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How Different Breathing Methods Affect Brain Activity in Young Adults With Chronic Ankle Instability (BRAIN-CAI)

2026年11月11日 更新者:hyeongju Yoon、Gwangju Health University

Comparative Analysis of Breathing Intervention Types on Neural Activation in Young Adults With Chronic Ankle Instability: An fNIRS-EEG Randomized Controlled Trial

Chronic ankle instability is a common condition that can affect balance, movement control, and daily activities in young adults. Breathing exercises may influence brain function and attention, but their immediate effects on brain activity in individuals with chronic ankle instability are not well understood.

This randomized controlled trial aims to investigate the immediate effects of different breathing interventions on brain activity in young adults with chronic ankle instability. Participants will be randomly assigned to different breathing intervention groups. Brain activity will be assessed before and after the intervention using functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG). The findings may improve understanding of the relationship between breathing exercises and brain function and support the development of rehabilitation strategies for individuals with chronic ankle instability.

調査の概要

状態

募集

条件

介入・治療

詳細な説明

Background and Rationale Chronic ankle instability (CAI) is a common sequela of lateral ankle sprain, characterized by recurrent giving way, perceived instability, and impaired dynamic balance. Growing evidence suggests that CAI involves not only peripheral deficits but also altered central nervous system processing, including changes in prefrontal cortical activity. Breathing-based interventions may influence postural control as well as cortical and autonomic regulation. However, it remains unclear how different types of breathing interventions compare in their immediate effects on brain activity in individuals with CAI. This study compared three breathing interventions: diaphragmatic breathing training, VR-based breathing meditation, and neurofeedback-based brain relaxation training.

Study Design This was a parallel-group, assessor-blinded randomized controlled trial. Thirty-three young adults with CAI were randomly allocated to one of three groups (n = 11 per group): the Diaphragmatic Breathing Group (DBG), the VR-based Breathing Meditation Group (VMG), or the Neurofeedback Brain Relaxation Training Group (NRG). Outcome assessors were blinded to group allocation. Each participant received a single intervention session according to group assignment, and outcomes were assessed before and immediately after the intervention. The study was designed and reported in accordance with the CONSORT guidelines.

Interventions The DBG performed diaphragmatic breathing training. The VMG performed breathing meditation delivered through a virtual reality environment. The NRG performed brain relaxation training based on EEG neurofeedback. The three groups differed in the type of breathing intervention while all received a single session. Detailed intervention procedures are described in the Arms and Interventions section.

Outcome Assessment The primary outcomes were cortical activity and EEG-based self-regulation indices. Cortical activity was measured by functional near-infrared spectroscopy (fNIRS) as oxygenated hemoglobin (HbO2) concentration in prefrontal regions of interest, including the dorsolateral prefrontal cortex, frontopolar cortex, orbitofrontal cortex, and medial prefrontal cortex. Neural self-regulation was evaluated using indices derived from EEG neurofeedback. The secondary outcomes were diaphragm contractility, measured as diaphragm thickening fraction using ultrasound; dynamic balance, measured by the Star Excursion Balance Test (SEBT); and ankle instability. Detailed outcome definitions and time frames are described in the Outcome Measures section.

Statistical Analysis Between-group differences were analyzed using analysis of variance (ANOVA), and within-group changes from pre- to post-intervention were analyzed using paired t-tests. Associations among fNIRS, EEG, and balance variables were examined using Pearson correlation analysis. Effect sizes were reported as Cohen's d. Bonferroni correction was applied where multiple comparisons were made. The significance level was set at 0.05.

Significance The findings of this study are expected to clarify how different types of breathing interventions immediately modulate prefrontal cortical activity and neural self-regulation in individuals with CAI, and to provide a basis for neuroscience-informed rehabilitation strategies for CAI.

研究の種類

介入

入学 (推定)

33

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

      • Gwangju、韓国、62287
        • 募集
        • Gwangju Health University
        • コンタクト:
        • コンタクト:
          • Seungwoo Shin Shin, Ph.D.
          • 電話番号:=82-10-9820-2382
          • メール:ptssw94@gmail.com

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~34年 (大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Young adults
  • CAIT-K score of ≤24
  • A history of at least one ankle sprain occurring at least 12 months prior to study enrollment
  • At least two episodes of ankle "giving way" within the 6months precending study enrollment

Exclusion Criteria:

  • A sprain of the involved ankle within 3 months prior to study enrollment
  • A History of lower-extremity surgery or fracture
  • A history of neurological disorder
  • The presence of cardiopulmonary disorder
  • Self-reported symptoms of cybersickness
  • Left-handedness

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:基礎科学
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:独身

武器と介入

参加者グループ / アーム
介入・治療
アクティブコンパレータ:Diaphragmatic brathing Training group

Participants in this group received diaphragmatic breathing training in a single session. Outcomes, including cortical activity, EEG indices, diaphragm contractility, dynamic balance, and ankle instability, were assessed before and immediately after the session.

Participants assigned to this intervention will perform diaphragmatic breathing training in a single session. Participants will be guided to breathe using the diaphragm, and the training will be delivered under the supervision of a trained researcher.

実験的:VR-based breathing meditation group

Participants in this group received breathing meditation delivered through a virtual reality environment in a single session. Outcomes, including cortical activity, EEG indices, diaphragm contractility, dynamic balance, and ankle instability, were assessed before and immediately after the session.

Participants assigned to this intervention will perform breathing meditation delivered through a virtual reality environment in a single session. Participants will wear a VR headset and follow the breathing meditation content presented in the virtual environment.

実験的:Neurofeedback relaxation training group

Participants in this group received brain relaxation training based on EEG neurofeedback in a single session. Outcomes, including cortical activity, EEG indices, diaphragm contractility, dynamic balance, and ankle instability, were assessed before and immediately after the session.

Participants assigned to this intervention will perform brain relaxation training based on EEG neurofeedback in a single session. Participants will receive real-time feedback on their EEG activity and will be trained to achieve a relaxed brain state.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change in dorsolateral prefrontal cortex oxygenated hemoglobin (HbO2) concentration measured by fNIRS
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Oxygenated hemoglobin (HbO2) concentration was measured by functional near-infrared spectroscopy (fNIRS) in the dorsolateral prefrontal cortex. Change was calculated as the difference between pre- and post-intervention values.

Baseline (before the intervention) and immediately after the single intervention session
Change in frontopolar cortex oxygenated hemoglobin (HbO2) concentration measured by fNIRS
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Oxygenated hemoglobin (HbO2) concentration was measured by functional near-infrared spectroscopy (fNIRS) in the frontopolar cortex. Change was calculated as the difference between pre- and post-intervention values.

Baseline (before the intervention) and immediately after the single intervention session
Change in orbitofrontal cortex oxygenated hemoglobin (HbO2) concentration measured by fNIRS
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Oxygenated hemoglobin (HbO2) concentration was measured by functional near-infrared spectroscopy (fNIRS) in the orbitofrontal cortex. Change was calculated as the difference between pre- and post-intervention values.

Baseline (before the intervention) and immediately after the single intervention session
Change in medial prefrontal cortex oxygenated hemoglobin (HbO2) concentration measured by fNIRS
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Oxygenated hemoglobin (HbO2) concentration was measured by functional near-infrared spectroscopy (fNIRS) in the medial prefrontal cortex. Change was calculated as the difference between pre- and post-intervention values.

Baseline (before the intervention) and immediately after the single intervention session
Change in EEG delta band power
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Delta band (0.5-4 Hz) power was measured by electroencephalography (EEG) at [electrode site(s)]. Change was calculated as the difference between pre- and post-intervention values. Unit: [µV²].

Baseline (before the intervention) and immediately after the single intervention session
Change in EEG theta band power
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Theta band (4-8 Hz) power was measured by electroencephalography (EEG) at [electrode site(s)]. Change was calculated as the difference between pre- and post-intervention values. Unit: [µV²].

Baseline (before the intervention) and immediately after the single intervention session
Change in EEG alpha band power
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Alpha band (8-12 Hz) power was measured by electroencephalography (EEG) at [electrode site(s)]. Change was calculated as the difference between pre- and post-intervention values. Unit: [µV²].

Baseline (before the intervention) and immediately after the single intervention session
Change in EEG sensorimotor rhythm (SMR) band power
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Sensorimotor rhythm (SMR) band (12-15 Hz) power was measured by electroencephalography (EEG) at [electrode site(s)]. Change was calculated as the difference between pre- and post-intervention values. Unit: [µV²].

Baseline (before the intervention) and immediately after the single intervention session
Change in EEG beta band power
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Beta band (15-30 Hz) power was measured by electroencephalography (EEG) at [electrode site(s)]. Change was calculated as the difference between pre- and post-intervention values. Unit: [µV²].

Baseline (before the intervention) and immediately after the single intervention session

二次結果の測定

結果測定
メジャーの説明
時間枠
Change in diaphragm thickening fraction measured by ultrasound
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Diaphragm thickness was measured by ultrasound at end-inspiration and end-expiration, and the diaphragm thickening fraction was calculated as (end-inspiration thickness - end-expiration thickness) / end-expiration thickness × 100 (%). Change was calculated as the difference between pre- and post-intervention values.

Baseline (before the intervention) and immediately after the single intervention session
Change in dynamic balance measured by the Star Excursion Balance Test (SEBT)
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Dynamic balance was assessed by the Star Excursion Balance Test (SEBT), in which participants reached as far as possible with the free limb while standing on the affected limb. Reach distance was measured in each direction, and change was calculated as the difference between pre- and post-intervention values.

Baseline (before the intervention) and immediately after the single intervention session
Change in ankle instability measured by CAIT-K
時間枠:Baseline (before the intervention) and immediately after the single intervention session

Ankle instability was assessed using [instrument name]. Change was calculated as the difference between pre- and post-intervention scores.

Baseline (before the intervention) and immediately after the single intervention session

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研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年12月14日

一次修了 (推定)

2027年2月14日

研究の完了 (推定)

2027年3月30日

試験登録日

最初に提出

2026年11月4日

QC基準を満たした最初の提出物

2026年11月11日

最初の投稿 (実際)

2026年11月13日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月13日

QC基準を満たした最後の更新が送信されました

2026年11月11日

最終確認日

2026年11月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • P01-202610-01-075

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

De-identified individual participant data underlying the results reported in the publication will be shared with qualified researchers upon reasonable request to the corresponding author. Data will be available after publication of the main results.

IPD 共有時間枠

Data will be available beginning 6 months after publication of the main results

IPD 共有アクセス基準

Qualified researchers may request access to de-identified individual participant data by contacting the corresponding author. Requests will be reviewed by the research team, and data will be shared for academic research purposes.

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL
  • ICF

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