Jiang Cai, Huang Dun-Bing, Li Xiao-Mei, Guo Jin-Hua, Guo Miao-Miao, Yu Sheng-Xian, Huang Sai'e, Lin Zhong-Hua
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
Fujian Provincial Hospital, Fuzhou, Fujian, China.
J Sports Med Phys Fitness. 2022 Dec;62(12):1707-1715. doi: 10.23736/S0022-4707.22.13566-8. Epub 2022 Mar 25.
Chronic ankle instability (CAI), which is characterized by deficient postural control, is associated with functional limitations and diminished self-reported quality of life. Recent studies have suggested that balance training can improve postural control, but high-quality evidence-based research to confirm the effect of balance training on dynamic postural stability in CAI patients is lacking. The purpose of this study was to synthesize current evidence regarding the effect of balance training on dynamic postural stability in CAI patients.
PubMed, Embase, Web of Science and Cochrane Library databases were searched for clinical trials that evaluated the effect of balance training on posture and balance in CAI patients from their inception to 15 July 2021. All statistical analyses were performed in RevMan 5.4. The risk of bias was assessed by the Cochrane Collaboration's risk of bias tool, and studies that reported statistically comparable outcomes were analyzed in meta-analyses using random effects models. Heterogeneity was assessed using the I2 statistic index.
A total of 12 RCTs included in this meta-analysis and revealed that balance training was effective for improving the dynamic posture stability of CAI patients (SMD=0:90; 95% CI: 0.54 to 1.26; P<0:00001, I=71%; Star Excursion Balance Test). Subgroup analysis (balance training vs. other training) revealed a small negative effect size, but this was not statistically significant (SMD=-0.12, 95% CI=-0.53 to 0.29, P=0.56, I=9%). Another subgroup analysis (balance training vs. no training) revealed that balance training was more likely to have greater improvement on the dynamic posture stability of CAI patients (SMD=0.94, 95% CI: 0.71 to 1.17; P<0.00001, I=0%).
Balance training yielded a statistically significant and clinically meaningful improvement in dynamic postural stability in CAI patients. Limited evidence indicates that balance training was more effective than other training methods.
慢性踝关节不稳（CAI）以姿势控制不足为特征，与功能受限及自我报告的生活质量下降相关。近期研究表明平衡训练可改善姿势控制，但缺乏高质量的循证研究来证实平衡训练对CAI患者动态姿势稳定性的影响。本研究的目的是综合当前关于平衡训练对CAI患者动态姿势稳定性影响的证据。
检索了PubMed、Embase、Web of Science和Cochrane图书馆数据库，以查找从数据库建立至2021年7月15日评估平衡训练对CAI患者姿势和平衡影响的临床试验。所有统计分析均在RevMan 5.4中进行。采用Cochrane协作网的偏倚风险工具评估偏倚风险，对报告具有统计学可比性结果的研究采用随机效应模型进行荟萃分析。使用I2统计指标评估异质性。
本荟萃分析共纳入12项随机对照试验，结果显示平衡训练对改善CAI患者的动态姿势稳定性有效（标准化均数差=0.90；95%置信区间：0.54至1.26；P<0.00001，I2=71%；星形偏移平衡测试）。亚组分析（平衡训练与其他训练）显示效应量为小的负值，但无统计学意义（标准化均数差=-0.12，95%置信区间=-0.53至0.29，P=0.56，I2=9%）。另一亚组分析（平衡训练与无训练）显示，平衡训练更有可能使CAI患者的动态姿势稳定性得到更大改善（标准化均数差=0.94，95%置信区间：0.71至1.17；P<0.00001，I2=0%）。
平衡训练在CAI患者的动态姿势稳定性方面产生了具有统计学意义和临床意义的改善。有限的证据表明平衡训练比其他训练方法更有效。
