The effect of proprioceptive training on recurrent ankle sprains in the athletic population : an umbrella review

Abstract

Ankle sprains are among the most predominant musculoskeletal injuries and have a high recurrence rate, especially in athletes. The aim of this umbrella review is to evaluate the effect of proprioceptive training in athletes with or without a history of ankle sprain. Proprioceptive training was compared to no intervention and other active comparators, with the primary outcome being the incidence or recurrence of ankle sprains. Eight electronic databases were used to conduct an electronic search and a filter for the year of publication ‘from 2015-2021’ was applied. The search produced 13,375 articles which were screened by title and abstract and six systematic reviews were included in this review. Standardised data extraction sheets were used to extrapolate information from these systematic reviews whilst the AMSTAR-II quality assessment tool was used to critically analyse their methodological value. 28 different primary studies were evaluated and mentioned 41 times within the 6 systematic reviews, indicating that 13 primary studies were overlapping. 23 of the primary studies were randomized control trials whilst the remaining 5 were clinical control trials. The results demonstrated that there was a net protective benefit favouring proprioceptive training over no intervention ranging between 38-46%, yet this protective effect decreased to 35% when compared to an active control. In addition, proprioceptive and neuromuscular training only provided a 2% protective advantage over bracing. Proprioceptive training is an effective modality which reduces the incidence and recurrence of ankle sprains in athletes both with and without previous ankle sprains. The exercises can be done in any rehabilitative or training setting, with or without equipment and therefore, can be easily carried out in clinical practice or as home exercise programs. Research regarding different combinations of proprioceptive training with other modalities and at which durations and intensities is warranted.