Actively Recruiting
Neurocognitive Ankle Training for Instability to Optimize Neuromusculoskeletal Outcomes (NATION)
Led by Womack Army Medical Center · Updated on 2026-04-22
180
Participants Needed
2
Research Sites
N/A
Total Duration
On this page
Sponsors
W
Womack Army Medical Center
Lead Sponsor
U
University of Kentucky
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are evaluating the effectiveness of a new ankle rehabilitation program called NATION for physically active individuals with chronic ankle instability (CAI). CAI often follows repeated ankle sprains and causes ongoing pain, instability, and difficulty with physical activity. This study aims to compare the NATION program, which includes neurocognitive exercises, against a standard evidence-based rehabilitation and a no-treatment control group to see if it improves clinical health outcomes, reduces injuries, and helps maintain active duty status in military and civilian participants. The study has three groups: the NATION intervention group, an evidence-based rehabilitation group without neurocognitive exercises, and a control group continuing their normal routine. Both rehabilitation groups undergo a 6-week program with up to 18 unsupervised home sessions and 12 supervised sessions that include exercises for range of motion, strength, balance, and ankle care. The NATION group adds neurocognitive tasks to address brain function alongside physical rehabilitation. The control group does not receive these interventions. Participants will be assessed at the start, after 6 weeks, and at 6 months for clinical measures like ankle strength, balance, motor cognition, range of motion, and sensation. They will also complete questionnaires about pain, function, fear, quality of life, and injury history. Active-duty service members will report on their confidence to deploy. Medical records will be checked for surgery related to CAI for up to 5 years. Participant workload during therapy and satisfaction with the programs will also be measured. The total participation involves supervised sessions over 6 weeks and follow-ups extending to several months and years for surgical outcomes.
CONDITIONS
Brief Title
Neurocognitive Ankle Training for Instability to Optimize Neuromusculoskeletal Outcomes (NATION)
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Physically active and engage in regular exercise or training
- Aged 18 to 44 years
- Answer yes to having ever sprained an ankle
- Answer yes to at least four questions on the Ankle Instability Instrument
- Score less than 24 on the Cumberland Ankle Instability Tool
- Report at least two episodes of the ankle "giving way" in the last six months
- Have access to a functional email address and internet
- Able to provide informed consent
You will not qualify if you...
- Unable to read or understand English
- An ankle sprain within the last six weeks causing missed or altered physical activity for one or more days
- History of ankle surgery
- History of lower extremity fracture in the last year or fracture requiring fixation
- Any peripheral neuropathies or other health conditions or injuries affecting balance
- Pregnant females (may participate after delivery and medical clearance)
AI-Screening
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Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - 6 weeks
Participants undergo a 6-week rehabilitation protocol. Those in the NATION group complete up to 18 unsupervised home sessions and up to 12 supervised sessions incorporating neurocognitive exercises. Participants in the Evidence-Based group complete a similar protocol without neurocognitive tasks. Control participants continue their normal routine.
Up to 12 supervised sessions conducted up to 2 times per week and up to 18 unsupervised home sessions
Duration - Up to 60 months
Participants complete clinical and health outcome assessments at 6 weeks and 6 months post-enrollment. Active-duty Service members also complete confidence to deploy assessments. Medical records are monitored for up to 60 months for surgical interventions related to chronic ankle instability.
3 assessment visits (baseline, 6 weeks, and 6 months post-enrollment) plus ongoing medical record surveillance
Trial Site Locations
Total: 2 locations
1
University of Kentucky
Lexington, Kentucky, United States, 40506
Actively Recruiting
2
Womack Army Medical Center
Fort Bragg, North Carolina, United States, 28310
Actively Recruiting
Research Team
M
Megan H. Roach, PhD
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
3
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