Ankle sprain is the most common injury, which has the greatest recurrence rate of all lower extremity musculoskeletal ailments. Ankle sprains restrict their ability to run, leap, kick, and change directions, among other activities. A sprain can be caused by a ligament damage, but it can also be caused by capsular, tendonous, or muscular injuries. The most frequent musculoskeletal injury among physically active people is lateral ankle sprains. 70% of college-aged students and 60% of athletes in high school and college had experienced at least one ankle sprain (Andrea K. Chomistek et al.; 2018).Furthermore, at least 7% of people with ankle sprain had additional repetitive symptoms, including re-injuries and functional anomalies. Re-injury of ankle sprain triggers chronic ankle instability (CAI), which acts as a cause for recurrent sprains in 55–72% of the cases. These patients with re injuries complained of residual symptoms for 6 to 18 months (Sung-Bum Ju et al.; 2017).
Recurring sprains can cause mechanical or functional deficiencies that result in proprioceptive loss, degenerative joint changes, chronic pain, and chronic ankle instability. Whether or not they are athletes, those with a history of ankle instability are more likely to suffer from ankle injuries, muscle imbalances, and joint degeneration (Gabriela Souza de Vasconcelos et al; 2018). Chronic ankle instability is defined as continuous instability and recurring sprains following an acute lateral ankle sprain that can last for years, resulting in limited physical activity, disability, and posttraumatic osteoarthritis (Cynthia J.Wright et al.; 2020).
Proprioception is the neurological process by which the body receives sensory information from its surroundings and integrates it to produce a muscular response. Balancing on a single leg with the eyes closed, balancing on a wobble board or ankle disc, and balancing on a single leg while executing a task such as catching or tossing a ball are all examples of proprioceptive training for the ankle joint. These types of activities can help the sensorimotor system adjust to changes in the environment and hence protect the body from damage (Matthew J. Rivera et al.; 2017).
Resistance training, often known as strength training, is primarily intended to improve the ankle muscles (Emily A. Hall et al; 2018).Strength training is important for a quick recovery and as a preventative strategy against recurring ankle issues. Many clinicians categorize chronic pain based on how long it has been since the first injury: usually 3 to 6 months. Chronic pain is thought to be a source of alterations in brain systems as well as a warning to avoid physical injury or sickness (Saeed Al Adal et al.; 2020).
Dual task training consists of a primary task and an additional secondary task. The two jobs could be completed as a single task with different and separate objectives. People practice both activities at the same time in a dual task intervention. Dual-task performance necessitates the simultaneous execution of two tasks (i.e., Task A and Task B). Single-task performance, in which the individual only has to complete one task at a time, is typically contrasted with this sort of performance. The brain is encouraged, compelled, and at times outright forced to process motor activities in one of four procedural memory centers: the basal ganglia, cerebellum, supplementary motor region, and premotor cortex(Kwang-Il Kwak et al.; 2016).
In people with Chronic Ankle Sprain, there have been a number of therapies aimed at reducing symptoms, improving function, and reducing recurring sprains. Balance training devices, such as unstable balance platforms, are prescribed in proprioceptive rehabilitation programmes to address proprioceptive deficiencies and restore functional stability of the ankle joint (Susan. Rozzi et al.; 1999). Balance training in the weight-bearing posture may be an effective way to reestablish neuromuscular control and hence improve functional ability. To rehabilitate ankle instability, therapeutic therapies such as ankle strength training, proprioceptive training, balance training, imagination exercise, isokinetic exercise, and ankle structure support have been adopted, as well as the effect of ankle instability (M. Spencer Cain et al.; 2020).
Therefore, this study was conducted on chronic ankle sprain patient to see the effect of dual task training on ankle stability. The dual task training performed with balance training and resistance training to see the effect on muscle strength, pain, balance- static and dynamic, ankle range of motion and proprioception were evaluated in patients with chronic ankle sprain.