Factors contributing to chronic ankle instability: a protocol for a systematic review of systematic reviews.
BACKGROUND
Ankle sprains are a significant clinical problem. Researchers have identified a multitude of factors contributing to the presence of recurrent ankle sprains including deficits in balance, postural control, kinematics, muscle activity, strength, range of motion, ligament laxity and bone/joint characteristics. Unfortunately, the literature examining the presence of these factors in chronic ankle instability (CAI) is conflicting. As a result, researchers have attempted to integrate this evidence using systematic reviews to reach conclusions; however, readers are now faced with an increasing number of systematic review findings that are also conflicting. The overall aim of this review is to critically appraise the methodological quality of previous systematic reviews and pool this evidence to identify contributing factors to CAI.


METHODS
A systematic review will be conducted on systematic reviews that investigate the presence of various deficits identified in CAI. Databases will be searched using pre-determined search terms. Reviews will then be assessed for inclusion based on the set eligibility criteria. Two independent reviewers will assess the articles for inclusion before evaluating the methodological quality and presence of bias of the included studies; any disagreements will be resolved by discussion between reviewers to reach consensus or by a third reviewer. Data concerning the specific research question, search strategy, inclusion/exclusion criteria, population, method and outcomes will be extracted. Findings will be analysed with respect to the methodological quality of the included reviews.


CONCLUSIONS
It is expected that this review will clarify the cause of contradicting findings in the literature and facilitate future research directions.


BACKGROUND
PROSPERO CRD42016032592 .
School of Science and Health, Western Sydney University, Campbelltown, Australia. c.thompson2@westernsydney.edu.au.
Cassandra
C
Thompson
School of Science and Health, Western Sydney University, Campbelltown, Australia.
Siobhan
S
Schabrun
School of Science and Health, Western Sydney University, Campbelltown, Australia.
Rick
R
Romero
School of Allied Health Sciences, Griffith University, Nathan, Australia.
Andrea
A
Bialocerkowski
School of Science and Health, Western Sydney University, Campbelltown, Australia.
Paul
P
Marshall
D016512:Ankle Injuries / Q000453:epidemiology*; D000843:Ankle Joint; D002908:Chronic Disease; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology*; D012196:Review Literature as Topic; D012307:Risk Factors; D013180:Sprains and Strains / Q000453:epidemiology*; D000078202:Systematic Reviews as Topic
Chronic ankle instability; Protocol; Systematic review of systematic reviews