CClinicalTrials.gg
CompletedNCT05981560Updated Aug 8, 2023

Effects of Closed Chain Exercise Versus Neuromuscular Training on Chronic Ankle Sprain in Football Players

An interventional study of Group A - Closed Chain Exercise and Group B - Neuromuscular Training Exercise in Ankle Sprains and Chronic Pain, sponsored by Riphah International University. Completed at 1 site in Pakistan. Open to participants aged 18 Years to 35 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-08-08.

Sponsored by Riphah International University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled Dec 2022, registered Jun 2023).
Phase
Not applicable
Study type
Interventional
Enrollment
34
Allocation
Randomized
Ages
18 Years to 35 Years
Sex
All
01

Study summary

A current study will be conducted to determine the effects of closed-chain exercise versus neuromuscular training on pain, range of motion, and functional performance in football players with a chronic ankle sprain. This study will be a clinical trial conducted at the Pakistan sports board in the Lahore district. The study will be completed within the time duration of Six months. Non-probability convenient sampling technique will be used to collect the data. The sample size of 17 participants in each group will be taken in this study to find the effects of closed-chain exercise versus neuromuscular training on pain, range of motion, and functional performance in football players with a chronic ankle sprain. Athletes will be divided into two groups. Group A will be treated with closed-chain exercises and Group B will be with neuromuscular training. Pain (Numeric pain rating scale NPRS), Proprioceptive (balancing on a single leg with the eyes closed, balancing on a wobble board, Dynamic balance (Star Excursion Balance test and Y Balance Test), Functional Ankle Instability (Greek version of the Identification functional ankle instability questionnaire IdFAI), Cumberland Ankle Instability Tool (CHRONIC ANKLE INSTABILITY) and Ankle Instability Instrument (AII), Foot and Ankle Ability Measure (FAAM)-Sport Subscale, Range of Motion ROM (measure Goniometer) will be used as Data collecting tools. Three sessions of treatment per week for 4 weeks will be given. Data will be analyzed on SPSS version 22. In descriptive statistics Frequency tables, pie charts, and bar charts will be used to show the summary of group measurements measured over time.

Read the detailed description

To determine the effects of closed-chain exercise versus neuromuscular training on pain, range of motion, and functional performance in football players with a chronic ankle sprain.

The study design will be a Randomized Clinical trial. Non-Probability Convenient Sampling will be used.

the sample size of 34 subjects is calculated.

TOOLS:

  1. Pain (Numeric pain rating scale NPRS)
  2. Range of Motion ROM (measure Goniometer)
  3. Proprioceptive (balancing on a single leg with the eyes closed, balancing on a wobble board)
  4. Dynamic balance (Star Excursion Balance test and Y Balance Test)
  5. Functional Ankle Instability (Greek version of the Identification functional ankle instability questionnaire IdFAI)
  6. Ankle Instability Instrument (AII)
  7. Foot and Ankle Ability Measure (FAAM)-Sport Subscale The data will be analyzed using SPSS for Windows software, version 25. Statistical significance will be set at P= 0.05. After assessing the normality of the data by Shapiro wilk test it will be decided whether parametric or non-parametric test will be used within a group or between two groups.
02

Conditions studied

  • Ankle Sprains
  • Chronic Pain

Keywords

  • Ankle Sprain
  • Chronic Ankle Instability
  • Exercise programs
  • Neuromuscular Training
  • Sports Injuries
03

In context

Chronic Pain

2,930 studies on the registry are indexed under Chronic Pain; 701 are open to participants now.

This study's enrollment of 34 is below the median of 60 across 2,161 interventional studies indexed under Chronic Pain.

Browse Chronic Pain studies →

Lead sponsor

Riphah International University is the lead sponsor of 2,133 studies on the registry; 633 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 35 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

    • Both male and female

      • Age 18-35 (3)
      • Grade 1, 2 Ankle Sprain
      • Recurrent ankle Sprains (3)
      • Ankle Sprain Special Tests (Squeeze Test, Talar Tilt Test)

Exclusion criteria

Exclusion Criteria:

    • Traumatic history or Ankle fracture (6 months)

      • any vestibular or balance disorders (1)
      • athletes who had suffered a sprain in the month prior to the start of the study(3)
      • who were taking anti-inflammatory drugs (3)
      • Poor physical fitness
      • Co-morbidities
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
34 participants (actual)

Study arms

  • Experimental
    Closed Chain Exercise

    closed chain exercise plan given to the participant of this group

    Other: Group A - Closed Chain Exercise

  • Experimental
    Neuromuscular Training Exercise

    Neuromuscular training plan given to the participants of this group

    Other: Group B - Neuromuscular Training Exercise

Interventions

  • OtherGroup A - Closed Chain Exercise

    17 participants were in experimental group giving them closed chain exercise plan of 5 exercises, 10reps x 3sets each, on alternate 3 days per week for duration of 4-weeks, all values measured before and after 4-weeks

  • OtherGroup B - Neuromuscular Training Exercise

    17 participants were in experimental group giving them neuromuscular training plan of 5 exercises, 10reps x 3sets each, on alternate 3 days per week for duration of 4-weeks, all values measured before and after 4-weeks.

06

What researchers measure

Primary outcomes

  1. Pain (NPRS Scale)

    The Numeric Pain Rating Scale (NPRS) is a widely used tool for measuring and assessing pain intensity. It is a simple and subjective rating scale that allows individuals to quantify and communicate their level of pain on a numerical scale. The NPRS typically consists of a horizontal or vertical line with numbers ranging from 0 to 10. The numbers represent a continuum of pain intensity, where 0 represents "no pain" and 10 represents the "worst possible pain." The individual is asked to select the number that best corresponds to their current level of pain, with 0 indicating no pain and 10 indicating the most severe pain imaginable.

    Time frame: 4 weeks

  2. Range of Motion (Goniometer)

    A goniometer is a measuring tool commonly used in healthcare and physical therapy to assess and quantify the range of motion (ROM) in joints. It consists of a stationary arm, a movable arm, and a protractor or scale to measure angles. To measure range of motion with a goniometer, the stationary arm is aligned with a fixed point on the body, typically an anatomical landmark associated with the joint being assessed. The movable arm is aligned with a second anatomical landmark, which moves as the joint is flexed or extended.

    Time frame: 4 weeks

  3. Functional Performance (Special Tests)

    Functional performance refers to an individual's ability to perform everyday tasks and activities effectively and independently. It encompasses the physical, cognitive, and emotional skills required to carry out various activities that are necessary for daily living, work, leisure, and social participation. Functional performance is closely tied to an individual's overall functional capacity, which involves the integration of physical abilities, such as strength, endurance, balance, and coordination, with cognitive and emotional factors, including problem-solving, decision-making, attention, and motivation. The concept of functional performance extends beyond isolated movements or specific skills and focuses on how individuals function within their unique environments and roles.

    Time frame: 4 weeks

07

Study locations

1 site
  • Pakistan Sports Board
    Lahore, Punjab 5400, Pakistan
08

References and documents

Publications

  • Alahmari KA, Kakaraparthi VN, Reddy RS, Silvian P, Tedla JS, Rengaramanujam K, Ahmad I. Combined Effects of Strengthening and Proprioceptive Training on Stability, Balance, and Proprioception Among Subjects with Chronic Ankle Instability in Different Age Groups: Evaluation of Clinical Outcome Measures. Indian J Orthop. 2020 Jul 15;55(Suppl 1):199-208. doi: 10.1007/s43465-020-00192-6. eCollection 2021 May. PubMed 34122771 ↗
  • Kachanathu S, Hafez A, Alenazi A, Hassan S, Algarni A, Albarrati AJPM, Rehabilitationsmedizin, Kurortmedizin. Efficacy of Closed and Open Kinematic Chain Exercises on Ankle Sprain Rehabilitation. 2016;26(01):28-31.
  • Allois R, Niglia A, Pernice A, Cuesta-Barriuso R. Fascial therapy, strength exercises and taping in soccer players with recurrent ankle sprains: A randomized controlled trial. J Bodyw Mov Ther. 2021 Jul;27:256-264. doi: 10.1016/j.jbmt.2021.03.022. Epub 2021 Apr 2. PubMed 34391242 ↗
  • Shiravi Z, Shadmehr A, Moghadam ST, Moghadam BA. Comparison of dynamic postural stability scores between athletes with and without chronic ankle instability during lateral jump landing. Muscles Ligaments Tendons J. 2017 May 10;7(1):119-124. doi: 10.11138/mltj/2017.7.1.119. eCollection 2017 Jan-Mar. PubMed 28717619 ↗
  • Thompson JY, Byrne C, Williams MA, Keene DJ, Schlussel MM, Lamb SE. Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review. BMC Musculoskelet Disord. 2017 Oct 23;18(1):421. doi: 10.1186/s12891-017-1777-9. PubMed 29061135 ↗
  • Greig M, McNaughton L. Soccer-specific fatigue decreases reactive postural control with implications for ankle sprain injury. Res Sports Med. 2014;22(4):368-79. doi: 10.1080/15438627.2014.944300. PubMed 25295475 ↗
  • Davenport TE, Kulig K, Fisher BE. Ankle manual therapy for individuals with post-acute ankle sprains: description of a randomized, placebo-controlled clinical trial. BMC Complement Altern Med. 2010 Oct 19;10:59. doi: 10.1186/1472-6882-10-59. PubMed 20958995 ↗
  • Czajka CM, Tran E, Cai AN, DiPreta JA. Ankle sprains and instability. Med Clin North Am. 2014 Mar;98(2):313-29. doi: 10.1016/j.mcna.2013.11.003. Epub 2014 Jan 10. PubMed 24559877 ↗
  • Faizullin I, Faizullina E. Effects of balance training on post-sprained ankle joint instability. Int J Risk Saf Med. 2015;27 Suppl 1:S99-S101. doi: 10.3233/JRS-150707. PubMed 26639734 ↗
  • Kim K, Jeon K. Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability. J Phys Ther Sci. 2016 May;28(5):1443-7. doi: 10.1589/jpts.28.1443. Epub 2016 May 31. PubMed 27313347 ↗
  • McCall A, Carling C, Nedelec M, Davison M, Le Gall F, Berthoin S, Dupont G. Risk factors, testing and preventative strategies for non-contact injuries in professional football: current perceptions and practices of 44 teams from various premier leagues. Br J Sports Med. 2014 Sep;48(18):1352-7. doi: 10.1136/bjsports-2014-093439. Epub 2014 May 16. PubMed 24837243 ↗
  • Mohammadi Nia Samakosh H, Brito JP, Shojaedin SS, Hadadnezhad M, Oliveira R. What Does Provide Better Effects on Balance, Strength, and Lower Extremity Muscle Function in Professional Male Soccer Players with Chronic Ankle Instability? Hopping or a Balance Plus Strength Intervention? A Randomized Control Study. Healthcare (Basel). 2022 Sep 21;10(10):1822. doi: 10.3390/healthcare10101822. PubMed 36292269 ↗
  • Medina McKeon JM, Hoch MC. The Ankle-Joint Complex: A Kinesiologic Approach to Lateral Ankle Sprains. J Athl Train. 2019 Jun;54(6):589-602. doi: 10.4085/1062-6050-472-17. Epub 2019 Jun 11. PubMed 31184957 ↗
  • Hung YJ. Neuromuscular control and rehabilitation of the unstable ankle. World J Orthop. 2015 Jun 18;6(5):434-8. doi: 10.5312/wjo.v6.i5.434. eCollection 2015 Jun 18. PubMed 26085985 ↗
  • Owoeye OB, Akinbo SR, Tella BA, Olawale OA. Efficacy of the FIFA 11+ Warm-Up Programme in Male Youth Football: A Cluster Randomised Controlled Trial. J Sports Sci Med. 2014 May 1;13(2):321-8. eCollection 2014 May. PubMed 24790486 ↗
  • Emery CA, Roy TO, Whittaker JL, Nettel-Aguirre A, van Mechelen W. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis. Br J Sports Med. 2015 Jul;49(13):865-70. doi: 10.1136/bjsports-2015-094639. PubMed 26084526 ↗
  • Soomro N, Sanders R, Hackett D, Hubka T, Ebrahimi S, Freeston J, Cobley S. The Efficacy of Injury Prevention Programs in Adolescent Team Sports: A Meta-analysis. Am J Sports Med. 2016 Sep;44(9):2415-24. doi: 10.1177/0363546515618372. Epub 2015 Dec 16. PubMed 26673035 ↗
  • Owoeye OBA, Palacios-Derflingher LM, Emery CA. Prevention of Ankle Sprain Injuries in Youth Soccer and Basketball: Effectiveness of a Neuromuscular Training Program and Examining Risk Factors. Clin J Sport Med. 2018 Jul;28(4):325-331. doi: 10.1097/JSM.0000000000000462. PubMed 29864071 ↗
  • Caldemeyer LE, Brown SM, Mulcahey MK. Neuromuscular training for the prevention of ankle sprains in female athletes: a systematic review. Phys Sportsmed. 2020 Nov;48(4):363-369. doi: 10.1080/00913847.2020.1732246. Epub 2020 Feb 28. PubMed 32067546 ↗
  • Kaminski TW, Hertel J, Amendola N, Docherty CL, Dolan MG, Hopkins JT, Nussbaum E, Poppy W, Richie D; National Athletic Trainers' Association. National Athletic Trainers' Association position statement: conservative management and prevention of ankle sprains in athletes. J Athl Train. 2013 Jul-Aug;48(4):528-45. doi: 10.4085/1062-6050-48.4.02. PubMed 23855363 ↗
  • O'Driscoll J, Delahunt E. Neuromuscular training to enhance sensorimotor and functional deficits in subjects with chronic ankle instability: A systematic review and best evidence synthesis. Sports Med Arthrosc Rehabil Ther Technol. 2011 Sep 22;3:19. doi: 10.1186/1758-2555-3-19. PubMed 21939557 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 8, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05981560
Lead sponsor
Riphah International University
Responsible party
Sponsor
First posted
Aug 8, 2023
Start date
Dec 22, 2022
Primary completion
May 30, 2023
Completion
Jun 30, 2023
Last update
Aug 8, 2023

Study contacts

Aamir Gul Memon, MS
principal investigator · Riphah International University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jul 2023. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion