Functional Ankle Instability, Kinesiophobia, Neuromuscular Control, Sports Rehabilitation
Conditions
Keywords
Balance Training, Athletes, Functional Ankle Instability, Table Tennis, Strength Training
Brief summary
This randomized controlled trial investigates the comparative effect of combined strength and balance training versus balance and core training on kinesiophobia (fear of movement), ankle instability, functional outcomes, and athletic performance in adolescent table tennis players with functional ankle instability (FAI). Participants will be randomly allocated into two groups over a 6-week intervention (3 sessions/week). The Experimental Group will receive combined strength and balance training, while the Control Group will receive balance and core training. Outcomes will be measured using validated tools: TSK-17, CAIT, FAAM, Y-Balance Test, Single-Leg Hop Test, T-Test, and Illinois Agility Test.
Interventions
OTHERExperimental : Combined Strength and Balance Training
A structured 6-week exercise program combining ankle strengthening exercises (Theraband resistance training, heel raises, lunges) with dynamic balance training (single-leg stance, wobble board, Y-balance drills). Sessions last 40-45 minutes and are conducted 3 times per week. Warm-up: 5-7 min light jogging/dynamic mobility. Main Training: 30 min combined strength and balance work. Cool-down: 5 min static stretching.
OTHERControl : Balance and Core Training
A structured 6-week program combining balance training (single-leg stance on firm and foam surfaces, tandem walking, Y-balance drills) with core stabilization exercises (plank, side plank, dead bug). Sessions last 40-45 minutes, 3 times per week with the same warm-up and cool-down structure as the experimental group
Sponsors
Ibadat International University, Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
The outcome assessor performing pre- and post-intervention measurements will be blinded to group allocation. Participants and the treating physiotherapist cannot be blinded due to the nature of the exercise intervention
Intervention model description
Participants are randomized into two parallel groups: Experimental Group (Combined Strength + Balance Training) and Control Group (Balance + Core Training). Both groups undergo 6 weeks of intervention (3 sessions/week, 40-45 min/session). Pre- and post-assessments are performed at baseline and week 6.
Eligibility
Sex/Gender
ALL
Age
15 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
1. Male/female table tennis players aged 15-30 years 2. Experienced at least one ankle sprain with swelling/pain that interrupted training for \>1 day within the last 6 months 3. Reported sensation of instability of the ankle 4. Scored ≤25 points on the Cumberland Ankle Instability Tool (CAIT), indicating functional ankle instability
Exclusion criteria
1. History of ankle fracture or surgery 2. Any fracture of lower limb history 3. Any neurological or vestibular disorders 4. Other injuries of lower limb affecting performance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Kinesiophobia - Tampa Scale for Kinesiophobia (TSK-17) | Baseline (Week 0) and Post-intervention (Week 6) | 17-item self-report questionnaire measuring fear of movement and re-injury. Good internal consistency (Cronbach's α = 0.70-0.86) and test-retest reliability (ICC = 0.72-0.90). Reduced scores indicate decreased kinesiophobia. |
| Ankle Instability - Cumberland Ankle Instability Tool (CAIT) | Baseline (Week 0) and Post-intervention (Week 6) | Validated questionnaire assessing functional ankle instability severity. Excellent test-retest reliability (ICC = 0.96) and internal consistency (Cronbach's α = 0.83). Increased post-intervention scores indicate improved perceived ankle stability |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Ability - Foot and Ankle Ability Measure (FAAM) | Baseline (Week 0) and Post-intervention (Week 6) | Self-reported tool assessing functional limitations in foot and ankle disorders. Excellent internal consistency (α = 0.89-0.98) and reliability (ICC = 0.84-0.92) for ADL and Sports subscales. Increased scores indicate improved functional ability |
| Dynamic Balance - Y Balance Test (YBT) | Baseline (Week 0) and Post-intervention (Week 6) | Measures dynamic balance and lower limb neuromuscular control. Excellent test-retest reliability (ICC = 0.85-0.91). Reach distances normalized to limb length. Increased post-intervention reach distance indicates improved ankle stability. |
| Functional Performance - Single-Leg Hop Test | Baseline (Week 0) and Post-intervention (Week 6) | Reliable measure of lower limb strength, dynamic stability, and functional performance (ICC = 0.85-0.95). Increased hop distance and improved landing control indicate enhanced neuromuscular function. |
| Agility and Performance - T-Test and Illinois Agility Test | Baseline (Week 0) and Post-intervention (Week 6) | Valid and reliable measures of agility and change-of-direction speed. T-Test (ICC = 0.90-0.98), Illinois Agility Test (ICC = 0.88-0.96). Reduced completion time indicates improved dynamic stability and neuromuscular control. |
Contacts
CONTACTAhmad Zia, MS-PT Sports
PRINCIPAL_INVESTIGATORHafsah Gul Khattak, DPT, MSNMPT
IBADAT INTERNATIONAL UNIVERSITY, ISLAMABAD (IIUI)
Outcome results
None listed