RecruitingNot ApplicableNCT07689747

Neurocognitive Enrichment During Functional Performance Testing in Chronic Ankle Instability

Acute Effects of Neurocognitively Enriched Functional Performance Testing Conditions on Balance and Functional Performance in Athletes With Chronic Ankle Instability: A Randomized Crossover Study

Sponsor

Bahçeşehir University

Enrollment

40 participants

Start Date

Jun 8, 2026

Study Type

INTERVENTIONAL

Conditions

Chronic Ankle Instability, CAI

Summary

Chronic ankle instability (CAI) is associated with recurrent ankle sprains, impaired postural control, and reduced functional performance. Traditional functional performance tests are commonly used to assess athletes with CAI; however, these assessments are typically conducted under isolated motor conditions and may not adequately reflect the neurocognitive demands encountered during sports participation. The aim of this randomized crossover study is to investigate the acute effects of neurocognitively enriched testing conditions on balance and functional performance in athletes with CAI. Participants will perform functional performance tests under four different conditions: standard testing, internal focus of attention, external focus of attention, and cognitive dual-task conditions. Dynamic balance, vertical jump performance, single-leg hop performance, figure-of-8 hop performance, and dual-task cost will be assessed and compared across conditions. The findings of this study may contribute to the development of more ecologically valid assessment approaches for athletes with CAI and provide insights into the influence of attentional focus and cognitive load on functional performance.

Eligibility

Min Age: 16 YearsMax Age: 25 Years

Inclusion Criteria9

Aged between 16 and 25 years.
Actively participating as a licensed football, basketball, or volleyball athlete.
History of at least one lateral ankle sprain occurring ≥12 months before study participation, associated with pain and/or swelling and resulting in at least one day of restricted physical activity.
History of recurrent ankle instability, defined as at least two episodes of giving way during the previous 6 months and/or recurrent ankle sprains.
Cumberland Ankle Instability Tool (CAIT) score ≤25.
Participating in regular sports training at least 3 times per week.
No ankle surgery within the previous 6 months.
Able to safely perform all functional performance tests.
Willing to undergo assessment of the more symptomatic ankle; in participants with bilateral chronic ankle instability, the ankle with the lower CAIT score will be evaluated.

Exclusion Criteria5

Acute ankle sprain within the previous 6 weeks accompanied by significant pain, swelling, or functional limitation.
History of major lower-extremity surgery (e.g., knee, hip, or ankle surgery).
History of neurological, vestibular, or systemic disorders that may affect balance or motor performance.
Visual or cognitive impairments that could interfere with test performance.
Lower-extremity injuries other than ankle instability within the previous 6 months that may negatively affect functional performance.

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Interventions

BEHAVIORALStandard Testing Condition

Participants perform functional performance tests under standard testing conditions without attentional focus instructions or additional cognitive tasks. This condition serves as the reference condition for comparison with neurocognitively enriched testing conditions

BEHAVIORALInternal Focus of Attention

Participants perform functional performance tests while receiving internal focus of attention instructions directing attention toward body movements, joint positions, and movement control during task execution.

BEHAVIORALExternal Focus of Attention

Participants perform functional performance tests while receiving external focus of attention instructions directing attention toward movement outcomes and environmental targets during task execution.

BEHAVIORALCognitive Dual-Task Condition

Participants perform functional performance tests while simultaneously completing a cognitive task involving backward repetition of number sequences, increasing cognitive load during motor performance.