Effect of Core Stability Training With Foot Exercises in Chronic Ankle Instability Patients

Official title

Effect of Core Stability Training With Foot Exercises on Proprioception, Balance and Foot Function in Chronic Ankle Instability Patients

Overview

This study aims to investigate the effects of various treatments on lumbar and ankle proprioception, balance, and foot function in patients with chronic ankle instability. The objectives include assessing the combined effects of core stability training and intrinsic foot muscle exercises with conventional therapy, the impact of core stability training alone, the effects of intrinsic foot muscle exercises in conjunction with conventional treatment, and the outcomes of conventional therapy alone. Additionally, the study will compare the effectiveness of these different treatment protocols.

Detailed description

Chronic ankle instability (CAI) is characterized by both mechanical and functional ankle joint instability, with various contributing factors persisting post-healing after an acute sprain. Recent studies emphasize that chronic ankle instability is a complex condition necessitating interdisciplinary research. Effective treatment requires multimodal protocols, integrating core stability training and intrinsic foot muscle exercises. Core stability enhances proximal neuromuscular control, while intrinsic exercises improve distal stability and foot function. This combined approach aims to improve lumbar and ankle proprioception, balance, and postural control, ultimately reducing recurrent injuries. Results will provide valuable insights to develop evidence-based rehabilitation programs addressing both proximal and distal factors in chronic ankle instability, enhancing understanding of sensorimotor control and rehabilitation strategies.

Interventions

• Other conventional physical therapy
  Stretching the gastrocnemius and soleus muscle (30 s) of three repetitions, three sets of strengthening exercises of ankle musculature, using Thera Band resistance (ten repetitions in each set), and balance training exercises: First, standing on one leg with eyes open, later will be progressed to eyes closed with 60 s hold for two repetitions will be given along with balance board exercises and double-leg and single-leg stances
• Other Core stability training
  The program is structured in three phases over six weeks. The first phase (1-2 weeks) focuses on abdominal drawing-in maneuvers to activate the transverses abdominis and lumbar multifidus muscles, with participants palpating the contractions for feedback. The second phase (3-4 weeks) integrates coordinated cocontraction of both muscles alongside upper and lower limb movements in various positions such as lying, sitting, standing, and quadruped. The third phase (5-6 weeks) emphasizes core activat
• Other intrinsic foot muscle exercises
  In this program, participants will engage in four exercises targeting the intrinsic foot muscles (IFMs): short-foot exercise, toe spread out, hallux extension, and lesser-toe extension. For the first two weeks, exercises will be done while sitting; during weeks three and four, they will shift to standing; and in weeks five and six, the exercises will be performed while standing on one leg.

Primary outcome measures

• Assessment of balance [Time frame: At baseline and after 6 weeks]

Secondary outcome measures (3)

• assessment of Lumbar proprioception [Time frame: At baseline and after 6 weeks]
• assessment of Ankle proprioception: [Time frame: At baseline and after 6 weeks]
• assessment of foot function [Time frame: At baseline and after 6 weeks]

Eligibility criteria

Inclusion criteria

Subjects will be selected from the outpatient clinic of Delta University hospital, Dakahlia, Egypt. 2. Both male \& female genders aged between 18 and 44 years. 3. Participants should have a history of at least one significant ankle sprain; the initial sprain must have occurred at least 12 months prior to the study enrolment and was associated with inflammatory symptoms (pain, swelling) 4. Patients having Scores on the Cumberland ankle instability tool of 24 or below 5. Participants should report at least 2 episodes of 'giving way' in the 6 months prior to the study enrolment. Episodes of giving way will be described as an incident in which the rearfoot suddenly rolled, felt weak, or lost stability; however, the individual did not sustain an ankle sprain and will have been able to continue with normal function after the incident 6. Body mass index for all groups will be ranged from 18.8-29 kg/m²

Exclusion criteria

• history of lower extremity surgery, lower extremity fractures, and immobilization of foot or ankle for 48 hr or longer within the previous 6 months
• Conditions other than ankle sprain that affect balance or they are receiving ankle rehabilitation at the time of screening.
• Acute injury to the musculoskeletal structures of other joints of the lower extremity in the previous 3 months, which impacted joint integrity and function (ie, sprains, fractures) resulting in at least 1 interrupted day of desired physical activity

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

Single blind

Primary purpose

Treatment

Study locations

Egypt · 1 center

• out-patient clinic, faculty of physical therapy, Delta university — Al Mansurah

Identifiers

NCT: NCT07731035 · Asmaa_Msc

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗