The Effectiveness of Neuromuscular Exercises with and without Cognitive Intervention on Strength and Postural Control Variables in Female Athletes Prone to Lateral Ankle Sprain: A Randomized Controlled Trial

Balance defect is a significant risk factor for ankle sprains. Research indicates that athletes with dynamic balance defects are 48% more likely to experience this injury. This study aimed to investigate the effectiveness of neuromuscular exercises, with and without cognitive intervention, in improving strength and postural control indices during single-leg stance with eyes open and closed in female athletes with balance deficiencies. Ankle muscle strength and postural control variables of 36 female athletes aged 15 to 30 years with dynamic balance defects were measured using hand-held dynamometers and foot scan devices. Participants were randomly divided into two groups: the training group (neuromuscular exercises with cognitive intervention) and the control group (neuromuscular exercises without cognitive intervention). Evaluations were conducted at two time points: pre- and post-intervention. Data were analyzed via repeated-measures analysis of variance (P<0/05). The findings revealed a significant interaction effect of time and group for the strength of the plantar flexor and eversion muscles. However, no significant interaction effects were observed for other variables. Pairwise comparisons demonstrated significant improvements across all measured variables, except for internal-external sways in the eyes-closed condition and center-of-pressure travel distance under similar conditions. These results suggest that incorporating dual-task cognitive challenges into neuromuscular exercise protocols may yield greater improvements in strength and postural control, potentially reducing injury risk in athletes with balance impairments.