Yin Yikun, Wang Jialin, Lin Qihan, Luo Yinghang, Liu Yongsheng, Sun Junzhi
School of Sport Human Science, Beijing Sport University, Beijing, China.
Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, China.
PLoS One. 2025 Jan 9;20(1):e0311355. doi: 10.1371/journal.pone.0311355. eCollection 2025.
This study conducts a rigorous meta-analysis of existing literature to rigorously examine the efficacy of Proprioceptive Neuromuscular Facilitation (PNF) in ameliorating functional deficits associated with Chronic Ankle Instability (CAI).
Literature searches were conducted in multiple databases including China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biology Medicine disc (CBM), PubMed, EBSCO (Medline, CINAHL, SPORTDiscus, and Rehabilitation & Sports Medicine Source), Embase, ScienceDirect, ProQuest, Cochrane Library, and Web of Science for randomized controlled trials assessing the effects of Proprioceptive Neuromuscular Facilitation interventions on patients with Chronic Ankle Instability. The publication timeframe spanned from the inception of each database until April 10, 2024. Meta-analysis was performed using STATA 12 software on the included studies.
① A total of 12 randomized controlled trials were included, encompassing 405 patients with Chronic Ankle Instability, demonstrating a generally high methodological quality of the literature.② Meta-analysis results indicate that compared to the control group, Proprioceptive Neuromuscular Facilitation (PNF) significantly enhanced the balance ability of patients with Chronic Ankle Instability as measured by the Y Balance Test (YBT) (Weighted Mean Difference (WMD) = 3.61, 95% CI [2.65, 4.56], z = 7.42, P<0.001) and the Star Excursion Balance Test (SEBT) (WMD = 5.50, 95% CI [3.80, 7.19], z = 6.36, P<0.001), with improvement in all eight directions of SEBT balance ability surpassing that of the control group (P<0.05); muscle strength around the ankle (SMD) = 0.19, 95% CI [0.03, 0.36], z = 2.26, P = 0.024), with both Plantar flexion and Dorsal flexion muscle strength improvements exceeding those of the control group (P<0.05); Visual Analog Scale (VAS) (WMD = -1.39, 95% CI [-1.72, -1.06], z = 8.23, P<0.001); Ankle instability questionnaire (WMD = 2.91, 95% CI [1.92, 3.89], z = 5.78, P<0.001).③Descriptive analysis results showed that the differences in Inversion Joint Position Sense and Dorsiflexion range of motion between the PNF and control groups were not statistically significant (P>0.05), however, the effects of PNF training persisted for a certain period even after cessation of treatment.
Proprioceptive Neuromuscular Facilitation (PNF) can significantly improve balance, muscle strength, and pain in patients with Chronic Ankle Instability (CAI). While PNF has shown improvements in joint position sense and dorsiflexion range of motion for CAI patients, with effects that remain for a period thereafter, these improvements were not significantly different when compared to the control group. Further research is required to substantiate these specific effects.
本研究对现有文献进行严谨的荟萃分析，以严格检验本体感觉神经肌肉促进法（PNF）改善与慢性踝关节不稳（CAI）相关功能缺陷的疗效。
在多个数据库中进行文献检索，包括中国知网（CNKI）、维普、万方、中国生物医学文献数据库（CBM）、PubMed、EBSCO（Medline、CINAHL、SPORTDiscus以及康复与运动医学资源库）、Embase、ScienceDirect、ProQuest、考克兰图书馆和Web of Science，检索评估本体感觉神经肌肉促进法干预对慢性踝关节不稳患者影响的随机对照试验。出版时间范围为各数据库创建至2024年4月10日。使用STATA 12软件对纳入研究进行荟萃分析。
①共纳入12项随机对照试验，涉及405例慢性踝关节不稳患者，表明文献的方法学质量总体较高。②荟萃分析结果表明，与对照组相比，本体感觉神经肌肉促进法（PNF）显著提高了慢性踝关节不稳患者的平衡能力，通过Y平衡测试（YBT）测量（加权均数差（WMD）=3.61，95%置信区间[2.65, 4.56]，z = 7.42，P<0.001）以及星形偏移平衡测试（SEBT）（WMD = 5.50，95%置信区间[3.80, 7.19]，z = 6.36，P<0.001），SEBT平衡能力的所有八个方向的改善均超过对照组（P<0.05）；踝关节周围肌肉力量（标准化均数差（SMD）=0.19，95%置信区间[0.03, 0.36]，z = 2.26，P = 0.024），跖屈和背屈肌肉力量的改善均超过对照组（P<0.05）；视觉模拟量表（VAS）（WMD = -1.39，95%置信区间[-1.72, -1.06]，z = 8.23，P<0.001）；踝关节不稳问卷（WMD = 2.91，95%置信区间[1.92, 3.89]，z = 5.78，P<0.001）。③描述性分析结果显示，PNF组与对照组之间的内翻关节位置觉和背屈活动度差异无统计学意义（P>0.05），然而，PNF训练的效果在治疗停止后仍持续一段时间。
本体感觉神经肌肉促进法（PNF）可显著改善慢性踝关节不稳（CAI）患者的平衡、肌肉力量和疼痛。虽然PNF已显示出对CAI患者关节位置觉和背屈活动度有改善，且此后效果持续一段时间，但与对照组相比，这些改善无显著差异。需要进一步研究来证实这些具体效果。
