Neurocognitive ankle training for chronic ankle instability
Neurocognitive Ankle Training for Instability to Optimize Neuromusculoskeletal Outcomes (NATION)
This program will test whether adding thinking and visual tasks to ankle rehabilitation helps physically active adults with chronic ankle instability improve function and have fewer lower‑body injuries.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 180 (estimated) |
| Ages | 18 Years to 44 Years |
| Sex | All |
| Sponsor | Womack Army Medical Center Federal |
| Locations | 2 sites (Lexington, Kentucky and 1 other locations) |
| Trial ID | NCT06527287 on ClinicalTrials.gov |
What this trial studies
This interventional study compares a novel Neurocognitive Ankle Training program (NATION), which integrates visual and cognitive dual‑task exercises with standard evidence‑based ankle rehabilitation, to evidence‑based rehabilitation alone in physically active adults with chronic ankle instability. Participants aged 18–44 who meet CAI criteria will complete supervised rehabilitation at either Womack Army Medical Center or the University of Kentucky, with outcome measures collected via clinic testing and remote questionnaires. Primary outcomes include ankle function, episodes of 'giving way', and incidence of subsequent lower‑extremity musculoskeletal injuries, while neurocognitive and dual‑task performance will also be measured. The study aims to determine whether targeting neurocognitive deficits alongside traditional impairments reduces recurrence and improves activity and duty retention.
Who should consider this trial
Good fit: Ideal participants are physically active adults aged 18–44 with chronic ankle instability who meet the Ankle Instability Instrument and Cumberland tool criteria and report recent episodes of the ankle 'giving way'.
Not a fit: Patients with very recent ankle sprains (within six weeks), prior ankle surgery, recent lower‑extremity fractures, inability to complete tests in English, or who are not regularly physically active are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, this approach could improve ankle stability, reduce recurrent sprains and downstream lower‑extremity injuries, and help active people stay engaged in work and physical activity.
How similar studies have performed: The concept is relatively novel: prior research links neurocognitive deficits to CAI, but few clinical programs have tested integrated neurocognitive dual‑task rehabilitation in randomized trials.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Physically active and engage in regular exercise/training * 18-44 years old (accounts for 86% of the individuals deployed in recent military conflicts) * Answer "yes" to Question 1 (i.e., have you ever sprained an ankle?) on the Ankle Instability Instrument * Answer "yes" to any four of the remaining Ankle Instability Instrument questions * Score \<24 on the Cumberland Ankle Instability Tool * Report at least two episodes of the ankle "giving way" in the last six months * Access to a functional email address and internet for completion of health and Service member outcomes * Ability to provide informed consent Exclusion Criteria: * Unable to read or comprehend the English language. * An ankle sprain within the last six (≤6) weeks that resulted in altered or missed physical activity for one or more (≥1) consecutive days. * History of ankle surgery. * History of lower extremity fracture in the last year or history of fracture that required fixation. * Any peripheral neuropathies or other health conditions/current musculoskeletal injuries that may influence balance. * Pregnant females (will be eligible for participation in the study after delivery of the baby and medical clearance by a qualified and licensed healthcare provider).
Where this trial is running
Lexington, Kentucky and 1 other locations
- University of Kentucky — Lexington, Kentucky, United States (Recruiting)
- Womack Army Medical Center — Fort Bragg, North Carolina, United States (Recruiting)
Study contacts
- Principal investigator: Megan H Roach — Womack Army Medical Center
- Study coordinator: Megan H. Roach, PhD
- Email: megan.h.roach.civ@health.mil
- Phone: 910-907-1042
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.