Arnold Brent L, De La Motte Sarah, Linens Shelley, Ross Scott E
Department of Health and Human Performance, Virginia Commonwealth University, Richmond, VA 23284-2020, USA.
Med Sci Sports Exerc. 2009 May;41(5):1048-62. doi: 10.1249/MSS.0b013e318192d044.
Our primary purpose was to determine whether balance impairments were associated with functional ankle instability (FAI).
Our literature search consisted of four parts: 1) an electronic search of PubMed, CINAHL, pre-CINAHL, and SPORTDiscus; 2) a forward search of articles selected from the electronic search using the Science Citation Index; 3) a hand search of the previously selected articles; and 4) a direct contact with corresponding authors of the previously selected articles. We initially identified 145 articles and narrowed these to 23 for inclusion in the meta-analysis. Identified outcomes were categorized by measurement units and balance task type (i.e., dynamic or static). Each study was coded based on whether inclusion or exclusion criteria were identified. Our statistical analysis included fixed, random, or mixed effect analyses based on the presence of within study heterogeneity and whether categories were being compared.
FAI was associated with poorer balance (standard difference of the mean [SDM] = 0.455, 95% confidence interval = 0.334-0.577, Z = 7.34, P < 0.001), but no difference existed between dynamic and static measure categories (Q = 3.44, P = 0.063). However, there was a significant difference between the dynamic measures (Q = 6.22, P = 0.013) with both time to stabilization and the Star Excursion Balance Test producing significant SDM and between static measures (Q = 13.00, P = 0.012) with the linear, time, velocity, and other measurement categories (but not area) producing significant SDM. Examination of individual outcomes revealed that time in balance and foot lifts produced very large SDM (3.3 and 4.8, respectively).
FAI is associated with impaired balance. Due to the relatively large effect sizes and simplicity of use of time in balance and foot lifts, we recommend that further research should establish their clinical validity and clinical cutoff scores.
我们的主要目的是确定平衡功能受损是否与功能性踝关节不稳（FAI）相关。
我们的文献检索包括四个部分：1）对PubMed、CINAHL、CINAHL前期数据库和SPORTDiscus进行电子检索；2）使用科学引文索引对从电子检索中选出的文章进行向前追溯检索；3）对先前选出的文章进行手工检索；4）与先前选出文章的通讯作者直接联系。我们最初识别出145篇文章，将其缩减至23篇纳入荟萃分析。识别出的结果根据测量单位和平衡任务类型（即动态或静态）进行分类。每项研究根据是否确定了纳入或排除标准进行编码。我们基于研究内部异质性的存在以及是否在比较类别进行固定效应、随机效应或混合效应分析。
FAI与较差的平衡功能相关（平均标准差[SDM]=0.455，95%置信区间=0.334 - 0.577，Z = 7.34，P < 0.001），但动态和静态测量类别之间无差异（Q = 3.44，P = 0.063）。然而，动态测量之间存在显著差异（Q = 6.22，P = 0.013），稳定时间和星形偏移平衡测试均产生显著的SDM，静态测量之间也存在显著差异（Q = 13.00，P = 0.012），线性、时间、速度和其他测量类别（但不包括面积）产生显著的SDM。对个体结果的检查显示，平衡时间和足部抬起产生了非常大的SDM（分别为3.3和4.8）。
FAI与平衡功能受损相关。由于平衡时间和足部抬起的效应量相对较大且使用简单，我们建议进一步研究应确定它们的临床有效性和临床临界值。
