The Effect of Cognitive Dual-Task on Athletic Performance Parameters in Volleyball Players With and Without Chronic Ankle Instability

Investigation of the Effect of Cognitive Dual-Task on Athletic Performance Parameters in Volleyball Players With and Without Chronic Ankle Instability

The aim of this study is to investigate the effect of the cognitive dual-task on athletic performance parameters in volleyball players with and without chronic ankle instability. In addition, it will examine how a pathology in the lower extremity affects upper extremity function.

This project is a cross-sectional and comparative study designed to investigate the effects of cognitive dual-task conditions on athletic performance parameters in volleyball players with and without chronic ankle instability (CAI). Chronic ankle instability is characterized by recurrent ankle sprains and a sensation of "giving way," and may lead to impairments in sensorimotor control, postural stability, and neuromuscular functions. Current approaches indicate that this pathology affects not only peripheral structures but also the central nervous system and cognitive processes. However, how CAI under cognitive load is reflected in upper extremity function through the kinetic chain has not been sufficiently investigated.

Volleyball players aged between 18 and 25 years who are actively playing volleyball will be included in the study. Participants will be divided into two main groups: those with CAI and a healthy control group; the CAI group will also be classified as unilateral and bilateral. In all participants, static balance, dynamic balance, lower extremity strength, ankle dorsiflexion range of motion, upper extremity functional performance, and spatiotemporal parameters of running will be evaluated under single-task and cognitive dual-task conditions.

The originality of this study lies in addressing not only lower extremity functions in CAI but also upper extremity performance and its interaction with cognitive processes through the kinetic chain, using a holistic approach. The findings obtained are expected to clarify the role of cognitive load on athletic performance in individuals with CAI and to contribute to the planning of more functional and holistic athlete assessment and rehabilitation programs.

Inclusion Criteria for players with CAI:

• Chronic Ankle Instability Group Patients who meet all of the following criteria will be included in the study. The inclusion criteria defined by the International Ankle Consortium will be accepted.

  1. Individuals must have been actively participating in the sport of volleyball for at least 5 years,
  2. Individuals' first ankle sprain history must have occurred at least 1 year prior to the study and must have been associated with inflammatory symptoms (pain, swelling),
  3. The most recent ankle sprain must have occurred 3 months or more before the start date of the study,
  4. Athletes must have experienced a sensation of giving way at least twice within the past 6 months,
  5. Athletes must have no history of ankle fracture,
  6. Athletes must not have undergone any surgical procedures affecting sensorimotor function in the lower extremity and must have no internal diseases,
  7. The score of the Identification of Functional Ankle Instability questionnaire must be greater than 11,
  8. The Foot and Ankle Ability Measure score must be less than 90%,
  9. The Foot and Ankle Ability Measure Sports subscale score must be less than 80%,
  10. The Cumberland Ankle Instability Tool (CAIT) score must be less than 24,
  11. The Foot and Ankle Outcome Score must be less than 75% in three or more categories.

Inclusion Criteria for players without CAI:

1. Participation in volleyball training at least 3 days per week for 1 hour for a minimum of 5 years,
2. A Cumberland Ankle Instability Tool score of 25 or higher,
3. A Tegner activity level of 4 or higher,
4. Absence of any systemic disease that could interfere with measurements.

Exclusion Criteria:

1. Presence of rheumatic, neurological, or cardiovascular disease,
2. History of ankle surgery,
3. Musculoskeletal injury affecting the lower extremity within the last 6 months,
4. Individuals who do not agree to participate in the study.