Original Article: JRCRS.2025:13(3):126- 133
2- Comparing Neuromuscular Training and Closed Chain Exercises in Athletes with Ankle Sprains: Efficacy in Pain Reduction, Joint Mobility, Balance, And Functional Disability: A Randomized Control Trial
Aamir Gul Memon1, 2, Suriyakala Perumal Chandran3, Abdul Hameed4, Shahzaib Saleem5, Ali Sheraz6
1 PhD (Scholar), Lincoln University College Malaysia
2 School of Basic Medical Sciences, Shandong University China
3 Assistant Professor/Deputy Dean MD Pre- Clinical, Lincoln University College, Malaysia
4 5 Lecturer Physical Therapy Department, Suleman Roshan Medical College, Tando Adam, Pakistan
6 MSc High Performance Sports Student, University of Saarland, Germany
Read Full-Text Full-Text PDF DOI: https://dx.doi.org/10.53389/JRCRS.2025130302
Abstract:
Background: Ankle sprains are one of the most common musculoskeletal injuries in athletes and are caused mainly by inversion during dynamic movement, change of direction, and jump. The injuries predominantly affect the lateral ligament complex, with emphasis on the anterior talofibular ligament
Objective: To determine the effects of neuromuscular training versus closed kinetic exercise on pain, range of motion, balance, and function in athletes with ankle sprain.
Methodology: This RCT compared Neuromuscular training (NMT) to Closed Chain exercises (CKC) in 40 athletes with acute grade I-II ankle sprains. Participants were randomly assigned to the group that got either CKC exercises (n=20) or neuromuscular training (n=20), 3×/week for 4 weeks. Outcomes measured were pain (Numerical Pain Rating Scale NPRS), range of motion (goniometer), balance (Star Excursion Balance Test), and function (Functional Ankle Ability Measure FAAM), with statistical analyses performed using t-tests (p<0.05). (CTR: NCT06198270)
Results: Statistically significant improvement occurred in pain, balance, ROM, and function for 2 groups (p<0.001). Pain reduction was better in the KT group (1.3±0.17 vs. 3.6±0.67), along with superior ROM gains on dorsiflexion (3.7°±1.8° vs. 2.5°±1.4°), on plantarflexion (6.8°±2.4° vs. 3.7°±2.2°), balance (20.6cm±3.7cm vs. 11.7cm±3.0cm SEBT), and function (16.9%±3.4% vs. 5.5%±1.7% FAAM-S) compared with the CKC group (all p<0.001). Hence, neuromuscular training was more effective than CKC exercises for some clinical variables.
Conclusion: Given that both therapies brought great improvements in pain, ROM, balance, and functional outcomes, those patients undergoing neuromuscular training were, in fact, more effective than the other groups, especially in improving balance and functional activities.
Keywords: Athletes, Closed Kinetic Chain Exercise, Functional Disability, Neuromuscular Training