Effect of Neuromuscular Training combined with Neurofeedback Training on the Ankle Joint Proprioception: A Double-Blind Randomized Clinical Trial

One of the most important complications of ankle sprain is chronic instability of this joint. Following chronic ankle instability (CAI), changes in the central nervous system, especially in the motor cortex, cause neuromuscular disorders in these patients. However, half of the athletes are not looking for any rehabilitation. Neurofeedback training (NFT) is one of the modern rehabilitations for regulating the central nervous system.The present study aimed to compare the effectiveness of combining neuromuscular training (NMT) and neurofeedback training (NFT) compared with NMT alone on the ankle joint proprioception of elite table tennis players with chronic ankle instability.A total number of ۲۹ elite male table tennis players, aged ۱۸-۲۵, with CAI were enrolled in this study. Participants included players who had experienced ankle sprain injury over the past year and were also identified as having chronic ankle instability. Participants were selected as a sample according to the inclusion criteria and were randomly divided into two neuromuscular (NG) and combined NMT+NFT groups (CG). The data were recorded in the pre-test and after eight-week training program.The proprioception at ۱۰ degrees of dorsiflexion as well as ۱۰ and ۲۰ degrees of plantar flexion was additionally assessed in the foot with CAI.The paired-samples t-test showed that the proprioception error declined significantly at the ۱۰ degrees of dorsiflexion (NG, p<۰.۰۰۱; CG, p<۰.۰۰۱), ۱۰ degrees of plantar flexion (NG, p=۰.۰۰۱; CG, p<۰.۰۰۱), and ۲۰ degrees of plantar flexion (NG, p<۰.۰۰۱; CG, p<۰.۰۰۱) in the injured ankle after eight weeks of training compared with the pretest stage values. The two-way repeated-measures analysis of variance results correspondingly revealed a significant difference in the group×time interaction for the proprioception error at the ۲۰ degrees of plantar flexion (p=۰.۰۰۱, Effect size=۰.۳۵۰).Considering that NMT+NFT as a treatment protocol showed more effectiveness in the improvement of the ankle joint proprioception, the use of NFT was recommended as an adjunct therapy for improvement the ankle joint proprioception, particularly elite table tennis players, suffering from CAI.

کلیدواژه ها:

chronic ankle instability ، Neurofeedback ، Neuromuscular training ، Proprioception ، ankle joint