Stroboscopic visual training combined with balance exercises for chronic ankle instability: a systematic review and meta-analysis.

Abstract

<h4>Objective</h4>This study aimed to assess the impact of combining stroboscopic visual training (SVT) with balance training on balance performance and self-reported ankle stability in individuals with chronic ankle instability (CAI).<h4>Methods</h4>This study followed the PRISMA 2020 guidelines and was registered in PROSPERO (Registration No.: CRD420251076956) in advance. The meta-analysis was conducted using RevMan 5.3 and Stata 16.0 software. A thorough systematic search of six databases, such as PubMed, Scopus, Web of Science, and the China National Knowledge Infrastructure (CNKI), was carried out to find randomized controlled trials that included patients with CAI who received SVT along with balance interventions. Cohen's d was used to calculate standardized mean differences (SMDs), and a random-effects model was utilized for pooling the effect sizes. Subgroup analyses were executed with balanced and self-reported scale outcome measures. The methodological quality and risk of bias of the included studies were evaluated using the physiotherapy evidence database (PEDro) scale and the Cochrane Risk of Bias 2.0 tool.<h4>Results</h4>The meta-analysis comprised seven randomized controlled trials, involving 235 participants in total. The participants included 149 males and 86 females, with an average age of 22 years. The meta-analysis showed that combining SVT with balance training had a significant positive impact on the balance ability of individuals with CAI (Cohen's d = 0.30, p = 0.01). The most significant dynamic balance improvement was in the anterior direction (d = 0.55, p = 0.004), with no significant changes in posterolateral, posteromedial directions, or static balance COP-V. In the same way, the combination of SVT with balance training resulted in a notable improvement in self-reported ankle stability among CAI patients (d = 0.53, p = 0.00). Cumberland ankle instability tool (CAIT) scores showed greatest improvement (d = 0.98, p = 0.00), with significant gains on foot and ankle ability measure (FAAM) -Sport subscale (d = 0.40, p = 0.04), but no change in FAAM- Activities of Daily Living (ADL) subscale.<h4>Conclusion</h4>Preliminary evidence suggests SVT + balance training may improve ankle stability in CAI. Further high-quality RCTs are needed to confirm these findings.