The effects of neurocognitive training on pain, proprioception, injury anxiety, and functional and neurocognitive performance in athletes with chronic ankle instability- randomized controlled trial

Abstract

Objectives: Considering the rapid motor-cognitive changes and increased risk of injury in preadolescent athletes, this study investigated the effects of neurocognitive training (NT) on pain, proprioception, injury-related anxiety, and functional and neurocognitive performance in athletes with chronic ankle instability (CAI). Design: Randomized controlled trial. Setting: Sports training facilities in Balıkesir, Türkiye. Participants: Thirty preadolescent athletes with CAI (mean age 11.10 ± 1.06 years) were randomly assigned to an NT group (n = 15) or a control group (n = 13). Main outcome measures: The Identification of Functional Ankle Instability (IdFAI), Cumberland Ankle Instability Tool (CAIT), pain severity, proprioception (dorsiflexion/plantarflexion), injury-related anxiety, Y Balance Test (YBT), Side Hop Test, Reactive Balance Test (RBT), and Upper Extremity Choice Reaction Time Test were evaluated pre- and post-intervention. Results: The NT group demonstrated significant improvements in IdFAI (p < 0.001), CAIT (p = 0.004), dorsi flexion (p = 0.003) and plantarflexion proprioception (p = 0.018), injury-related anxiety (p = 0.013), YBT anterior reach (p = 0.048), RBT reaction time (p = 0.030), and accuracy (p = 0.003). The control group showed improvement only in plantarflexion proprioception (p = 0.028), with an increase in post-training pain (p = 0.030). Conclusions: NT reduced ankle instability symptoms and injury-related anxiety while improving proprioception and neurocognitive performance. NT may enhance functional adaptation by addressing sport-specific cognitivemotor demands.