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Exercise Therapy for Chronic Ankle Instability: Which Modality for Which Deficit? A Systematic Review and
Jia Sheng Xu1,2,3, Hui Juan Lin1,2,3, Zhi Kun Li4
1University of Sports and Health, Guangzhou Sport University, Guangzhou, China.
Journal of Foot and Ankle Research
|March 2, 2026
Summary
Balance training offers comprehensive benefits for chronic ankle instability (CAI), improving function and balance. Tailoring exercise interventions based on specific sensorimotor deficits can optimize rehabilitation outcomes for CAI patients.
Area of Science:
- Biomechanics and Rehabilitation Science
- Sports Medicine and Physical Therapy
Background:
- Chronic ankle instability (CAI) presents with varied sensorimotor impairments.
- Limited evidence exists comparing different exercise interventions for specific CAI deficits.
- Personalized rehabilitation strategies for CAI are hindered by a lack of comparative data.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of various exercise interventions for sensorimotor deficits in CAI.
- To establish an evidence-based framework for prescribing exercise based on individual sensorimotor deficits in CAI.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched 9 electronic databases up to September 1, 2025, for RCTs comparing exercise interventions against no intervention.
- Assessed methodological quality using PEDro criteria and risk of bias using the Cochrane Risk of Bias tool 2.
Main Results:
- Fifty-eight studies (n=2097) were included, with varying risk of bias.
- Balance training significantly improved patient-reported function, dynamic balance, joint position sense, concentric strength, and functional performance.
- Other modalities showed specific benefits (e.g., strength training for function and strength, 3D/stroboscopic/neuromuscular training for function and balance), but no intervention improved force sense or eccentric strength.
Conclusions:
- Different exercise modalities demonstrate distinct efficacy profiles for sensorimotor deficits in CAI.
- Balance training emerges as a foundational intervention for CAI.
- A framework for deficit-specific exercise prescription can optimize CAI management.
