The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: a systematic review and meta-analysis.
OBJECTIVE
To systematically summarise the evidence on the effectiveness of proprioceptive training in reducing the incidence and recurrence rates of ankle sprains in the sporting population.


METHODS
A systematic review and meta-analysis of randomised controlled trials.


METHODS
A computer-based literature search of MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro (to October 2013) was conducted. Methodological quality of individual studies was assessed using the PEDro scale. Meta-analysis was performed on eligible studies to produce a pooled estimate of the effectiveness of the intervention.


RESULTS
Seven moderate-to-high quality randomised controlled trials involving 3726 participants were included. Results of the meta-analysis combining all participants, irrespective of ankle injury history status, revealed a significant reduction of ankle sprain incidence when proprioceptive training was performed compared to a range of control interventions (relative risk=0.65, 95% CI 0.55-0.77). Results favouring the intervention remained significant for participants with a history of ankle sprain (relative risk=0.64, 95% CI 0.51-0.81). Results looking exclusively at primary prevention in those without a history were also statistically significant (relative risk=0.57, 95% CI 0.34 to 0.97), although the pooled effect was obtained from two non-significant trials.


CONCLUSIONS
Proprioceptive training programmes are effective at reducing the rate of ankle sprains in sporting participants, particularly those with a history of ankle sprain. Current evidence remains inconclusive on the benefits for primary prevention of ankle sprains.
Department of Physiotherapy, La Trobe University, Australia.
Gabriella Sophie
GS
Schiftan
Department of Physiotherapy, La Trobe University, Australia.
Lauren Ashleigh
LA
Ross
Department of Physiotherapy, La Trobe University, Australia. Electronic address: a.hahne@latobe.edu.au.
Andrew John
AJ
Hahne
D016512:Ankle Injuries / Q000517:prevention & control*; D001265:Athletic Injuries / Q000517:prevention & control*; D056228:Feedback, Sensory; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013180:Sprains and Strains / Q000517:prevention & control*
Ankle injuries; Athletic injuries; Prevention and control; Proprioception