Aquatic vs. hopping exercises: A novel comparison of their impacts on motor and sensorimotor rehabilitation in chronic ankle instability

Background Chronic ankle instability (CAI) is a common condition characterized by recurrent instability, reduced proprioception, and impaired balance, increasing the risk of further injuries. While various rehabilitation strategies exist, evidence comparing the efficacy of aquatic and hopping exercises in improving motor and sensorimotor functions in individuals with CAI remains limited. This study aimed to address this gap. Methods In this quasi-experimental study, 53 women with unilateral CAI were allocated to control (n = 18), aquatic exercise (n = 17), or hopping exercise (n = 18) groups. Interventions lasted six weeks (three sessions/week, 45 min/session). Motor function (Fusionetics Scoring System: overhead and single-leg squats), dynamic balance (Y-Balance Test), static balance (Balance Error Scoring System), and proprioception (goniometric evaluation) were assessed pre- and post-intervention. Mixed-design ANOVA and Bonferroni post-hoc tests analyzed within- and between-group differences. Results Both interventions significantly improved all outcomes compared to the control group (P < 0.05). Proprioceptive errors in dorsiflexion and plantarflexion decreased by 19.69 % and 25.54 % (aquatic) and 24.62 % and 26.67 % (hopping). Dynamic balance improved by 4.39 % (aquatic) and 7.44 % (hopping). Hopping exercises showed superior benefits in single-leg squat performance (P < 0.05). Conclusions Both exercise modalities effectively enhance motor and sensorimotor functions in individuals with CAI. Hopping exercises demonstrated greater improvements in dynamic balance and motor control, making them particularly beneficial for athletes or advanced rehabilitation stages. Future studies should explore long-term outcomes and diverse populations.