Purpose: This study aimed to compare the effects of different exercise therapies on dynamic postural control and self-reported function in individuals with chronic ankle instability (CAI) and provide an evidence-based medical basis for selecting the optimal exercise therapy. Methods: A systematic search for randomized controlled trials (RCTs) involving exercise interventions in CAI individuals was conducted across five electronic databases, encompassing data from their inception up to December 2024. This review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in PROSPERO (registration number: CRD42024620821). Results: A total of 48 RCTs including 1,630 individuals with CAI were included. Seven exercise therapies were involved: balance training, strength training, comprehensive training, plyometric training, whole-body vibration training, blood flow restriction training, and visual occlusion balance training. All exercise therapies significantly improved dynamic posture control. Visual occlusion balance training was superior to plyometric training (SMD = 0.72, 95% CI: 0.01-1.43). Six exercise therapies significantly improved self-reported function, except for whole-body vibration training, for which evidence was lacking. Blood flow restriction training (SMD = 1.49, 95% CI: 0.59-2.40) and visual occlusion balance training (SMD = 0.90, 95% CI: 0.06-1.75) were superior to strength training. Conclusions: Visual occlusion balance training may be the most effective exercise therapy for improving dynamic postural control in CAI individuals. Blood flow restriction training and visual occlusion training may be the most effective exercise therapies in improving self-reported function. However, interventions should be chosen with caution because the certainty of evidence is very low.
Chen et al. (2026) studied this question.