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Ankle InstabilityNCT07376915

Acute Effect of Graded Motor Imagery on Ankle Rehabilitation: A Pilot Study

A study testing graded motor imagery in people with Ankle Instability and Healthy Controls, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The primary aim of this study is to evaluate the immediate and short-term effects of the Graded Motor Imagery (GMI) method on individuals with chronic ankle instability (CAI). In this context, the effects of the Graded Motor Imagery intervention on pain level, muscle stiffness, muscle strength, functional performance… Read more about this study

Who is it for?
Ages 18 to 40 years
Conditions the study is for
Ankle Instability, Healthy Controls
What is being tested?
graded motor imagery
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
1 siteTurkey (Türkiye)
Study dates
9 Feb 2026to 9 Jun 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Aged between 18 and 40 years.
  • Diagnosed with chronic ankle instability (CAIT ≤ 24).
  • History of an acute ankle sprain occurring more than 3 months prior to enrollment.
  • Has not received ankle rehabilitation treatment.
  • Voluntarily participated in this study

Who cannot join

  • Vestibular or neurological disorders
  • Other lower extremity injuries
  • History of surgery

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

SEDA ATEŞ, Bachelor degree contact

90+ 5388543087

seda.ates@ogr.iuc.edu.tr

Turkey (Türkiye)1 site, 1 recruiting

  • İstanbul Üniversitesi-Cerrahpaşa

    Istanbul

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Official title: The Acute Effect of Graded Motor Imagery-Based Mental Preparation on Ankle Rehabilitation: A Pilot Clinical Study

The primary aim of this study is to evaluate the immediate and short-term effects of the Graded Motor Imagery (GMI) method on individuals with chronic ankle instability (CAI). In this context, the effects of the Graded Motor Imagery intervention on pain level, muscle stiffness, muscle strength, functional performance, and subjective instability level will be investigated. Additionally, these effects will be comparatively analyzed with an age- and sex-matched control group consisting of healthy individuals.

Being tested
graded motor imagery

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • graded motor imageryOther

    The Graded Motor Imagery (GMI) program will be applied six consecutive days nd will consist of three progressive stages:

    Laterality Training:

    Participants will perform right-left ankle discrimination tasks using validated foot and ankle images. Accuracy and response time will be recorded.

    Motor Imagery:

    Participants will mentally rehearse ankle movements such as dorsiflexion, plantarflexion, inversion, and eversion without performing the motion. Imagery tasks will progress from simple movements to functional patterns based on tolerance.

    Mirror Therapy:

    A mirror will be placed in the midsagittal plane, allowing participants to view the reflection of the non-affected ankle while performing movements. The visual illusion of normal movement is intended to improve motor control and proprioception.

Study groups in NCT07376915
Study groupRoleWhat they receive
instability groupExperimentalNot described
Receives: Other: graded motor imagery
control groupActive comparatorNot described
Receives: Other: graded motor imagery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Subjective Instability (CAIT)

    A valid-reliable questionnaire that questions the perceived instability in daily life and sports activities.

    Clinical Significance: ≥ 3 point increase is considered clinically significant

    Measured: baseline

  2. Subjective Instability (CAIT)

    A valid-reliable questionnaire that questions the perceived instability in daily life and sports activities.

    Clinical Significance: ≥ 3 point increase is considered clinically significant

    Measured: 1-week post-intervention

  3. Ground Reaction Force & Static Balance (ForceDecks)

    Device: ForceDecks dual force platform.

    1. Single-Leg Jump Test* Values: Net vertical ground reaction force (N·kg-¹), flight time (ms), asymmetry (%).
    2. Single-Leg Static Balance* Values: Total sway path (mm), ellipse area (mm²).

    Clinical Importance:* Captures short-term changes in neuromuscular control and explosive strength in a detailed manner.

    Measured: baseline

  4. Ground Reaction Force & Static Balance (ForceDecks)

    Device: ForceDecks dual force platform.

    1. Single-Leg Jump Test* Values: Net vertical ground reaction force (N·kg-¹), flight time (ms), asymmetry (%).
    2. Single-Leg Static Balance* Values: Total sway path (mm), ellipse area (mm²).

    Clinical Importance:* Captures short-term changes in neuromuscular control and explosive strength in a detailed manner.

    Measured: 1-week post-intervention

Secondary outcomes (8)

  1. Muscle Stiffness (Myoton PRO)

    Tonic stiffness (N·m-¹) reflects the passive mechanical properties of muscle tissue. The device applies a 0.4 N mechanical impulse to the skin and records the resulting tissue oscillation response. In this study, data will be recorded as the average of 3 impulses.

    Clinical Importance: Acute changes in stiffness are considered an indirect indicator of neuroplastic responses in proprioception and motor control.

    Measured: baseline

  2. Muscle Stiffness (Myoton PRO)

    Tonic stiffness (N·m-¹) reflects the passive mechanical properties of muscle tissue. The device applies a 0.4 N mechanical impulse to the skin and records the resulting tissue oscillation response. In this study, data will be recorded as the average of 3 impulses.

    Clinical Importance: Acute changes in stiffness are considered an indirect indicator of neuroplastic responses in proprioception and motor control.

    Measured: 1-week post-intervention

  3. Muscle Strength Assessment - Isokinetic dynamometer (Isoforce)

    Parameter: Concentric inversion-eversion peak torque (Nm) at 60°·s-¹ Objectively measures agonist-antagonist muscle performance around the ankle joint.

    Clinical Significance:* Improvements in strength contribute to functional stability and a reduced risk of re-injury.

    Measured: baseline

  4. Muscle Strength Assessment - Isokinetic dynamometer (Isoforce)

    Parameter: Concentric inversion-eversion peak torque (Nm) at 60°·s-¹ Objectively measures agonist-antagonist muscle performance around the ankle joint.

    Clinical Significance:* Improvements in strength contribute to functional stability and a reduced risk of re-injury.

    Measured: 1-week post-intervention

  5. Pain Level

    Visual Analog Scale (VAS, 0-10 cm): 0 = "no pain," 10 = "unbearable pain"; the participant marks the scale before and after the session.

    Measured: baseline

  6. Pain Level

    Visual Analog Scale (VAS, 0-10 cm): 0 = "no pain," 10 = "unbearable pain"; the participant marks the scale before and after the session.

    Measured: 1-week post-intervention

  7. Functional Performance

    Star Excursion Balance Test (SEBT) Parameter: Normalized reach distance in three primary directions (anteromedial, medial, posteromedial), expressed as a percentage of leg length.

    Clinical Significance: Assesses dynamic balance and lateral load-transfer capacity; asymmetries in individuals with chronic ankle instability (CAI) may serve as prognostic indicators.

    Measured: baseline

  8. Functional Performance

    Star Excursion Balance Test (SEBT) Parameter: Normalized reach distance in three primary directions (anteromedial, medial, posteromedial), expressed as a percentage of leg length.

    Clinical Significance: Assesses dynamic balance and lateral load-transfer capacity; asymmetries in individuals with chronic ankle instability (CAI) may serve as prognostic indicators.

    Measured: 1-week post-intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jan 2026
  2. Study start9 Feb 2026
  3. Primary completion9 Jun 2026 (estimated)
  4. Study completion9 Jun 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
48 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07376915
Sponsor's protocol ID
2025/377
Status last verified
Jan 2026
First submitted
17 Dec 2025
Last updated
11 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kim KM, Estepa-Gallego A, Estudillo-Martinez MD, Castellote-Caballero Y, Cruz-Diaz D. Comparative Effects of Neuromuscular- and Strength-Training Protocols on Pathomechanical, Sensory-Perceptual, and Motor-Behavioral Impairments in Patients with Chronic Ankle Instability: Randomized Controlled Trial. Healthcare (Basel). 2022 Jul 22;10(8):1364. doi: 10.3390/healthcare10081364.

    PubMed 35893186

  • Naderi A, Ahi K. Comparative analysis of land-based vs. water-based balance training on quality of life and physical and psychological deficits in athletes with chronic ankle instability: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2025 Jan 20;17(1):9. doi: 10.1186/s13102-024-01049-3.

    PubMed 39828772

  • David P, Halimi M, Mora I, Doutrellot PL, Petitjean M. Isokinetic testing of evertor and invertor muscles in patients with chronic ankle instability. J Appl Biomech. 2013 Dec;29(6):696-704. doi: 10.1123/jab.29.6.696. Epub 2013 Jan 18.

    PubMed 23343782

  • Wright CJ, Linens SW, Cain MS. Establishing the Minimal Clinical Important Difference and Minimal Detectable Change for the Cumberland Ankle Instability Tool. Arch Phys Med Rehabil. 2017 Sep;98(9):1806-1811. doi: 10.1016/j.apmr.2017.01.003. Epub 2017 Jan 27.

    PubMed 28137476

  • Moseley GL. Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology. 2006 Dec 26;67(12):2129-34. doi: 10.1212/01.wnl.0000249112.56935.32. Epub 2006 Nov 2.

    PubMed 17082465

Questions about this trial

What is this clinical trial studying?

A study testing graded motor imagery in people with Ankle Instability and Healthy Controls, run by Istanbul University - Cerrahpasa at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 11 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact SEDA ATEŞ, Bachelor degree (90+ 5388543087, seda.ates@ogr.iuc.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Subjective Instability (CAIT) (time frame: baseline). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07376915, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Feb 2026.

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