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Characteristics of people with recurrent ankle sprains: a systematic review with meta-analysis
  1. Claire E Hiller1,
  2. Elizabeth J Nightingale1,
  3. Chung-Wei Christine Lin2,
  4. Garrett F Coughlan3,
  5. Brian Caulfield3,
  6. Eamonn Delahunt3
  1. 1University of Sydney, Sydney, Australia
  2. 2The George Institute for Global Health and Sydney Medical School, University of Sydney, Sydney, Australia
  3. 3School of Public Health, Physiotherapy and Population Science, and Institute for Sport and Health, University College Dublin, Dublin, Ireland
  1. Correspondence to Dr Claire Hiller, Discipline of Physiotherapy, University of Sydney, PO Box 170, Lidcombe NSW 1825, Australia; claire.hiller{at}


Objective To examine whether people with recurrent ankle sprain, have specific physical and sensorimotor deficits.

Design A systematic review of journal articles in English using electronic databases to September 2009. Included articles compared physical or sensorimotor measures in people with recurrent (≥2) ankle sprains and uninjured controls.

Main outcome groups Outcome measures were grouped into: physical characteristics, strength, postural stability, proprioception, response to perturbation, biomechanics and functional tests. A meta-analysis was undertaken where comparable results within an outcome group were inconsistent.

Results Fifty-five articles met the inclusion criteria. Compared with healthy controls, people with recurrent sprains demonstrated radiographic changes in the talus, changes in foot position during gait and prolonged time to stabilisation after a jump. There were no differences in ankle range of motion or functional test performance. Pooled results showed greater postural sway when standing with eyes closed (SMD=0.9, 95% CI 0.4 to 1.4) or on unstable surfaces (0.5, 0.1 to 1.0) and decreased concentric inversion strength (1.1, 0.2 to 2.1) but no difference in evertor strength, inversion joint position sense or peroneal latency in response to a perturbation.

Conclusion There are specific impairments in people with recurrent ankle sprain but not necessarily in areas commonly investigated.

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  • Funding CEH was funded by a University of Sydney Postdoctoral Scholarship. C-WL was funded by the National Health and Medical Research Council.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.