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Updated: Jan 7, 2026
Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
Which therapeutic exercise is most effective for improving ankle inversion muscle function in individuals with
Haipeng Zhang1,2, Lijiang Luan3, Xiaojian Shi4
1Department of Rehabilitation, JiangWan Hospital of Hongkou District, Shanghai University of Medicine and Health Sciences, Shanghai, China.
Objective:
This study was conducted to investigate the effects of diverse therapeutic exercise regimens on enhancing ankle inversion muscle function in individuals with chronic ankle instability (CAI).
Methods:
A systematic search was performed across five international electronic databases (e.g., PubMed, Cochrane Library, Embase, Web of Science, and EBSCO) from their inception to December 2024. Randomized controlled trials focusing on the keywords "ankle instability," "exercise therapy," and "muscle strength" was screened. Data extraction and quantitative analysis were subsequently executed. Methodological quality and risk of bias were assessed with Cochrane Collaboration Bias Risk Assessment Tool.
Results:
Nine studies involving 366 participants were included in the network meta-analysis (NMA). The findings demonstrated that all therapeutic exercise modalities (neuromuscular training (NT), (Effect size (ES) = 1.05; 95%CI = 0.29-1.82), strength training (ST), (ES = 1.36; 95%CI = 0.73-1.99), combined neuromuscular and strength training (NST), (ES = 2.82; 95%CI = 1.89-3.74) and combined neuromuscular and whole-body vibration training (NWBVT), (ES = 1.92; 95%CI = 0.62-3.22) exhibited statistically superior efficacy compared to control groups. Surface Under the Cumulative Ranking Curve (SUCRA) probability rankings identified NST as the intervention with the highest likelihood of optimal efficacy (99.9%). ST (64.6%) alone demonstrated a significant advantage over NT alone (45.9%). Conversely, NWBVT was associated with the lowest therapeutic probability (38.9%).
Conclusion:
Combined neuromuscular and strength training (NST) constitutes the most effective therapeutic exercise for augmenting ankle inversion muscle function in CAI populations. Compared to isolated NT or ST interventions, the integration of these modalities demonstrates greater efficacy in addressing functional impairments in CAI individuals.
