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.
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.
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.
Crossover
Standard Testing Condition
BehavioralParticipants 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
Internal Focus of Attention
BehavioralParticipants perform functional performance tests while receiving internal focus of attention instructions directing attention toward body movements, joint positions, and movement control during task execution.
External Focus of Attention
BehavioralParticipants perform functional performance tests while receiving external focus of attention instructions directing attention toward movement outcomes and environmental targets during task execution.
Cognitive Dual-Task Condition
BehavioralParticipants perform functional performance tests while simultaneously completing a cognitive task involving backward repetition of number sequences, increasing cognitive load during motor performance.
Dynamic Balance Performance
Dynamic balance performance assessed using the Y Balance Test under standard, internal focus of attention, external focus of attention, and cognitive dual-task conditions.
Vertical Jump Performance
Vertical jump height assessed using the My Jump 2 application under different neurocognitive testing conditions.
Figure-of-8 Hop Performance
Figure-of-8 hop completion time assessed under different neurocognitive testing conditions.
Dual-Task Cost
Dual-task cost calculated as the percentage change in motor performance between single-task and dual-task conditions.
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Bahçeşehir University
Lead sponsor
The Scientific and Technological Research Council of Turkey
Collaborator
