- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04131842
External Versus Internal Feedback in Patients With Chronic Ankle Instability
June 7, 2023 updated by: Luke Donovan, University of North Carolina, Charlotte
External Versus Internal Feedback on Biomechanics and Self-reported Function in Patients With Chronic Ankle Instability
Although altered biomechanics has been well documented as an impairment associated with chronic ankle instability (CAI), effective interventions targeting biomechanics with long-term outcomes measuring patient-reported outcomes (PROs) are absent.
Evidence suggests that external focus of attention (ExFOCUS), internal focus of attention (InFOCUS) feedback, and auditory feedback during movement training can alter biomechanics in other patient populations, with ExFOCUS and auditory enhancing retention of learned biomechanics.
Therefore, this randomized controlled trial will determine if a 4-week (12 session) impairment-based rehabilitation program that includes feedback (ExFOCUS or InFOCUS or Auditory) can (1) decrease ankle inversion kinematics and lateral plantar pressure during walking and (2) improve self-reported function.
Study Overview
Status
Recruiting
Conditions
Study Type
Interventional
Enrollment (Estimated)
100
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
North Carolina
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Charlotte, North Carolina, United States, 28223
- Recruiting
- UNC Charlotte
-
Contact:
- Luke Donovan, PhD
- Phone Number: 704-687-8611
- Email: ldonova2@uncc.edu
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Principal Investigator:
- Luke Donovan, PhD
-
Principal Investigator:
- Abbey Thomas, PhD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 40 years (Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Characterized as having chronic ankle instability (CAI) by reporting a history of recurrent ankle sprains, with the first sprain occurring longer than 12 months ago. Participants will have lingering symptoms, and disability, but have not actively sought treatment for their CAI.
- All participants will be physically active: Participating in some form of physical activity for at least 20 min per day, three times per week.
Exclusion Criteria:
- Neurological or vestibular disorders affecting balance
- Currently seeking medical care for CAI
- History of ankle surgery
- History of ankle sprain within the past 6 weeks
- History of other musculoskeletal injuries within the past 6 weeks
- Current/previous self-reported disability due to lower extremity pathology that may adversely affect neuromuscular function
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: ExFOCUS Visual
Participants will complete 12 sessions over 4-weeks of impairment-based rehabilitation that incorporates ankle range of motion, ankle strength, balance, and functional activity exercises.
For the balance and functional activity exercises, participants will use traditional instability tools and will receive external focus of attention visual feedback.
|
Patients will receive external focus of attention visual feedback during the impairment-based rehabilitation program.
|
Experimental: ExFOCUS Auditory
Participants will complete 12 sessions over 4-weeks of impairment-based rehabilitation that incorporates ankle range of motion, ankle strength, balance, and functional activity exercises.
For the balance and functional activity exercises, participants will use traditional instability tools and will receive auditory feedback.
|
Patients will receive external focus of attention auditory feedback during the impairment-based rehabilitation program.
|
Experimental: InFOCUS Visual
Participants will complete 12 sessions over 4-weeks of impairment-based rehabilitation that incorporates ankle range of motion, ankle strength, balance, and functional activity exercises.
For the balance and functional activity exercises, participants will use traditional instability tools and will receive internal focus of attention visual feedback via video.
|
Patients will receive internal focus of attention visual feedback during the impairment-based rehabilitation program.
|
Active Comparator: NoFeedback
Participants will complete 12 sessions over 4-weeks of impairment-based rehabilitation that incorporates ankle range of motion, ankle strength, balance, and functional activity exercises.
For the balance and functional activity exercises, participants will use traditional instability tools and receive no feedback.
|
Patients will receive no feedback during the impairment-based rehabilitation program.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes from baseline in lower extremity kinematics and kinetics during walking
Time Frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
|
Ankle, knee, and hip motion and moments during walking measured by a 3D motion capture system and in shoe plantar pressure system
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Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
|
Changes from baseline in self-reported ankle function
Time Frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
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Changes from baseline in self-reported function as measured by the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living and Sport questionnaire.
Scores range from 100% (no decrease in function) to 0% (complete loss of function).
|
Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes from baseline in ankle range of motion measured in degrees
Time Frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
|
Four different ankle ranges of motion will be measured
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Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
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Changes from baseline in ankle maximum voluntary isometric strength
Time Frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
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Ankle maximum voluntary isometric strength will be measured during four different ankle positions using a hand-held dynamometer.
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Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
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Changes from baseline in static and dynamic balance
Time Frame: Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
|
Static balance will be measured via a force plate and dynamic balance will be measured using the Star Excursion Balance Test
|
Immediate post-intervention, 1-month post-intervention, 3-months post-intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 18, 2020
Primary Completion (Estimated)
June 1, 2024
Study Completion (Estimated)
June 17, 2024
Study Registration Dates
First Submitted
October 16, 2019
First Submitted That Met QC Criteria
October 16, 2019
First Posted (Actual)
October 18, 2019
Study Record Updates
Last Update Posted (Actual)
June 9, 2023
Last Update Submitted That Met QC Criteria
June 7, 2023
Last Verified
June 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UNCCharlotte
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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