Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
Graduate School of Health Science, Gunma University, Maebashi, Japan.
J Sport Rehabil. 2024 Aug 19;33(8):619-629. doi: 10.1123/jsr.2023-0437. Print 2024 Nov 1.
Several clinical tests are available to assess static postural stability in individuals with chronic ankle instability (CAI); however, it is unclear which test should be used.
To determine which noninstrumented clinical tests should be used to detect static postural stability deficits in individuals with CAI.
We searched 4 databases from their inception to February 2023, and included studies comparing static postural stability in individuals with CAI and healthy controls using noninstrumented assessments. Two reviewers independently extracted study characteristics, participant information, static postural stability assessment methods, and results. We calculated the pooled standardized mean difference (SMD) and 95% confidence interval using a random effects meta-analysis and assessed the certainty of the evidence.
Fourteen cross-sectional studies (293 participants with CAI and 284 healthy controls) were included. The meta-analysis showed no significant differences between the CAI and healthy groups in the double-leg stance condition of the Balance Error Scoring System (BESS) (SMD, -0.03; low-certainty evidence). Significant group differences were found in the BESS single-leg stance (SLS) on firm and foam surfaces (SLS firm: SMD, 0.47, very low-certainty evidence; SLS foam: SMD, 0.80, very low-certainty evidence), the tandem stance (TS) on firm and foam surfaces (TS firm: SMD, 0.39, low-certainty evidence; TS foam: SMD, 0.76, low-certainty evidence), and the total BESS in the foam conditions (SMD, 1.12, very low certainty evidence). Significant differences were also found between the CAI and healthy groups in the foot-lift (SMD, 1.24; very low certainty evidence) and time-in-balance tests (SMD, -0.94; very low certainty evidence).
Due to the large magnitude of the differences, the SLS foam, TS foam, and the total BESS in the foam conditions, as well as the foot-lift test or time-in-balance test, may be the most appropriate to clinically identify static postural stability impairment in individuals with CAI.
有几种临床测试可用于评估慢性踝关节不稳定（CAI）患者的静态姿势稳定性；然而，尚不清楚应该使用哪种测试。
确定哪些非仪器化的临床测试可用于检测 CAI 患者的静态姿势稳定性缺陷。
我们从建库开始至 2023 年 2 月，在 4 个数据库中进行了搜索，并纳入了使用非仪器评估比较 CAI 患者和健康对照者静态姿势稳定性的研究。两位审查员独立提取研究特征、参与者信息、静态姿势稳定性评估方法和结果。我们使用随机效应荟萃分析计算了合并后的标准化均数差（SMD）和 95%置信区间，并评估了证据的确定性。
纳入了 14 项横断面研究（293 名 CAI 患者和 284 名健康对照者）。荟萃分析显示，CAI 组和健康组在平衡错误评分系统（BESS）的双腿站立条件下（SMD，-0.03；低确定性证据）无显著差异。在 BESS 的单腿站立（SLS）于坚实和泡沫表面（SLS 坚实：SMD，0.47，极低确定性证据；SLS 泡沫：SMD，0.80，极低确定性证据）、在坚实和泡沫表面的 tandem stance（TS）（TS 坚实：SMD，0.39，低确定性证据；TS 泡沫：SMD，0.76，低确定性证据）以及泡沫条件下的总 BESS（SMD，1.12，极低确定性证据）中，两组间存在显著差异。在抬脚（SMD，1.24；极低确定性证据）和平衡时间测试（SMD，-0.94；极低确定性证据）中，CAI 组和健康组之间也存在显著差异。
由于差异幅度较大，SLS 泡沫、TS 泡沫和泡沫条件下的总 BESS 以及抬脚测试或平衡时间测试可能是临床上识别 CAI 患者静态姿势稳定性损伤最适宜的测试。
