Effectiveness of balance training in patients with chronic ankle instability: protocol for a systematic review and meta-analysis

Introduction Lateral ankle sprains are one of the most common musculoskeletal injuries. Up to 70% of individuals who sustain lateral ankle sprains develop chronic ankle instability (CAI). Balance training has been used in patients with CAI, but the evidence for its efficacy is inconsistent. This systematic review and meta-analysis aims to determine the short-term (end of the treatment period) and long-term (6 months after treatment) effectiveness of balance training for patients with CAI. Methods and analysis We will search PubMed, EMBASE, the Cochrane Library, Ovid, EBSCO-host, Pedro, ClinicalKey, ScienceDirect, Springer, China National Knowledge Infrastructure, Technology Periodical Database (VIP), WanFang Data and China Biology Medicine for reports of randomised trials of balance training in patients with CAI, from inception to 1 October 2021. The language will be restricted to English and Chinese, and articles will be screened and collected by two reviewers independently. Dynamic balance and functional ankle instability are the primary outcomes of this study. Secondary outcomes include pain, ankle range of motion, ankle strength and health-related quality of life. Review Manager V.5.3 software will be used for meta-analysis, and stratification analysis will be conducted for study quality according to the Jadad score. Subgroup and sensitivity analyses will be conducted. Grading of Recommendations, Assessment, Development and Evaluation will be used to assess confidence in the cumulative evidence. The protocol follows the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines. Ethics and dissemination Ethical approval is not required for literature-based studies. The results will be disseminated through peer-reviewed publications.