Echoguided Percutaneous Neuromodulation in the Management of Chronic Ankle Instability in Physically Active Subjects.
Transcutaneous Electric Nerve Stimulation, Ankle Injuries and Disorders : Chronic Ankle Instability, Exercise Therapy
About this trial
This is an interventional supportive care trial for Transcutaneous Electric Nerve Stimulation focused on measuring Ankle, exercise therapy, chronic ankle instability, echoguided percutaneous neuromodulation
Eligibility Criteria
Inclusion Criteria: History of at least one major ankle sprain. The initial sprain must have occurred at least 12 months prior to study participation, be associated with inflammatory symptoms (pain, edema) and have generated at least one day of interruption in physical activity. The most recent sprain must have occurred at least 3 months prior to study participation. History in the injured ankle of "dropping the ankle" (at least 2 episodes in the 6 months prior to study participation) and/or repeated sprains (two or more sprains in the same ankle) and/or feelings of instability in activities of daily living or sports (score less than 24 on the Cumberland Ankle Instability Tool (CAIT). Have a score of less than 75% in three or more categories in the Foot and ankle Outcome Score(FAOS) or a level of less than 90% in activities of daily living or a level of less than 80% in sports activities in the Foot and ankle ability measure (FAAM). Pain on the Numeric pain rating scale (NPRS) above 3 points out of 10 in their physical activity. Exclusion Criteria: History of surgery in either of the two lower extremities that may interfere with the performance of the tests. History of a fracture in either of the two lower extremities requiring alignment. Acute injury to the musculoskeletal structures of other lower extremity joints in the previous 3 months, which impact joint integrity and function, resulting in at least one day of loss of physical activity. Chronic concomitant pathology at the level of the lower extremity (for example: osteoarthritis, vascular disease, neural pathology). Regular use of analgesic medication that may mask symptoms. Contraindications of percutaneous puncture and specific to the execution of neuromodulation. Being receiving physiotherapy or medical treatment during the intervention. Being pregnant at the start of the study.
Sites / Locations
- Escuelas Universitarias Gimbernat
Arms of the Study
Arm 1
Arm 2
Active Comparator
Placebo Comparator
Neuromodulation Percutaneous echoguided plus exercise
Strength program
The experimental group will receive a EPNM in the common peroneal nerve of the affected ankle. . Three interventions will be carried out, in a dosage of 1 per week. Moreover, a 3-week of strength exercises will be carried out with two sessions per week. The strength program includes a protocol for the use of Theraband ® according to that described by Kaminsky et al. Moreover, the participants will have to do a balance exercises program.The EPNM will be applied prior to the exercise program session
The strength program includes a Theraband® use protocol as described by Kaminsky et al. The balance exercise program will consist of performing a series of closed kinetic chain exercises in a weight-bearing standing position that will progress from bilateral to unilateral depending on the acceptance of the load.