COMPARATIVE EFFECTS OF CLOSED KINETIC CHAIN EXERCISES VERSUS NEUROMUSCULAR TRAINING ON PAIN, POSTURAL STABILITY, AND FUNCTION IN PATIENTS WITH ACUTE LATERAL ANKLE SPRAIN

Abstract

Background:  Acute lateral ankle sprain is one of the most prevalent musculoskeletal injuries and is frequently associated with pain, impaired postural control, and limitations in functional performance. Although both closed kinetic chain (CKC) exercises and neuromuscular training (NMT) are routinely incorporated into ankle rehabilitation programs, their comparative effectiveness in individuals with acute Grade I–II lateral ankle sprain remains insufficiently established.

Objective: To compare the effects of CKC exercises and NMT on pain intensity, dynamic postural stability, and functional performance in individuals with acute Grade I–II lateral ankle sprain.

Methods: This randomized controlled trial included participants aged 18–45 years with acute Grade I–II lateral ankle sprain. Participants were randomly allocated to either a CKC exercise group (n = 39) or an NMT group (n = 39). Both groups received supervised rehabilitation three times weekly for 12 weeks. Pain intensity was assessed using the Visual Analogue Scale (VAS), dynamic postural stability using the Y-Balance Test (YBT), and functional performance using the Foot and Ankle Ability Measure (FAAM), comprising the Activities of Daily Living (ADL) and Sports subscales. Data were analyzed using SPSS. Descriptive statistics were used to summarize participant characteristics, while the Shapiro–Wilk test was employed to assess data normality. Within-group changes were analyzed using the Wilcoxon signed-rank test, whereas between-group differences were examined using the Mann–Whitney U test. Statistical significance was established at p < 0.05.

Results: Following six weeks of rehabilitation, both groups demonstrated statistically significant improvements in pain, dynamic postural stability, and functional performance (p < 0.001). However, the NMT group demonstrated significantly greater improvements than the CKC group in pain reduction (U = 128.000, p < 0.001), dynamic postural stability as measured by the Y-Balance Test (U = 403.000, p < 0.001), FAAM-ADL scores (U = 302.500, p < 0.001), and FAAM-Sports scores (U = 470.500, p = 0.003).

Conclusion:  Both CKC exercises and NMT were effective in reducing pain and enhancing dynamic postural stability and functional performance among individuals with acute Grade I–II lateral ankle sprain. Nevertheless, NMT produced significantly superior improvements across all assessed clinical outcomes and may therefore represent a more effective rehabilitation approach for this population.