RecruitingNot Applicable

Ankle vs. Hip vs. Combined Strengthening in Chronic Ankle Instability

Belgium45 participantsStarted 2026-03-02

Plain-language summary

Chronic ankle instability (CAI) is a common condition that can develop after a lateral ankle sprain. Up to 40% of people who sprain their ankle experience a recurrence within a year, and as many as 30% develop persistent symptoms such as ankle "giving way," weakness, or instability. These symptoms can limit daily activities, sports participation, and increase the risk of future sprains. Muscle weakness in both the ankle and hip has been identified as an important factor contributing to CAI. Strengthening these muscles may therefore help improve stability and function. The SHAC study is a randomized controlled trial designed to compare three different strengthening programs in people with chronic ankle instability: (1) an ankle-focused strengthening program, (2) a hip-focused strengthening program, and (3) a combined ankle-hip strengthening program. The goal is to determine which approach leads to the greatest improvement in functional ability, muscle strength, balance, and ankle mobility. A total of 45 participants aged 18 to 35 years with documented chronic ankle instability will be recruited from local sports clubs and the University of Liège. All participants must have a history of at least one ankle sprain that occurred more than 12 months before entering the study, report episodes of ankle instability in the previous six months, and meet specific questionnaire criteria (CAIT \< 24 and FAAM Sport \< 80%). People with recent injuries, previous lower-limb surgery, fractures requiring realignment, neuromuscular conditions, or current pain or swelling will not be able to participate. After the first assessment (T1), participants will be randomly assigned to one of the three groups. Each intervention lasts four weeks and includes three supervised sessions per week. All strengthening exercises are isometric, performed using a handheld dynamometer to measure force accurately. The ankle program includes plantarflexion, dorsiflexion, inversion, and eversion exercises. The hip program includes clamshells, hip external rotation, abduction, and extension. The combined group alternates between hip and ankle exercises. A warm-up and standardized familiarization are performed before each session. All participants will attend two additional assessment sessions: one immediately after the four-week program (T2) and one at a later follow-up time point (T3). During each visit, they will complete functional questionnaires, report their sports participation, and undergo several strength and performance tests. These include hip and ankle muscle strength measurements using a dynamometer, the Heel Rise Test, the modified Y-Balance Test, the Side Hop Test, and a dorsiflexion mobility test. The study aims to identify whether one of the strengthening approaches leads to better functional outcomes for individuals with chronic ankle instability. Understanding these effects may help clinicians design more effective rehabilitation programs for people recovering from ankle sprains and for those experiencing ongoing instability. Participant data will be kept confidential and stored securely in anonymized form for 20 years. Participation is voluntary, and individuals may withdraw at any time without consequences. Results will be presented anonymously in scientific publications and conferences.

Who can participate

Age range

18 Years – 35 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * Have a history of at least one major ankle sprain that occurred at least 12 months prior to enrolment in the study, was associated with inflammatory symptoms (pain, swelling, etc), created at least one interrupted day of desired physical activity. * Have had at least two episodes of feeling like an "unstable" ankle in the six months preceding the study. * The Cumberland Ankle Instability Tool (CAIT) with a score of less than 24. * The Foot and Ankle Ability Measure (FAAM) Sport scale with a score below 80%. * Between 18 and 35 years old * Must be able to understand the study procedures and provide written informed consent Exclusion Criteria: * Have had a recent injury of less than three months prior to enrolment in the study. * A history of surgery on the musculoskeletal structures of the lower limbs. * Have a history of fracture of one of the lower limbs requiring realignment. * Being diagnosed with a neuromuscular disease. * The appearance of swelling or pain in the lower limb during the experiment.

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

Cumberland Ankle Instability Tool (CAIT)

Timeframe: Baseline and week 4 (end of intervention)

Trial details

NCT IDNCT07606534

SponsorUniversity of Liege

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2027-09

Contact for this trial

Aude Aguilaniu Aude, PhD

+32483421291 aude.aguilaniu@uliege.be

View on ClinicalTrials.gov More Chronic Ankle Instability, CAI trials