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To assess exercise therapies that aim to enhance proprioception in individuals with chronic ankle instability (CAI).Five databases (PubMed, Embase, Cochrane Library, Web of Science, and EBSCO) were searched in October 2021.Randomized controlled trials involving exercise therapy conducted on individuals with CAI were included.Data were extracted by 2 independent reviewers using a standardized form. Methodological quality and risk of bias were assessed with the Physiotherapy Evidence Database scale.The end trial weighted mean difference and standard deviations were analyzed, and the synthetic value for the improvement in error scores of ankle joint position sense in multiple directions was evaluated.Eleven trials with 333 participants were eligible for inclusion in this systematic review and were included in the network meta-analysis. Foot and ankle muscle strengthening exercise showed the highest probability of being among the best treatments (surface under the cumulative ranking [SUCRA]=74.6%). The next 2 were static balance exercise only (SUCRA=67.9%) and corrective exercise (SUCRA=56.1%). The SUCRA values of proprioceptive exercise, dynamic balance exercise only, aquatic exercise, rehabilitation exercise with brace, mixed static/dynamic balance exercise, and control were at relatively low levels and scored at 49.6%, 48.8%, 47.8%, 47.7%, 44.0%, and 13.5%, respectively.Foot and ankle muscle strengthening exercise may have a good effect when used to improve joint position sense in individuals with CAI. The more complex balance exercise intervention becomes, the less effective the proprioceptive outcome.

Objective Strength training as a form of exercise therapy has long been used to maintain or promote strength, but its effectiveness as a treatment intervention in chronic ankle instability (CAI) is not fully understood. The purpose of this study was to evaluate the effects of strength training compared with no exercise and neuromuscular control training on balance and self-reported function in people with CAI. Methods Eight databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, PEDro, CNKI, and WanFang) were searched in June 2020. Randomized controlled trials (RCTs) involving strength training conducted on individuals with CAI were included. Data were extracted by 2 independent reviewers using a standardized form. Methodological quality and risk of bias were assessed by using the PEDro Scale. In addition, the GRADE evaluation system (Grading of Recommendations Assessment, Development and Evaluation) was used to determine the strength of evidence. A total of 554 studies were initially screened, resulting in a final selection of 11 RCTs involving 428 participants, and 8 RCTs were included in the final meta-analysis. Compared with no exercise, strength training demonstrated some benefits in the Star Excursion Balance Test (anterior: weighted mean difference [WMD] = 2.39, 95% CI = 0.60–4.18; posteromedial: WMD = 3.30, 95% CI = 0.24–6.35; posterolateral: WMD = 2.97, 95% CI = 0.37–5.57), but these intervention results did not reach the minimal detectable change values. Conclusion Available evidence showed that, compared with controls, strength training did not produce any minimal detectable changes on Star Excursion Balance Test or Foot and Ankle Ability Measure scores in individuals with CAI. Clinicians should use strength training cautiously for improving balance and symptoms in CAI. Impact The results of this study may have an impact on selecting effective physical therapy interventions for managing symptoms associated with CAI.