BACKGROUND: Chronic ankle instability (CAI) is characterized by recurrent ankle sprains and neuromuscular deficits, including arthrogenic muscle inhibition (AMI), which impairs motor control. Physiotherapeutic interventions targeting neural excitability may help mitigate AMI and improve function. OBJECTIVE: To evaluate the effectiveness of physiotherapeutic interventions in modulating neural excitability and reducing AMI in CAI. METHODS: A systematic search of six databases identified studies examining the effects of physiotherapy interventions on spinal (H-waves/M-waves (H/M) ratio) and corticospinal excitability (transcranial magnetic stimulation (TMS) outcomes) in CAI. Quality was assessed using the PEDro scale. RESULTS: Thirteen studies investigated proprioceptive training, manual therapy, taping, cryotherapy, anodal transcranial direct current stimulation (atDCS), electrotherapy, and dry needling. Prolonged balance training, cryotherapy, and atDCS showed the most consistent effects. CONCLUSION: atDCS, manual therapy, cryotherapy, electrotherapy and balance training may help reduce AMI in CAI, but further studies with larger samples and long-term follow-ups are needed.

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