Zheng Shanshan, Xue Xiao'ao, Yu Le, Tao Weichu, Wang Ru, Sun Yang, Hua Yinghui
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
PM R. 2025 Jan;17(1):76-87. doi: 10.1002/pmrj.13235. Epub 2024 Aug 3.
Chronic ankle instability (CAI) is a common musculoskeletal injury associated with static balance deficits. The Balance Error Scoring System (BESS) is commonly used to assess static balance in individuals with CAI. However, the sensitivity of BESS in detecting balance deficits in CAI is unknown. This study compared BESS performance between people with CAI and controls and investigated which stances most effectively identified balance deficits in individuals with CAI.
Seven electronic databases (Web of Science, CINAHL, Embase, PubMed, Scopus, SPORTDiscus, and Cochrane Library) were searched from July 13, 2023, to September 10, 2023, using the ankle instability and balance related terms as keywords to search original studies and perform a systematic review.
Studies that compared BESS scores between individuals with CAI and healthy controls were systematically identified. Extracted data included study characteristics, participant demographics, and assessment details. The risk of bias was assessed using the Newcastle-Ottawa Scale. The standardized mean difference (SMD) and 95% confidence interval (CI) were used as effect sizes to compare groups for the BESS components used to assess CAI.
Six studies met the eligibility criteria. The double-leg foam stance yielded an SMD of -0.02 (95% CI: -0.32 to 0.29), with an I value of 3.5%. Significant differences between groups were noted in the single foam (SMD = 0.89; 95% CI: 0.33-1.45; I = 78.3%) and single firm (SMD = 0.62; 95% CI: 0.14-1.10; I = 72.1%) performances, although both demonstrated high heterogeneity. Conversely, the tandem foam (SMD = 0.77; 95% CI: 0.51-1.02; I = 0.0%) and tandem firm (SMD = 0.38; 95% CI: 0.11-0.68; I = 23.8%) performances showed small to moderate between-group differences with considerably lower heterogeneity.
This review indicates that tandem stances on foam and firm surfaces in the BESS are reliable indicators of static balance deficits in individuals with CAI.
慢性踝关节不稳（CAI）是一种常见的肌肉骨骼损伤，与静态平衡缺陷有关。平衡误差评分系统（BESS）常用于评估CAI患者的静态平衡。然而，BESS在检测CAI患者平衡缺陷方面的敏感性尚不清楚。本研究比较了CAI患者与对照组之间的BESS表现，并调查了哪种姿势能最有效地识别CAI患者的平衡缺陷。
2023年7月13日至2023年9月10日，检索了七个电子数据库（科学网、护理学与健康领域数据库、Embase、PubMed、Scopus、体育文献数据库和考克兰图书馆），以踝关节不稳和平衡相关术语作为关键词，检索原始研究并进行系统综述。
系统识别比较CAI患者与健康对照组之间BESS评分的研究。提取的数据包括研究特征、参与者人口统计学信息和评估细节。使用纽卡斯尔-渥太华量表评估偏倚风险。标准化均数差（SMD）和95%置信区间（CI）用作效应量，以比较用于评估CAI的BESS各组成部分的组间差异。
六项研究符合纳入标准。双腿泡沫垫站立的SMD为-0.02（95%CI：-0.32至0.29），I²值为3.5%。单腿泡沫垫站立（SMD = 0.89；95%CI：0.33 - 1.45；I² = 78.3%）和单腿硬地面站立（SMD = 0.62；95%CI：0.14 - 1.10；I² = 72.1%）的组间差异显著，尽管两者均显示出高度异质性。相反，串联泡沫垫站立（SMD = 0.77；95%CI：0.51 - 1.02；I² = 0.0%）和串联硬地面站立（SMD = 0.38；95%CI：0.11 - 0.68；I² = 23.8%）的表现显示组间差异小至中等，异质性显著更低。
本综述表明，BESS中在泡沫垫和硬地面上的串联站立姿势是CAI患者静态平衡缺陷的可靠指标。
