Foot Intensive Rehabilitation With Perturbation Based Training in Ankle Sprain Patients

Foot Intensive Rehabilitation With & Without Perturbation Based Training in Patients With Ankle Sprain

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.

Study Overview

• Status: Completed
• Conditions: Ankle Sprain
• Intervention / Treatment: Other: Group A: Foot-Intensive Rehabilitation; Other: Foot-Intensive Rehabilitation + Perturbation-Based Training

Detailed Description

Group A: Foot-Intensive Rehabilitation with Perturbation-Based Training

Foot-Intensive Rehabilitation:

Participants in Group A will undergo a structured rehabilitation program focused on addressing ankle sprains and improving foot-specific impairments. This program will typically include:

• Therapeutic Exercises: Range of motion exercises, strengthening exercises for foot and ankle muscles, proprioceptive training, and flexibility exercises tailored to individual needs.
• Manual Therapy: Hands-on techniques performed by a physical therapist or trained personnel to address soft tissue restrictions, joint mobilization, and mayofascial release.
• Modalities: Use of modalities like ice, heat, ultrasound, or electrical stimulation for pain relief and enhancing tissue healing.
• Functional Training: Specific drills and activities mimicking daily tasks or sports- related movements to improve functional capacity.

Perturbation-Based Training: In addition to the foot-intensive rehabilitation program, participants will undergo perturbation-based training sessions:

• Balance Challenges: Engaging in exercises on unstable surfaces (e.g., balance boards, foam pads) or using devices inducing controlled instability to challenge balance and neuro- muscular control.
• Dynamic Movements: Performing controlled perturbations or sudden movements to elicit adaptive responses and improve reactive balance strategies.
• Progression: Gradual progression of difficulty and complexity in perturbation-based exercises based on individual tolerance and improvement.

Group B: Foot-Intensive Rehabilitation without Perturbation-Based Training

Foot-Intensive Rehabilitation:

Participants in Group B will receive the same structured rehabilitation program focusing on foot- intensive exercises as in Group A. This program includes similar components such as therapeutic exercises, manual therapy, modalities, and functional training targeting ankle sprain recovery and foot-specific impairments.

Both groups will undergo the assigned interventions for the duration of 6 weeks under the supervision of trained physical therapists or healthcare professionals

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Pakistan Sports Board

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• • Gender: male /female

  • Participants aged 18 to 35 years old.
  • Diagnosis of an ankle sprain (within 4 weeks of injury).
  • No prior history of severe ankle fractures or surgeries(Hoch et al., 2023)

Exclusion Criteria:

• Presence of severe or complex ankle fractures requiring surgical intervention.
• Conditions other than ankle sprain like neuropathy that affect balance or cutaneous sensation.
• Neurological disorders impacting balance or proprioception.
• Pregnancy or planning to become pregnant during the study period(Hoch et al., 2023)

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
Other: Group A; Foot-Intensive Rehabilitation: Participants in Group A will undergo a structured rehabilitation program focused on addressing ankle sprains and improving foot-specific impairments	Other: Group A: Foot-Intensive Rehabilitation; Foot-Intensive Rehabilitation This program will typically include: Therapeutic Exercises: Range of motion exercises, strengthening exercises for foot and ankle muscles, proprioceptive training, and flexibility exercises tailored to individual needs.; Manual Therapy: Hands-on techniques performed by a physical therapist or trained personnel to address soft tissue restrictions, joint mobilization, and mayofascial release.; Modalities: Use of modalities like ice, heat, ultrasound, or electrical stimulation for pain relief and enhancing tissue healing.; Functional Training: Specific drills and activities mimicking daily tasks or sports- related movements to improve functional capacity.
Experimental: Group B; In addition to the foot-intensive rehabilitation program, participants will undergo perturbation-based training sessions	Other: Foot-Intensive Rehabilitation + Perturbation-Based Training; In addition to the foot-intensive rehabilitation program, participants in experimental group will undergo perturbation-based training sessions: Balance Challenges: Engaging in exercises on unstable surfaces (e.g., balance boards, foam pads) or using devices inducing controlled instability to challenge balance and neuro- muscular control.; Dynamic Movements: Performing controlled perturbations or sudden movements to elicit adaptive responses and improve reactive balance strategies.; Progression: Gradual progression of difficulty and complexity in perturbation-based exercises based on individual tolerance and improvement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric pain rate scale (NPRS)	Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain" (Riley et al., 2019)	6 weeks (Baseline, 3rd week, 6th week)
Range of Motion (ROM) Measurement	Goniometer: To measure dorsiflexion, plantarflexion, inversion, and eversion of the ankle joint(Rome & Cowieson, 1996).	6 weeks (Baseline, 3rd week, 6th week)
Balance Assessment:	Star Excursion Balance Test (SEBT): Measures reach distances in multiple directions to assess dynamic balance and reach symmetry.(Coughlan et al., 2012)	6 weeks (Baseline, 3rd week, 6th week)
Functional Instability Measurement	Cumberland Ankle Instability Tool (CAIT): A questionnaire to assess the severity of functional ankle instability.(ALEXANDRE et al., 2024)	6 weeks (Baseline, 3rd week, 6th week)

Collaborators and Investigators

• Sponsor: University of Lahore
• Investigators: Principal Investigator: Sana Akram, MSOMPT, University of Lahore

Study record dates

Study Major Dates

• Study Start (Actual): December 27, 2025
• Primary Completion (Actual): March 12, 2026
• Study Completion (Actual): April 27, 2026

Study Registration Dates

• First Submitted: June 13, 2026
• First Submitted That Met QC Criteria: June 13, 2026
• First Posted (Actual): June 18, 2026

Study Record Updates

• Last Update Posted (Actual): June 18, 2026
• Last Update Submitted That Met QC Criteria: June 13, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Ankle Sprain; Foot Perturbation; Foot Intensive Rehabilitation
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Ankle Injuries
• Other Study ID Numbers: UOL/IREB/25/15/03/10

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No