PTOTMeta-AnalysisJournal of neuroengineering and rehabilitation2026

Does transcranial direct current stimulation enhance sensorimotor recovery in chronic ankle instability? A systematic review and meta-analysis.

Zhaohong Zeng, Zhen Xu, Bin Shen and 5 others

PMID 41761341

WHAT IT FOUND

Adding tDCS to rehab improved balance control and sensorimotor function, but did not change ankle movement patterns, brain excitability measures, or patient-reported scores.

The benefit was small and the evidence quality was low.

Key findings

01tDCS produced significant moderate improvements in balance control and small improvements in sensorimotor functional performance compared to control.

02There were no significant pooled effects on kinematics, neural excitability, or patient-reported outcomes.

03Subgroup analyses showed that online stimulation, high-definition tDCS, and pairing with foot core exercises yielded significant balance improvements, whereas offline stimulation, conventional tDCS, and balance training combinations did not.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The certainty of evidence was rated as very low to low due to risk of bias, imprecision, and small-study effects. Most trials were modestly sized, and several outcome domains included very few studies, limiting the power to detect effects or confirm subgroup findings. Long-term durability of the effects was not tested, as most studies focused on immediate post-intervention outcomes. Stimulation parameters and intervention protocols varied substantially across the included studies, contributing to heterogeneity. Publication bias was detected for balance control at the within-study level, though it diminished when aggregated at the study level.

Declared interests

The study was funded by the National Natural Science Foundation of China and the 2024 Shanghai Oriental Talent Plan top talent project. No financial or non-financial conflicts of interest were declared by the authors.

The easy way to misread this

Do not assume tDCS improves how patients feel about their ankle instability. While objective balance measures improved, there was no significant change in patient-reported outcomes, and the overall certainty of the evidence is very low.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →