Related Experiment Video
Updated: Jan 9, 2026
Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
Balance Exercise Parameters for Rehabilitation of Adult Chronic Ankle Instability: A Systematic Review of Randomised
Lew Teck Yew Milton1,2, Jewel Wee Jing Yi1, Daniel S Harvie1
1IIMPACT in Health, Allied Health & Human Performance, Adelaide University, Adelaide, Australia.
Background And Purpose:
The optimal ingredients underpinning effective rehabilitation of Chronic Ankle Instability are not well established. This systematic review aimed to consolidate the exercise parameters associated with effective balance rehabilitation in individuals with CAI and contrast variables distinguishing effective and ineffective balance training programmes.
Methods:
This review was registered with PROSPERO (ID: CRD42024593743). A systematic electronic search was performed until September 2024 in Medline, Embase, CINAHL and Web of Science. Randomised controlled trials (RCTs) that compared the effectiveness of balance exercise against non-balance exercise interventions with respect to pain, function and/or perceived instability, among individuals with CAI were included. Studies that used non-exercise or balance control groups or were not published in English were excluded. Risk of bias was assessed using the Physiotherapy Evidence Database (PEDro) scale. Exercise parameters were extracted and presented in tables according to their effectiveness to elucidate commonalities and differences between protocols with and without statistically significant benefit.
Results:
Nine RCTs were included, inclusive of 342 participants. The average PEDro score across studies was 6.8, suggesting 'good' quality and a low-to-moderate risk of bias overall. Six studies included protocols demonstrating statistically significant improvements in pain, self-reported function, and/or perceived instability. Overall, effective programs had a greater cumulative duration and a greater range of balance exercises.
Discussion:
There is fair-to-good quality evidence supporting balance exercise programs for chronic ankle instability that incorporate higher training volumes and greater task variety. Effective programs typically span at least 4 weeks, with sessions three times per week, 30 min each, and include five or more exercises across multiple balance types. Progression should be based on the patient's ability to perform tasks with good control.
