Effect of Functional Core Stability Training or Cognitive Training on Balance and Postural Control in Chronic Ankle Instability

Ankle pain will be evaluated using the Arabic version of the Cumberland Ankle Instability Tool, which consists of questions that the patient must answer to reflect their condition. The scoring ranges from 0 to 30, with 0 indicating severe instability and 30 indicating normal stability. A score below 24 suggests Chronic Ankle Instability as defined by the International Ankle Consortium

Ankle instability will be evaluated using the Arabic version of the Cumberland Ankle Instability Tool, which consists of questions that the patient must answer to reflect their condition. The scoring ranges from 0 to 30, with 0 indicating severe instability and 30 indicating normal stability. A score below 24 suggests Chronic Ankle Instability as defined by the International Ankle Consortium

Participants will complete a 29-item questionnaire consisting of the Foot and Ankle Ability Measure, which includes a 21-item Activities of Daily Living (ADL) Subscale and an 8-item Sports Subscale. Each item is rated on a 5-point Likert scale from 0 (unable to perform) to 4 (no difficulty), yielding a potential score of 0 to 84 for the ADL subscale and 0 to 32 for the Sports subscale. The total score is calculated by subtracting the raw score from the maximum possible score, dividing by the maximum score, and multiplying by 100 to determine the percentage of maximum ability achieved.

The side-hop test involves participants hopping laterally on one limb over a distance of 30 cm for 10 repetitions, with a stopwatch recording the fastest time. Trials are invalidated if the contralateral foot touches the ground. After 1-3 practice trials, 3 test trials are conducted, and the average time is used for analysis (Kamonseki et al., 2018). Additionally, the figure of the hop test requires participants to hop twice around a 5-m cone-marked course as fast as possible, with penalties for footfall or course deviations, and timing recorded to the nearest 0.01 seconds.

The modified star test grid features three lines emanating from a center point, oriented as anterior, posteromedial, and posterolateral. Participants stand at the center with feet together and perform single-limb squats, reaching towards maximum points along each direction line with the swinging limb. The participant must lightly touch the line with the distal part of the reaching foot without shifting their weight to it or resting on it. They must then return the limb to the center while maintaining balance on the stance limb. Any heavy contact, resting, or shifting during the trial invalidates it. Maximum reach distances are measured with a tape measure.

The "Self-check" mode provides two measurement options for Static Balance Testing and alternative assessments using an Electronic Balance Board. Participants stand with feet shoulder-width apart (~30 cm) and are monitored via a computer screen displaying a target zone of five concentric circles. The test includes a 15-second adaptation phase followed by a 20-second measurement period, during which stability is assessed based on how long a tracking ball remains within the inner circle. Scores range from 1 (Excellent Stability) to 5 (Bad Stability), with lower scores indicating better performance. Additionally, dynamic tasks require participants to track a target point on-screen, measuring time in the target for scoring. After the tests, scores for each foot and the overall percentage difference are displayed, with values below 10% indicating good body balance.

The inclinometer will be fixed to the lateral side of the distal leg just above the ankle joint using a strap. It should be oriented laterally, and its zero point should be parallel to the floor. Participant will make dorsiflexion from weightbearing position by proximal segment, the degree of changed range from zero will be appeared on inclinometer

using the National Aeronautics and Space Administration-Task Load Index questionnaire. Participants assess the workload of a comprehension task after reading selected texts by answering 10 questions. A rater evaluates and assigns weights to six scales based on 15 pair-wise comparisons. Each scale is represented by a line divided into intervals, with descriptors ranging from 'low' to 'high', except for 'performance', which goes from 'good' to 'poor' and is reverse scored. The overall workload score is computed by multiplying raw ratings by participant weights, summing these, and dividing by 15, resulting in a score from 0 to 100.