Evaluation of joint position recognition measurement variables associated with chronic ankle instability: a meta-analysis.
OBJECTIVE
To identify the most precise and consistent variables using joint repositioning for identifying joint position recognition (JPR) deficits in individuals with chronic ankle instability (CAI).


METHODS
We conducted a computerized search of the relevant scientific literature from January 1, 1965, to July 31, 2010, using PubMed Central, CINAHL, MEDLINE, SPORTDiscus, and Web of Science. We also conducted hand searches of all retrieved studies to identify relevant citations. Included studies were written in English, involved human participants, and were published in peer-reviewed journals.


METHODS
Studies were included in the analysis if the authors (1) had examined JPR deficits in patients with CAI using active or passive repositioning techniques, (2) had made comparisons with a group or contralateral limb without CAI, and (3) had provided means and standard deviations for the calculation of effect sizes.


METHODS
Studies were selected and coded independently and assessed for quality by the investigators. We evaluated 6 JPR variables: (1) study comparisons, (2) starting foot position, (3) repositioning method, (4) testing range of motion, (5) testing velocity, and (6) data-reduction method. The independent variable was group (CAI, control group or side without CAI). The dependent variable was errors committed during joint repositioning. Means and standard deviations for errors committed were extracted from each included study.


RESULTS
Effect sizes and 95% confidence intervals were calculated to make comparisons across studies. Separate meta-analyses were calculated to determine the most precise and consistent method within each variable. Between-groups comparisons that involved active repositioning starting from a neutral position and moving into plantar flexion or inversion at a rate of less than 5°/s as measured by the mean absolute error committed appeared to be the most sensitive and precise variables for detecting JPR deficits in people with CAI.
Department of Rehabilitation Sciences, University of Kentucky, CT Wethington Building, 900 S Limestone, Lexington, KY 40536, USA. jennifer.medina@uky.edu
Jennifer Medina M
JM
McKeon
Patrick O
PO
McKeon
D016512:Ankle Injuries / Q000628:therapy; D000843:Ankle Joint / Q000502:physiology*; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000628:therapy*; D026741:Physical Therapy Modalities; D004856:Postural Balance; D011434:Proprioception; D016059:Range of Motion, Articular; D013180:Sprains and Strains / Q000175:diagnosis / Q000628:therapy