Background and Objective: Ankle sprain is one of the most common sports-related injuries and is often accompanied by residual symptoms such as pain, impaired proprioception, neuromuscular control deficits, and an increased risk of re-injury, potentially leading to chronic ankle instability. Given the critical role of the core region in providing a stable base for lower limb function and motor control, reduced core endurance may further contribute to ankle instability. This study aimed to investigate the effects of neuromuscular training combined with cognitive dual-task interventions on pain, ankle dorsiflexion range of motion, and core endurance in female athletes with chronic ankle instability.
Methods: This randomized clinical trial was conducted on 36 female athletes from Shiraz, with at least three years of regular participation in basketball or volleyball. Participants were randomly assigned to either a neuromuscular training group without cognitive tasks (n=18) or a neuromuscular training group combined with cognitive tasks (n =18). Both groups participated in a six-week training program, consisting of five sessions per week. Pain was assessed using the Visual Analog Scale (VAS), ankle dorsiflexion range of motion was measured using an isokinetic dynamometer, and core endurance was evaluated using the McGill test battery. Paired t-tests were used to assess within-group differences, and analysis of covariance (ANCOVA) was used to compare between-group changes. The significance level was set at P<0.05.
Results: Paired t-test results indicated that both groups showed significant improvements in pain, ankle dorsiflexion range of motion, and core endurance compared to pre-test values (P<0.05). ANCOVA results revealed a significant between-group difference in pain (P<0.05), favoring the cognitive dual-task group. However, no significant between-group differences were observed for dorsiflexion range of motion or core endurance (P>0.05).
Conclusion: The addition of cognitive tasks to neuromuscular training appears to be more effective in reducing pain in athletes with chronic ankle instability. However, this combined intervention did not demonstrate a significant advantage over neuromuscular training alone in improving dorsiflexion range of motion or core endurance. Therefore, incorporating cognitive tasks may be recommended as a complementary strategy for pain management in rehabilitation programs for this population.