- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07726810
Dynamic Neuromuscular Stability Exercises With and Without Rhythmic Auditory Stimulation in Lateral Ankle Sprain (DNS)
Effect of Dynamic Neuromuscular Stability Exercises With and Without Rhythmic Auditory Stimulation on Balance, Proprioception, and Performance Among Badminton Players With Lateral Ankle Sprain
Study Overview
Status
Conditions
Detailed Description
A randomized controlled trial compared Dynamic Neuromuscular Stabilization (DNS), balance training, and conventional rehabilitation in amateur athletes with chronic ankle sprain. The findings demonstrated that both DNS and balance training significantly improved ankle stability, balance, reaction time, and functional performance, highlighting their effectiveness in rehabilitation.
A quasi-experimental study investigated the effects of ankle proprioceptive training in recreational badminton players with pronated feet. The intervention resulted in significant improvements in agility, dynamic balance, and ankle function compared with conventional training.
Another study evaluated neuromuscular training with and without kinesio taping in football players following ankle sprain. Both interventions effectively reduced pain and improved range of motion, balance, and functional performance, while the addition of kinesio taping produced greater clinical benefits.
A randomized study assessed the effectiveness of a six-week neuromuscular training program in individuals with lateral ankle sprain. The intervention significantly enhanced muscle strength, proprioception, balance, range of motion, and overall functional recovery compared with routine training.
A pilot randomized trial examined rhythmic auditory stimulation-based gait training in older adults undergoing rehabilitation. The intervention significantly improved gait speed and demonstrated its feasibility as an effective rehabilitation strategy.
A randomized controlled trial evaluated the effects of Dynamic Neuromuscular Stabilization on functional movement. The results showed that DNS training produced significant improvements in movement quality and functional performance compared with conventional physical fitness exercises.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Imran Amjad, PhD
- Phone Number: 03324390125
- Email: imran.amjad@riphah.edu.pk
Study Locations
-
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Punjab Province
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Lahore, Punjab Province, Pakistan, 54000
- Recruiting
- Sports Board of Punjab
-
Contact:
- Sidra Shafique, MS
- Phone Number: 03053783183
- Email: sidra.shafique@riphah.edu.pk
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18-30 years
- Both male and female genders
- Diagnosed with Grade I or II lateral ankle sprain (subacute to chronic phase)
- Within 2-8 weeks post-injury
Exclusion Criteria:
- History of ankle surgery
- Vestibular, neurological, or hearing disorders
- Acute pain prevents participation
- Current involvement in other rehab programs
- Any fracture or other injury
- Any systemic illness
- Any inflammatory disease (Rheumatoid arthritis, gout)
Study Plan
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: Dynamic Neuromuscular Stabilization with Rhythmic Auditory Stimulation
The intervention was progressively advanced over six weeks.
Baseline treatment included warm-up exercises, stretching, and basic balance training with rhythmic auditory cues.
During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening.
In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced with increased rhythmic cueing.
By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements synchronized with rhythmic auditory stimulation to enhance neuromuscular control and functional performance.
|
The intervention was progressively advanced over six weeks.
Baseline treatment included warm-up exercises, stretching, and basic balance training with rhythmic auditory cues.
During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening.
In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced with increased rhythmic cueing.
By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements synchronized with rhythmic auditory stimulation to enhance neuromuscular control and functional performance.
Other Names:
|
|
Active Comparator: Dynamic Neuromuscular Stabilization Alone
The intervention was progressively advanced over six weeks.
Baseline treatment included warm-up exercises, stretching, and basic balance training.
During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening.
In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced.
By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements to enhance neuromuscular control, balance, and functional performance.
|
The intervention was progressively advanced over six weeks.
Baseline treatment included warm-up exercises, stretching, and basic balance training.
During Week 2, participants performed DNS breathing and core stabilization exercises, proprioceptive training, and Theraband ankle strengthening.
In Week 4, advanced DNS postures, dynamic balance, and functional movement exercises were introduced.
By Week 6, participants progressed to advanced DNS exercises, unilateral balance and hopping drills, agility training, and badminton-specific movements to enhance neuromuscular control, balance, and functional performance.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Joint Position Sense Test
Time Frame: 6 weeks
|
JPS evaluates proprioception by measuring a subject's ability to actively or passively reproduce a joint angle without visual input.
It has shown moderate to high reliability (ICC = 0.70-0.93)
and is a valid measure of sensorimotor deficits following lateral ankle injuries.
Pre and post assessment will be done.
|
6 weeks
|
|
Star Excursion Balance Test
Time Frame: 6 weeks
|
The SEBT is a dynamic balance test that assesses neuromuscular control and postural stability during multi-directional reaching tasks while standing on one leg.
It demonstrates high reliability (ICC = 0.85-0.96)
and good validity in identifying lower limb deficits, especially following ankle sprains and in athletic populations.
Pre and post assessment will be done.
|
6 weeks
|
|
Sports Ankle Rating Scale (SARS)
Time Frame: 6 weeks
|
The SARS is a subjective questionnaire designed to assess functional limitations, pain, and instability related to ankle injuries in athletic populations.
It demonstrates good reliability (Cronbach's alpha > 0.80) and acceptable validity when compared with clinical outcomes.
The scale includes sections on pain, function during sports, and instability episodes to provide a comprehensive ankle health profile.
Pre and post assessment will be done.
|
6 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Sidra Shafique, MS, Riphah International University
Publications and helpful links
General Publications
- Igusa T, Kobayashi T, Uchida H, Tsuchiya K, Akiba T, Sema S, Kaneko S, Yoshita T, Nagai S, Tanaka Y, Kikuchi S, Hirao K. Effect of gait training using rhythmic auditory stimulation on gait speed in older adults admitted to convalescent rehabilitation wards: A study protocol for a pilot randomized controlled clinical trial. Contemp Clin Trials Commun. 2023 Apr 1;33:101125. doi: 10.1016/j.conctc.2023.101125. eCollection 2023 Jun.
- Karami M, Jamehbozorgi A, Salemi P, Rezaei M. The Effect of 6 Weeks Neuromuscular Training On Muscle Strength, Balance, Range of Motion & Proprioception In Males With Lateral Ankle Sprain. Journal of Modern Rehabilitation. 2025.
- Yesilkir S, Sahin GE. Dynamic neuromuscular stabilization training for chronic ankle instability: A randomized controlled trial in amateur athletes. J Back Musculoskelet Rehabil. 2026 Jul;39(4):1157-1169. doi: 10.1177/10538127251338170. Epub 2025 May 11.
- Meng L, Wang Y, Wang Z, Liu Y, Tan Y, Zhang Y, Wei X, Mao X, Zhang Q. Effects of auditory rhythmic adaptation on lower limb joint mechanics during single-leg drop landings in individuals with functional ankle instability. Front Hum Neurosci. 2025 Jul 2;19:1579260. doi: 10.3389/fnhum.2025.1579260. eCollection 2025.
- Mansouri M, Saki F. The Effectiveness of Neuromuscular Training With and Without Cognitive Intervention on Dynamic Balance and Proprioception of Female Athletes Prone to Ankle Sprain Injury: A Randomized Control Trial.
- Kim KM, Kim JS, Needle AR. Soleus arthrogenic muscle inhibition following acute lateral ankle sprain correlates with symptoms and ankle disability but not with postural control. J Sport Health Sci. 2024 Jul;13(4):559-568. doi: 10.1016/j.jshs.2024.02.005. Epub 2024 Feb 28.
- Mansur H, Durigan JLQ, Contessoto S, Maranho DA, Nogueira-Barbosa MH. Evaluation of the Healing Status of Lateral Ankle Ligaments 6 Weeks After an Acute Ankle Sprain. J Foot Ankle Surg. 2024 Nov-Dec;63(6):637-645. doi: 10.1053/j.jfas.2024.07.004. Epub 2024 Jul 25.
- Taketomi S, Kawaguchi K, Mizutani Y, Takei S, Yamagami R, Kono K, Murakami R, Kage T, Arakawa T, Fujiwara S, Tanaka S, Ogata T. Factors Associated With a Lateral Ankle Sprain in Young Female Soccer Players: A Prospective Cohort Study. Orthop J Sports Med. 2024 Feb 26;12(2):23259671231221481. doi: 10.1177/23259671231221481. eCollection 2024 Feb.
- Liu Z, Yamaguchi R, Fu S, Zhao H, Li Y, Kobayashi Y, Gong Y, Kumai T. Epidemiology of ankle sprain and chronic ankle instability in elite adolescent dancesport athletes. Phys Sportsmed. 2025 Apr;53(2):119-128. doi: 10.1080/00913847.2024.2418283. Epub 2024 Oct 20.
- Wagemans J, Dingenen B, Clockaerts S, Bleakley C. Physiotherapists Approach in Lateral Ankle Sprain Rehabilitation: A Survey Study. J Sport Rehabil. 2025 Apr 4;35(1):31-38. doi: 10.1123/jsr.2024-0442. Print 2026 Jan 1.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- REC/RCR & AHS/25/0441
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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