A Systematic Review of Rehabilitation Interventions for Athletes with Chronic Ankle Instability

Background: Ankle sprains affect approximately 8% of the general population, and recurrence occurs in as many as 80% of patients participating in high-risk sports. The aim of this review was to assess the impact of physiotherapy interventions on chronic ankle stability (CAI), providing evidence for the effectiveness of clinical treatment and care for patients with CAI. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) evaluating the effectiveness of physiotherapy interventions in athletes with CAI following injury were analyzed. PubMed, Embase, PEDro, and Cochrane electronic databases were searched. A modified McMaster Critical Review Form for quantitative studies was used to assess the methodological quality of the included studies, in accordance with the guidelines. Results: The literature search yielded 316 results, of which 13 articles met all required eligibility criteria and were included in the study. The RCTs included 490 athletes with CAI. Interventions included various types of exercises, including balance training (BT), plyometric training, CrossFit, and neuromuscular training. The duration of the intervention was 4-12 weeks. Both subjective and objective measures were used to assess the effectiveness of the therapy in the following seven domains: Dynamic Balance, Static Balance, Patient-Reported Outcomes, Kinematic Outcomes, Proprioception, Body-Composition, and Strength Assessment. Conclusions: The evidence supports the effectiveness of rehabilitation interventions in athletes with CAI. Further large-scale randomized controlled trials, incorporating control groups and long-term follow-up, are needed to better determine the robust impact of conservative management on improving both the physical and psychological health of patients with CAI.