PREVALENCE OF ANKLE INSTABILITY IN FOOTBALL PLAYERS IN

KOLHAPUR CITY.
A protocol submitted to
D. Y. Patil Education Society, Deemed to be University, Kolhapur

For the degree of bachelor of physiotherapy (B.P.Th)

By,
Master. Rushikesh Sanjay Patil
Under the guidance of
Dr. Aditi Jadhav
Departmental address: D. Y. Patil College of Physiotherapy, kolhapur
Year: 2023-2024
 Section – A (General Information)

Title of the Research / Dissertation Project: PREVALENCE OF ANKLE

INSTABILITY IN FOOTBALL PLAYERS IN KOLHAPUR CITY.

 Name and Designation:

 (a) Under-graduate Guide : Dr. Aditi Jadhav

 (b) Head of the Dept. :

 Under-graduate Student : Master. Rushikesh Sanjay Patil

 Department : Musculoskeletal physiotherapy

 Date of Registration :

 Duration of Research / Dissertation Project:

1st 2nd 3rd Final

Quarter Quarter Quarter Quarter
Review of progress Date
of the Dissertation
Review of Date
collected data
Review of Date
analyzed data
 Date of submission of Project:
a) I. R.C. COMMITTEE……………………………………………..
b) Ethical COMMITTEE…………………………………………….
 Date of Clearance of Project:
a. I. R. C. COMMITTEE………….…………………………………..
b. Ethical COMMITTEE………………….………………………….

 Signature of :
c. U.G. Student ………………………………………………………..
d. U.G. Guide ………………………………………………….………

e. Principal D Y Patil college of physiotherapy…………………………….

f. Signature of I. R.C. COMMITTEE (Chairman)……………………

g. Remarks and Signature of Secretary- Ethical Committee: ……………………….

……………..……………………………………
PREVALENCE OF ANKLE INSTABILITY IN FOOTBALL PLAYERS IN
KOLHAPUR CITY.

INTRODUCTION:

The most frequent type of ankle sprain suffered by football players is ankle inversion sprain.
Football Leads To Various Injuries In Which the possibility of Ankle Sprain Is Between 11% To 18% 2.
Prevalence Of Ankle Sprain Is 80% 2.After Ankle Sprain It Develops Into Ankle Instability In Chronic Time
Frame /Period Which Can Cause Recurrence Of Ankle Sprain With Loss Of Joint Scenes 3.Comparing With
Uninjured Side The Injured Side Is At Risk Of Injury five Times More 2.If The Injury Is Ignored It Can
Cause Chronic Ankle Instability (CAI) Or Functional Ankle Instability (FAI) 1,3 .

One of the most popular sports in the world, football has a rising number of viewers and active
players. The lower extremities of football players are most commonly injured, particularly the ankle and
knee regions. Ankle sprains are among the most frequent sports injuries, according to studies, with a 15% to
45% occurrence rate throughout the football season. The majority of ankle sprains are caused by lateral or
medial pressures acting over the ankle or foot, respectively, which cause excessive inversion or eversion.
Ankle instability is accompanied by deficiencies in strength, proprioception, and neuromuscular and postural
control4. In terms of prevalence, more than 25% of individuals who play sports claim to have CAI or
recurrent sprains. Patients with CAI have four characteristics:

(1)their first ankle sprain occurred more than a year ago;

(2) they have a tendency to sustain repeated ankle sprains;

(3) they frequently feel as though their ankle is giving way; and

(4) they experience repetitive pain, swelling, diminished range of motion, weakness, and decreased daily
function5.

Only self-reported questionaries, not historical medical records (such as a major Lateral ankle sprain
(LAS), recurring LAS, or ankles "giving way"), were used to detect the existence of CAI6.
 NEED FOR STUDY

The common physical factor amongst football players is affected to musculoskeletal system because of
playing sports .

The majority of research to far has been on prevalence rates and risk factors in top teams, but the expansion
of smaller teams and the rising participation rate support the necessity for research in this new area.

The main goal of the study is to determine the positive rate of ankle instabilities among football players.
Therefore, the aim of this study was to ascertain the prevalence of ankle instability.

AIM

Study the Prevalence rate of ankle instability in football players in kolhapur city.

OBJECTIVE:

To find the prevalence of ankle instability with ankle joint function assessment tool among football players in
Kolhapur city.
 REVIEW OF LITERATURE:

1) A study was done on Effect of combined balance exercise and kinesio taping balance, postural
stability and severity of ankle instability in female athletes with functional ankle instability. The aim
of the study was to find out the effect of combine balance exercise and kinesio taping in female
athletes with FAI. This study included 24 samples. The study identified that balance exercise on
wobble board combine with kinesio taping enhanced balance and postural stability and reduced the
severity of ankle in stability in female athletes who had FAI and it had most significant effect than
solitary exercise.
2) The study was done on Six week combined vibration and wobble board training on balance and
stability in footballers with functional ankle instability. The aim is this study was to examine the
effect of six week combine vibration and wobble board training against wobble training alone on
absolute center of mass. This study included 33 samples. The study concluded that six week of
progressive wobble board and vibration training significantly improved COM distribution, SEBT and
SLTHD in comparison with wobble board training alone . combined wobble board and vibration
training seem to be beneficial in football players suffering FAI.
3) A study was done on Comparison of kinesiology taping techniques to promote ankle stability in male
football athletes with chronic ankle instability. The aim of this study was to find out effect of
kinesiology taping in football athletes. The study included 40 samples. This Study showed that
kinesiology taping improved the dynamic balance in professional football players with chronic ankle
instability.
4) A study was conducted on Functional Ankle Instability Prevalence and Associated Risk Factors in
Male Football Players. The aim of this study was to find out the prevalence of functional ankle
instability in football players. The study included 66 samples. The investigation found as significant
as training methods or outcomes are discussions of elements that might possibly increase the risk of
injury in sports.
5) A study was done on Prevalence and Impact of Chronic Ankle Instability in Adolescent Athletes,
And identified that CAI is a common condition among adolescents that should not be considered an
innocuous injury. The study included 1341 samples. Based on our results, the presence of CAI in
adolescents affects their long-term health, given the deficits reported in ankle function and HRQoL.
6) A study was conducted on the prevalence and characteristics of chronic ankle instability in elite
athletes of different sports. The aim was to find out prevalence and characteristics of chronic ankle
instability in elite athletes. The study included 170 samples According to the study, 170/198 athletes
 had experienced an ankle sprain in the past, and 128 athletes had CAI, which was present in 64.6%
of cases.
WORK PLAN

Materials
 Subject reported ankle elvaluation
 Ankle joint functional assessment tool questionnaire
 Permission letter
 Consent form
 Visual Analogue Scale

Methodology

 Study type: observational study.

 Study design: Cross sectional study.

 Study duration: 6 months

Sample size: The sample size is calculated by using prevalence:

Prevalence of ankle sprain in football players is 80%

The sample size was calculated by using the following formula:

2
( Ζ 1−α / 2 ) p ( 1− p )
n=
( d )2

where Ζ1−α /2 is the critical value of the normal distribution at α (e.g. for a confidence level of 95%), α is 0.05
and the critical value is 1.96, p is the expected prevalence = 97.4 % = 0.80 and d is the margin of error = 10
%

Taking, p = 0.80 , and d = 10% =0.10

( 1.96 )2 × 0.80× ( 1−0.80 )

n= 2
( 0.10 )

n=62

The minimum sample size is 62.

By taking 10% drop out sample size is 70.

 Sample design: simple random sampling

Inclusion Criterias:

• Gender: male and female.

• Age group -18-30 yrs.

• Football players in Kolhapur city.

• Participants willing to participate in study.

• Players practicing football for more than 3 years.

Exclusion Criterias:

• Particpants with ACL reconstruction.

• Participants with recent history of Ankle fracture.

• Visual analogue score more than 7.

• Participants with open wound at ankle joint.

Procedure:

• Ethical clearance will be obtained from the institutional ethical committee.

• The participants will be screened according to inclusion and exclusion criteria.

• Information regarding study will be given to the participants.

• Written consent from the participant will be obtained after explaining the procedure.

• Participants will be given Ankle joint functional assessment tool questionnaire.

• The scale will be explained to all the participants.

• All the instructions about filling the questionnaire will be given to the participants.

• All the doubts regarding filling the questionnaire will be cleared prior.

• Assessment will be done using special test.

• Statistical analysis will be recorded and result will be obtained.

Outcome measures:

1. Visual analogue scale : VAS typically consist of 10 cm line. The extreme left side of the line
equals no pain, the extreme right-side equals to worst pain. When responding to a VAS item,
respondents specify their level of agreement to a statement by indicating a position along a
continuous line between two endpoints.
Validity and reliability
The validity of scale is 0.76 to 0.84.
The reliability of scale is 0.60 to 0.77.

2. Ankle joint functional assessment tool: This questionnaire has been designed to give your
therapist information as to how your ankle problems have affected your functional ability.

3. Special test:
Anterior drawer test: for ligament instability.
Posterior drawer test: for ligament instability.
 CONSENT FORM:

I, Mr/Mrs/Ms …………............................................... Gender ………… Age: …………………

residing at .............................................................................................................
do hereby confirm that:
(i) I have been asked by the student/researcher of D Y Patil Medical College (“the Medical College”) whether I
wish to participate in a study under the aegis of the Medical College;
(ii) The nature of the study being undertaken by the student/ researcher, as well as the extent of my participation
in it, have been duly explained to me in a language that I understand;
(iii) The potential risks and consequences associated with this study have also been duly explained to me in a
language that I understand;
(iv) I also understand that my participation in this study is only for the benefit of advancement in the field of
medical research and that at no point in time is my participation being solicited for any pecuniary gain by the
researcher or the Medical College;
(v) I have also been explained that I am in no way obliged to participate in the study and that, once I have agreed
to participate in the study, I am still free to withdraw from participation in the study at any point in time upon
notifying the Medical College in writing in the prescribed form without assigning any reason;
(vi) There will be no financial transaction between myself, the researcher and/or the Dr. D Y Patil Medical
College for my participation in that study;
(vii) I have been explained that any data collected out of my participation in the study will only be used for
academic purposes and/or for further medical research;
(viii) I have also been reassured that any publication of the data collected during the course of the study or any
publication of its conclusions, shall be done on a ‘no names’ basis and shall under no circumstances reveal my
personal identity. Any personal details
likely to reveal my personal identity shall at all times remain confidential;
(ix)I understand that if any accident or undesirable medical complication arises out of a procedure or treatment
done solely for the purpose of research, I will be offered treatment, free of cost, by the Padmashri Dr D Y Patil
Hospital & Research Center, Kolhapur. Any additional compensation considered necessary by the Institutional
Ethics Committee may also be given to me.
(x) The contents and effect of this consent form have also been duly explained to me in a language that I
understand;

By affixing my signature/thumb print hereto, I am therefore freely and voluntarily signifying my consent, intent
and willingness to participate in the study of the student researcher for the purposes of the postgraduate
dissertation under the egis of the Medical College. I also certify that my right to privacy has not been infringed in
any manner.
[SIGNATURE/THUMB PRINT OF PARTICIPANT]
DATE:

WITNESSED BY:
(1) NAME:

TITLE/CAPACITY:
SIGNATURE:
(2) NAME:

TITLE/CAPACITY:
SIGNATURE:
 रुग्ण समंती पत्र
डॉ. डी वाय. पाटील मेडीकल कॉलेज आणि डॉ. डी. वाय. पाटील हॉस्पिटल व रिसर्च इन्स्टिट्युट,
कोल्हापूर.
मी. री ./सौ./कु./श्रीमती ……………………………………….लिंग ...........
रीरी वय .......

राहणार ..................................................................................................................
या पत्राद्वारे खात्री देतो /देते की,
धकशो
१. मला डी. वाय. पाटील मेडीकल कॉलेजच्या द मेडीकल कॉलेज वैदयकिय डाँक्टर सं धक
धनशो
यांच्याकडून विचारले गेले की, मेडीकल कॉलेजच्या सहकार्याखाली सं धन अभ्यासात माझी भाग
घ्यायची इच्छा आहे का?
धकशो
२. वैद्यकीय डॉक्टर सं धक धनशो
यांच्याकडून केल्या जाणाऱ्या सं धन अभ्यासाचे स्वरूप व त्या मध्ये
माझ्या सहभागाचा कालावधी याविषयी व्यवस्थितपणे मला समजणाऱ्या भाषेत सांगितले आहे.
धनशोअभ्यासा दरम्यान उध्दभवणारे धोके आणि त्यांचे परिणाम मला समजावून व समजणाऱ्या
३. सं धन
भाषेत सांगितले आहेत.
धनशो
४. मला हे सुध्दा माहित आहे की, माझा अभ्यासातील सहभाग हा फक्त वैद्यकीय सं धन क्षेत्राच्या
धनशोकर्त्याकडून
प्रगतीकरिता फायदा होण्यासाठी आहे, ना की मेडीकल कॉलेज किंवा सं धन
च्या
पैयाच्या श्या
फायद्याकरिता.
५. मला याची पण कल्पना दिली आहे की, मी कोणत्याही स्थितींत सहभागासाठी बांधील नाही आणि एकदा
मी अभ्यासात सहभागासाठी सहमती दिली तरी मी माझा अभ्यासातील सहभाग कोणत्याही वेळी विहित
नमुन्यात मेडिकल कॉलेज ला लेखी अर्ज करून कोणतेही कारण नमूद न देता रद्द करू शकतो.
धनकर्तेशो
६. माझ्यामध्ये आणि सं धनकर्ते आणि किंवा डी. वाय. पाटील मेडिकल कॉलेज यांच्यात अभ्यासात
सहभागासाठी कोणताही आर्थिक व्यवहार असणार नाही.
७. मला याची पण कल्पना दिली आहे की, माझ्या अभ्यासातील सहभागातून जी काही माहिती गोळा केली
धनाकरिता
जाईल त्याचा वापर फक्त शैक्षणिक हेतू आणि किंवा पुढील वैद्यकीय सं धनाकरिताचचशो
होईल.
८. मला याचीपण खात्री दिली आहे की, अभ्यासाच्या काळात गोळा केलेल्या माहितीचे सार्वजनिक
प्रसारण किंवा त्यांचा परिणामांचे सार्वजनिक प्रसारण नाव न जाहीर करता केले जाईल. कोणत्याही
परिस्थीतीत माझी स्वतःची ओळख दाखवली जाणार नाही. कोणतीही वैयक्तिक माहिती माझी वैयक्तिक
ओळख दाखवण्याची शक्यता असेल तर नेहमीच गुप्त राखली जाईल.
धनाच्या
९. मला माहित आहे की, सं धनाच्या शोहेतूकरिता केला जाणाऱ्या एखाद्या उपचार किंवा तपासणीमधून
जरा एखादा अपघात किंवा काही अनपेक्षित वैद्यकीय गुंतागुंत निर्माण झाली तर, माझ्यावर डी. वाय.
कता
पाटील हॉस्पिटल, कोल्हापूर कडून विना मोबदला उपचार केला जाईल. तसेच जादा भरपाईची आवयकता श्य
वाटल्यास इन्स्टिट्यूशनल एथिक्स कमिटीकडून मला दिली जाईल.
१०. या संमती पत्रातील मजकूर आणि त्याचा परिणाम मला समजणाऱ्या भाषेत व्यवस्थित समजावून
सांगितलं आहे.

रुग्णाचे नाव व पत्ता साक्षीदार

………………………………………… १. ………………………………………….
……………………………................... २. …………………………………………
 Data collection sheet:

Subject no.
Date- Time-
 Name:
 Age:
 Gender:
 Occupation:
 Address:
 Contact no.:
 Dominant leg:
 Chief complaints:
 Past surgical history:

 No. of hours playing football:

 No. of years playing football:
 Any injury caused while playing:

 Outcome measure:

Sr No. scales Score/ Interpretation

1 Visual Analogue Scale /10
2 Ankle Joint Functional Assessment Tool /48
3 Anterior Drawer Test Positive/Negative
4 Posterior Drawer Test Positive/Negative

Name of participant: Date and signature:

Name of investigator: Date and signature:

Name of Guide: Date and Signature:

References

1.Khalili SM, Barati AH, Oliveira R, Nobari H. Effect of Combined Balance Exercises and Kinesio Taping on Balance, Postural
Stability, and Severity of Ankle Instability in Female Athletes with Functional Ankle Instability. Life. 2022 Jan 26;12(2):178.

2.Cloak R, Nevill A, Day S, Wyon M. Six-week combined vibration and wobble board training on balance and stability in
footballers with functional ankle instability. Clinical journal of sport medicine. 2013 Sep 1;23(5):384-91.

3.Phuaklikhit C, Sripramong P, Salarak P, Wanna S. Comparison of Kinesiology Taping Techniques to Promote Ankle Stability in
Male Football Athletes with Chronic ankle instability. InRSU International Research Conference 2020.

4. Cruz A, Oliveira R, Silva AG. Functional ankle instability prevalence and associated risk factors in male football players. Open
Journal of Orthopedics. 2020 Apr 22;10(04):77.

5. Donovan L, Hetzel S, Laufenberg CR, McGuine TA. Prevalence and impact of chronic ankle instability in adolescent athletes.
Orthopaedic Journal of Sports Medicine. 2020 Feb 17;8(2):2325967119900962.

6. Zhang C, Chen N, Wang J, Zhang Z, Jiang C, Chen Z, Fang J, Peng J, Li W, Song B. The Prevalence and Characteristics of
Chronic Ankle Instability in Elite Athletes of Different Sports: A Cross-Sectional Study. Journal of Clinical Medicine. 2022
Jan;11(24):7478.

7. B D Chaurasia. Vol 2