According to researchers from Western Sydney University and Griffith University in Australia and Vrije University in The Netherlands, patients with chronic ankle instability are not adequately represented in current literature.
More Research Needed on Chronic Ankle Instability
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Secondary
Wanting to investigate why previous systematic reviews on ankle instability have shown conflicting findings, they conducted their own systemic review and meta-analysis “Factors Contributing to Chronic Ankle Instability: A Systematic Review and Meta-Analysis of Systematic Reviews” was published in the September online issue of Sports Medicine to specifically look at the statistical significance and effect size of primary factors contributing to chronic ankle instability (CAI).
The researchers reviewed CINAHL, MEDLINE, PubMed, Scopus and SPORTDiscus and chose systematic reviews that included a focused research question, a clearly defined search strategy criteria and study selection. The reviews also had to have completed a comprehensive search of the literature and to review observational studies of factors and/or characteristics of persons with CAI, with or without meta-analysis.
According to results, only 17% of primary studies measured a clearly defined CAI population.
The researchers wrote, “Evidence from previous systematic reviews does not accurately reflect the CAI population. For treatment of non-specific ankle instability, clinicians should focus on dynamic balance, reaction time and strength deficits; however, these findings may not be translated to the CAI population.”
They added that “research needs to be updated with an adequately controlled CAI population.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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