Conclusions The main findings from this systematic review were balance training provided the most consistent improvements in self-reported function for patients with CAI
Objective To identify which therapeutic intervention may be most effective for improving self-reported function in patients with chronic ankle instability ( CAI ) .
Effects of a proximal or distal tibiofibular joint manipulation on ankle range of motion and functional outcomes in individuals with chronic ankle instability.
STUDY DESIGN R and omized clinical trial . OBJECTIVES To determine whether manipulation of the proximal or distal tibiofibular joint would change ankle dorsiflexion range of motion and functional outcomes over a 3-week period in individuals with chronic ankle instability . BACKGROUND Altered joint arthrokinematics may play a role in chronic ankle instability dysfunction . Joint mobilization or manipulation may offer the ability to restore normal joint arthrokinematics and improve function . METHODS Forty-three participants ( mean ± SD age , 25.6 ± 7.6 years ; height , 174.3 ± 10.2 cm ; mass , 74.6 ± 16.7 kg ) with chronic ankle instability were r and omized  to proximal tibiofibular joint manipulation , distal tibiofibular joint manipulation , or a control group . Outcome measures included ankle dorsiflexion range of motion , the single-limb stance on foam component of the Balance Error Scoring System , the step-down test , and the Foot and Ankle Ability Measure sports subscale . Measurements were obtained prior to the intervention ( before day 1 ) and following the intervention ( on days 1 , 7 , 14 , and 21 ) . RESULTS There was no significant change in dorsiflexion between groups across time . When groups were pooled , there was a significant increase ( P<.001 ) in dorsiflexion at each postintervention time interval . No differences were found among the Balance Error Scoring System foam , step-down test , and Foot and Ankle Ability Measure sports subscale scores . CONCLUSIONS The use of a proximal or distal tibiofibular joint manipulation in isolation did not enhance outcome effects beyond those of the control group . Collectively , all groups demonstrated increases in ankle dorsiflexion range of motion over the 3-week intervention period . These increases might have been due to practice effects associated with repeated testing . LEVEL OF EVIDENCE Therapy , level 2b-
Conclusions The main findings from this systematic review were balance training provided the most consistent improvements in self-reported function for patients with CAI
Objective To identify which therapeutic intervention may be most effective for improving self-reported function in patients with chronic ankle instability ( CAI ) .