Ankle Sprain, Athletic Performance, Chronic Ankle Instability, Functional Performance Deficit
Conditions
Keywords
Chronic Ankle Instability (CAI), Lateral Ankle Sprain, Functional Performance Tests, Jumping Ability, Agility, Hop Tests, Countermovement Jump (CMJ), 5-10-5 Agility Test, Deepsport AI Analysis, Volleyball, Basketball, Soccer Athletes
Brief summary
This study investigated how chronic ankle instability (CAI) affects functional performance in athletes compared with healthy controls. CAI is a condition that develops after repeated ankle sprains, leading to ongoing giving way episodes, pain, and reduced stability. A total of 32 athletes participated: 16 with CAI and 16 healthy, age- and sport-matched controls. Participants performed a series of sport-specific functional performance tests, including single-leg hop tests, triple crossover hop, lateral hop, 6-meter timed hop, side jump, countermovement jump (CMJ), the 5-10-5 agility test, and the acceleration-deceleration-acceleration (ADA) test. The Deepsport AI program was used for precise measurement of jumping and agility parameters. Results showed that athletes with CAI had significantly lower jump height and power, reduced hop distances, and slower times in agility and hopping tests compared to controls. These findings suggest that CAI negatively impacts performance in explosive and multidirectional movements, which are essential in sports such as basketball, volleyball, and soccer. No strong correlation was found between CAIT (Cumberland Ankle Instability Tool) scores and objective performance outcomes, suggesting that subjective reports alone may not fully capture functional deficits. This study highlights the importance of using both subjective questionnaires and objective tests to evaluate ankle instability in athletes. It also supports the need for rehabilitation programs that include not only balance and proprioception training but also specific exercises to improve jumping, agility, and multidirectional performance.
Detailed description
Chronic ankle instability (CAI) is a frequent consequence of lateral ankle sprains, affecting up to 74% of athletes with previous ankle injuries. It is characterized by recurrent sprains, repeated giving way episodes, reduced function, and impaired performance. While CAI has been extensively studied in relation to balance and proprioception, its direct effects on sport-specific performance metrics such as jumping and agility remain less clear. In this cross-sectional case-control study, 32 athletes were enrolled: 16 athletes with CAI and 16 matched healthy athletes with no history of ankle instability. The CAI group was diagnosed using International Ankle Consortium (IAC) criteria (history of ≥1 lateral ankle sprain ≥12 months prior, ≥2 giving way episodes in the past 6 months, CAIT score ≤24, ≥5 years of sports participation). Controls had CAIT scores ≥25 and no ankle injury history. The testing battery included: Hop tests: single-leg hop, 6-meter timed hop, triple crossover hop, and lateral hop. Agility tests: 5-10-5 pro-agility shuttle and acceleration-deceleration-acceleration (ADA) test. Jump tests: countermovement jump (height, flight time, power) and side jump test. Measurements were supported by the Deepsport AI program for objective performance analysis.
Interventions
OTHERFunctional Performance Testing Battery
Participants performed a standardized battery of sport-specific performance tests during a single laboratory session, including: Countermovement Jump (height, power, flight time) 5-10-5 Pro-Agility Shuttle Test Acceleration-Deceleration-Acceleration (ADA) Test Side Jump Test 6-Meter Timed Hop Test Single-Leg Hop Test Triple Crossover Hop Test Lateral Hop Test Performance was assessed using the Deepsport AI program and standard timing/distance protocols. Results compared between CAI and control cohorts.
Sponsors
Manisa Celal Bayar University
Saglik Bilimleri Universitesi
Australian Catholic University
Ankara Yildirim Beyazıt University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
MALE
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* CAI Group: * History of at least one significant lateral ankle sprain ≥12 months prior to testing * At least 2 episodes of ankle giving way in the past 6 months * Cumberland Ankle Instability Tool (CAIT) score ≤24 * Minimum of 5 years of sports participation and ≥3 hours of training per week Inclusion Criteria - Control Group: * No history of ankle sprain or ankle instability * CAIT score ≥25 * Matched to CAI group by age, sex, and sport participation * Minimum of 5 years of sports participation and ≥3 hours of training per week
Exclusion criteria
* History of fracture, surgery, or major injury in the lower extremity within the past year * Musculoskeletal injury in the knee, hip, or back in the past 3 months * Neurological or vestibular disorders affecting balance or movement * Acute ankle pain, swelling, or inflammation at time of testing * Current use of orthotics or ankle braces during performance testing * Systemic or cardiovascular disease preventing safe participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Countermovement Jump - Jump Height | Single laboratory session (~60 minutes) | Jump height (cm) measured during countermovement jump using Deepsport AI. Best of 3 trials recorded. |
| Countermovement Jump - Flight Time | Single laboratory session | Flight time (s) measured during countermovement jump with Deepsport AI. Best of 3 trials recorded. |
| Countermovement Jump - Power Output | Single laboratory session | Power output (W) calculated from CMJ using Deepsport AI (jump force-time algorithm). Best of 3 trials recorded. |
| 5-10-5 Pro-Agility Shuttle - Completion Time | Single session | Total completion time (s) for the 5-10-5 shuttle test, measured with electronic timing gates. Best of 2 trials recorded. |
| Acceleration-Deceleration-Acceleration (ADA) - Total Time | Single session | Total sprint time (s) across 10 m acceleration, 5 m deceleration, and 10 m re-acceleration, measured with Deepsport AI. |
| Side Jump Test - Completion Time | Single session | Time (s) to complete 10 consecutive lateral single-leg jumps across a line. Best attempt recorded. |
| 6-Meter Timed Hop - Completion Time | Single session | Time (s) to hop forward 6 meters on one leg, measured with stopwatch. Best of 3 trials recorded. |
| Single-Leg Hop - Completion Time | Single session | Time (s) to hop forward 6 meters on one leg. Best of 3 attempts recorded. |
| Triple Crossover Hop - Distance | Single session | Distance (m) covered in 3 consecutive crossover hops over a 15 cm line. Best of 3 trials recorded. |
| Lateral Hop Test - Distance | Single session | Distance (m) covered in 3 consecutive lateral hops on one leg. Best of 3 attempts recorded. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cumberland Ankle Instability Tool (CAIT) Score | Baseline assessment (same day as testing) | Self-reported ankle instability using CAIT questionnaire (0-30 points). Lower scores = greater instability. |
Countries
Turkey (Türkiye)
Outcome results
None listed