Effect of balance training on ankle function and dynamic balance ability in patients with chronic ankle instability：A systematic review and meta- analysis

Abstract Conclusion: Balance training benefits ankle function with CAI patients and improve the dynamic balance ability. It is recommended to obtain the best rehabilitation effect by intervening 3 times a week, each intervention time of 20min to 30min, and consecutively intervening for 4 weeks or 6 weeks. Objective: To investigate and contrast the effects of balance training on ankle function and dynamic balance ability in patients with chronic ankle instability (CAI). Methods: The PubMed, Embase, Web of Science, Medline, Cochrane were searched up to December 2023. Quality assessment was performed using the Cochrane Collaboration’s risk-of-bias guidelines, and the standardized mean differences (SMD) or mean differences (MD) for each outcome were calculated. Results: Among 20 eligible studies, including 682 participants were analyzed in this meta-analysis. The results of the meta-analysis showed that balance training was effective in improving ankle function with self-functional scores (SMD =1.02 ; 95% CI,0.61 to 1.43;P I2 = 72%) and variables associated with the ability of dynamic balance such as SEBT-A (MD=5.88; 95% CI, 3.37 to 8.40; PI2 = 84%), SEBT-PM (MD=5.47; 95% CI, 3.40 to 7.54; PI2 = 61%), and SEBT-PL (MD=6.04; 95% CI, 3.30 to 8.79; PI2 = 79%) of CAI patients. Meta-regression showed that the intervention time may be the main reason for heterogeneity (P=0.046) in self-functional scores. In subgroup analyses of self-functional score across intervention types, among the intervention time, more than 20 minutes and less than 30 minutes had the best effect(MD=1.21, 95% CI: 0.96 to 1.46, P2=55%);among the intervention period, 4 weeks (MD=0.84, 95% CI:0.50 to 1.19, P2=78%)and 6 weeks (MD=1.21, 95% CI: 0.91 to1.51, P2=71%) had significant effects; among the intervention frequency, 3 times (MD=1.14, 95% CI:0.89 to 1.38), P2=57%)had significant effects. Secondly, in subgroup analyses of SEBT across intervention types, a 4-week and 6-week intervention with balance training 3 times a week for 20-30 min is the best combination of interventions to improve SEBT (dynamic balance) in patients with chronic ankle instability. Conclusion: Balance training benefits ankle function with CAI patients and improve the dynamic balance ability. It is recommended to obtain the best rehabilitation effect by intervening 3 times a week, each intervention time of 20min to 30min, and consecutively intervening for 4 weeks or 6 weeks. Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/,identifier CRD4202450 2230.