age

16 Years

Maximum Eligible Age

26 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Biruni University

OTHER

Sponsor Role lead

Responsible Party

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Berivan Beril Kılıç

Asistant professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Biruni University

Fatih, İ̇stanbul, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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BERİL KILIÇ

Role: CONTACT

+905069496158

Facility Contacts

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Role: primary

References

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Anaforoglu Kulunkoglu B, Celik D. Reliability and Validity of the Turkish Version of Foot and Ankle Ability Measure for Patients With Chronic Ankle Disability. J Foot Ankle Surg. 2019 Jan;58(1):38-41. doi: 10.1053/j.jfas.2018.07.007. Epub 2018 Nov 15.

Reference Type RESULT
PMID: 30448187 (View on PubMed)

Goble DJ. Proprioceptive acuity assessment via joint position matching: from basic science to general practice. Phys Ther. 2010 Aug;90(8):1176-84. doi: 10.2522/ptj.20090399. Epub 2010 Jun 3.

Reference Type RESULT
PMID: 20522675 (View on PubMed)

Carcia CR, Martin RL, Drouin JM. Validity of the Foot and Ankle Ability Measure in athletes with chronic ankle instability. J Athl Train. 2008 Apr-Jun;43(2):179-83. doi: 10.4085/1062-6050-43.2.179.

Reference Type RESULT
PMID: 18345343 (View on PubMed)

Haynes T, Bishop C, Antrobus M, Brazier J. The validity and reliability of the My Jump 2 app for measuring the reactive strength index and drop jump performance. J Sports Med Phys Fitness. 2019 Feb;59(2):253-258. doi: 10.23736/S0022-4707.18.08195-1. Epub 2018 Mar 27.

Reference Type RESULT
PMID: 29589412 (View on PubMed)

Shaffer SW, Teyhen DS, Lorenson CL, Warren RL, Koreerat CM, Straseske CA, Childs JD. Y-balance test: a reliability study involving multiple raters. Mil Med. 2013 Nov;178(11):1264-70. doi: 10.7205/MILMED-D-13-00222.

Reference Type RESULT
PMID: 24183777 (View on PubMed)

Powden CJ, Hoch JM, Jamali BE, Hoch MC. A 4-Week Multimodal Intervention for Individuals With Chronic Ankle Instability: Examination of Disease-Oriented and Patient-Oriented Outcomes. J Athl Train. 2019 Apr;54(4):384-396. doi: 10.4085/1062-6050-344-17. Epub 2018 Dec 27.

Reference Type RESULT
PMID: 30589387 (View on PubMed)

Gribble PA, Delahunt E, Bleakley CM, Caulfield B, Docherty CL, Fong DT, Fourchet F, Hertel J, Hiller CE, Kaminski TW, McKeon PO, Refshauge KM, van der Wees P, Vicenzino W, Wikstrom EA. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. J Athl Train. 2014 Jan-Feb;49(1):121-7. doi: 10.4085/1062-6050-49.1.14. Epub 2013 Dec 30.

Reference Type RESULT
PMID: 24377963 (View on PubMed)

Lee H, Han S, Hopkins JT. Altered Visual Reliance Induced by Stroboscopic Glasses during Postural Control. Int J Environ Res Public Health. 2022 Feb 12;19(4):2076. doi: 10.3390/ijerph19042076.

Reference Type RESULT
PMID: 35206263 (View on PubMed)

Kim KM, Estudillo-Martinez MD, Castellote-Caballero Y, Estepa-Gallego A, Cruz-Diaz D. Short-Term Effects of Balance Training with Stroboscopic Vision for Patients with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial. Int J Environ Res Public Health. 2021 May 18;18(10):5364. doi: 10.3390/ijerph18105364.

Reference Type RESULT
PMID: 34069907 (View on PubMed)

Clark JF, Ellis JK, Bench J, Khoury J, Graman P. High-performance vision training improves batting statistics for University of Cincinnati baseball players. PLoS One. 2012;7(1):e29109. doi: 10.1371/journal.pone.0029109. Epub 2012 Jan 19.

Reference Type RESULT
PMID: 22276103 (View on PubMed)

Kim KM, Kim JS, Grooms DR. Stroboscopic Vision to Induce Sensory Reweighting During Postural Control. J Sport Rehabil. 2017 Sep 1;26(5). doi: 10.1123/jsr.2017-0035. Epub 2017 Jun 12.

Reference Type RESULT
PMID: 28605310 (View on PubMed)

Hertel J. Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med. 2008 Jul;27(3):353-70, vii. doi: 10.1016/j.csm.2008.03.006.

Reference Type RESULT
PMID: 18503872 (View on PubMed)

Song K, Rhodes E, Wikstrom EA. Balance Training Does Not Alter Reliance on Visual Information during Static Stance in Those with Chronic Ankle Instability: A Systematic Review with Meta-Analysis. Sports Med. 2018 Apr;48(4):893-905. doi: 10.1007/s40279-017-0850-8.

Reference Type RESULT
PMID: 29288435 (View on PubMed)

Song K, Burcal CJ, Hertel J, Wikstrom EA. Increased Visual Use in Chronic Ankle Instability: A Meta-analysis. Med Sci Sports Exerc. 2016 Oct;48(10):2046-56. doi: 10.1249/MSS.0000000000000992.

Reference Type RESULT
PMID: 27635773 (View on PubMed)

Molla-Casanova S, Ingles M, Serra-Ano P. Effects of balance training on functionality, ankle instability, and dynamic balance outcomes in people with chronic ankle instability: Systematic review and meta-analysis. Clin Rehabil. 2021 Dec;35(12):1694-1709. doi: 10.1177/02692155211022009. Epub 2021 May 31.

Reference Type RESULT
PMID: 34058832 (View on PubMed)

Hertel J. Functional instability following lateral ankle sprain. Sports Med. 2000 May;29(5):361-71. doi: 10.2165/00007256-200029050-00005.

Reference Type RESULT
PMID: 10840868 (View on PubMed)

Verhagen EA, Van der Beek AJ, Bouter LM, Bahr RM, Van Mechelen W. A one season prospective cohort study of volleyball injuries. Br J Sports Med. 2004 Aug;38(4):477-81. doi: 10.1136/bjsm.2003.005785.

Reference Type RESULT
PMID: 15273190 (View on PubMed)

Fong DT, Hong Y, Chan LK, Yung PS, Chan KM. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007;37(1):73-94. doi: 10.2165/00007256-200737010-00006.

Reference Type RESULT
PMID: 17190537 (View on PubMed)

Chinn L, Hertel J. Rehabilitation of ankle and foot injuries in athletes. Clin Sports Med. 2010 Jan;29(1):157-67, table of contents. doi: 10.1016/j.csm.2009.09.006.

Reference Type RESULT
PMID: 19945591 (View on PubMed)

Other Identifiers

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5

Identifier Type: -

Identifier Source: org_study_id

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