Therapeutic interventions for improving self-reported function in patients with chronic ankle instability: a systematic review.
OBJECTIVE
To identify which therapeutic intervention may be most effective for improving self-reported function in patients with chronic ankle instability (CAI).


METHODS
Systematic literature review. Articles were appraised using the Downs and Black Checklist by 3 reviewers.


METHODS
PubMed along with CINAHL, MEDLINE and SPORTDiscus within EBSCOhost for pertinent articles from their inception through August 2016.


METHODS
Articles included were required to (1) be written in English, (2) report adequate data to calculate effect sizes, (3) identify patients with CAI, (4) use some form of therapeutic intervention and (5) use a self-reported questionnaire as a main outcome measurement.


RESULTS
A broad spectrum of therapeutic interventions were identified related to balance training, multimodal rehabilitation, joint mobilisation, resistive training, soft-tissue mobilisation, passive calf stretching and orthotics. All of the articles included in the balance training category had moderate-to-strong Hedges g with none of the 95% CIs crossing 0. Hedges g effect sizes ranged from -0.67 to -2.31 and -0.51 to -1.43 for activities of daily living and physical activity, respectively. The multimodal rehabilitation category also produced moderate-to-strong Hedges g effect sizes but with large CIs crossing 0. Hedges g effect sizes ranged from -0.47 to -9.29 and -0.62 to -24.29 for activities of daily living and physical activity, respectively.


CONCLUSIONS
The main findings from this systematic review were balance training provided the most consistent improvements in self-reported function for patients with CAI.
Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA.
Kyle B
KB
Kosik
Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA.
Ryan S
RS
McCann
College of Sport and Health Sciences, Ritsumeikan University, Kyoto, Japan.
Masafumi
M
Terada
Department of Rehabilitation Sciences, University of Kentucky, Lexington, Kentucky, USA.
Phillip A
PA
Gribble
D000203:Activities of Daily Living; D000843:Ankle Joint / Q000503:physiopathology*; D005081:Exercise Therapy; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000534:rehabilitation*; D052580:Muscle Stretching Exercises; D026741:Physical Therapy Modalities; D004856:Postural Balance; D055070:Resistance Training; D057566:Self Report; D011795:Surveys and Questionnaires
Ankle; Intervention effectiveness; Rehabilitation