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What interventions can treat arthrogenic muscle inhibition in patients with chronic ankle instability? A systematic review with meta-analysis [with consumer summary] |
Kim K-M, Needle AR, Kim J-S, An YW, Cruz-Diaz D, Taube W |
Disability and Rehabilitation 2024;46(2):241-256 |
systematic review |
PURPOSE: To identify, critically appraise, and synthesize the existing evidence regarding the effects of therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability (CAI). MATERIALS AND METHODS: Two reviewers independently performed exhaustive database searches in Web of Science, PubMed, Medline, CINAHL, and SPORTDiscus. RESULTS: Nine studies were finally included. Five types of disinhibitory interventions were identified: focal ankle joint cooling (FAJC), manual therapy, fibular reposition taping (FRT), whole-body vibration (WBV), and transcranial direct current stimulation (tDCS). There were moderate effects of FAJC on spinal excitability in ankle muscles (g 0.55, 95% CI 0.03 to 1.08, p = 0.040 for the soleus and g 0.54, 95% CI 0.01 to 1.07, p = 0.046 for the fibularis longus). In contrast, manual therapy, FRT, WBV were not effective. Finally, 4 weeks of tDCS combined with eccentric exercise showed large effects on corticospinal excitability in 2 weeks after the intervention (g 0.99, 95% CI 0.14 to 1.85 for the fibularis longus and g 1.02, 95% CI 0.16 to 1.87 for the tibialis anterior). CONCLUSIONS: FAJC and tDCS may be effective in counteracting AMI. However, the current evidence of mainly short-term studies to support the use of disinhibitory interventions is too limited to draw definitive conclusions.
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