The Effects of Vestibulo-Ocular Reflex Exercises Added to Postural Stabilization Training in Chronic Ankle Instability

Chronic ankle instability (CAI) is a common condition after lateral ankle sprain. CAI is characterized by mechanical and/or functional instability, or recurrent episodes of "giving way," persisting for at least 12 months after the initial injury, and is associated with limitations in activity and participation. In amateur athletes, CAI may be overlooked or undertreated, although sport-specific activities require rapid integration of visual, vestibular, somatosensory, and cognitive information. Postural stabilization training is commonly used to improve balance and neuromuscular control in individuals with CAI. However, individuals with CAI may show increased reliance on visual information and altered visual-vestibular sensory reweighting during postural control tasks. The vestibulo-ocular reflex (VOR) contributes to gaze stability and visual clarity during head movements and may also be related to neurocognitive processes such as attention and processing speed. This study is designed as a randomized controlled, prospective, parallel-group, pretest-posttest design trial to investigate whether VOR exercises added to postural stabilization training improve dynamic balance, functional instability, and neurocognitive performance in amateur athletes with CAI.

Inclusion Criteria: * Being between 18 and 35 years of age. * Being classified as a Tier 2 athlete according to the McKay et al. Participant Classification Framework (trained/developmental level). * Having a history of at least one lateral ankle sprain (LAS) occurring at least 12 months before enrollment, resulting in swelling, pain, and functional impairment, and followed by persistent instability. * Having the most recent ankle sprain at least 3 months before study enrollment. * Having a history of recurrent ankle sprains or episodes of "giving way." * Having a diagnosis of unilateral chronic ankle instability (CAI). * Having a Cumberland Ankle Instability Tool - Turkish Version (CAIT-T) score of ≤24. * Having a Foot and Ankle Ability Measure (FAAM) score of \