Effects of plyometric and balance training on neuromuscular control of recreational athletes with functional ankle instability: a randomized controlled laboratory study
| ISRCTN | ISRCTN16780192 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN16780192 |
- Submission date
- 05/05/2021
- Registration date
- 07/05/2021
- Last edited
- 13/06/2023
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Musculoskeletal Diseases
Plain English summary of protocol
Background and study aims
Ankle sprains injuries are the most common lower limb injuries. These can influence sports activities and lead to diminishing athletic performance. Balance training is an effective way of reducing episodes of inversion in individuals with chronic or functional ankle instability (FAI) and improving joint position error. In addition, plyometric exercise (jump training) is recognized as an effective strategy for “reactive neuromuscular training” since it changes the motor unit recruitment pattern and muscle activity by facilitating the sensorimotor system and increases the excitability of the neurological receptors. Even though the updated evidence obviously shows that plyometrics improves neuromuscular control through the facilitation of the neurological receptors, the feasibility and effects of plyometric training for the neuromuscular rehabilitation of athletes with FAI are unclear. Also, the effects of isolated plyometric training and combined with balance training on neuromuscular adaptation have not been directly compared among athletes with FAI. This study aims to investigate the change of joint position sense and neuromuscular activity of the unstable ankle after a six-week integrated balance/plyometric training and six-week plyometric training.
Who can participate?
Collegiate recreational athletes with functional ankle instability (18-30 years old) were recruited and screened using the Cumberland Ankle Instability Tool questionnaire (the score lower than 24 indicated severe instability).
What does the study involve?
Recreational athletes with functional ankle instability were recruited and allocated into three groups: plyometric group, plyometric integrated with balance training group, and control group. Ankle joint position sense, integrated electromyography (EMG), and balance adjusting time during medial single-leg drop landing tasks was measured before and after a six-week training period.
What are the possible benefits and risks of participating?
Both training groups would increase their lower limb muscles strength and power, and improve the neuromuscular system, leading to reduce the recurrence of ankle sprain risk factors. However, this study might have some minor risks such as muscular fatigue after the training or slip and fall during performing a single-leg drop landing test.
Where does the study run from?
The study was conducted at motion analysis laboratory, Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
When is the study starting and how long is it expected to run for?
March 2009 to June 2010
Who is funding the study?
Investigator initiated and funded
Who is the main contact?
Associate Professor Cheng-Feng Lin, connie@mail.ncku.edu.tw
Contact information
Scientific
Institute of Allied Health Sciences
College of Medicine
National Cheng Kung University
Tainan
70101
Taiwan
| Phone | +886 971652242 |
|---|---|
| hospital@mail.hosp.ncku.edu.tw |
Study information
| Study design | Interventional randomized controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Other |
| Study type | Treatment |
| Participant information sheet | Not available in web format, please use the contact details to request a patient information sheet. |
| Scientific title | Effects of plyometric and balance training on neuromuscular control of recreational athletes with functional ankle instability: a randomized controlled laboratory study |
| Study objectives | Both isolated plyometric training and integrated balance and plyometric training improve the joint position error, minimize the time required to stabilization, and increase EMG activity of ankle muscles. |
| Ethics approval(s) | Approved 26/06/2009, Institutional Review Board of National Cheng Kung University Hospital (No.138, Sheng Li Road, Tainan, Taiwan 704, R.O.C.; +886-6-2353535; em73636@mail.hosp.ncku.edu.tw), ref: ER-98-103 |
| Health condition(s) or problem(s) studied | Isolated plyometric training and integrated balance and plyometric training on neuromuscular control of recreational athletes with functional ankle instability |
| Intervention | Participants were blinded to the study group and randomly assigned by the sealed opaque envelopes to the plyometric group (P), integrated balance training/plyometric training group (BP), and control group (C). Each training program lasted for 6 weeks with 3 individual sessions per week. Each individual was requested to participate in at least two-thirds of the sessions (i.e., 12 of the 18 sessions) and was advised that failure to do so would result in their exclusion from the study. A licensed physical therapist trained and supervised all the participants in the training period, and properly adjusted the intensity of the training protocol depending on the ability and performance of each participant. The content of plyometric training started with simple squat jump and progressively to challenged jump and hops while the integrated balance training/plyometric training group involved jumps and balanced squat or balanced lunge every week. |
| Intervention type | Behavioural |
| Primary outcome measure | 1. Joint Position Sense was measured using electrogoniometer before and after the training programs 2. muscle activity of the lower limb muscles was measured using a surface EMG system (Myomonitor, Delsys Inc., Boston, USA) before and after the training programs 3. The adjusting time parameter during single-leg medial drop landing was measured using the Kistler force platform (Type 9281B, Kistler Instrument Corp., Winterhur, Switzerland) before and after the training programs |
| Secondary outcome measures | There are no secondary outcome measures |
| Overall study start date | 07/03/2009 |
| Completion date | 24/06/2010 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Upper age limit | 30 Years |
| Sex | Both |
| Target number of participants | The sample size was calculated based on pilot data. The calculated effect size is 0.8, at least 26 participants were required |
| Total final enrolment | 30 |
| Key inclusion criteria | 1. Recreational athletes aged 18-30 years old in sports activities (at least 1-2 hours each time, 2-3 times per week) 2. Have experienced at least one prior ankle inversion sprain that results in swelling, pain and dysfunction over the past 12 months 3. Have experienced multiple ankle sprains or ankle “giving way” events over the past 12 months 4. Score less than 24 on the CAIT questionnaire 5. Clinically test negative in anterior drawer and talar tilt tests |
| Key exclusion criteria | 1. History of bilateral ankle sprains 2. The ankle with the lower CAIT score was chosen for testing 3. Present neurological disorder, lower extremity injuries that would affect balance, or an ankle sprain within a month |
| Date of first enrolment | 07/10/2009 |
| Date of final enrolment | 05/05/2010 |
Locations
Countries of recruitment
- Taiwan
Study participating centre
College of Medicine
No.1 University Road
Tainan
70101
Taiwan
Sponsor information
Hospital/treatment centre
No.138
Sheng Li Road
Tainan City
704
Taiwan
| Phone | +886-6-2353535 |
|---|---|
| em73636@mail.hosp.ncku.edu.tw | |
| Website | http://www.hosp.ncku.edu.tw/nckm/english/HomeStyle.aspx?Type=11&ContentPage=0 |
"ROR" |
https://ror.org/04zx3rq17 |
Funders
Funder type
Other
No information available
Results and Publications
| Intention to publish date | 10/05/2021 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | International Journal of Environmental Research and Public Health. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are/will be available upon request from Prof. Cheng-Feng Lin, connie@mail.ncku.edu.tw for de-ID raw data or averaged mean values of our outcome variables. The signed consent form will not be provided to public. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | 01/03/2014 | 07/05/2021 | Yes | No | |
| Results article | 15/05/2021 | 13/06/2023 | Yes | No |
Editorial Notes
13/06/2023: Publication reference added.
01/07/2021: The trial contact has been updated.
07/05/2021: Trial's existence confirmed by Institutional Review Board of National Cheng Kung University Hospital.
