Acute Effect of Graded Motor Imagery on Ankle Rehabilitation: A Pilot Study
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-40
SponsorIstanbul University - Cerrahpasa
About this trial
The primary aim of this study is to evaluate the immediate and short-term effects of the Graded Motor Imagery (GMI) method on individuals with chronic ankle instability (CAI). In this context, the effects of the Graded Motor Imagery intervention on pain level, muscle stiffness, muscle strength, functional performance, and subjective instability level will be investigated. Additionally, these effects will be comparatively analyzed with an age- and sex-matched control group consisting of healthy individuals.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Aged between 18 and 40 years.
Diagnosed with chronic ankle instability (CAIT ≤ 24).
History of an acute ankle sprain occurring more than 3 months prior to enrollment.
Has not received ankle rehabilitation treatment.
Disqualifiers
Vestibular or neurological disorders
Other lower extremity injuries
History of surgery
Trial design
Design model
Parallel
Treatments tested in this trial
graded motor imagery
Other interventionThe Graded Motor Imagery (GMI) program will be applied six consecutive days nd will consist of three progressive stages: Laterality Training: Participants will perform right-left ankle discrimination tasks using validated foot and ankle images. Accuracy and response time will be recorded. Motor Imagery: Participants will mentally rehearse ankle movements such as dorsiflexion, plantarflexion, inversion, and eversion without performing the motion. Imagery tasks will progress from simple movements to functional patterns based on tolerance. Mirror Therapy: A mirror will be placed in the midsagittal plane, allowing participants to view the reflection of the non-affected ankle while performing movements. The visual illusion of normal movement is intended to improve motor control and proprioception.
Treatment groups
48 Participants
are divided into 2 treatment groupsGroup A: instability groupExperimental treatment 1 intervention
Group B: control groupActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Subjective Instability (CAIT)
A valid-reliable questionnaire that questions the perceived instability in daily life and sports activities. Clinical Significance: ≥ 3 point increase is considered clinically significant
Time frame
baseline2
Subjective Instability (CAIT)
A valid-reliable questionnaire that questions the perceived instability in daily life and sports activities. Clinical Significance: ≥ 3 point increase is considered clinically significant
Time frame
1-week post-intervention3
Ground Reaction Force & Static Balance (ForceDecks)
Device: ForceDecks dual force platform. 1. Single-Leg Jump Test\* Values: Net vertical ground reaction force (N·kg-¹), flight time (ms), asymmetry (%). 2. Single-Leg Static Balance\* Values: Total sway path (mm), ellipse area (mm²). Clinical Importance:\* Captures short-term changes in neuromuscular control and explosive strength in a detailed manner.
Time frame
baseline4
Ground Reaction Force & Static Balance (ForceDecks)
Device: ForceDecks dual force platform. 1. Single-Leg Jump Test\* Values: Net vertical ground reaction force (N·kg-¹), flight time (ms), asymmetry (%). 2. Single-Leg Static Balance\* Values: Total sway path (mm), ellipse area (mm²). Clinical Importance:\* Captures short-term changes in neuromuscular control and explosive strength in a detailed manner.
Time frame
1-week post-interventionSecondary outcomes
1
Muscle Stiffness (Myoton PRO)
Tonic stiffness (N·m-¹) reflects the passive mechanical properties of muscle tissue. The device applies a 0.4 N mechanical impulse to the skin and records the resulting tissue oscillation response. In this study, data will be recorded as the average of 3 impulses. Clinical Importance: Acute changes in stiffness are considered an indirect indicator of neuroplastic responses in proprioception and motor control.
Time frame
baseline2
Muscle Stiffness (Myoton PRO)
Tonic stiffness (N·m-¹) reflects the passive mechanical properties of muscle tissue. The device applies a 0.4 N mechanical impulse to the skin and records the resulting tissue oscillation response. In this study, data will be recorded as the average of 3 impulses. Clinical Importance: Acute changes in stiffness are considered an indirect indicator of neuroplastic responses in proprioception and motor control.
Time frame
1-week post-intervention3
Muscle Strength Assessment - Isokinetic dynamometer (Isoforce)
Parameter: Concentric inversion-eversion peak torque (Nm) at 60°·s-¹ Objectively measures agonist-antagonist muscle performance around the ankle joint. Clinical Significance:\* Improvements in strength contribute to functional stability and a reduced risk of re-injury.
Time frame
baseline4
Muscle Strength Assessment - Isokinetic dynamometer (Isoforce)
Parameter: Concentric inversion-eversion peak torque (Nm) at 60°·s-¹ Objectively measures agonist-antagonist muscle performance around the ankle joint. Clinical Significance:\* Improvements in strength contribute to functional stability and a reduced risk of re-injury.
Time frame
1-week post-interventionSponsors and contacts
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Source ClinicalTrials.gov