Comparison of Resistance Training With and Without Plyometric Exercises on Athletes With Chronic Ankle Instability.

Official title

Comparison of Resistance Training With and Without Plyometric Exercises on Pain, Range of Motion, Dynamic Balance and Strength Among Athletes With Chronic Ankle Instability.

Overview

Chronic ankle instability is characterized by a patient's being more than 12 months removed from the initial LAS and exhibiting a propensity for recurrent ankle sprains, frequent episodes or perceptions of the ankle giving way, and persistent symptoms such as pain, swelling, limited motion, weakness, and diminished self-reported function. This study will Compare Resistance Training with and without Plyometric exercises on Athletes with Chronic Ankle instability and changes will be recorded using different methods and tools. Patients will be randomly allocated into two different groups. Group A will be treated with resistance training and Group B will be treated with resistance training along with plyometric exercises . Participants will complete clinician-oriented tests. Participants of both groups will be evaluated before and after the application of respective interventions at the end of 8th week. Data will be analysed.

Detailed description

Resistance training applies effort to overcome resistance, which results in increased muscle fibre recruitment and stronger synchronization, ultimately enhancing neuromuscular control and leading to muscular growth. Elastic resistance training is not only the cheaper intervention but is also able to promote similar strength gains to conventional resistance training. Both isokinetic muscle strength training and Thera-Band strength training have been used extensively to increase muscle strength after sports injuries and improve muscle performance in athletes, thereby accelerating injury recovery. Plyometric training provided benefits in both static and dynamic balances for individuals with Functional ankle instability. Plyometric are more effective than resistive exercises in improving functional performance of athletes after lateral ankle sprain. Convenient sampling technique will be used to collect the data. The sample size of 24 patients will be recruited. Patients will be randomly allocated into two different groups through sealed envelope method.12 patients will be allocated in each group A will be treated with resistance training and Group B will be treated with resistance training along with plyometric exercises so resistance training exercises are help full in athletic performance .Group B will be treated with resistance training along with plyometric exercises . Participants will complete patient-oriented questionnaires (CAIT for measuring the severity of functional ankle instability Foot and Ankle Ability Measure \[FAAM\] to assess physical function for individuals with foot and ankle related impairments, Numeric pain rating scale for pain, Short-Form 36 \[SF-36\] to indicate the health status of particular populations, to help with service planning and to measure the impact of clinical and social interventions. Culture-specific data are required to calculate SF-36 norm-based. Goniometer to measure available ranges will also be used Participants of both groups will be evaluated before the application of interventional techniques and re-evaluated after the application of respective interventions at the end of 8th week. Data will be analysed on SPSS 21 .The combination of both resistance and plyometric exercises could give more significant result.

Interventions

• Other Resistance Exercises with Plyometric exercises
  We will apply protocol for 8 weeks 24 Sessions (3 sessions in a week) and 10 sec rest between each segment, 3 sets of 10 repetitions. Resistive training will start in the form of manual resistive exercise for dorsiflexion, plantar flexion, eversion and inversion (manual resistance was applied for 3 to 5 seconds for ten repetitions in each cardinal plane).After resistance training the athletes will go for plyometric exercises and will follow the following guidelines.Tubing Exercises,Plyometric A
• Other Resistance Exercises without Plyometric exercises
  We will apply protocol for 8 weeks 24 Sessions (3 sessions in a week) and 10 sec rest between each segment, 3 sets of 10 repetitions. Resistive training will start in the form of manual resistive exercise for dorsiflexion, plantar flexion, eversion and inversion (manual resistance was applied for 3 to 5 seconds for ten repetitions in each cardinal plane). While controlling the time that a maximal contraction will be maintained, the therapist will assure that the targeted musculature will being m

Primary outcome measures

• Numeric pain rating scale [Time frame: 8 Weeks]
• Goniometer [Time frame: 8 Weeks]
• The Star Excursion Balance Test (SEBT) [Time frame: 8 Weeks]
• 1 RM Leg Press test [Time frame: 8 Weeks]

Eligibility criteria

Inclusion criteria

• A history of at least 1 substantial ankle sprain with associated inflammatory symptoms and at least 1 interrupted day of desired physical activity, multiple episodes of the ankle "giving way," recurrent sprain, and "feelings of instability" in the 6 months before the study. Patients scoring the FAAM, there should be two scores, less than the ADL subscale and the Sports subscale, 20/21 items and 7/8 items must be completed, respectively
• If both ankles qualified, the ankle with the highest score (i.e. the most severely affected ankle) was considered the involved limb.

Exclusion criteria

• Volunteers were excluded if they had sustained an acute lower extremity injury in the 3 months before the study
• Having participated in formal rehabilitation in the 3 months before the study
• Having a history of lower extremity surgery or fracture that required alignment in the involved limb
• Having any diagnosed neurologic dysfunction, such as multiple sclerosis, Parkinson disease, or head injury.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• Sehat Medical Complex, Pakistan sports board complex — Lahore

Publications

• Tanen L, Docherty CL, Van Der Pol B, Simon J, Schrader J. Prevalence of chronic ankle instability in high school and division I athletes. Foot Ankle Spec. 2014 Feb;7(1):37-44. doi: 10.1177/1938640013509670. Epub 2013 Nov 27. PMID 24287210
• Brown CN, Mynark R. Balance deficits in recreational athletes with chronic ankle instability. J Athl Train. 2007 Jul-Sep;42(3):367-73. PMID 18059992
• Chan KW, Ding BC, Mroczek KJ. Acute and chronic lateral ankle instability in the athlete. Bull NYU Hosp Jt Dis. 2011;69(1):17-26. PMID 21332435
• Yu P, Mei Q, Xiang L, Fernandez J, Gu Y. Differences in the locomotion biomechanics and dynamic postural control between individuals with chronic ankle instability and copers: a systematic review. Sports Biomech. 2022 Apr;21(4):531-549. doi: 10.1080/14763141.2021.1954237. Epub 2021 Aug 19. PMID 34412557
• Hall EA, Docherty CL, Simon J, Kingma JJ, Klossner JC. Strength-training protocols to improve deficits in participants with chronic ankle instability: a randomized controlled trial. J Athl Train. 2015 Jan;50(1):36-44. doi: 10.4085/1062-6050-49.3.71. Epub 2014 Nov 3. PMID 25365134
• Anderson K, Behm DG. The impact of instability resistance training on balance and stability. Sports Med. 2005;35(1):43-53. doi: 10.2165/00007256-200535010-00004. PMID 15651912
• Fakontis C, Iakovidis P, Kasimis K, Lytras D, Koutras G, Fetlis A, Algiounidis I. Efficacy of resistance training with elastic bands compared to proprioceptive training on balance and self-report measures in patients with chronic ankle instability: A systematic review and meta-analysis. Phys Ther Sport. 2023 Nov;64:74-84. doi: 10.1016/j.ptsp.2023.09.009. Epub 2023 Sep 30. PMID 37801793
• Wang B, Zhang X, Zhu F, Zhu W, Wang X, Jia F, Chen W, Zhang M. A randomized controlled trial comparing rehabilitation with isokinetic exercises and Thera-Band strength training in patients with functional ankle instability. PLoS One. 2022 Dec 1;17(12):e0278284. doi: 10.1371/journal.pone.0278284. eCollection 2022. PMID 36454876

Identifiers

NCT: NCT06552533 · REC/RCR&AHS/23/0473

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗