The purpose of this study is to investigate the feasibility of a psychologically informed physical therapy intervention in individuals with Chronic Ankle Instability.
This project will target the psychological impairments in addition to pathomechanical and motor behavior impairment in individuals with Chronic Ankle Instability, using a cognitive behavioral based physical therapy approach. All participants will first complete a baseline assessment, then will be randomly assigned to treatment groups (CBPT/home exercise program (HEP) or HEP only) using a random number generator by an investigator not involved in participant screening, outcome measures, or intervention administration. Individuals in the CBPT/HEP group will participate in six sessions of 45 minutes each for three weeks (two sessions a week). After three weeks, a post-assessment will be completed for both groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
36
Rehabilitation Science Research Lab
Omaha, Nebraska, United States
Number of Prescribed Sessions Attended per Subject
At least 85% of subjects must complete follow-up testing. A subject who attends post-intervention visit at 3 weeks has completed the follow-up testing.
Time frame: 3 weeks
Percentage of Subjects Completing All Prescribed Sessions Within 3 Weeks
At least 80% of subjects must attend all the sessions prescribed. Attendance means the subject has showed up and completed the tasks for the session.
Time frame: 3 weeks
Number of Intervention-Related Serious Adverse Events Per Group Within 3 Weeks
Adverse events are recorded as unfavorable events in which a subject has unintentional and abnormal signs or symptoms temporarily associated with participation in the intervention. The number of adverse events in the intervention group should be similar to that of the control group and will not exceed three serious adverse events related to the intervention.
Time frame: 3 weeks
Change from baseline kinesiophobia at 3 weeks (post-intervention)
The Tampa Scale of Kinesiophobia (11-question version), which uses a 4-point Likert scale, will be used to assess fear of movement. Individual item scores range from 1-4. Total score is the sum of all scores. Minimum possible total score is 11 and maximum possible total score is 44. Higher scores indicate a worse outcome or greater fear of movement.
Time frame: 3 weeks
Change from baseline self-efficacy at 3 weeks (post-intervention)
Self-efficacy will be assessed using the 17-item self-efficacy questionnaire. 17 statements of physical activity are scored from 0-100% according to subject's perceived ability to carry out the tasks in the statement. Total score is the average of all scores. Higher scores represent a better outcome or greater self-efficacy.
Time frame: 3 weeks
Change from baseline health related quality of life at 3 weeks (post-intervention)
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Health related quality of life will be assessed using the Disablement in the Physically Active Scale. Individual scores range from 0-4. Total scores are calculated as a sum of individual scores. 2 sub-scales (physical summary component and mental summary component) are calculated along with a total score. Physical summary component scores range from 0-48. Mental summary component scores range from 0-16. Total scores range from 0-64. Higher scores represent worse outcome or worse health related quality of life.
Time frame: 3 weeks
Change from baseline physical activity at 3 weeks (post-intervention)
Physical activity will be measured by daily steps recorded using Actigraph activity monitor watches.
Time frame: 3 weeks
Change from baseline foot and ankle range of motion at 3 weeks (post-intervention)
Foot and ankle range of motion will be measured using clinical goniometry techniques and recorded in the unit of degrees.
Time frame: 3 weeks
Change from baseline dynamic balance at 3 weeks (post-intervention)
Dynamic balance will be measured using a modified Star Excursion Balance Test and reported as a relative distance (%).
Time frame: 3 weeks
Change from baseline center of force anterior-posterior excursion balance (cm)
Measurements will be taken using a Tekscan pressure mat in a single-leg balance test and recorded in units of cm.
Time frame: 3 weeks
Change from baseline center of force left-right excursion balance (cm)
Measurements will be taken using a Tekscan pressure mat in a single-leg balance test and recorded in units of cm.
Time frame: 3 weeks
Change from baseline foot and ankle muscle strength (Newtons)
Foot and ankle muscle strength will be measured using hand held dynamometry and reported in units of Newtons.
Time frame: 3 weeks
Change from baseline center of force total area (cm^2)
Center of force will be measured using a Tekscan pressure mat in a single-leg balance test and recorded in units of cm\^2.
Time frame: 3 weeks