The Effects of Different Exercise Interventions on Improving Symptoms of Chronic Ankle Instability: A Network Meta-Analysis

Objective Chronic ankle instability (CAI) is characterized by symptoms such as muscle weakness, impaired neuromuscular control, and recurrent sprains. Exercise intervention can effectively ameliorate these symptoms. This study employed a network meta-analysis to quantitatively evaluate the efficacy of various exercise interventions on CAI, specifically examining their effect sizes and the moderating role of exercise dosage. Methods We conducted a systematic literature search in the Cochrane Library, PubMed, Web of Science, Embase, and CNKI databases. The review primarily included randomized controlled trials (RCTs) investigating exercise interventions for the prevention and treatment of CAI. Meta-analyses were performed using Review Manager 5.4 and Stata 18. Results A total of 22 studies involving 851 patients with CAI were included. The network meta-analysis revealed that GISTM-CT and CROSSFIT interventions were most effective in improving the Star Excursion Balance Test (SEBT; Sucra = 76.0) and Cumberland Ankle Instability Tool (CAIT; Sucra = 85.2) outcomes, respectively. For the Foot and Ankle Ability Measure (FAAM), BOT (Sucra = 82.8) and BAPS (Sucra = 82.6) interventions demonstrated superior efficacy. Furthermore, an intervention regimen combining neuromuscular control and strength training, delivered over a period of more than 8 weeks with a frequency of three sessions per week, each lasting 30–60 minutes, was identified as an optimal exercise prescription for patients with CAI. Conclusion Diverse forms of exercise are effective in improving instability symptoms and dynamic balance in patients with CAI. Neuromuscular control training, in particular, demonstrates comprehensive benefits. These findings suggest that a multi-modal combined training approach is a more effective rehabilitation strategy than single-modality exercise interventions.