Effects of Pilates Training on Ankle Proprioception, Postural Control and Performance in Footballers With Chronic Ankle Instability (CAI)

This study aims to contribute to the effects of Pilates training on ankle proprioception, postural control, and performance in football players with chronic ankle instability. Eighty eight participants will be randomly allocated into two groups and will receive both Pilates and balance training for eight weeks. it is hypothesized that the group that will receive Pilates taring will produce greater improvements as compared to other group.

Study Overview

• Status: Not yet recruiting
• Conditions: Performance; Proprioception, Postural Balance; Chronic Ankle Instability, CAI
• Intervention / Treatment: Other: Pilates exercises; Other: Balance exercises

Detailed Description

Chronic ankle instability is a frequently encountered issue in footballers, characterized by repeated episodes of the ankle "giving way," resulting in functional limitations and increased risk of future injuries. Conventional rehabilitation protocols often fail to restore optimal neuromuscular control, particularly proprioceptive and postural capabilities. Given the demands of football, this deficit can significantly hinder athletic performance and increase injury susceptibility. While Pilates-based rehabilitation has shown promise in improving core strength, balance, and neuromuscular coordination, there is a paucity of research examining its role in the context of CAI. This study addresses this research gap by assessing the effectiveness of Pilates training in improving key functional deficits among footballers with CAI, potentially informing more effective and sport-specific rehabilitation strategies.

Participants will be randomized into two groups:

1. Pilates Training Group
2. Control Group Intervention The intervention will last [insert duration 8 weeks], with participants attending three supervised sessions per week. Each session will last 60 minutes and will be led by a qualified physical therapist experienced in Pilates and sports rehabilitation.

After the intervention period, post-intervention assessments using the same outcome tools will be conducted by the same blinded assessor under identical conditions to the baseline evaluation. Any adverse events or dropouts will be recorded throughout the study.

Group A: Pilates Intervention Group Duration: 8 weeks (3 sessions/week) Session Duration: 60 minutes per session Equipment Used: Yoga mat, resistance bands, Pilates ring, small stability ball, foam roller.

Structure of Each Session:

Phase Time Activities Warm-Up 10 min Gentle dynamic stretches and mobility exercises (e.g., neck rolls, shoulder circles, hip openers, ankle circles) Core Pilates Training 40 min - Beginner-Intermediate Mat Pilates targeting core, hips, gluts, and lower leg muscles - Sample Exercises: - Pelvic tilts - Hundred - Single-leg stretch - Shoulder bridge with ankle engagement - Side-lying leg circles - Toe taps and leg lifts with ankle focus Cool Down 10 min Static stretching, deep breathing, and relaxation techniques

Progression:

Exercises will be progressed weekly by:

• Increasing repetitions and sets
• Reducing support (e.g., double leg to single leg)
• Incorporating dynamic and unstable surfaces (foam pads, balance discs) Group B: Control Group Duration: 8 weeks (3 sessions/week) Session Duration: 60 minutes per session Equipment Used: Balance board, wobble disc, cones, foam pads, resistance bands.

Structure of Each Session:

Phase Time Activities Warm-Up 10 min Light jogging, ankle mobility drills, dynamic stretching Balance Training 40 min - Static and Dynamic Balance Drills: - Single-leg stance (eyes open/closed) - Wobble board balancing - Star excursion balance test practice - Tandem walking on a line - Forward/backward hops on one leg - Cone drills with reach tasks and steps up Cool Down 10 min Ankle and lower limb stretching, breathing techniques

Progression:

• Decrease base of support
• Introduce perturbations (e.g., partner tapping)
• Dual-task activities (catching, counting, etc.)

• Study Type: Interventional
• Enrollment (Estimated): 88
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Rabia Shaheen; Phone Number: +923201451094; Email: rabiameer488@gmail.com
• Study Contact Backup: Name: Muhammad Tariq Shafi; Phone Number: +923454190056; Email: muhammadtariq@ubas.edu.pk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Male footballers aged 22-35

• History of unilateral ankle sprain in past 12 months
• Inability to bear weight post-injury
• CAIT score < 24
• Minimum of 1-year experience in football

Exclusion Criteria:

• Bilateral ankle sprains
• Lower limb fractures or surgeries
• Neurological conditions (e.g., MS, CMT, Stroke)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group A; Pilates training group	Other: Pilates exercises; Duration: 8 weeks (3 sessions/week) Session Duration: 60 minutes per session Equipment Used: Yoga mat, resistance bands, Pilates ring, small stability ball, foam roller. Structure of Each Session: Phase Time Activities Warm-Up 10 min Gentle dynamic stretches and mobility exercises (e.g., neck rolls, shoulder circles, hip openers, ankle circles) Core Pilates Training 40 min - Beginner-Intermediate Mat Pilates targeting core, hips, gluts, and lower leg muscles - Sample Exercises: - Pelvic tilts - Hundred - Single-leg stretch - Shoulder bridge with ankle engagement - Side-lying leg circles - Toe taps and leg lifts with ankle focus Cool Down 10 min Static stretching, deep breathing, and relaxation techniques Progression: Exercises will be progressed weekly by: Increasing repetitions and sets; Reducing support (e.g., double leg to single leg); Incorporating dynamic and unstable surfaces (foam pads, balance discs)
Experimental: Group B; Balance training group	Other: Balance exercises; Group B: Control Group Duration: 8 weeks (3 sessions/week) Session Duration: 60 minutes per session Equipment Used: Balance board, wobble disc, cones, foam pads, resistance bands. Structure of Each Session: Phase Time Activities Warm-Up 10 min Light jogging, ankle mobility drills, dynamic stretching Balance Training 40 min - Static and Dynamic Balance Drills: - Single-leg stance (eyes open/closed) - Wobble board balancing - Star excursion balance test practice - Tandem walking on a line - Forward/backward hops on one leg - Cone drills with reach tasks and steps up Cool Down 10 min Ankle and lower limb stretching, breathing techniques Progression: Decrease base of support; Introduce perturbations (e.g., partner tapping); Dual-task activities (catching, counting, etc.)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postural control	The YBT has the patient stand on one leg while reaching out in 3 different directions with the other lower extremity. They are anterior, posteromedial and posterolateral. When using the Y-Balance test kit, the 3 reaches yield a "composite reach distance" or composite score used to predict injury.	Base line before intervention after 8 weeks post intervention
ankle proprioception	The goniometer was used to measure the ankle proprioception. Testing was performed the way that the person would sit on a chair so that a 90-degree angle of thigh and knee was maintained, and the height of the chair was such that the soles of the individual could not reach the ground. Then the person's foot was positioned with the goniometer in such a way that the eyes of the person were closed. Then the individual foot was inactively taken to the midrange. This angle was 10 degrees for dorsiflexion, 20 degrees for plantar flexion, 15 degrees for inversion and 10 degrees for eversion. Afterwards, the person was asked to actively re-create the desired angle with his closed eye; the test was performed three times, and the mean of three times of the angle of reconstruction determined the individual's score in each of the state.	Baseline: Before intervention 8 weeks post-intervention
performance	The Foot and Ankle Ability Measure (FAAM) is a self-report outcome instrument developed to assess physical function for individuals with foot and ankle related impairments. This self-report outcome instrument is available in English, German, French and Persian. The Foot and Ankle Ability Measure is a 29-item questionnaire divided into two subscales: The Foot and Ankle Ability Measure, 21-item Activities of Daily Living Subscale and the Foot and Ankle Ability Measure, 8-item Sports Subscale. The Sports subscale assesses more difficult tasks that are essential to sport, it is a population-specific subscale designed for athletes.	base line before intervention and 8 weeks post intervention

Collaborators and Investigators

• Sponsor: Lahore University of Biological and Applied Sciences
• Investigators: Study Chair: Muhammad Tariq Shafi, Lahore University of Biological and Applied Sciences

Publications and helpful links

General Publications

• Alghadir AH, Iqbal ZA, Iqbal A, Ahmed H, Ramteke SU. Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes. Int J Environ Res Public Health. 2020 Jul 23;17(15):5318. doi: 10.3390/ijerph17155318.
• Ghorbani M, Yaali R, Sadeghi H, Granacher U. Effects of Pilates Exercise Training on Static Balance and Lower Limbs Proprioception in Adult Females With and Without Flexible Flatfeet. Foot Ankle Spec. 2024 Sep 26:19386400241279930. doi: 10.1177/19386400241279930. Online ahead of print.
• Zhang C, Chen N, Wang J, Zhang Z, Jiang C, Chen Z, Fang J, Peng J, Li W, Song B. The Prevalence and Characteristics of Chronic Ankle Instability in Elite Athletes of Different Sports: A Cross-Sectional Study. J Clin Med. 2022 Dec 16;11(24):7478. doi: 10.3390/jcm11247478.
• Ziaei Ziabari E, Haghpanahi M, Razi M, Lubberts B, Ashkani-Esfahani S, DiGiovanni CW. The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait. Orthop Surg. 2022 Sep;14(9):2238-2244. doi: 10.1111/os.13307. Epub 2022 Jul 19.

Study record dates

Study Major Dates

• Study Start (Estimated): November 25, 2025
• Primary Completion (Estimated): May 25, 2026
• Study Completion (Estimated): May 30, 2026

Study Registration Dates

• First Submitted: November 24, 2025
• First Submitted That Met QC Criteria: November 24, 2025
• First Posted (Actual): December 5, 2025

Study Record Updates

• Last Update Posted (Actual): December 5, 2025
• Last Update Submitted That Met QC Criteria: November 24, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Performance; proprioception; Chronic Ankle Instability; Postural Control
• Additional Relevant MeSH Terms: Therapeutics; Physical Therapy Modalities; Exercise Movement Techniques
• Other Study ID Numbers: UBAS/ERB/FoRS/25/020

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