Considering the rapid motor-cognitive changes and increased risk of injury in preadolescent athletes, this study investigated the effects of neurocognitive training (NT) on pain, proprioception, injury-related anxiety, and functional and neurocognitive performance in athletes with chronic ankle instability (CAI). Randomized controlled trial. Sports training facilities in Balikesir, Turkiye. Thirty preadolescent athletes with CAI (mean age 11.10 +/- 1.06 years) were randomly assigned to an NT group (n = 15) or a control group (n = 13). The Identification of Functional Ankle Instability (IdFAI), Cumberland Ankle Instability Tool (CAIT), pain severity, proprioception (dorsiflexion/plantarflexion), injury-related anxiety, Y Balance Test (YBT), Side Hop Test, Reactive Balance Test (RBT), and Upper Extremity Choice Reaction Time Test were evaluated pre- and post-intervention. The NT group demonstrated significant improvements in IdFAI (p < 0.001), CAIT (p = 0.004), dorsiflexion (p = 0.003) and plantarflexion proprioception (p = 0.018), injury-related anxiety (p = 0.013), YBT anterior reach (p = 0.048), RBT reaction time (p = 0.030), and accuracy (p = 0.003). The control group showed improvement only in plantarflexion proprioception (p = 0.028), with an increase in post-training pain (p = 0.030). NT reduced ankle instability symptoms and injury-related anxiety while improving proprioception and neurocognitive performance. NT may enhance functional adaptation by addressing sport-specific cognitive-motor demands.

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