To determine the foot-intensive rehabilitation with and without perturbation-based training on pain reduction, range of motion improvement, balance enhancement, and functional instability in patients recovering from ankle sprains NULL HYPOTHESIS There will be no significant difference in the effectiveness of foot-intensive rehabilitation with perturbation-based training compared to foot-intensive rehabilitation alone in reducing pain, improving range of motion, enhancing balance, or reducing functional instability among patients recovering from ankle sprains.

ALTERNATE HYPOTHESIS There will be a significant difference in pain reduction, range of motion improvement, balance enhancement, and reduction in functional instability between patients undergoing foot- intensive rehabilitation with perturbation-based training compared to those undergoing foot-intensive rehabilitation.

Study Design:

It will be a Randomized Clinical Trial

Study Population:

Ankle Sprain Both groups will undergo the assigned interventions for the duration of 6 weeks under the supervision of trained physical therapists or healthcare professionals. The interventions will aim to address pain reduction, range of motion improvement, balance enhancement, and reduction in functional instability among participants recovering from ankle sprains.

Group A: Foot-Intensive Rehabilitation with Perturbation-Based Training

Foot-Intensive Rehabilitation:

Participants in Group A will undergo a structured rehabilitation program focused on addressing ankle sprains and improving foot-specific impairments. This program will typically include:

• Therapeutic Exercises: Range of motion exercises, strengthening exercises for foot and ankle muscles, proprioceptive training, and flexibility exercises tailored to individual needs.
• Manual Therapy: Hands-on techniques performed by a physical therapist or trained personnel to address soft tissue restrictions, joint mobilization, and mayofascial release.
• Modalities: Use of modalities like ice, heat, ultrasound, or electrical stimulation for pain relief and enhancing tissue healing.
• Functional Training: Specific drills and activities mimicking daily tasks or sports- related movements to improve functional capacity.

Perturbation-Based Training: In addition to the foot-intensive rehabilitation program, participants will undergo perturbation-based training sessions:

• Balance Challenges: Engaging in exercises on unstable surfaces (e.g., balance boards, foam pads) or using devices inducing controlled instability to challenge balance and neuro- muscular control.
• Dynamic Movements: Performing controlled perturbations or sudden movements to elicit adaptive responses and improve reactive balance strategies.
• Progression: Gradual progression of difficulty and complexity in perturbation-based exercises based on individual tolerance and improvement.

Group B: Foot-Intensive Rehabilitation without Perturbation-Based Training

Foot-Intensive Rehabilitation:

Participants in Group B will receive the same structured rehabilitation program focusing on foot- intensive exercises as in Group A. This program includes similar components such as therapeutic exercises, manual therapy, modalities, and functional training targeting ankle sprain recovery and foot-specific impairments.

Both groups will undergo the assigned interventions for the duration of 6 weeks under the supervision of trained physical therapists or healthcare professionals

Inclusion Criteria:

• • Gender: male /female

  • Participants aged 18 to 35 years old.
  • Diagnosis of an ankle sprain (within 4 weeks of injury).
  • No prior history of severe ankle fractures or surgeries(Hoch et al., 2023)

Exclusion Criteria:

• Presence of severe or complex ankle fractures requiring surgical intervention.
• Conditions other than ankle sprain like neuropathy that affect balance or cutaneous sensation.
• Neurological disorders impacting balance or proprioception.
• Pregnancy or planning to become pregnant during the study period(Hoch et al., 2023)