Hip muscle strength in patients with chronic ankle instability: A systematic review and meta-analysis

To determine whether chronic ankle instability (CAI) individuals exhibit hip muscle strength deficits compared to healthy people.

A comprehensive search of five databases was conducted from inception to May 2025 according to PRISMA guidelines. Quality assessment of included studies was performed using the modified Downs and Black checklist, and meta-analysis was conducted using random-effects models with results reported as standardized mean differences (SMD).

Ten studies involving 548 participants (271 CAI, 277 healthy controls) were included. Individuals with CAI demonstrated significantly decreased isometric hip abduction (SMD: 0.56, P < 0.001), extension (SMD: 0.62, P = 0.003), and external rotation strength (SMD: 0.59, P = 0.005) compared to controls. No significant differences were found in isokinetic strength at 60°/s. Sensitivity analysis showed unstable results for hip external rotation strength, while other outcomes remained stable.

Individuals with CAI demonstrated significant deficits in isometric hip abduction and extension strength compared to healthy people. Hip muscle strength assessment should be incorporated into routine examination of CAI individuals.