Effect of Functional Rehabilitation on Performance of the Star Excursion Balance Test Among Recreational Athletes With Chronic Ankle Instability: A Systematic Review.

Only recreational athletes were studied, so these results may not carry over to less active patients or to general clinical groups. The whole review rests on 10 small trials with 368 people between them, and a single small study could sway the average change. Seven of the 10 trials were low quality and only 2 were high quality. Common problems were poor concealment of who got which treatment, no blinding of the people assessing the results, no intention-to-treat analysis, and no check that participants actually did the exercises. Five trials were rated at high risk of bias, mainly because it is hard to blind participants to an exercise programme. No meta-analysis was done, so the numbers in this review are descriptions of separate studies rather than one combined estimate; the authors themselves say the findings are not conclusive. Only 2 trials followed anyone up, at 1 week and 6 weeks, so nothing is known about longer-term effects. The only outcome examined was dynamic postural control on the Star Excursion Balance Test or Y Balance Test; self-reported function measures were not included. The suggestion that 4 weeks is long enough comes from comparing different studies with each other, not from a head-to-head trial, and only one of the 4-week trials was high quality. Only one low-quality trial directly compared two rehabilitation types, so no rehabilitation type can be called better than another.

The article text supplied contains no funding statement and no conflict of interest declaration, so it is not possible to say who paid for the work or what the authors declared.

Do not read the suggested dose of three sessions a week for four to six weeks as tested and proven. Seven of the ten trials were low quality, the review combined no numbers, and the recommendation is the authors' reading of studies that mostly differed from one another. Nothing here shows these programmes reduce future ankle sprains.