Volume 12, Issue 1 (6-2026)                   J Sport Biomech 2026, 12(1): 70-88 | Back to browse issues page


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Ahanjan S, Dashti Rostami K, Jalalvand A. Investigation of Chronic Ankle Instability in Athletes Using Artificial Neural Networks. J Sport Biomech 2026; 12 (1) :70-88
URL: http://biomechanics.iauh.ac.ir/article-1-444-en.html
1- Department of Sport Sciences and Health, Amirkabir University of Technology, Tehran, Iran.
2- Department of Motor Behavior and Biomechanics, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran.
3- Department of Sport Biomechanics, Ha.C., Islamic Azad University, Hamedan, Iran.
Abstract:   (14 Views)
Objective An artificial neural network (ANN) is an information-processing concept inspired by the biological nervous system, capable of handling data in a manner similar to the human brain. The key feature of this approach is its architecture, which consists of numerous interconnected processing elements that operate collectively to solve complex problems. Chronic ankle instability (CAI) is one of the most common and troublesome sequelae of acute ankle sprains. It is typically attributed to mechanical and functional instability, yet these categories do not fully capture the range of pathological conditions contributing to CAI. Therefore, the present study aimed to estimate and classify chronic ankle instability in athletes using artificial neural networks.
Methods Forty athletes participated in this study and were divided into two groups: 20 athletes with chronic ankle instability and 20 without a history of ankle injury. The analyzed variables included height, weight, forefoot width, foot pronation, active and passive dorsiflexion, plantarflexion, inversion, and eversion ranges of motion (ROM), static postural control, and performance in the Illinois agility test. Independent t-tests and discriminant analyses were used for statistical comparisons. Subsequently, ANN modeling was applied to identify the most influential predictors of CAI.
Results Data modeling with the optimal neural network achieved an R value of 0.9997, with a minimal error between the experimental and predicted data, indicating very high predictive accuracy. The ANN results identified forefoot width and passive inversion ROM as the most critical factors influencing ankle instability.
Conclusion The artificial neural network demonstrated exceptional accuracy in predicting ankle instability. The findings suggest that increased forefoot width and excessive inversion range of motion are major contributors to chronic ankle instability. Preventive strategies such as the use of ankle braces or taping are recommended for athletes exhibiting these characteristics.
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Type of Study: Research | Subject: Special
Received: 2025/09/27 | Accepted: 2025/10/30 | Published: 2025/11/1

References
1. Hassabis D, Kumaran D, Summerfield C, Botvinick M. Neuroscience-inspired artificial intelligence. Neuron. 2017;95(2):245-58. [DOI:10.1016/j.neuron.2017.06.011] [PMID]
2. LeCun Y, Bengio Y, Hinton G. Deep learning. Nature. 2015;521(7553):436-44. [DOI:10.1038/nature14539] [PMID]
3. Haataamee F, Shojaodin SS. The Effect of Balance and Combined Exercises on Pain and Functional Characteristics of Female Athletes With Chronic Ankle Instability. Journal of Sport Biomechanics. 2019;4(4):28-41. [DOI:10.32598/biomechanics.4.4.28]
4. Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: a prospective cohort analysis. The American Journal of Sports Medicine. 2016;44(4):995-1003. [DOI:10.1177/0363546516628870] [PMID]
5. Hertel J, Corbett RO. An updated model of chronic ankle instability. Journal of Athletic Training. 2019;54(6):572-88. [DOI:10.4085/1062-6050-344-18] [PMID]
6. Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Journal of Orthopaedic & Sports Physical Therapy. 2013;43(8):585-91. [DOI:10.2519/jospt.2013.0303] [PMID]
7. Claudino JG, Capanema DdO, de Souza TV, Serrão JC, Machado Pereira AC, Nassis GP. Current approaches to the use of artificial intelligence for injury risk assessment and performance prediction in team sports: a systematic review. Sports Medicine-Open. 2019;5(1):28. [DOI:10.1186/s40798-019-0202-3] [PMID]
8. Kaminski TW, Needle AR, Delahunt E. Prevention of lateral ankle sprains. Journal of Athletic Training. 2019;54(6):650-61. [DOI:10.4085/1062-6050-487-17] [PMID]
9. Fong DT, Chan Y-Y, Mok K-M, Yung PS, Chan K-M. Understanding acute ankle ligamentous sprain injury in sports. BMC Sports Science, Medicine and Rehabilitation. 2009;1(1):14. [DOI:10.1186/1758-2555-1-14] [PMID]
10. Rossi A, Pappalardo L, Cintia P, Iaia FM, Fernández J, Medina D. Effective injury forecasting in soccer with GPS training data and machine learning. PloS One. 2018;13(7):e0201264. [DOI:10.1371/journal.pone.0201264] [PMID]
11. Ulijaszek SJ, Kerr DA. Anthropometric measurement error and the assessment of nutritional status. British Journal of Nutrition. 1999;82(3):165-77. [DOI:10.1017/S0007114599001348] [PMID]
12. Bosy-Westphal A, Schautz B, Later W, Kehayias J, Gallagher D, Müller M. What makes a BIA equation unique? Validity of eight-electrode multifrequency BIA to estimate body composition in a healthy adult population. European Journal of Clinical Nutrition. 2013;67(1):S14-S21. [DOI:10.1038/ejcn.2012.160] [PMID]
13. Wang Y, Mei Q, Jiang H, Hollander K, Van den Berghe P, Fernandez J, et al. The Biomechanical Influence of Step Width on Typical Locomotor Activities: A Systematic Review. Sports Medicine-Open. 2024;10(1):83. [DOI:10.1186/s40798-024-00750-4] [PMID]
14. Menz HB. Alternative techniques for the clinical assessment of foot pronation. Journal of the American Podiatric Medical Association. 1998;88(3):119-29. [DOI:10.7547/87507315-88-3-119] [PMID]
15. Konor MM, Morton S, Eckerson JM, Grindstaff TL. Reliability of three measures of ankle dorsiflexion range of motion. International Journal of Sports Physical Therapy. 2012;7(3):279.
16. Rome K, Brown C. Randomized clinical trial into the impact of rigid foot orthoses on balance parameters in excessively pronated feet. Clinical Rehabilitation. 2004;18(6):624-30. [DOI:10.1191/0269215504cr767oa] [PMID]
17. Youdas JW, Bogard CL, Suman VJ. Reliability of goniometric measurements and visual estimates of ankle joint active range of motion obtained in a clinical setting. Archives of Physical Medicine and Rehabilitation. 1993;74(10):1113-8. [DOI:10.1016/0003-9993(93)90071-H] [PMID]
18. Bell DR, Guskiewicz KM, Clark MA, Padua DA. Systematic review of the balance error scoring system. Sports Health. 2011;3(3):287-95. [DOI:10.1177/1941738111403122] [PMID]
19. Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. Journal of Geriatric Physical Therapy. 2007;30(1):8-15. [DOI:10.1519/00139143-200704000-00003] [PMID]
20. Raya MA, Gailey RS, Gaunaurd IA, Jayne DM, Campbell SM, Gagne E, et al. Comparison of three agility tests with male servicemembers: Edgren Side Step Test, T-Test, and Illinois Agility Test. Journal of Rehabilitation Research & Development. 2013;50(7): 951-960. [DOI:10.1682/JRRD.2012.05.0096] [PMID]
21. Waterman BR, Belmont PJ, Cameron KL, DeBerardino TM, Owens BD. Epidemiology of ankle sprain at the United States Military Academy. The American Journal of Sports Medicine. 2010;38(4):797-803. [DOI:10.1177/0363546509350757] [PMID]
22. Silva AJ, Costa AM, Oliveira PM, Reis VM, Saavedra J, Perl J, et al. The use of neural network technology to model swimming performance. Journal of Sports Science & Medicine. 2007;6(1):117.
23. Milgrom C, Shlamkovitch N, Finestone A, Eldad A, Laor A, Danon YL, et al. Risk factors for lateral ankle sprain: a prospective study among military recruits. Foot & ankle. 1991;12(1):26-30. [DOI:10.1177/107110079101200105] [PMID]
24. Guan Y. Why Do Humans Twist Their Ankle: A Nonlinear Dynamical Stability Model for Lower Limb. arXiv preprint arXiv:230503140. 2023.
25. Maeda N, Ikuta Y, Tsutsumi S, Arima S, Ishihara H, Ushio K, et al. Relationship of chronic ankle instability with foot alignment and dynamic postural stability in adolescent competitive athletes. Orthopaedic Journal of Sports Medicine. 2023;11(10):23259671231202220. [DOI:10.1177/23259671231202220] [PMID]
26. Martin RL, Davenport TE, Paulseth S, Wukich DK, Godges JJ, Altman RD, et al. Ankle stability and movement coordination impairments: ankle ligament sprains: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy. 2013;43(9):A1-A40. [DOI:10.2519/jospt.2013.0305] [PMID]
27. Vomacka MM, Calhoun MR, Lininger MR, Ko J. Dorsiflexion range of motion in copers and those with chronic ankle instability. International Journal of Exercise Science. 2019;12(1):614. [DOI:10.70252/QLDK8340] [PMID]
28. Hubbard TJ, Kramer LC, Denegar CR, Hertel J. Contributing factors to chronic ankle instability. Foot & Ankle International. 2007;28(3):343-54. [DOI:10.3113/FAI.2007.0343] [PMID]
29. Sarvestan J, Svoboda Z. Acute effect of ankle kinesio and athletic taping on ankle range of motion during various agility tests in athletes with chronic ankle sprain. Journal of Sport Rehabilitation. 2019;29(5):527-32. [DOI:10.1123/jsr.2018-0398] [PMID]

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