Ankle instability is associated with balance impairments: a meta-analysis

Area of Science:

• Biomechanics
• Sports Medicine
• Rehabilitation Science

Background:

• Functional ankle instability (FAI) is a common condition following ankle sprains.
• Balance impairments are frequently reported in individuals with FAI, but the extent and nature of these impairments require further elucidation.

Purpose of the Study:

• To systematically review and meta-analyze the association between functional ankle instability and balance impairments.
• To identify specific balance measures that are most sensitive to the effects of FAI.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, CINAHL, SPORTDiscus) including forward citation searching and direct author contact.
• Twenty-three studies were included in the meta-analysis, with balance outcomes categorized by dynamic and static tasks.
• Statistical analyses employed fixed, random, or mixed effects models depending on study heterogeneity.

Main Results:

• Functional ankle instability was significantly associated with poorer balance performance (SDM = 0.455, P < 0.001).
• No significant difference was found between dynamic and static balance measures overall.
• Specific dynamic measures (time to stabilization, Star Excursion Balance Test) and static measures (time in balance, foot lifts) demonstrated significant associations with FAI, with time in balance and foot lifts showing very large effect sizes.

Conclusions:

• Functional ankle instability is demonstrably linked to impaired balance.
• Time in balance and foot lifts are identified as sensitive and simple measures for assessing balance deficits in FAI.
• Further research is recommended to establish the clinical validity and cutoff scores for these promising measures.