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Meta-analysis of the dosage of balance training on ankle function and dynamic balance ability in patients with chronic ankle instability |
Tang F, Xiang M, Yin S, Li X, Gao P |
BMC Musculoskeletal Disorders 2024 Aug 31;25(689):Epub |
systematic review |
OBJECTIVE: To explore and compare the dosage of balance training on ankle function and dynamic balance ability in patients with chronic ankle instability (CAI). METHODS: The PubMed, Embase, Web of Science, Medline, and Cochrane databases were searched up to December 2023. Quality assessment was carried out using the risk-of-bias guidelines of the Cochrane Collaboration, and the standardized mean differences (SMD) or mean differences (MD) for each outcome were compute. RESULTS: Among 20 eligible studies, including 682 participants were analyzed in this meta-analysis. The results of the meta-analysis demonstrated that balance training was effective in enhancing ankle function with self-functional scores (SMD 1.02; 95% CI 0.61 to 1.43; p < 0.00001; I2 72%) and variables associated with the ability of dynamic balance such as SEBT-A (MD 5.88; 95% CI 3.37 to 8.40; p < 0.00001; I2 84%), SEBT-PM (MD 5.47; 95% CI 3.40 to 7.54; p < 0.00001; I2 61%), and SEBT-PL (MD 6.04; 95% CI 3.30 to 8.79; p < 0.0001; I2 79%) of CAI patients. Meta-regression indicated that the intervention time might be the principal cause of heterogeneity (p = 0.046) in self-functional scores. In subgroup analyses of self-functional score across intervention types, among the intervention time, more than 20 min and less than 30 min had the most favorable effect (MD 1.21, 95% CI 0.96 to 1.46, p < 0.00001, I2 55%); among the intervention period, 4 weeks (MD 0.84, 95% CI 0.50 to 1.19, p < 0.00001, I2 78%) and 6 weeks (MD 1.21, 95% CI 0.91 to 1.51, p < 0.00001, I2 71%) had significant effects; among the intervention frequency, 3 times (MD 1.14, 95% CI 0.89 to 1.38), p < 0.00001, I2 57%) had significant effects. Secondly, in subgroup analyses of SEBT across intervention types, a 4-week and 6-week intervention with balance training 3 times a week for 20 to 30 min is the optimal combination of interventions to improve SEBT (dynamic balance) in patients with chronic ankle instability. CONCLUSION: Balance training proves beneficial for ankle function in patients with CAI. Intervention time constitutes a major factor influencing self-function in patients with CAI. It is recommended that the optimal dosage of balance training for CAI involves intervention three times a week, lasting for 20 to 30 min over a period of 4 to 6 weeks for superior rehabilitation.
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