Abstract
Objective
To determine which conservative interventions are effective for static and dynamic
balance in patients with chronic ankle instability (CAI).
Data Sources
PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to
March 20, 2022.
Study Selection
Randomized controlled trials investigating the effects of conservative interventions
on static and/or dynamic balance in patients with CAI compared with those of different
conservative interventions or controls were included.
Data Extraction
Two independent reviewers extracted the data. Certainty of the evidence was assessed
using the GRADE approach.
Data Synthesis
Forty-eight studies (1906 participants) were included. Whole-body vibration training
(WBVT) was significantly more effective than controls for both static (standardized
mean difference, 1.13; 95% confidence interval [CI], 0.58-1.68; moderate-certainty
evidence) and dynamic balance (0.56; CI, 0.24-0.88; low-certainty evidence). Balance
training (BT) and joint mobilization were significantly more effective than controls
for dynamic balance (0.77; CI, 0.41-1.14; and 0.75; CI, 0.35-1.14, respectively),
but not for static balance (very low to low-certainty evidence). Adding other interventions
to BT had no significant effect on either type of balance compared with that of BT
alone (moderate to low-certainty evidence). Strength training (ST) and taping had
no significant effect on either type of balance (very low- to low-certainty evidence).
Multimodal interventions were significantly effective in improving dynamic balance
(0.76; CI, 0.32-1.20; low-certainty evidence). Adding transcranial direct current
stimulation to ST was significantly more effective for dynamic balance than ST (0.81;
CI, 0.08-1.53; moderate-certainty evidence). The effects on balance were not significantly
different among BT, ST, and WBVT (very low- to low-certainty evidence).
Conclusions
The significantly effective interventions reviewed may be treatment options for balance
impairments associated with CAI. However, interventions should be chosen carefully,
as much of the certainty of evidence is very low to low.
Keywords
List of abbreviations:
BT (balance training), CAI (chronic ankle instability), CI (confidence interval), COP (center of pressure), LAS (lateral ankle sprain), RCT (randomized controlled trial), SMD (standardized mean difference), ST (strength training), TDCS (transcranial direct current stimulation), WBVT (whole-body vibration training)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 20, 2022
Accepted:
October 31,
2022
Received in revised form:
October 28,
2022
Received:
April 1,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Supported by JSPS KAKENHI Grant Number JP19K19823.
Disclosures: The authors declare no conflict of interest.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
