The Effects of Vestibulo-Ocular Reflex Exercises Added to Postural Stabilization Training in Chronic Ankle Instability

Condition(s) studied

Investigational drug(s) / intervention(s)

Postural Stabilization Training: Participants in this group will receive ankle joint mobilization followed by a structured postural stabilization training program. The program will include single-leg stance progression, hop stabilization tasks, and number-sequence hop tasks. Exercises will be progressed according to the participant's ability to complete each task without errors. Ankle joint mobilization will include talocrural anteroposterior mobilization and distal fibular mobilization with movement, applied before the exercise session for approximately 5 minutes. The total session will last approximately 45 minutes and will be performed 3 times per week for 6 weeks.

Vestibulo-Ocular Reflex Exercise in addition to Postural Stabilization Training: Participants in this group will receive the same ankle joint mobilization and postural stabilization training program as the Postural Stabilization Training Group. In addition, vestibulo-ocular reflex (VOR) exercises involving fixation on a visual target during head movements will be implemented. VOR exercises will be structured to progressively increase postural demands and will include sitting, standing, walking, and single-leg stance positions. The total session will last approximately 45 minutes and will be performed 3 times per week for 6 weeks.

Study summary

Chronic ankle instability (CAI) is a common condition after lateral ankle sprain. CAI is characterized by mechanical and/or functional instability, or recurrent episodes of "giving way," persisting for at least 12 months after the initial injury, and is associated with limitations in activity and participation. In amateur athletes, CAI may be overlooked or undertreated, although sport-specific activities require rapid integration of visual, vestibular, somatosensory, and cognitive information.

Postural stabilization training is commonly used to improve balance and neuromuscular control in individuals with CAI. However, individuals with CAI may show increased reliance on visual information and altered visual-vestibular sensory reweighting during postural control tasks. The vestibulo-ocular reflex (VOR) contributes to gaze stability and visual clarity during head movements and may also be related to neurocognitive processes such as attention and processing speed. This study is designed as a randomized controlled, prospective, parallel-group, pretest-posttest design trial to investigate whether VOR exercises added to postural stabilization training improve dynamic balance, functional instability, and neurocognitive performance in amateur athletes with CAI.

Eligibility

Primary outcome measure(s)

• Y Balance Test — baseline, 6 weeks after baseline, and 10-week after baseline
  The Y-Balance Test will be used to assess dynamic postural control. Participants will perform the test barefoot, standing on the test limb with hands on the hips, and will reach in the anterior, posteromedial, and posterolateral directions with the free limb. Invalid trials, including loss of balance, movement of the stance foot, or removal of the hands from the hips, will be repeated. Reach distances will be recorded in centimeters, normalized to limb length, and a composite score will be calculated.

Trial sites (1)

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