College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China; Department of Physiotherapy and Sports Rehabilitation, Shanghai University of Sport, Shanghai, China; Research Institute for Sport and Exercise, University of Canberra, Bruce, Australia; Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia.
Department of Physiotherapy and Sports Rehabilitation, Shanghai University of Sport, Shanghai, China.
Arch Phys Med Rehabil. 2022 Nov;103(11):2232-2244. doi: 10.1016/j.apmr.2022.04.007. Epub 2022 May 10.
To assess exercise therapies that aim to enhance proprioception in individuals with chronic ankle instability (CAI).
Five databases (PubMed, Embase, Cochrane Library, Web of Science, and EBSCO) were searched in October 2021.
Randomized controlled trials involving exercise therapy conducted on individuals with CAI were included.
Data were extracted by 2 independent reviewers using a standardized form. Methodological quality and risk of bias were assessed with the Physiotherapy Evidence Database scale.
The end trial weighted mean difference and standard deviations were analyzed, and the synthetic value for the improvement in error scores of ankle joint position sense in multiple directions was evaluated.
Eleven trials with 333 participants were eligible for inclusion in this systematic review and were included in the network meta-analysis. Foot and ankle muscle strengthening exercise showed the highest probability of being among the best treatments (surface under the cumulative ranking [SUCRA]=74.6%). The next 2 were static balance exercise only (SUCRA=67.9%) and corrective exercise (SUCRA=56.1%). The SUCRA values of proprioceptive exercise, dynamic balance exercise only, aquatic exercise, rehabilitation exercise with brace, mixed static/dynamic balance exercise, and control were at relatively low levels and scored at 49.6%, 48.8%, 47.8%, 47.7%, 44.0%, and 13.5%, respectively.
Foot and ankle muscle strengthening exercise may have a good effect when used to improve joint position sense in individuals with CAI. The more complex balance exercise intervention becomes, the less effective the proprioceptive outcome.
评估旨在增强慢性踝关节不稳（CAI）患者本体感觉的运动疗法。
2021 年 10 月，检索了 5 个数据库（PubMed、Embase、Cochrane 图书馆、Web of Science 和 EBSCO）。
纳入了涉及 CAI 患者运动疗法的随机对照试验。
两名独立审查员使用标准化表格提取数据。使用物理治疗证据数据库量表评估方法学质量和偏倚风险。
分析了最终试验加权均数差值和标准差，并评估了多方向踝关节位置感误差评分改善的综合值。
11 项试验共 333 名参与者符合纳入本系统评价和网络荟萃分析的条件。足部和踝关节肌肉强化运动显示最有可能成为最佳治疗方法之一（累积排序曲线下面积[SUCRA]=74.6%）。其次是仅静态平衡运动（SUCRA=67.9%）和矫正运动（SUCRA=56.1%）。本体感觉运动、仅动态平衡运动、水上运动、带支具康复运动、混合静态/动态平衡运动和对照组的 SUCRA 值处于相对较低水平，分别为 49.6%、48.8%、47.8%、47.7%、44.0%和 13.5%。
足部和踝关节肌肉强化运动可能对改善 CAI 患者关节位置感有良好效果。平衡运动干预越复杂，本体感觉效果越差。
