Clinical Research Directory

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

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 and participation. Contemporary theoretical models emphasize that CAI should not be explained solely by biomechanical or neuromuscular deficits, but rather as a dynamic condition shaped by the interaction of motor-behavioral, sensory-perceptual, psychological, and environmental factors. 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 visuo-motor reaction performance, fear avoidance behavior related to sports injuries and kinesiophobia in amateur athletes with CAI.

Collagen Scaffold Bioaugmentation for ATFL Repair in Chronic Ankle Instability

This is a multicenter, randomized, controlled clinical trial comparing two surgical techniques for the treatment of chronic ankle instability (CAI). CAI is a condition in which the outer ligaments of the ankle remain loose and the ankle continues to give way after repeated sprains, causing pain, swelling, and difficulty with sports and daily activities. About 30-40% of patients who sprain an ankle go on to develop CAI. All patients in this study receive arthroscopic repair of the anterior talofibular ligament (ATFL) - the main ligament on the outside of the ankle - together with an Internal Brace, a high-strength suture tape that provides immediate mechanical reinforcement. In the experimental group, an absorbable type I collagen scaffold (REGENETEN) is additionally wrapped onto the repair to promote the regrowth of ligament-like tissue. Patients in the control group receive the Internal Brace repair alone. Eligible patients are aged 18 to 65 with chronic lateral ankle instability that has not improved with standard non-surgical treatment and in whom the ATFL tissue is of poor quality or a previous repair has failed. Participants are randomly assigned 1:1 to one of the two groups, and treatment is assigned by a central computer-generated schedule stratified by study site. Both groups follow the same standardized surgical steps and the same post-operative rehabilitation program. The main question is whether adding the collagen scaffold leads to better ankle function and stability 12 months after surgery. Patient-reported function, pain, return to sport, MRI evidence of ligament healing, and any complications will be followed for up to 24 months.

Computed Tomography With Stress Maneuvers for Evaluation of Distal Tibiofibular Syndesmosis Instability (CTMETS)

The main aim of this study was to investigate which strategy can diagnose more accurately syndesmotic instability among an existing index test (ankle CT in neutral position) and two new add-on index tests (ankle CT in a stress position with extended-knees and ankle CT in a stress position with flexed-knees). This study hypothesized that the two add-on ankle CT with stress maneuvers (CTSM) have a more accurate capability of diagnosing syndesmotic instability than ankle CT in a neutral position (CTNP) alone. The secondary objective is to investigate the participants' disability outcomes by applying the Foot and Ankle Ability Measure questionnaire.

Changes in Brain-Muscle Coupling After Microneedle-Knife Therapy for Ankle Sprain

This study evaluated changes in brain-muscle coordination in patients with ankle sprain after one session of microneedle-knife therapy. Microneedle-knife therapy is a minimally invasive treatment applied to soft tissues related to the lower leg and foot. Eleven participants completed electroencephalography (EEG) and electromyography (EMG) recordings before and after treatment. During each recording, participants performed ankle dorsiflexion, eversion, and inversion or isometric contraction tasks. The primary analysis examined corticomuscular coupling, which reflects coordination between activity in motor-related brain regions and lower-limb muscles, particularly within the beta frequency band of 15 to 30 Hz.

Ankle Evertor and Invertor Strength Training

The aim of this study was to investigate the effects of a 12-week ankle evertor and invertor strength training program performed on a specially designed device, which allows isolated strengthening of evertor and invertor muscles. Outcome measures included isometric ankle torque, EMG activity of six tibial muscles, muscle coactivation, and kinematic parameters during three walking conditions. This trial was retrospectively registered. The study was conducted in 2017 as part of a doctoral dissertation at the Faculty of Sport, University of Ljubljana, prior to the authors' awareness of prospective registration requirements.

Dynamic Neuromuscular Stability Exercises With and Without Rhythmic Auditory Stimulation in Lateral Ankle Sprain

To examine the effects of Dynamic Neuromuscular Stability exercises with and without Rhythmic Auditory Stimulation on balance, proprioception, and functional performance in badminton players with lateral ankle sprain.

Foot Intensive Rehabilitation With Perturbation Based Training in Ankle Sprain Patients

To determine the foot-intensive rehabilitation with and without perturbation-based training on pain reduction, range of motion improvement, balance enhancement, and functional instability in patients recovering from ankle sprains NULL HYPOTHESIS There will be no significant difference in the effectiveness of foot-intensive rehabilitation with perturbation-based training compared to foot-intensive rehabilitation alone in reducing pain, improving range of motion, enhancing balance, or reducing functional instability among patients recovering from ankle sprains. ALTERNATE HYPOTHESIS There will be a significant difference in pain reduction, range of motion improvement, balance enhancement, and reduction in functional instability between patients undergoing foot- intensive rehabilitation with perturbation-based training compared to those undergoing foot-intensive rehabilitation. Study Design: It will be a Randomized Clinical Trial Study Population: Ankle Sprain Both groups will undergo the assigned interventions for the duration of 6 weeks under the supervision of trained physical therapists or healthcare professionals. The interventions will aim to address pain reduction, range of motion improvement, balance enhancement, and reduction in functional instability among participants recovering from ankle sprains.

A Study on Reducing Opioid Use After Ankle Arthroscopy

Study Title Effect of a Postoperative Multimodal Analgesic Protocol Predominantly Based on Non-Opioid Medications vs Opioid-Based Analgesia on Pain After Ankle Arthroscopy: A Noninferiority Randomized Clinical Trial Purpose This study aims to compare the pain control effect and side effects of non-opioid versus opioid medications in patients undergoing ankle arthroscopy. The goal is to find a safer analgesic strategy to reduce opioid use and related risks (e.g., addiction, respiratory depression) while maintaining effective postoperative pain management. Design Study Type: Prospective, randomized controlled trial. Participants: 110 adults (18-65 years) scheduled for ankle arthroscopy under general anesthesia. Interventions: Experimental Group: Non-opioid regimen (celecoxib + acetaminophen). Control Group: Opioid regimen (oxycodone + acetaminophen). Assessments: Pain scores (NRS) at 2 hours,6 hours,12 hours, 24 hours, and days 2-6 postoperatively; Area under the curve (AUC\\\_{0-24}) of Numerical Rating Scale (NRS) pain intensity scores from 0-24 hours.adverse events (e.g., nausea, constipation); The total consumption of additional rescue opioids, expressed as oral morphine equivalent dose (OME); patient satisfaction. Key Eligibility Able to provide informed consent. ASA physical status I-II. BMI 16-32 kg/m². Exclusion criteria: Chronic pain, opioid use history, allergies to study drugs, or severe organ dysfunction. Benefits \& Risks Benefits: Standardized analgesia management and personalized pain monitoring; potential contribution to safer clinical pain protocols. Risks: Opioids may cause nausea, sedation, or respiratory depression; non-opioids may carry risks of gastrointestinal bleeding or liver injury. Emergency support is available for severe events. Contact Information For more details, contact the research team at Zhejiang University Second Affiliated Hospital: Phone: 0571-87783759 Email: keyanlunli\_zheer@163.com This trial is registered to evaluate non-opioid alternatives for ankle arthroscopy pain control, prioritizing patient safety and evidence-based care.

Ankle vs. Hip vs. Combined Strengthening in Chronic Ankle Instability

Chronic ankle instability (CAI) is a common condition that can develop after a lateral ankle sprain. Up to 40% of people who sprain their ankle experience a recurrence within a year, and as many as 30% develop persistent symptoms such as ankle "giving way," weakness, or instability. These symptoms can limit daily activities, sports participation, and increase the risk of future sprains. Muscle weakness in both the ankle and hip has been identified as an important factor contributing to CAI. Strengthening these muscles may therefore help improve stability and function. The SHAC study is a randomized controlled trial designed to compare three different strengthening programs in people with chronic ankle instability: (1) an ankle-focused strengthening program, (2) a hip-focused strengthening program, and (3) a combined ankle-hip strengthening program. The goal is to determine which approach leads to the greatest improvement in functional ability, muscle strength, balance, and ankle mobility. A total of 45 participants aged 18 to 35 years with documented chronic ankle instability will be recruited from local sports clubs and the University of Liège. All participants must have a history of at least one ankle sprain that occurred more than 12 months before entering the study, report episodes of ankle instability in the previous six months, and meet specific questionnaire criteria (CAIT \< 24 and FAAM Sport \< 80%). People with recent injuries, previous lower-limb surgery, fractures requiring realignment, neuromuscular conditions, or current pain or swelling will not be able to participate. After the first assessment (T1), participants will be randomly assigned to one of the three groups. Each intervention lasts four weeks and includes three supervised sessions per week. All strengthening exercises are isometric, performed using a handheld dynamometer to measure force accurately. The ankle program includes plantarflexion, dorsiflexion, inversion, and eversion exercises. The hip program includes clamshells, hip external rotation, abduction, and extension. The combined group alternates between hip and ankle exercises. A warm-up and standardized familiarization are performed before each session. All participants will attend two additional assessment sessions: one immediately after the four-week program (T2) and one at a later follow-up time point (T3). During each visit, they will complete functional questionnaires, report their sports participation, and undergo several strength and performance tests. These include hip and ankle muscle strength measurements using a dynamometer, the Heel Rise Test, the modified Y-Balance Test, the Side Hop Test, and a dorsiflexion mobility test. The study aims to identify whether one of the strengthening approaches leads to better functional outcomes for individuals with chronic ankle instability. Understanding these effects may help clinicians design more effective rehabilitation programs for people recovering from ankle sprains and for those experiencing ongoing instability. Participant data will be kept confidential and stored securely in anonymized form for 20 years. Participation is voluntary, and individuals may withdraw at any time without consequences. Results will be presented anonymously in scientific publications and conferences.

Comparison of MBR + Suture Tape and MBR for CLAI : A Prospective Cohort Study

GJL is a risk factor for postoperative recurrent instability following an MBR for CLAI. Additional suture tape augmentation has been suggested to provide more strength and stability. However, the outcomes of the MBP with suture tape augmentation were unknown, which requires further exploration.

Semiconductor Embedded Socks for Ankle Sprains

The goal of this clinical trial is to determine if semiconductor fabric embedded in socks can improve healing after non operative ankle sprains. The main questions it aims to answer are: 1. How does semiconductor embedded sock effect outcomes in patients undergoing rehabilitation from ankle injury? 2. How does semiconductor embedded socks effect injury symptoms and function throughout the course of treatment? Researchers will compare semiconductor embedded socks with typical compression socks to determine differences in healing. Participants will be given the socks and be asked to wear them throughout the healing process and record symptoms and functional measures.

Efficacy of Tecar Device With Exercises in Ankle Sprain

The goal of this clinical trial is to evaluate the effect of applying TECAR therapy during active therapeutic exercises on pain, ankle dynamic balance, proprioception, and daily function in patients with acute ankle sprain. the main questions it aims to answer are: * Does there is a significant effect of applying TECAR therapy during active exercise after acute lateral ankle sprain on Pain? * Does there is a significant effect of applying TECAR therapy during active exercise after acute lateral ankle sprain on balance? * Does there is a significant effect of applying TECAR therapy during active exercise after acute lateral ankle sprain on proprioception? * Does there is a significant effect of applying TECAR therapy during active exercise after acute lateral ankle sprain on daily function? The patients will be randomly divided into two groups. The control group (A) will receive the conventional therapy which is ankle and subtalar ROM in a pain-free range, calf muscle stretch, ankle strengthening exercises against resistance bands in all directions, weight-bearing exercise, forward lunges, bilateral and unilateral squats, bilateral and unilateral heel raises against bodyweight resistance, and balance training. The experiment group (B) will receive conventional therapy with TECAR therapy application during active therapeutic exercises. Treatment will be for 4 weeks with 2 sessions per week. TECAR application will be 20 mins per session (10 mins capacitive and 10 mins resistive). To the best of the researchers' knowledge, no study has proved the effects of applying TECAR therapy during active therapeutic exercises after an acute lateral ankle sprain has yet been done. Thus, the purpose of the present study was to prove if there an effect of applying TECAR therapy during active therapeutic exercises included in the conventional physiotherapy (PRICE with therapeutic exercises) and conventional physiotherapy alone on pain, ankle dynamic balance, proprioception, and daily function in subjects with an acute lateral ankle sprain.

Comparison of Anesthetic Techniques for Early Recovery After Ankle Arthroscopy

Ankle arthroscopy is increasingly performed as a day-case procedure, making rapid recovery and efficient discharge critical. Anesthetic technique substantially influences postoperative recovery, yet high-quality evidence comparing anesthetic strategies in ankle arthroscopy is limited. This multicenter randomized trial compares total intravenous anesthesia with propofol plus peripheral nerve block (PNB), general anesthesia plus PNB, and spinal anesthesia, with PACU-I recovery time as the primary outcome. Secondary outcomes include postoperative pain, opioid consumption, hospital length of stay, adverse events, recovery quality, satisfaction, limb weakness, and intraoperative hemodynamics.

the Efficacy of Hyperbaric Oxygen on Acute Ankle Sprain

Investigators recruited 208 patients with acute ankle sprain who were from the Rehabilitation Department of the Second Affiliated Hospital of Zhejiang University, School of Medicine from January 2026 to November 2028. Perform the improvement in AOFAS scores and Baird-Jackson ankle scores study and Rehabilitation assessments followed up after 3 years.

NMES With PNF for Ankle Sprain Rehabilitation

Ankle sprains are one of the most common sports injuries. In some people, they can lead to chronic ankle problems that affect daily life and sports performance. In this study, we want to see if combining neuromuscular electrical stimulation (NMES) with proprioceptive neuromuscular facilitation (PNF) can help improve these problems. We plan to recruit 60 participants, with 30 in the experimental group and 30 in the control group. The experimental group will receive PNF stretching with NMES, while the control group will only do PNF stretching. Both groups will have training three times a week for four weeks (12 sessions in total). We will test participants before and after the program, looking at pain, balance, range of motion, proprioception, strength, joint mobility, and functional limitations. We expect that 12 sessions will help improve chronic ankle problems, and that NMES combined with PNF will be more effective than PNF alone.

Surgical Management of Lateral Ankle Instability: Modified Broström-Gould Versus Arthroscopic Allograft Reconstruction of the Anterior Talofibular and Calcaneofibular Ligaments.

Primary Objective: To clarify whether arthroscopic reconstruction with allograft provides tangible benefits over the modified open Broström-Gould technique, or if both are equivalent in efficacy and safety. The clinical AOFAS scale will be used for assessment. Secondary Objectives: To determine if there are differences in health outcomes and patient-perceived pain using the specific SP-36 scale and verbal numeric rating scale (VNRS). Additionally, to assess differences in postoperative complication rates and time to return to daily life activities between the two surgical techniques. Study Design: Prospective, randomized, controlled clinical trial with two parallel groups stratified by age and functional demand. Condition or Disorder Being Studied: Chronic lateral ankle instability. Study Population and Sample Size: The target population includes subjects diagnosed with chronic lateral ankle instability. The study population consists of patients diagnosed in the Orthopedics consultations at Hospital Infanta Elena who meet the inclusion and exclusion criteria. Based on sample size calculations, a total of 36 patients will be recruited. However, due to the prospective nature and stratification by epidemiological and functional variables, the sample size may be increased to ensure comparable groups in each stratum. Study Timeline and Estimated Completion Date: The study is expected to begin in the third quarter of 2025. Recruitment is estimated to last 24 months, with a follow-up period of 12 months, for a total duration of 3 years, ending in the third quarter of 2028.

Validity and Reliability of Calf Raise Tests in Patients With Achilles Tendon Rupture and Lateral Ankle Sprain

This study aims to evaluate the validity and reliability of clinically used Calf Raise Test parameters (collected with the "the Calf Raise App") between patients with Lateral Ankle Sprain or Achilles Tendon Repair and healthy controls.

Validation of a Portable Ankle Arthrometer

The purpose of this study is to assess the validity and reliability of a prototype portable ankle arthrometer in various populations. There are two aims to this study. Aim 1 will look to determine the reliability and validity of a prototype portable ankle arthrometer on young adults with no history of ankle sprain, copers, and young adults with chronic ankle instability. It is hypothesized that the prototype portable ankle arthrometer will be a valid and reliable tool to assess joint laxity across the three different populations. Aim 2 will look to determine the validity of a prototype portable ankle arthrometer in young adults with an acute ankle sprain across multiple timepoints in their first month post injury. It is hypothesized that the prototype portable ankle arthrometer will be a valid tool to assess joint laxity at three different timepoints for the same individual.

Topical Treatments for Ankle Sprains

Our aim was to evaluate the effects of topical analgesic drugs on rapid recovery of joint functions and pain relief in acute ankle injuries. A total of 100 patients were included in the study and divided into 2 groups as Diclofenac and Etofenamate. The pain scores of the patients were evaluated with the Numeric Rating scale and Wong-Baker scale before and after treatment. Dorsiflexion and plantarflexion active joint movements were measured with a hand-held goniometer for joint function before and after treatment. We found that ankle sprains were more common in men. In our study, we found that both topical analgesics were effective in improving joint movements and reducing pain.