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The Effect of Additional Neuromuscular Training on Peri-Ankle Muscle Morphology and Function in Chronic Ankle Instability Subjects: A Randomized Controlled Trial.

作者信息

Kazemi Khadijeh, Javanshir Khodabakhsh, Saadi Feryal, Goharpey Shahin, Shaterzadeh Yazdi Mohammad Jafar, Calvo-Lobo César, López-López Daniel, Nassadj Gholamhossein

机构信息

Department of Rehabilitation, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.

Department of Physiotherapy, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran.

出版信息

Sports Health. 2025 May-Jun;17(3):572-584. doi: 10.1177/19417381241258467. Epub 2024 Jun 20.


DOI:10.1177/19417381241258467
PMID:38898814
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11569680/
Abstract

BACKGROUND: Lateral ankle sprain is one of the most common musculoskeletal issues during sports and activities of daily living. This study investigated the effect of combined neuromuscular training and conventional training (including strengthening, range of motion, and balance exercises) on muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with chronic ankle instability (CAI). HYPOTHESIS: The combination of neuromuscular and conventional training programs might result in additional benefits on the morphology of muscle, dynamic balance, and functional capacity in subjects with CAI. STUDY DESIGN: A single-blind parallel-arm randomized controlled trial. LEVEL OF EVIDENCE: Level 2. METHODS: A total of 34 participants with CAI were divided randomly into experimental (EG) and control groups (CG). The EG received conventional and neuromuscular training, while the CG underwent conventional training. Cross-sectional areas of the peroneus longus and tibialis anterior muscles were measured using ultrasonography. Measurements included reaching direction distance, ankle instability, and the foot and ankle outcome score, all evaluated before and immediately after 12 intervention sessions and 4 weeks later in the follow-up phase. RESULTS: Repeated-measures analysis of variance (ANOVA) revealed significant improvement in the EG, particularly in the cross-sectional area of the tibialis anterior muscle on the injured side and the posteromedial reaching direction displacement of the Y balance test. Moreover, the EG's foot and ankle outcome scores increased significantly compared with the CG ( < 0.05). However, the group effect size ranged from minor to moderate (Hedges , 0.40-0.73). CONCLUSION: Combining neuromuscular and conventional training programs yields greater benefits than conventional training alone regarding tibialis anterior muscle morphology, posteromedial dynamic balance, and functional capacity in persons with CAI. CLINICAL RELEVANCE: The combination of neuromuscular and conventional training programs could enhance muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with CAI.

摘要

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引用本文的文献

[1]
Synergistic Effects of Joint-Biased Rehabilitation and Combined Transcranial Direct Current Stimulation (tDCS) in Chronic Ankle Instability: A Single-Blind, Three-Armed Randomized Controlled Trial.

Brain Sci. 2025-4-27

[2]
Predictors of Chronic Ankle Instability Among Soccer Players.

Medicina (Kaunas). 2025-3-21

[3]
Adult Tillaux-Chaput tubercle fracture of the ankle with rupture of the peroneus tertius muscle: a case report.

BMC Musculoskelet Disord. 2024-10-3

本文引用的文献

[1]
Minimal important change for Foot and Ankle Outcome Score (FAOS).

Foot Ankle Surg. 2022-1

[2]
Is chronic ankle instability associated with impaired muscle strength? Ankle, knee and hip muscle strength in individuals with chronic ankle instability: a systematic review with meta-analysis.

Br J Sports Med. 2020-1-14

[3]
Effects of the standard physiotherapy programme on pain and isokinetic ankle strength in individuals with grade I ankle sprain.

J Taibah Univ Med Sci. 2018-11-30

[4]
An Updated Model of Chronic Ankle Instability.

J Athl Train. 2019-6-4

[5]
Quantity and quality of the peroneus longus assessed using ultrasonography in leg with chronic ankle instability.

J Phys Ther Sci. 2018-12

[6]
Ultrasound Characteristics of Foot and Ankle Structures in Healthy, Coper, and Chronically Unstable Ankles.

J Ultrasound Med. 2018-9-12

[7]
Neuromuscular control of ankle and hip during performance of the star excursion balance test in subjects with and without chronic ankle instability.

PLoS One. 2018-8-13

[8]
Functional performance deficits in adolescent athletes with a history of lateral ankle sprain(s).

Phys Ther Sport. 2018-9

[9]
Ultrasound Evaluation of the Abdominal Wall and Lumbar Multifidus Muscles in Participants Who Practice Pilates: A 1-year Follow-up Case Series.

J Manipulative Physiol Ther. 2018-6

[10]
Effect of Impairment-Based Rehabilitation on Lower Leg Muscle Volumes and Strength in Patients With Chronic Ankle Instability: A Preliminary Study.

J Sport Rehabil. 2018-12-4

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