Biodynamics Research Laboratory, Kinesiology Department, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
Med Sci Sports Exerc. 2009 Jun;41(6):1287-95. doi: 10.1249/MSS.0b013e318196cbc6.
Despite the high incidence of lateral ankle sprains, the issue about whether postural control is impaired after acute or chronic injury is still unresolved. In addition, the literature is unclear if balance training, a commonly prescribed intervention, improves postural control after a history of lateral ankle trauma.
To conduct a meta-analysis on studies reporting the effects of lateral ankle trauma on postural control and how balance training affects postural control after acute and chronic lateral ankle trauma cumulatively and separately as moderating variables.
Thirty-seven postural control studies qualified for inclusion in the meta-analysis. Twenty-five studies investigated postural control independent of an intervention, and 15 studies administered balance-training interventions. Separate analyses on the two types of studies calculated Hedges' g individual effect sizes (ES). Further, we explored moderating variables for both the postural stability and the intervention studies.
A significant cumulative effect size (ES) indicated that postural stability is impaired after a history of ankle injury (ES = 0.492, P < 0.0001). Moderator analysis revealed that both acute and chronic lateral ankle trauma negatively affected balance: a) acute: ES = 0.419, P < 0.0001, and b chronic, ES = 0.570, P < 0.0001. A third meta-analysis showed that balance training improves postural control (ES = -0.857, P < 0.0001). In addition, moderator variables indicated large ES for both types of ankle trauma.
Postural control impairments are present in patients with a history of lateral ankle trauma. However, clinicians should exercise caution when using the uninjured contralateral limb as a reference of normal postural control. In addition, balance training improves postural control scores after both acute and lateral ankle trauma. However, further research should determine the optimal dosage, intensity, type of training, and a risk reduction/preventative effect associated with balance training after both acute and chronic ankle trauma.
对报告急性和慢性踝关节外侧扭伤后姿势控制情况的研究进行荟萃分析，并评估平衡训练对急性和慢性踝关节外侧创伤后姿势控制的影响，同时将其作为调节变量。
37 项符合纳入标准的姿势控制研究被纳入荟萃分析。其中 25 项研究在未进行干预的情况下调查了姿势控制，15 项研究则进行了平衡训练干预。分别对这两种类型的研究进行分析，计算出每个研究的 Hedge's g 个体效应大小（ES）。此外，我们还对两种类型的研究都进行了调节变量的探索。
累积效应量（ES）显著，表明踝关节损伤后姿势稳定性受损（ES = 0.492，P < 0.0001）。调节分析表明，急性和慢性踝关节外侧扭伤均对平衡产生负面影响：a）急性：ES = 0.419，P < 0.0001，b）慢性：ES = 0.570，P < 0.0001。进一步的荟萃分析表明，平衡训练可改善姿势控制（ES = -0.857，P < 0.0001）。此外，调节变量表明，两种类型的踝关节扭伤都具有较大的 ES。
有踝关节外侧扭伤病史的患者存在姿势控制障碍。然而，临床医生在使用未受伤的对侧肢体作为正常姿势控制的参考时应谨慎。此外，平衡训练可改善急性和慢性踝关节外侧扭伤后的姿势控制评分。但是，需要进一步研究来确定平衡训练的最佳剂量、强度、训练类型以及与急性和慢性踝关节扭伤相关的风险降低/预防效果。
