: To determine which conservative interventions are effective for static and dynamic
balance in patients with chronic ankle instability (CAI).
PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to
March 20, 2022.
Randomized controlled trials investigating the effects of conservative interventions
on static and/or dynamic balance in patients with CAI compared to those of different
conservative interventions or controls were included.
Two independent reviewers extracted the data. Certainty of the evidence was assessed
using the GRADE approach.
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 to 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).
: 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.