Aquatic Exercise Enhances Functional Movement and Sensorimotor Performance in Athletes With Chronic Ankle Instability: A Randomized Controlled Trial.

Abstract

Context: Chronic ankle instability (CAI) is prevalent among athletes and is associated with impaired sensorimotor function, reduced dynamic stability, and limited functional movement, increasing the risk of reinjury. Aquatic exercise offers a low-impact alternative to land-based rehabilitation by reducing joint loading and promoting neuromuscular adaptations. This study evaluated the effectiveness of an 8-week aquatic exercise program on functional outcomes in athletes with CAI.

Design: Randomized controlled trial with preintervention and postintervention assessments.

Methods: Forty male athletes (aged 18-30) with clinically diagnosed CAI were randomly assigned to an intervention group (n = 20) which completed an 8-week aquatic exercise program or a control group (n = 20) which continued regular activity without structured rehabilitation. The intervention included 3 weekly aquatic sessions targeting balance, proprioception, and strength. Primary outcomes were functional movement (Functional Movement Screen), dynamic balance (Y-Balance Test), and self-reported ankle function (Cumberland Ankle Instability Tool, Identification of Functional Ankle Instability, Foot and Ankle Ability Measure, Foot and Ankle Ability Measure-Sport). Secondary outcomes included static balance, dorsiflexion range of motion, proprioception, and jumping performance. Repeated-measures analysis of variance and nonparametric tests were used, with P < .05 as significance.

Results: The intervention group showed significant improvements in Functional Movement Screen scores, dynamic balance (P < .001), dorsiflexion range of motion (+19.6%, P < .001), and self-reported ankle function (up to +46.9%, P < .001). Jumping performance significantly improved, with reduced completion times in the side-hop (-18.1%) and 8-line hop (-12.9%) tests, and increased distance in the triple-hop test (+8.5%; all P < .01). Static balance improved in eyes-open condition (P < .001). No significant change occurred in proprioception (P = .506). The control group showed no significant improvements.

Conclusions: An 8-week aquatic exercise program significantly improves functional movement, balance, flexibility, jumping ability, and self-reported ankle function in athletes with CAI. These findings support aquatic therapy as a clinically effective, low-impact rehabilitation option for restoring sensorimotor performance and sport readiness.