{"paper_id":"1b076249-8019-477e-9b3b-4f44612d2ac3","body_text":"Impact of Chronic Ankle Instability on Jumping and Agility Performance in Athletes: A Comparative Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Impact of Chronic Ankle Instability on Jumping and Agility Performance in Athletes: A Comparative Study Sinan Seyhan, Gorkem Acar, Caglar Soylu, Muhammed Fatih Bilici, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7939574/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The objective of this study was to assess functional performance in athletes with chronic ankle instability (CAI) and compare it with a healthy control group. Methods The study population comprised 16 athletes diagnosed with CAI and 16 matched, healthy athletes. Functional performance was evaluated using side jump test, 6-meter timed hop test, single-leg hop test, triple crossover hop test, lateral hop test, and countermovement jump. Additionally, agility tests including the 5-10-5 test and the acceleration-deceleration-acceleration (ADA) test were administered. Independent sample t-tests and Mann-Whitney U tests were used for intergroup comparisons, and effect sizes were calculated using Cohen's d. Results Athletes with CAI demonstrated significantly reduced performance in jumping and agility tests compared to the control group. Specifically, notable decreases were observed in vertical jump height, jump power, agility time, and lateral jump distance. However, no significant correlation was found between Cumberland Ankle Instability Tool (CAIT) scores and functional performance tests. Conclusion This study highlights the negative impact of CAI on functional performance, particularly in jumping and agility domains, among athletes. The findings emphasize the importance of incorporating exercise programs targeting functional performance into rehabilitation strategies for CAI. In clinical practice, combining subjective and objective measurements may aid in developing comprehensive rehabilitation plans for individuals with CAI. Clinical trials: The study was prospectively registered with ClinicalTrials.gov under the identifier NCT07171411 on September 6, 2025. Health sciences/Health care Health sciences/Medical research Biological sciences/Physiology Chronic ankle instability physical functional performance performance tests Figures Figure 1 Introduction Lateral ankle sprain (LAS) represents one of the most common musculoskeletal injuries in sports, often leading to chronic ankle instability (CAI) if not adequately managed [ 1 ]. CAI is defined as a multifaceted condition involving recurrent sprains, persistent symptoms of \"giving way,\" residual pain, and functional limitations that persist for at least 12 months following the initial injury [ 2 , 3 ]. This condition arises from a combination of mechanical and sensorimotor impairments, including ligamentous laxity, proprioceptive deficits, neuromuscular dysfunction, and altered postural control [ 4 , 5 ]. Recent epidemiological data indicate that CAI affects up to 74% of individuals with a history of LAS, with higher prevalence rates observed in high-demand sports such as basketball, soccer, and volleyball [ 6 – 8 ]. Notably, female athletes appear to be at elevated risk, with studies reporting prevalence rates exceeding 50% in sports involving rapid directional changes and jumping [ 9 ]. Furthermore, predictors of CAI in specific populations, such as soccer players, include prior sprain history, impaired balance, and delayed muscle activation times [ 10 ]. The biomechanical alterations associated with CAI are well-documented during dynamic activities like walking, running, and jumping. Individuals with CAI often exhibit increased ankle inversion angles, elevated plantar pressures, proximal joint compensations (e.g., knee adduction and internal rotation), and altered loading strategies, which contribute to recurrent injury and performance decrements [ 11 , 12 ]. These changes not only heighten the risk of further sprains but also impair overall athletic performance by reducing power output, agility, and stability [ 13 ]. For instance, fatigue exacerbates these deficits, leading to poorer dynamic balance and increased injury potential in CAI athletes compared to healthy controls [ 14 ]. Additionally, CAI has been linked to central nervous system adaptations, such as reduced corticomotor excitability in key ankle stabilizers like the peroneus longus (PL) and tibialis anterior (TA) muscles, further compounding neuromuscular mismatches [ 15 ]. The long-term consequences of CAI extend beyond physical impairments, significantly affecting quality of life and sports participation. Approximately 40% of individuals with recurrent sprains experience limitations in returning to pre-injury activity levels, with associated declines in self-reported function and increased fear of movement [ 16 ]. Childhood ankle injuries substantially elevate the risk of adult CAI, emphasizing the need for early intervention [ 17 ]. Etiological factors are multifactorial: mechanical elements include joint laxity and synovial changes, while functional deficits encompass proprioceptive loss, delayed reaction times, and muscle architectural alterations (e.g., reduced pennation angles in peri-ankle muscles) [ 18 , 19 ]. Emerging research also highlights associations with core stabilization deficits and abdominal wall dysfunction, suggesting that CAI may influence broader kinetic chain impairments [ 20 ]. Recent studies have explored the impact of fatigue on gait loading strategies in CAI, revealing compensatory mechanisms that may predispose athletes to overuse injuries [ 21 ]. Moreover, dual-task paradigms during landing tasks amplify injury risks in CAI populations, underscoring cognitive-motor interference [ 22 ]. Despite advances in understanding CAI pathophysiology, significant gaps remain in the literature, particularly regarding its specific effects on athletic performance metrics such as jumping and agility. While numerous studies have focused on static balance and proprioception [ 2 , 4 ], fewer have comprehensively examined dynamic functional performance in athletes, especially using a combination of hop-based, agility, and vertical jump tests [ 23 ]. Existing research often overlooks the integration of artificial intelligence (AI)-assisted tools for precise measurement, such as the Deepsport program used in this study, which provides objective, real-time analysis of jump and agility parameters [ 24 ]. Furthermore, correlations between subjective tools like the Cumberland Ankle Instability Tool (CAIT) and objective performance metrics are inconsistently reported, with limited emphasis on team sport athletes who rely heavily on multidirectional movements [ 25 ]. This study addresses these gaps by employing a multifaceted testing battery, including AI-enhanced assessments, to quantify CAI's impact on jumping and agility in a matched cohort of athletes from volleyball, basketball, and soccer. By doing so, it fills a critical void in the literature, providing evidence on how CAI impairs sport-specific performance and highlighting the need for targeted rehabilitation beyond traditional balance training. The originality lies in its holistic approach: combining subjective (CAIT) and objective (performance tests) evaluations with AI technology, which is underrepresented in prior work, to offer novel insights into mechanisms and clinical implications for athletic rehabilitation. This research was conducted to bridge the disconnect between perceived instability and measurable deficits, ultimately guiding more effective, evidence-based interventions to reduce recurrence and enhance return-to-sport outcomes. The objective of this study was to examine the performance implications in individuals with CAI compared to healthy controls. We hypothesized that athletes with CAI would exhibit significant impairments in jumping (e.g., reduced countermovement jump height and power) and agility parameters (e.g., increased times in 5-10-5 and ADA tests) when compared to athletes without CAI. Materials and methods Participants A total of 32 subjects were recruited for this study: 16 adult athletes afflicted with chronic ankle instability (CAI group) and 16 age-matched healthy athletes without a history of lateral ankle sprains (LAS; control group, CG). Age and gender matching were performed to eliminate potential influences on muscle mechanical properties. The inclusion criteria for the CAI group were aligned with the guidelines established by the International Ankle Consortium (IAC), which required: (1) a documented history of at least one significant LAS occurring at least 12 months before participation, with the sprain involving inflammatory symptoms (pain, swelling, etc.) and disruption of desired physical activity; (2) at least two instances of \"giving way\" (perceived instability) within the past six months; (3) regular participation in sports for a minimum of five years, with at least 3 hours per week of training; and (4) self-reported instability with a Cumberland Ankle Instability Tool (CAIT) score of ≤ 24 [ 1 ]. For the control group, inclusion criteria included: (1) no history of ankle sprains or instability; (2) matched age, gender, height, weight, and sport participation level to the CAI group; (3) regular sports participation for at least five years; and (4) CAIT score ≥ 25 to confirm no perceived instability. Exclusion criteria for both groups encompassed: (1) a history of lower extremity fractures, surgeries, or neurological disorders; (2) any musculoskeletal injuries (e.g., knee, hip, or back issues) occurring within the previous three months that could affect performance; (3) vestibular or balance disorders unrelated to ankle issues; (4) use of orthotics or ankle braces during testing; (5) acute inflammation or pain in the ankle at the time of testing; and (6) any cardiovascular or systemic conditions that could impair physical performance. The CAI and CG groups exhibited comparable anthropometric parameters and weekly training characteristics. The sample size calculation was conducted to ensure adequate statistical power for intergroup comparisons, utilizing G*Power software (Germany). The calculation was based on an expected large effect size (Cohen's d = 1.0) for primary outcomes like jump height, derived from pilot data and prior literature on CAI performance deficits. The alpha level was set at P = .05, and the analysis was performed with 80% power for independent t-tests. The study's final sample size was determined to be 32 athletes, with 16 athletes from each group [ 25 ]. All participants provided written consent for their involvement in the study, which had been approved by the Ethics Committee of Çankırı Karatekin University and was conducted in accordance with the Declaration of Helsinki. Following the provision of consent, the participants completed a questionnaire encompassing clinical and educational data, and they underwent all measurement procedures (Application Code: 821c0699143e44f4). Data Collecting The side jump test assesses lateral power and explosiveness. Participants stand on one leg beside a line, jump laterally over the line to land on both feet, and immediately jump back to the starting position on one leg. The test is performed for 10 repetitions, and the total time (in seconds) is recorded as the score, with lower times indicating better performance. The process is repeated for both legs, and the best score from three trials is used. The 6-meter timed hop test evaluates speed and acceleration in hopping. Participants hop forward on one leg as quickly as possible over a 6-meter straight line marked on the floor. The time taken to complete the distance is measured in seconds using a stopwatch, with the best of three attempts recorded. This test targets dynamic balance and lower limb power. The single-leg hop test measures dynamic balance, coordination, and leg strength. Participants hop forward on one leg for a fixed distance (typically 6 meters or as far as possible), and the time to complete or the number of hops required is recorded. In this study, time in seconds for a 6-meter distance was used, with three trials per leg and the best score noted. The triple crossover hop test assesses lower limb explosive power and coordination. Participants start on one leg, hop forward over a 15 cm wide line to land on the opposite leg, then hop back over the line to the original side on the first leg, and finally hop forward again over the line on the opposite leg—covering three hops in a crossover pattern. The total distance covered in meters is measured, with the best of three trials recorded. The lateral hop test evaluates lateral jumping ability. Participants perform three consecutive lateral hops on one leg over a distance marked by cones (e.g., 30 cm apart), aiming for maximum distance in the final hop. The total distance in meters from the starting point to the final landing is recorded, with three trials per leg. The 5-10-5 test (also known as the pro-agility shuttle) measures agility and change-of-direction speed. Participants start in a three-point stance, sprint 5 meters to one side, touch a line, sprint 10 meters to the opposite side, touch another line, and sprint 5 meters back to the start. Time in seconds is recorded using timing gates or a stopwatch, with the best of two trials used. The acceleration-deceleration-acceleration (ADA) test assesses speed, acceleration, and deceleration capabilities. Participants accelerate maximally over 10 meters, then decelerate to a complete stop within the next 5 meters, and immediately accelerate again for another 10 meters. Total time in seconds and stop time (deceleration phase) are recorded separately using timing systems. The countermovement jump (CMJ) evaluates explosive power. Participants start from an upright position, perform a rapid downward squat (countermovement), and immediately jump vertically as high as possible with arms swinging. Jump height (cm), flight time (sec), and power output (Watts) are measured using a force platform or optical system, with the best of three jumps recorded (Fig. 1). Figure 1. Jump analysis Procedures Prior to the commencement of the functional performance tests, the athletes underwent a five-minute warm-up period at submaximal intensity. Subsequently, they were apprised of the specifics of the performance tests. Thereafter, the side jump test, the 6-meter timed hop test, and the single-leg hop test were executed expeditiously to assess the athletes' speed. Following the completion of the speed tests, the athletes were allotted a two-minute passive rest period. Subsequently, the triple crossover hop and lateral hop tests were conducted, with the results expressed in centimeters for distance. Following a five-minute passive rest period, the Deepsport program, an artificial intelligence algorithm, was implemented. This program performs and interprets a series of tests designed to assess various physical abilities in athletes. The CMJ, the 5-10-5 test, and the ADA test were performed in front of the camera using the Deepsport application. The DeepSport program was analyzed from a distance of 3 meters at a height of 97 cm with the camera positioned at 90 degrees perpendicular. Statistical Analysis The parameters associated with performance tests and CAI were expressed as group mean and standard deviation values. Normality of distribution was assessed using the Shapiro-Wilk test for each variable in both groups. For intergroup comparisons, parametric independent samples t-tests were applied when data were normally distributed in both groups; otherwise, non-parametric Mann-Whitney U tests were used. Effect sizes were calculated using Cohen's d, interpreted as small (0.2), medium (0.5), or large (0.8). To explore relationships, Pearson correlation coefficients were computed for normally distributed variables, while Spearman rho was used for non-normal data. Correlations were classified as weak (< 0.3), moderate (0.3–0.5), or strong (> 0.5). Additional exploratory analyses included partial correlations controlling for gender and multiple linear regression to examine predictors of performance (e.g., CAIT score and sprain history as independent variables for key outcomes like CMJ height and 5-10-5 time). All statistical analyses were performed using SPSS Statistics 26.0 software (IBM, Armonk, NY, USA), with significance set at P ≤ 0.05. Power analysis confirmed the sample size provided > 80% power for detecting medium-to-large effects. Results The study found no statistically significant differences between the groups in terms of age, height, weight, and BMI (p > .05; Table 1 ). However, significant differences were observed in CAIT scores, number of ankle sprains, \"giving way\" episodes, time since first LAS, and time to last LAS between the groups (p < .001; Table 1 ). The CAI group comprised 9 females and 7 males, and the injured lower extremity of the included athletes was the right lower extremity. The sports in which these athletes participated included volleyball (n = 9), basketball (n = 3), and soccer (n = 4). The CG group comprised 3 females and 13 males, and the dominant lower extremity of the included athletes was considered. The dominant side was the right lower extremity in 10 athletes and the left lower extremity in 6 athletes. The sports in which these athletes participated included volleyball (n = 6), basketball (n = 5), and soccer (n = 5). Table 1 Anthropometric characteristics of the athletes and test results related to CAI Parameter CAI (n = 16) M ± SD CG (n = 16) M ± SD Test Statistic p-value Cohen's d 95% CI (lower, upper) Age (year) 20.63 ± 1.36 21.75 ± 3.07 u 0.285 -0.47 -2.84, 0.59 Height (cm) 176.63 ± 10.05 182.63 ± 7.82 u 0.099 -0.67 -12.50, 0.50 Weight (kg) 72.88 ± 17.44 77.06 ± 15.51 u 0.450 -0.25 -16.10, 7.73 BMI (kg/m²) 23.16 ± 3.84 22.94 ± 3.37 t 0.865 0.06 -2.39, 2.83 CAIT (points) 19.81 ± 2.01 28.63 ± 1.45 u < 0.001* -5.03 -10.08, -7.55 Ankle Sprain (numbers) 11.50 ± 2.56 0 ± 0 t < 0.001* 6.36 10.14, 12.86 “Giving way” episodes (number /6 months) 3.69 ± 0.95 0 ± 0 u < 0.001* 5.51 3.18, 4.19 Time since the first LAS (years) 9.13 ± 1.02 0 ± 0 t < 0.001* 12.59 8.58, 9.67 Time to the last LAS (months) 4.94 ± 1.34 0 ± 0 t < 0.001* 5.21 4.22, 5.65 CAI: Chronic Ankle Instability group; LAS: Lateral Ankle Sprain; CG: control group; M: Mean; SD: standard deviation; CAIT: Cumberland Ankle Instability Tool; t: independent t-test; u: Mann-Whitney U test; *: statistically significant inter-group (CAI vs CG) difference at the level of P ≤ 0.05. Cohen's d calculated for continuous variables; not applicable for zero-variance in CG for injury-related parameters. 95% CI provided for mean difference (t-test) or approximated for u-test. A substantial discrepancy was identified between the CAI group and the CG group concerning CMJ jump height, CMJ power, 5-10-5 agility time, ADA test time, side jump time, 6-meter hop time, hops jump time, triple crossover hop distance, and lateral hop distance (p < 0.05; Table 2 ). The CAI group exhibited reduced jump height and distances, alongside increased times in agility and hop tests, indicating impaired performance. No significant differences were found in CMJ flight time or ADA stop time (p > 0.05). Exploratory regression analysis revealed that sprain history significantly predicted triple crossover hop distance in the CAI group (β = -0.52, p = 0.03), accounting for 29% of variance (R² = 0.29, F = 5.89, p = 0.03), while controlling for gender showed no moderating effect (p > 0.05). Table 2 Comparative Functional Performance Outcomes in Athletes With and Without CAI Parameter CAI M ± SD CG M ± SD Test Statistic p-value Cohen's d 95% CI (lower, upper) CMJ (cm) 32.25 ± 8.25 41.63 ± 13.05 u 0.020* -0.86 -17.26, -1.49 CMJ flight (sec) 50.63 ± 12.82 57.13 ± 15.49 t 0.206 -0.46 -16.77, 3.77 CMJ (Watt) 4275.58 ± 1140.28 5349.66 ± 1053.13 t 0.010* -0.98 -1648.40, -571.76 5-10-5 test (sec) 5.48 ± 1.17 4.17 ± 1.08 u < 0.001* 1.16 0.49, 2.12 ADA test (sec) 11.59 ± 2.45 10.25 ± 1.69 u 0.025* 0.63 -0.18, 2.85 ADA test stop time (sec) 1.28 ± 0.31 1.06 ± 0.32 t 0.053 0.71 -0.00, 0.46 Side jump test (sec) 5.33 ± 0.71 3.97 ± 0.42 u < 0.001* 2.34 0.94, 1.78 6 meter timed hop test (sec) 2.75 ± 0.57 2.24 ± 0.38 t 0.006* 1.05 0.16, 0.86 Single-leg hop test (sec) 3.95 ± 0.25 3.68 ± 0.30 t 0.009* 0.99 0.08, 0.48 Triple crossover hop test (m) 3.52 ± 0.90 5.02 ± 0.80 t < 0.001* -1.77 -2.12, -0.89 Lateral Hop Test (m) 3.84 ± 0.67 5.00 ± 0.56 t < 0.001* -1.87 -1.60, -0.71 CMJ: countermovement jump; CAI: Chronic Ankle Instability; CG: control group; cm: centimeter; sec: second; m: meter; M: mean; SD: standard deviation; t: independent t-test; u: Mann-Whitney U test; *: p < 0.05. 95% CI provided for mean difference (t-test) or approximated for u-test. The correlation tests yielded a significant negative moderate correlation between the CAIT score and triple crossover hop test in the CG (ρ = -0.639, p < 0.01). In the CAI group, a significant negative moderate correlation was identified between the number of ankle sprains and triple crossover hop test (ρ = -0.556, p < 0.05). Partial correlations controlling for gender confirmed these associations (p < 0.05). No other significant correlations were found (Table 3 ). Table 3 Correlations Between Functional Performance and Ankle Instability Measures Parameter CAIT (points) CAI (r/p) CAIT (points) CG (r/p) Ankle sprain (number) CAI (r/p) Ankle sprain (number) CG (r/p) CMJ (cm) 0.325 (p) 0.164 (r) -0.095 (p) - CMJ flight (sec) 0.238 (p) 0.446 (r) -0.024 (p) - CMJ (Watt) 0.260 (p) -0.054 (r) 0.058 (p) - 5-10-5 test (sec) 0.208 (r) -0.298 (r) 0.124 (r) - ADA test (sec) -0.016 (r) 0.171 (r) -0.244 (r) - ADA test stop time (sec) -0.128 (p) -0.604 (r)* 0.430 (p) - Side jump test (sec) -0.229 (p) -0.149 (r) 0.475 (p) - 6-meter timed hop test (sec) 0.127 (p) 0.139 (r) 0.297 (p) - Single-leg hop test (sec) 0.439 (p) 0.265 (r) 0.182 (p) - Triple crossover hop test (m) 0.116 (p) -0.639 (r)** -0.556 (p)* - Lateral Hop Test (m) -0.208 (p) -0.345 (r) -0.272 (p) - CMJ: countermovement jump; CAI: Chronic Ankle Instability; CG: control group; cm: centimeter; sec: second; m: meter; r: Spearman correlation test; p: Pearson correlation test; *: Correlation is significant at the 0.05 level (2-tailed). **: Correlation is significant at the 0.01 level (2-tailed). Discussion The present study found that athletes with CAI demonstrated significantly lower performance in multiple functional tests compared to the control group. The reduced CMJ height (p = 0.020, d=-0.86) in the CAI group can be attributed to proprioceptive deficits and neuromuscular control impairments, which hinder optimal force generation during the eccentric loading phase of the jump. Mechanistically, CAI disrupts joint position sense and muscle spindle feedback, leading to inefficient energy storage and release in the Achilles tendon and calf muscles [ 2 , 4 ]. This result aligns with literature showing decreased vertical jump performance in CAI due to altered ankle dorsiflexion and knee flexion kinematics [ 13 , 23 ]. Clinically, this implies that athletes with CAI may struggle with sports requiring explosive vertical movements, increasing injury risk; thus, rehabilitation should incorporate plyometric training to restore power output. Similarly, the decreased CMJ power (p = 0.010, d=-0.98) reflects diminished rate of force development, stemming from delayed peroneal muscle activation and reduced corticomotor excitability in ankle stabilizers [ 15 ]. Compared to studies, this mirrors findings where CAI athletes exhibit 15–20% lower power during jumps, attributed to central nervous system adaptations post-injury [ 22 ]. The clinical implication is the need for neuromuscular retraining, such as biofeedback exercises, to enhance power and prevent performance decline in competitive sports. Increased times in the 5-10-5 test (p < 0.001, d = 1.16) and ADA test (p = 0.025, d = 0.63) indicate agility impairments, mechanistically linked to postural control deficits and compensatory hip strategies that slow direction changes [ 5 , 12 ]. Literature comparisons show similar delays in CAI, with meta-analyses reporting 10–15% longer agility times due to fear of instability [ 9 , 21 ]. Clinically, this suggests higher recurrence risk in multidirectional sports; interventions like agility drills with perturbation could improve response times. The side jump (p < 0.001, d = 2.34), 6-meter hop (p = 0.006, d = 1.05), and single-leg hop tests (p = 0.009, d = 0.99) revealed longer durations in CAI, driven by dynamic balance deficits from proprioceptive loss and muscle weakness in invertors/evertors [ 18 , 19 ]. These align with research on hop tests, where CAI groups take 20% longer due to instability episodes [ 14 , 24 ]. Clinically, this highlights functional limitations in hopping sports, recommending balance boards for rehabilitation to reduce times and enhance confidence. Shorter distances in the triple crossover hop (p < 0.001, d=-1.77) and lateral hop tests (p < 0.001, d=-1.87) result from reduced explosive power and coordination, mechanistically caused by synovial changes and core deficits affecting kinetic chain efficiency [ 20 ]. Consistent with studies, CAI reduces hop distances by 25%, linked to recurrent sprains [ 11 , 16 ]. Clinically, this implies poorer performance in lateral movements; multidirectional hop training could mitigate this. Non-significant results, such as CMJ flight time (p = 0.206) and ADA stop time (p = 0.053), may indicate preserved airborne control but impaired ground phases, possibly due to variable deceleration strategies [ 3 , 10 ]. Correlation analyses showed no broad CAIT-performance links, suggesting subjective tools underestimate objective deficits [ 7 , 17 ]. However, negative correlations with triple crossover hop in CG (ρ=-0.639, p < 0.01) and sprain history in CAI (ρ=-0.556, p < 0.05) highlight cumulative effects, supported by regression [ 8 ]. Limitations include the small sample size (n = 32), limiting generalizability; cross-sectional design precludes causality; reliance on self-reported history; potential gender imbalance (more males in CG); focus on specific sports (volleyball, basketball, soccer), excluding others; no control for training load or fatigue; and absence of kinematic/electromyographic data to elucidate mechanisms. Future longitudinal studies with larger cohorts and advanced biomechanics are needed. Conclusion The present study demonstrated that CAI exerts deleterious effects on functional performance parameters such as jumping, agility, and multidirectional jumping in athletes. Significant impairments in CMJ height, agility times, hop durations, and distances underscore the need for targeted rehabilitation. The findings highlight the significance of goal-oriented exercises in enhancing functional performance during the rehabilitation process of individuals with CAI. Specifically, the study recommended exercises focused on balance, proprioception, strengthening, and foot core muscles. Recent evidence supports exercise therapy, including hop-stabilization and combined land-water programs, for improving functional scores and reducing recurrence [ 6 , 15 , 20 ]. Feedback-augmented training and transcranial stimulation may further address neuromuscular deficits [ 5 , 22 ]. In clinical practice, a comprehensive assessment of individuals with CAI is imperative. This comprehensive approach involves a multifaceted evaluation that encompasses balance and proprioceptive assessments, ultrasound-guided muscle architectural analysis of pretibial muscles, muscle tone measurements, and muscle activation assessments with sEMG. In addition, sports-specific tests are integral to the evaluation process, providing a comprehensive picture of an individual's functional capacity. The employment of subjective instruments such as the CAIT is advocated for the estimation of perceived instability; nevertheless, the implementation of objective measurement techniques and functional performance evaluation is imperative to ascertain actual performance. This multifaceted assessment approach will facilitate the development of customized rehabilitation programs tailored to the needs of individuals, potentially incorporating advanced modalities like virtual reality or transcranial stimulation [ 9 , 22 ]. Declarations Funding: None Conflict of Interest: No financial or conflicts of interest were disclosed by the authors. Acknowledgment: None Author contributions Conceptualisation and supervision: Designing this study:Sinan Seyhan, Gorkem Acar, Caglar Soylu; methodology: Sinan Seyhan, Gorkem Acar, Caglar Soylu, M. Fatih Bilici, Omer Fatih Bilici, Fatma Gozlukaya Girginer; formal analysis and investigation: Sinan Seyhan, Gorkem Acar, Caglar Soylu; writing — original draft preparation: M. Fatih Bilici, Omer Fatih Bilici, Fatma Gozlukaya Girginer; writing — review and editing: Sinan Seyhan, Gorkem Acar, Caglar Soylu. Declarations Ethics approval and consent to participate All participants provided written consent for their involvement in the study, which had been approved by the Ethics Committee of Çankırı Karatekin University and was conducted in accordance with the Declaration of Helsinki. Following the provision of consent, the participants completed a questionnaire encompassing clinical and educational data, and they underwent all measurement procedures (Application Code: 821c0699143e44f4). Consent for publication Not applicable. Data availability The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. 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Proactive and reactive neuromuscular control in subjects with chronic ankle instability: evidence from a pilot study on landing. Gait Posture . 41 (1), 106–111. https://doi.org/10.1016/j.gaitpost.2014.09.005 (2015). Alrowaili, M. The impact of fatigue on dynamic balance in coopers athletes with chronic ankle instability. Sci. Rep. 14 (1), 73908. https://doi.org/10.1038/s41598-024-73908-5 (2024). Nanbancha, A., Tretriluxana, J., Limroongreungrat, W. & Sinsurin, K. Decreased supraspinal control and neuromuscular function controlling the ankle joint in athletes with chronic ankle instability. Eur. J. Appl. Physiol. 119 (9), 2041–2052. https://doi.org/10.1007/s00421-019-04191-w (2019). Jamsandekar, S. J., Patel, V. D., Prabhakar, A. J., Eapen, C. & Keogh, J. W. L. Investigation of the effect of chronic ankle instability on core stabilization, dynamic balance, and agility in university-level basketball players. J. Bodyw. Mov. Ther. 40 , 224–229. https://doi.org/10.1016/j.jbmt.2024.07.024 (2024). Li, Y., Wang, H. & Huang, L. Impact of chronic ankle instability on gait loading strategy in individuals with chronic ankle instability: a systematic review with meta-analysis. J. Neuroeng. Rehabil . 21 (1), 178. https://doi.org/10.1186/s12984-024-01478-8 (2024). Chen, X., Liu, Y. & Wang, Z. Effects of dual-task paradigm on the injury potential during landing in individuals with chronic ankle instability. Front. Physiol. 15 , 1473844. https://doi.org/10.3389/fphys.2024.1473844 (2024). Yu, H. et al. Peri-ankle muscles architecture and performance changes in patients with chronic ankle instability: A retrospective cross-sectional study. J. Foot Ankle Res. 17 (3), e12035. https://doi.org/10.1002/jfa2.12035 (2024). Jamsandekar, S. J., Patel, V. D., Prabhakar, A. J., Eapen, C. & Keogh, J. W. L. Ability of functional performance assessments to discriminate athletes with and without chronic ankle instability: a case-control study. PeerJ 10 , e13390. https://doi.org/10.7717/peerj.13390 (2022). Emamvirdi, M. et al. Comparing kinematic asymmetry and lateral step-down test scores in healthy, chronic ankle instability, and patellofemoral pain syndrome female basketball players: a cross-sectional study. Sci. Rep. 13 (1), 12412. https://doi.org/10.1038/s41598-023-39625-1 (2023). Wang, L., Zhang, Y. & Li, H. Transcranial direct current stimulation reduces injury potential but improves movement performance in chronic ankle instability: A randomized trial. Front. Physiol. 16 , 1595844. https://doi.org/10.3389/fphys.2025.1595844 (2025). Kim, K. J., Lee, J. H. & Kim, H. J. Effect of hop-stabilization training on ankle instability and function in athletes with chronic ankle instability: A randomized controlled trial. J. Clin. Med. 14 (10), 3502. https://doi.org/10.3390/jcm14103502 (2025). Alghadir, A. H., Iqbal, Z. A. & Alqahtani, A. Comparative analysis of land-based vs. water-based balance training on ankle stability in athletes with chronic ankle instability. BMC Sports Sci. Med. Rehabil . 17 (1), 10. https://doi.org/10.1186/s13102-024-01049-3 (2025). Madsen, L. P., Hall, E. A. & Docherty, C. L. Assessing outcomes in people with chronic ankle instability: The ability of functional performance tests to measure deficits in physical function and perceived instability. J. Orthop. Sports Phys. Ther. 48 (5), 372–380. https://doi.org/10.2519/jospt.2018.7514 (2018). Additional Declarations No competing interests reported. Supplementary Files caiplosoneveri.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Comparative Study\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eLateral ankle sprain (LAS) represents one of the most common musculoskeletal injuries in sports, often leading to chronic ankle instability (CAI) if not adequately managed [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. CAI is defined as a multifaceted condition involving recurrent sprains, persistent symptoms of \\\"giving way,\\\" residual pain, and functional limitations that persist for at least 12 months following the initial injury [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. This condition arises from a combination of mechanical and sensorimotor impairments, including ligamentous laxity, proprioceptive deficits, neuromuscular dysfunction, and altered postural control [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. Recent epidemiological data indicate that CAI affects up to 74% of individuals with a history of LAS, with higher prevalence rates observed in high-demand sports such as basketball, soccer, and volleyball [\\u003cspan additionalcitationids=\\\"CR7\\\" citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e]. Notably, female athletes appear to be at elevated risk, with studies reporting prevalence rates exceeding 50% in sports involving rapid directional changes and jumping [\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. Furthermore, predictors of CAI in specific populations, such as soccer players, include prior sprain history, impaired balance, and delayed muscle activation times [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eThe biomechanical alterations associated with CAI are well-documented during dynamic activities like walking, running, and jumping. Individuals with CAI often exhibit increased ankle inversion angles, elevated plantar pressures, proximal joint compensations (e.g., knee adduction and internal rotation), and altered loading strategies, which contribute to recurrent injury and performance decrements [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. These changes not only heighten the risk of further sprains but also impair overall athletic performance by reducing power output, agility, and stability [\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e]. For instance, fatigue exacerbates these deficits, leading to poorer dynamic balance and increased injury potential in CAI athletes compared to healthy controls [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e]. Additionally, CAI has been linked to central nervous system adaptations, such as reduced corticomotor excitability in key ankle stabilizers like the peroneus longus (PL) and tibialis anterior (TA) muscles, further compounding neuromuscular mismatches [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eThe long-term consequences of CAI extend beyond physical impairments, significantly affecting quality of life and sports participation. Approximately 40% of individuals with recurrent sprains experience limitations in returning to pre-injury activity levels, with associated declines in self-reported function and increased fear of movement [\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]. Childhood ankle injuries substantially elevate the risk of adult CAI, emphasizing the need for early intervention [\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e]. Etiological factors are multifactorial: mechanical elements include joint laxity and synovial changes, while functional deficits encompass proprioceptive loss, delayed reaction times, and muscle architectural alterations (e.g., reduced pennation angles in peri-ankle muscles) [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]. Emerging research also highlights associations with core stabilization deficits and abdominal wall dysfunction, suggesting that CAI may influence broader kinetic chain impairments [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. Recent studies have explored the impact of fatigue on gait loading strategies in CAI, revealing compensatory mechanisms that may predispose athletes to overuse injuries [\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e]. Moreover, dual-task paradigms during landing tasks amplify injury risks in CAI populations, underscoring cognitive-motor interference [\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eDespite advances in understanding CAI pathophysiology, significant gaps remain in the literature, particularly regarding its specific effects on athletic performance metrics such as jumping and agility. While numerous studies have focused on static balance and proprioception [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e], fewer have comprehensively examined dynamic functional performance in athletes, especially using a combination of hop-based, agility, and vertical jump tests [\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e]. Existing research often overlooks the integration of artificial intelligence (AI)-assisted tools for precise measurement, such as the Deepsport program used in this study, which provides objective, real-time analysis of jump and agility parameters [\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e]. Furthermore, correlations between subjective tools like the Cumberland Ankle Instability Tool (CAIT) and objective performance metrics are inconsistently reported, with limited emphasis on team sport athletes who rely heavily on multidirectional movements [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e]. This study addresses these gaps by employing a multifaceted testing battery, including AI-enhanced assessments, to quantify CAI's impact on jumping and agility in a matched cohort of athletes from volleyball, basketball, and soccer. By doing so, it fills a critical void in the literature, providing evidence on how CAI impairs sport-specific performance and highlighting the need for targeted rehabilitation beyond traditional balance training. The originality lies in its holistic approach: combining subjective (CAIT) and objective (performance tests) evaluations with AI technology, which is underrepresented in prior work, to offer novel insights into mechanisms and clinical implications for athletic rehabilitation. This research was conducted to bridge the disconnect between perceived instability and measurable deficits, ultimately guiding more effective, evidence-based interventions to reduce recurrence and enhance return-to-sport outcomes.\\u003c/p\\u003e\\u003cp\\u003eThe objective of this study was to examine the performance implications in individuals with CAI compared to healthy controls. We hypothesized that athletes with CAI would exhibit significant impairments in jumping (e.g., reduced countermovement jump height and power) and agility parameters (e.g., increased times in 5-10-5 and ADA tests) when compared to athletes without CAI.\\u003c/p\\u003e\"},{\"header\":\"Materials and methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eParticipants\\u003c/h2\\u003e\\u003cp\\u003eA total of 32 subjects were recruited for this study: 16 adult athletes afflicted with chronic ankle instability (CAI group) and 16 age-matched healthy athletes without a history of lateral ankle sprains (LAS; control group, CG). Age and gender matching were performed to eliminate potential influences on muscle mechanical properties. The inclusion criteria for the CAI group were aligned with the guidelines established by the International Ankle Consortium (IAC), which required: (1) a documented history of at least one significant LAS occurring at least 12 months before participation, with the sprain involving inflammatory symptoms (pain, swelling, etc.) and disruption of desired physical activity; (2) at least two instances of \\\"giving way\\\" (perceived instability) within the past six months; (3) regular participation in sports for a minimum of five years, with at least 3 hours per week of training; and (4) self-reported instability with a Cumberland Ankle Instability Tool (CAIT) score of \\u0026le;\\u0026thinsp;24 [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. For the control group, inclusion criteria included: (1) no history of ankle sprains or instability; (2) matched age, gender, height, weight, and sport participation level to the CAI group; (3) regular sports participation for at least five years; and (4) CAIT score\\u0026thinsp;\\u0026ge;\\u0026thinsp;25 to confirm no perceived instability.\\u003c/p\\u003e\\u003cp\\u003eExclusion criteria for both groups encompassed: (1) a history of lower extremity fractures, surgeries, or neurological disorders; (2) any musculoskeletal injuries (e.g., knee, hip, or back issues) occurring within the previous three months that could affect performance; (3) vestibular or balance disorders unrelated to ankle issues; (4) use of orthotics or ankle braces during testing; (5) acute inflammation or pain in the ankle at the time of testing; and (6) any cardiovascular or systemic conditions that could impair physical performance.\\u003c/p\\u003e\\u003cp\\u003eThe CAI and CG groups exhibited comparable anthropometric parameters and weekly training characteristics. The sample size calculation was conducted to ensure adequate statistical power for intergroup comparisons, utilizing G*Power software (Germany). The calculation was based on an expected large effect size (Cohen's d\\u0026thinsp;=\\u0026thinsp;1.0) for primary outcomes like jump height, derived from pilot data and prior literature on CAI performance deficits. The alpha level was set at P\\u0026thinsp;=\\u0026thinsp;.05, and the analysis was performed with 80% power for independent t-tests. The study's final sample size was determined to be 32 athletes, with 16 athletes from each group [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003e All participants provided written consent for their involvement in the study, which had been approved by the Ethics Committee of \\u0026Ccedil;ankırı Karatekin University and was conducted in accordance with the Declaration of Helsinki. Following the provision of consent, the participants completed a questionnaire encompassing clinical and educational data, and they underwent all measurement procedures (Application Code: 821c0699143e44f4).\\u003c/p\\u003e\\u003c/div\\u003e\\n\\u003ch3\\u003eData Collecting\\u003c/h3\\u003e\\n\\u003cp\\u003eThe side jump test assesses lateral power and explosiveness. Participants stand on one leg beside a line, jump laterally over the line to land on both feet, and immediately jump back to the starting position on one leg. The test is performed for 10 repetitions, and the total time (in seconds) is recorded as the score, with lower times indicating better performance. The process is repeated for both legs, and the best score from three trials is used.\\u003c/p\\u003e\\u003cp\\u003eThe 6-meter timed hop test evaluates speed and acceleration in hopping. Participants hop forward on one leg as quickly as possible over a 6-meter straight line marked on the floor. The time taken to complete the distance is measured in seconds using a stopwatch, with the best of three attempts recorded. This test targets dynamic balance and lower limb power.\\u003c/p\\u003e\\u003cp\\u003eThe single-leg hop test measures dynamic balance, coordination, and leg strength. Participants hop forward on one leg for a fixed distance (typically 6 meters or as far as possible), and the time to complete or the number of hops required is recorded. In this study, time in seconds for a 6-meter distance was used, with three trials per leg and the best score noted.\\u003c/p\\u003e\\u003cp\\u003eThe triple crossover hop test assesses lower limb explosive power and coordination. Participants start on one leg, hop forward over a 15 cm wide line to land on the opposite leg, then hop back over the line to the original side on the first leg, and finally hop forward again over the line on the opposite leg\\u0026mdash;covering three hops in a crossover pattern. The total distance covered in meters is measured, with the best of three trials recorded.\\u003c/p\\u003e\\u003cp\\u003eThe lateral hop test evaluates lateral jumping ability. Participants perform three consecutive lateral hops on one leg over a distance marked by cones (e.g., 30 cm apart), aiming for maximum distance in the final hop. The total distance in meters from the starting point to the final landing is recorded, with three trials per leg.\\u003c/p\\u003e\\u003cp\\u003eThe 5-10-5 test (also known as the pro-agility shuttle) measures agility and change-of-direction speed. Participants start in a three-point stance, sprint 5 meters to one side, touch a line, sprint 10 meters to the opposite side, touch another line, and sprint 5 meters back to the start. Time in seconds is recorded using timing gates or a stopwatch, with the best of two trials used.\\u003c/p\\u003e\\u003cp\\u003eThe acceleration-deceleration-acceleration (ADA) test assesses speed, acceleration, and deceleration capabilities. Participants accelerate maximally over 10 meters, then decelerate to a complete stop within the next 5 meters, and immediately accelerate again for another 10 meters. Total time in seconds and stop time (deceleration phase) are recorded separately using timing systems.\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003cp\\u003eThe countermovement jump (CMJ) evaluates explosive power. Participants start from an upright position, perform a rapid downward squat (countermovement), and immediately jump vertically as high as possible with arms swinging. Jump height (cm), flight time (sec), and power output (Watts) are measured using a force platform or optical system, with the best of three jumps recorded (Fig.\\u0026nbsp;1).\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eFigure\\u0026nbsp;1.\\u003c/b\\u003e Jump analysis\\u003c/p\\u003e\\n\\u003ch3\\u003eProcedures\\u003c/h3\\u003e\\n\\u003cp\\u003ePrior to the commencement of the functional performance tests, the athletes underwent a five-minute warm-up period at submaximal intensity. Subsequently, they were apprised of the specifics of the performance tests. Thereafter, the side jump test, the 6-meter timed hop test, and the single-leg hop test were executed expeditiously to assess the athletes' speed. Following the completion of the speed tests, the athletes were allotted a two-minute passive rest period. Subsequently, the triple crossover hop and lateral hop tests were conducted, with the results expressed in centimeters for distance. Following a five-minute passive rest period, the Deepsport program, an artificial intelligence algorithm, was implemented. This program performs and interprets a series of tests designed to assess various physical abilities in athletes. The CMJ, the 5-10-5 test, and the ADA test were performed in front of the camera using the Deepsport application. The DeepSport program was analyzed from a distance of 3 meters at a height of 97 cm with the camera positioned at 90 degrees perpendicular.\\u003c/p\\u003e\\u003cdiv id=\\\"Sec6\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eStatistical Analysis\\u003c/h2\\u003e\\u003cp\\u003eThe parameters associated with performance tests and CAI were expressed as group mean and standard deviation values. Normality of distribution was assessed using the Shapiro-Wilk test for each variable in both groups. For intergroup comparisons, parametric independent samples t-tests were applied when data were normally distributed in both groups; otherwise, non-parametric Mann-Whitney U tests were used. Effect sizes were calculated using Cohen's d, interpreted as small (0.2), medium (0.5), or large (0.8). To explore relationships, Pearson correlation coefficients were computed for normally distributed variables, while Spearman rho was used for non-normal data. Correlations were classified as weak (\\u0026lt;\\u0026thinsp;0.3), moderate (0.3\\u0026ndash;0.5), or strong (\\u0026gt;\\u0026thinsp;0.5). Additional exploratory analyses included partial correlations controlling for gender and multiple linear regression to examine predictors of performance (e.g., CAIT score and sprain history as independent variables for key outcomes like CMJ height and 5-10-5 time). All statistical analyses were performed using SPSS Statistics 26.0 software (IBM, Armonk, NY, USA), with significance set at P\\u0026thinsp;\\u0026le;\\u0026thinsp;0.05. Power analysis confirmed the sample size provided \\u0026gt;\\u0026thinsp;80% power for detecting medium-to-large effects.\\u003c/p\\u003e\\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eThe study found no statistically significant differences between the groups in terms of age, height, weight, and BMI (p\\u0026thinsp;\\u0026gt;\\u0026thinsp;.05; Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). However, significant differences were observed in CAIT scores, number of ankle sprains, \\\"giving way\\\" episodes, time since first LAS, and time to last LAS between the groups (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;.001; Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). The CAI group comprised 9 females and 7 males, and the injured lower extremity of the included athletes was the right lower extremity. The sports in which these athletes participated included volleyball (n\\u0026thinsp;=\\u0026thinsp;9), basketball (n\\u0026thinsp;=\\u0026thinsp;3), and soccer (n\\u0026thinsp;=\\u0026thinsp;4). The CG group comprised 3 females and 13 males, and the dominant lower extremity of the included athletes was considered. The dominant side was the right lower extremity in 10 athletes and the left lower extremity in 6 athletes. The sports in which these athletes participated included volleyball (n\\u0026thinsp;=\\u0026thinsp;6), basketball (n\\u0026thinsp;=\\u0026thinsp;5), and soccer (n\\u0026thinsp;=\\u0026thinsp;5).\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eAnthropometric characteristics of the athletes and test results related to CAI\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"7\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eParameter\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eCAI (n\\u0026thinsp;=\\u0026thinsp;16) M\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eCG (n\\u0026thinsp;=\\u0026thinsp;16) M\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eTest Statistic\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003ep-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003eCohen's d\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e95% CI (lower, upper)\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eAge (year)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e20.63\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.36\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e21.75\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.07\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.285\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-0.47\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-2.84, 0.59\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eHeight (cm)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e176.63\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;10.05\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e182.63\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;7.82\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.099\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-0.67\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-12.50, 0.50\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eWeight (kg)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e72.88\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;17.44\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e77.06\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;15.51\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.450\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-0.25\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-16.10, 7.73\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eBMI (kg/m\\u0026sup2;)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e23.16\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.84\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e22.94\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.37\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.865\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e0.06\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-2.39, 2.83\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCAIT (points)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e19.81\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.01\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e28.63\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.45\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-5.03\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-10.08, -7.55\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eAnkle Sprain (numbers)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e11.50\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.56\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e6.36\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e10.14, 12.86\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e\\u0026ldquo;Giving way\\u0026rdquo; episodes (number /6 months)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3.69\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.95\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e5.51\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e3.18, 4.19\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eTime since the first LAS (years)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e9.13\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.02\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e12.59\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e8.58, 9.67\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eTime to the last LAS (months)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e4.94\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.34\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e5.21\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e4.22, 5.65\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eCAI: Chronic Ankle Instability group; LAS: Lateral Ankle Sprain; CG: control group; M: Mean; SD: standard deviation; CAIT: Cumberland Ankle Instability Tool; t: independent t-test; u: Mann-Whitney U test; *: statistically significant inter-group (CAI vs CG) difference at the level of P\\u0026thinsp;\\u0026le;\\u0026thinsp;0.05. Cohen's d calculated for continuous variables; not applicable for zero-variance in CG for injury-related parameters. 95% CI provided for mean difference (t-test) or approximated for u-test.\\u003c/p\\u003e\\u003cp\\u003eA substantial discrepancy was identified between the CAI group and the CG group concerning CMJ jump height, CMJ power, 5-10-5 agility time, ADA test time, side jump time, 6-meter hop time, hops jump time, triple crossover hop distance, and lateral hop distance (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05; Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e). The CAI group exhibited reduced jump height and distances, alongside increased times in agility and hop tests, indicating impaired performance. No significant differences were found in CMJ flight time or ADA stop time (p\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.05). Exploratory regression analysis revealed that sprain history significantly predicted triple crossover hop distance in the CAI group (β = -0.52, p\\u0026thinsp;=\\u0026thinsp;0.03), accounting for 29% of variance (R\\u0026sup2; = 0.29, F\\u0026thinsp;=\\u0026thinsp;5.89, p\\u0026thinsp;=\\u0026thinsp;0.03), while controlling for gender showed no moderating effect (p\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.05).\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eComparative Functional Performance Outcomes in Athletes With and Without CAI\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"7\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eParameter\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eCAI M\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eCG M\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;SD\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eTest Statistic\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003ep-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003eCohen's d\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e95% CI (lower, upper)\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCMJ (cm)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e32.25\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;8.25\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e41.63\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;13.05\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.020*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-0.86\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-17.26, -1.49\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCMJ flight (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e50.63\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;12.82\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e57.13\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;15.49\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.206\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-0.46\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-16.77, 3.77\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCMJ (Watt)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e4275.58\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1140.28\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e5349.66\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1053.13\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.010*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-0.98\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-1648.40, -571.76\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e5-10-5 test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e5.48\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.17\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4.17\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.08\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e1.16\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e0.49, 2.12\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eADA test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e11.59\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;2.45\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e10.25\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.69\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.025*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e0.63\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-0.18, 2.85\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eADA test stop time (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1.28\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.31\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e1.06\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.32\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.053\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e0.71\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-0.00, 0.46\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eSide jump test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e5.33\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.71\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e3.97\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.42\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eu\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e2.34\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e0.94, 1.78\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e6 meter timed hop test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e2.75\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.57\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2.24\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.38\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.006*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e1.05\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e0.16, 0.86\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eSingle-leg hop test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3.95\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.25\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e3.68\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.30\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.009*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e0.99\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e0.08, 0.48\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eTriple crossover hop test (m)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3.52\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.90\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e5.02\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.80\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-1.77\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-2.12, -0.89\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eLateral Hop Test (m)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3.84\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.67\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\"\\u0026plusmn;\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e5.00\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.56\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003et\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e-1.87\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e-1.60, -0.71\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eCMJ: countermovement jump; CAI: Chronic Ankle Instability; CG: control group; cm: centimeter; sec: second; m: meter; M: mean; SD: standard deviation; t: independent t-test; u: Mann-Whitney U test; *: p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05. 95% CI provided for mean difference (t-test) or approximated for u-test.\\u003c/p\\u003e\\u003cp\\u003eThe correlation tests yielded a significant negative moderate correlation between the CAIT score and triple crossover hop test in the CG (ρ = -0.639, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.01). In the CAI group, a significant negative moderate correlation was identified between the number of ankle sprains and triple crossover hop test (ρ = -0.556, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05). Partial correlations controlling for gender confirmed these associations (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05). No other significant correlations were found (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eCorrelations Between Functional Performance and Ankle Instability Measures\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"5\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eParameter\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eCAIT (points) CAI (r/p)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eCAIT (points) CG (r/p)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eAnkle sprain (number) CAI (r/p)\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eAnkle sprain (number) CG (r/p)\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCMJ (cm)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.325 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.164 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e-0.095 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCMJ flight (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.238 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.446 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e-0.024 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCMJ (Watt)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.260 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e-0.054 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.058 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e5-10-5 test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.208 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e-0.298 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.124 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eADA test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e-0.016 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.171 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e-0.244 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eADA test stop time (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e-0.128 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e-0.604 (r)*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.430 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eSide jump test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e-0.229 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e-0.149 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.475 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003e6-meter timed hop test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.127 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.139 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.297 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eSingle-leg hop test (sec)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.439 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.265 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.182 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eTriple crossover hop test (m)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0.116 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e-0.639 (r)**\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e-0.556 (p)*\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eLateral Hop Test (m)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e-0.208 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e-0.345 (r)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e-0.272 (p)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e-\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eCMJ: countermovement jump; CAI: Chronic Ankle Instability; CG: control group; cm: centimeter; sec: second; m: meter; r: Spearman correlation test; p: Pearson correlation test; *: Correlation is significant at the 0.05 level (2-tailed). **: Correlation is significant at the 0.01 level (2-tailed).\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThe present study found that athletes with CAI demonstrated significantly lower performance in multiple functional tests compared to the control group. The reduced CMJ height (p\\u0026thinsp;=\\u0026thinsp;0.020, d=-0.86) in the CAI group can be attributed to proprioceptive deficits and neuromuscular control impairments, which hinder optimal force generation during the eccentric loading phase of the jump. Mechanistically, CAI disrupts joint position sense and muscle spindle feedback, leading to inefficient energy storage and release in the Achilles tendon and calf muscles [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. This result aligns with literature showing decreased vertical jump performance in CAI due to altered ankle dorsiflexion and knee flexion kinematics [\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e]. Clinically, this implies that athletes with CAI may struggle with sports requiring explosive vertical movements, increasing injury risk; thus, rehabilitation should incorporate plyometric training to restore power output.\\u003c/p\\u003e\\u003cp\\u003eSimilarly, the decreased CMJ power (p\\u0026thinsp;=\\u0026thinsp;0.010, d=-0.98) reflects diminished rate of force development, stemming from delayed peroneal muscle activation and reduced corticomotor excitability in ankle stabilizers [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. Compared to studies, this mirrors findings where CAI athletes exhibit 15\\u0026ndash;20% lower power during jumps, attributed to central nervous system adaptations post-injury [\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e]. The clinical implication is the need for neuromuscular retraining, such as biofeedback exercises, to enhance power and prevent performance decline in competitive sports.\\u003c/p\\u003e\\u003cp\\u003eIncreased times in the 5-10-5 test (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001, d\\u0026thinsp;=\\u0026thinsp;1.16) and ADA test (p\\u0026thinsp;=\\u0026thinsp;0.025, d\\u0026thinsp;=\\u0026thinsp;0.63) indicate agility impairments, mechanistically linked to postural control deficits and compensatory hip strategies that slow direction changes [\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. Literature comparisons show similar delays in CAI, with meta-analyses reporting 10\\u0026ndash;15% longer agility times due to fear of instability [\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e]. Clinically, this suggests higher recurrence risk in multidirectional sports; interventions like agility drills with perturbation could improve response times.\\u003c/p\\u003e\\u003cp\\u003eThe side jump (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001, d\\u0026thinsp;=\\u0026thinsp;2.34), 6-meter hop (p\\u0026thinsp;=\\u0026thinsp;0.006, d\\u0026thinsp;=\\u0026thinsp;1.05), and single-leg hop tests (p\\u0026thinsp;=\\u0026thinsp;0.009, d\\u0026thinsp;=\\u0026thinsp;0.99) revealed longer durations in CAI, driven by dynamic balance deficits from proprioceptive loss and muscle weakness in invertors/evertors [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]. These align with research on hop tests, where CAI groups take 20% longer due to instability episodes [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e]. Clinically, this highlights functional limitations in hopping sports, recommending balance boards for rehabilitation to reduce times and enhance confidence.\\u003c/p\\u003e\\u003cp\\u003eShorter distances in the triple crossover hop (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001, d=-1.77) and lateral hop tests (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001, d=-1.87) result from reduced explosive power and coordination, mechanistically caused by synovial changes and core deficits affecting kinetic chain efficiency [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. Consistent with studies, CAI reduces hop distances by 25%, linked to recurrent sprains [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]. Clinically, this implies poorer performance in lateral movements; multidirectional hop training could mitigate this.\\u003c/p\\u003e\\u003cp\\u003eNon-significant results, such as CMJ flight time (p\\u0026thinsp;=\\u0026thinsp;0.206) and ADA stop time (p\\u0026thinsp;=\\u0026thinsp;0.053), may indicate preserved airborne control but impaired ground phases, possibly due to variable deceleration strategies [\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. Correlation analyses showed no broad CAIT-performance links, suggesting subjective tools underestimate objective deficits [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e]. However, negative correlations with triple crossover hop in CG (ρ=-0.639, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.01) and sprain history in CAI (ρ=-0.556, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05) highlight cumulative effects, supported by regression [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eLimitations include the small sample size (n\\u0026thinsp;=\\u0026thinsp;32), limiting generalizability; cross-sectional design precludes causality; reliance on self-reported history; potential gender imbalance (more males in CG); focus on specific sports (volleyball, basketball, soccer), excluding others; no control for training load or fatigue; and absence of kinematic/electromyographic data to elucidate mechanisms. Future longitudinal studies with larger cohorts and advanced biomechanics are needed.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eThe present study demonstrated that CAI exerts deleterious effects on functional performance parameters such as jumping, agility, and multidirectional jumping in athletes. Significant impairments in CMJ height, agility times, hop durations, and distances underscore the need for targeted rehabilitation. The findings highlight the significance of goal-oriented exercises in enhancing functional performance during the rehabilitation process of individuals with CAI. Specifically, the study recommended exercises focused on balance, proprioception, strengthening, and foot core muscles. Recent evidence supports exercise therapy, including hop-stabilization and combined land-water programs, for improving functional scores and reducing recurrence [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. Feedback-augmented training and transcranial stimulation may further address neuromuscular deficits [\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e].\\u003c/p\\u003e\\u003cp\\u003eIn clinical practice, a comprehensive assessment of individuals with CAI is imperative. This comprehensive approach involves a multifaceted evaluation that encompasses balance and proprioceptive assessments, ultrasound-guided muscle architectural analysis of pretibial muscles, muscle tone measurements, and muscle activation assessments with sEMG. In addition, sports-specific tests are integral to the evaluation process, providing a comprehensive picture of an individual's functional capacity. The employment of subjective instruments such as the CAIT is advocated for the estimation of perceived instability; nevertheless, the implementation of objective measurement techniques and functional performance evaluation is imperative to ascertain actual performance. This multifaceted assessment approach will facilitate the development of customized rehabilitation programs tailored to the needs of individuals, potentially incorporating advanced modalities like virtual reality or transcranial stimulation [\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e].\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eFunding:\\u003c/strong\\u003e None\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConflict of Interest:\\u003c/strong\\u003e No financial or conflicts of interest were disclosed by the authors.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgment:\\u003c/strong\\u003e None\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor contributions Conceptualisation and supervision:\\u0026nbsp;\\u003c/strong\\u003eDesigning this study:Sinan Seyhan, Gorkem Acar, Caglar Soylu; methodology: Sinan Seyhan, Gorkem Acar, Caglar Soylu, M. Fatih Bilici, Omer Fatih Bilici, Fatma Gozlukaya Girginer; formal analysis and investigation: Sinan Seyhan, Gorkem Acar, Caglar Soylu; writing — original draft preparation: M. Fatih Bilici, Omer Fatih Bilici, Fatma Gozlukaya Girginer; writing — review and editing: Sinan Seyhan, Gorkem Acar, Caglar Soylu.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eDeclarations\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthics approval and consent to participate\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAll participants provided written consent for their involvement in the study, which had been approved by the Ethics Committee of Çankırı Karatekin University and was conducted in accordance with the Declaration of Helsinki. Following the provision of consent, the participants completed a questionnaire encompassing clinical and educational data, and they underwent all measurement procedures (Application Code: 821c0699143e44f4).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData availability\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets used and/or analysed during the current study available from the corresponding author on reasonable request.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting interests\\u0026nbsp;\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare no competing interests\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eGribble, P. A. et al. 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Physiol.\\u003c/em\\u003e \\u003cb\\u003e16\\u003c/b\\u003e, 1595844. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.3389/fphys.2025.1595844\\u003c/span\\u003e\\u003cspan address=\\\"10.3389/fphys.2025.1595844\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e (2025).\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eKim, K. J., Lee, J. H. \\u0026amp; Kim, H. J. Effect of hop-stabilization training on ankle instability and function in athletes with chronic ankle instability: A randomized controlled trial. \\u003cem\\u003eJ. Clin. 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Ther.\\u003c/em\\u003e \\u003cb\\u003e48\\u003c/b\\u003e (5), 372\\u0026ndash;380. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.2519/jospt.2018.7514\\u003c/span\\u003e\\u003cspan address=\\\"10.2519/jospt.2018.7514\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e (2018).\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Chronic ankle instability, physical functional performance, performance tests\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-7939574/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-7939574/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e\\u003cp\\u003eThe objective of this study was to assess functional performance in athletes with chronic ankle instability (CAI) and compare it with a healthy control group.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e\\u003cp\\u003eThe study population comprised 16 athletes diagnosed with CAI and 16 matched, healthy athletes. Functional performance was evaluated using side jump test, 6-meter timed hop test, single-leg hop test, triple crossover hop test, lateral hop test, and countermovement jump. Additionally, agility tests including the 5-10-5 test and the acceleration-deceleration-acceleration (ADA) test were administered. Independent sample t-tests and Mann-Whitney U tests were used for intergroup comparisons, and effect sizes were calculated using Cohen's d.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e\\u003cp\\u003eAthletes with CAI demonstrated significantly reduced performance in jumping and agility tests compared to the control group. Specifically, notable decreases were observed in vertical jump height, jump power, agility time, and lateral jump distance. However, no significant correlation was found between Cumberland Ankle Instability Tool (CAIT) scores and functional performance tests.\\u003c/p\\u003e\\u003ch2\\u003eConclusion\\u003c/h2\\u003e\\u003cp\\u003eThis study highlights the negative impact of CAI on functional performance, particularly in jumping and agility domains, among athletes. The findings emphasize the importance of incorporating exercise programs targeting functional performance into rehabilitation strategies for CAI. In clinical practice, combining subjective and objective measurements may aid in developing comprehensive rehabilitation plans for individuals with CAI.\\u003c/p\\u003e\\u003ch2\\u003eClinical trials:\\u003c/h2\\u003e\\u003cp\\u003eThe study was prospectively registered with ClinicalTrials.gov under the identifier NCT07171411 on September 6, 2025.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Impact of Chronic Ankle Instability on Jumping and Agility Performance in Athletes: A Comparative Study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-11-13 11:20:34\",\"doi\":\"10.21203/rs.3.rs-7939574/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"fe67b796-7e39-47e7-9552-2955aaf30d33\",\"owner\":[],\"postedDate\":\"November 13th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":57604681,\"name\":\"Health sciences/Health care\"},{\"id\":57604682,\"name\":\"Health sciences/Medical research\"},{\"id\":57604683,\"name\":\"Biological sciences/Physiology\"}],\"tags\":[],\"updatedAt\":\"2025-12-01T17:53:19+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-11-13 11:20:34\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-7939574\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-7939574\",\"identity\":\"rs-7939574\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}