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

Chronic ankle instability (CAI) is prevalent among athletes and is associated with impaired sensorimotor function, reduced dynamic stability, and limited functional movement, increasing the risk of reinjury. Aquatic exercise offers a low-impact alternative to land-based rehabilitation by reducing joint loading and promoting neuromuscular adaptations. This study evaluated the effectiveness of an 8-week aquatic exercise program on functional outcomes in athletes with CAI. Randomized controlled trial with preintervention and postintervention assessments. Forty male athletes (aged 18-30) with clinically diagnosed CAI were randomly assigned to an intervention group (n = 20) which completed an 8-week aquatic exercise program or a control group (n = 20) which continued regular activity without structured rehabilitation. The intervention included 3 weekly aquatic sessions targeting balance, proprioception, and strength. Primary outcomes were functional movement (Functional Movement Screen), dynamic balance (Y-Balance Test), and self-reported ankle function (Cumberland Ankle Instability Tool, Identification of Functional Ankle Instability, Foot and Ankle Ability Measure, Foot and Ankle Ability Measure-Sport). Secondary outcomes included static balance, dorsiflexion range of motion, proprioception, and jumping performance. Repeated-measures analysis of variance and nonparametric tests were used, with P < .05 as significance. The intervention group showed significant improvements in Functional Movement Screen scores, dynamic balance (P < .001), dorsiflexion range of motion (+19.6%, P < .001), and self-reported ankle function (up to +46.9%, P < .001). Jumping performance significantly improved, with reduced completion times in the side-hop (-18.1%) and 8-line hop (-12.9%) tests, and increased distance in the triple-hop test (+8.5%; all P < .01). Static balance improved in eyes-open condition (P < .001). No significant change occurred in proprioception (P = .506). The control group showed no significant improvements. An 8-week aquatic exercise program significantly improves functional movement, balance, flexibility, jumping ability, and self-reported ankle function in athletes with CAI. These findings support aquatic therapy as a clinically effective, low-impact rehabilitation option for restoring sensorimotor performance and sport readiness.