Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jan-Feb;16(1):29-37.
doi: 10.1177/19417381231152490. Epub 2023 Mar 5.

Postural Control Deficits During Static Single-leg Stance in Chronic Ankle Instability: A Systematic Review and Meta-Analysis

Xiao'ao Xue  1 , Yiran Wang  1 , Xiaoyun Xu  2 , Hong Li  1 , Qianru Li  1 , Yuyan Na  1 , Weichu Tao  2 , Le Yu  2 , Zhengbiao Jin  1 , Hongyun Li  1 , Ru Wang  2 , Yinghui Hua  3
Affiliations
Meta-Analysis

Postural Control Deficits During Static Single-leg Stance in Chronic Ankle Instability: A Systematic Review and Meta-Analysis

Xiao'ao Xue et al. Sports Health. 2024 Jan-Feb.

Abstract

Context: Postural control deficits arising from injured ankles are central to chronic ankle instability (CAI) and its persistent symptoms. This is usually measured by recording the center of pressure (CoP) trajectory during static single-leg stance using a stable force plate. However, existing studies have produced conflicting results on whether this mode of measurement adequately reveals the postural deficits in CAI.

Objective: To determine whether postural control during static single-leg stance is impaired in CAI patients when compared with uninjured healthy controls.

Data sources: Literature databases, PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, and SPORTDiscus, were searched from inception to April 1, 2022, using ankle-, injury-, and posture-related terms.

Study selection: Two authors independently performed the step-by-step screening of article titles, abstracts, and full texts to select peer-reviewed studies investigating CoP trajectory during static single-leg stance using a stable force plate in CAI patients and healthy controls. A total of 13,637 studies were reviewed, and 38 studies (0.003%) met the selection criteria.

Study design: Meta-analyses of descriptive epidemiological study.

Level of evidence: Level 4.

Data extraction: CoP parameters, sway directions, visual condition, and numerical data (means and standard deviations) were extracted.

Results: The injured ankles of CAI patients had higher standard deviations of sway amplitude in both anterior-posterior and medial-lateral directions (standardized mean difference [SMD] = 0.36 and 0.31, respectively) under conditions of open eyes than controls. Higher mean sway velocity in anterior-posterior, medial-lateral, and total directions (SMD = 0.41, 0.37, and 0.45, respectively) with closed eyes was also found.

Conclusion: CAI patients had deficits of postural control during static single-leg stance, and these deficits were identified by the CoP trajectory. Further methodological explorations of CoP parameters and corresponding test conditions are required to enhance the sensitivity and reliability of postural deficit assessments in CAI using force plates.

Keywords: ankle; balance/posture; chronic ankle instability; systematic reviews/meta-analyses.

PubMed Disclaimer

Conflict of interest statement

The authors report no potential conflicts of interest in the development and publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of the systematic review selection process.
See this image and copyright information in PMC

References

    1. Arnold BL, De La Motte S, Linens S, Ross SE. Ankle instability is associated with balance impairments: a meta-analysis. Med Sci Sports Exerc. 2009;41(5):1048-1062. - PubMed
    1. Bleakley C, Wagemans J, Netterström-Wedin F. Understanding chronic ankle instability: model rich, data poor. Br J Sports Med. 2021;55(9):463-464. - PubMed
    1. Bleakley CM, Matthews M, Smoliga JM. Most ankle sprain research is either false or clinically unimportant: a 30-year audit of randomized controlled trials. J Sport Health Sci. 2021;10(5):523-529. - PMC - PubMed
    1. Bruce AS, Howard JS, Van Werkhoven H, McBride JM, Needle AR. The effects of transcranial direct current stimulation on chronic ankle instability. Med Sci Sports Exerc. 2020;52(2):335-344. - PubMed
    1. Burcal CJ, Wikstrom EA. Cognitive loading-induced sway alterations are similar in those with chronic ankle instability and uninjured controls. Gait Posture. 2016;48:95-98. - PubMed