Sports Medicine

, Volume 48, Issue 1, pp 189–205 | Cite as

Factors Contributing to Chronic Ankle Instability: A Systematic Review and Meta-Analysis of Systematic Reviews

  • Cassandra Thompson
  • Siobhan Schabrun
  • Rick Romero
  • Andrea Bialocerkowski
  • Jaap van Dieen
  • Paul Marshall
Systematic Review



Many factors are thought to contribute to chronic ankle instability (CAI). Multiple systematic reviews have synthesised the available evidence to identify the primary contributing factors. However, readers are now faced with several systematic reviews that present conflicting findings.


The aim of this systematic review and meta-analysis was to establish the statistical significance and effect size of primary factors contributing to CAI and to identify likely reasons for inconsistencies in the literature.


Relevant health databases were searched: CINAHL, MEDLINE, PubMed, Scopus and SPORTDiscus. Systematic reviews were included if they answered a focused research question, clearly defined the search strategy criteria and study selection/inclusion and completed a comprehensive search of the literature. Included reviews needed to be published in a peer-reviewed journal and needed to review observational studies of factors and/or characteristics of persons with CAI, with or without meta-analysis. There was no language restriction. Studies using a non-systematic review methodology (e.g. primary studies and narrative reviews) were excluded. Methodological quality of systematic reviews was assessed using the modified R-AMSTAR tool. Meta-analysis on included primary studies was performed.


Only 17% of primary studies measured a clearly defined CAI population. There is strong evidence to support the contribution of dynamic balance, peroneal reaction time and eversion strength deficits and moderate evidence for proprioception and static balance deficits to non-specific ankle instability.


Evidence from previous systematic reviews does not accurately reflect the CAI population. For treatment of non-specific ankle instability, clinicians should focus on dynamic balance, reaction time and strength deficits; however, these findings may not be translated to the CAI population. Research should be updated with an adequately controlled CAI population.

Systematic review registration

PROSPERO 2016, CRD42016032592.


Author Contributions

Cassandra Thompson was responsible for the conception of the review question and the acquisition, analysis and interpretation of the data. Siobhan Schabrun assisted in review design, interpretation and revision and drafting of the manuscript. Rick Romero assisted with data acquisition. Paul Marshall, Andrea Bialocerkowski and Jaap van Dieen contributed to the revision of the manuscript.

Compliance with Ethical Standards


Cassandra Thompson is supported by a Western Sydney University Post-Graduate Research Award. Siobhan Schabrun is supported by a Career Development Fellowship from The National Health and Medical Research Council of Australia (1105040). No other sources of funding were used to assist in the conduct of this research or the preparation of this article.

Conflict of interest

Cassandra Thompson, Siobhan Schabrun, Rick Romero, Andrea Bialocerkowski, Jaap van Dieen and Paul Marshall declare that they have no conflicts of interest relevant to the content of this review.

Supplementary material

40279_2017_781_MOESM1_ESM.pdf (86 kb)
Supplementary material 1 (PDF 86 kb)
40279_2017_781_MOESM2_ESM.pdf (94 kb)
Supplementary material 2 (PDF 94 kb)


  1. 1.
    Soboroff SH, Pappius EM, Komaroff AL. Benefits, risks, and costs of alternative approaches to the evaluation and treatment of severe ankle sprain. Clin Orthop Relat Res. 1984;183:160–8.Google Scholar
  2. 2.
    Verhagen E, Van Tulder M, Van der Beek A, et al. An economic evaluation of a proprioceptive balance board training programme for the prevention of ankle sprains in volleyball. Br J Sports Med. 2005;39(2):111–5.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Yeung M, Chan KM, So C, et al. An epidemiological survey on ankle sprain. Br J Sports Med. 1994;28(2):112–6.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Hintermann B, Valderrabano V, Dereymaeker G, et al. The HINTEGRA ankle: rationale and short-term results of 122 consecutive ankles. Clin Orthop Relat Res. 2004;424:57–68.CrossRefGoogle Scholar
  5. 5.
    Valderrabano V, Hintermann B, Dick W. Scandinavian total ankle replacement: a 3.7-year average followup of 65 patients. Clin Orthop Relat Res. 2004;424:47–56.CrossRefGoogle Scholar
  6. 6.
    Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train. 2011;46(2):133–41.PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Arnold BL, De La Motte S, Linens S, et al. Ankle instability is associated with balance impairments: A meta-analysis. Med Sci Sports Exerc. 2009;41(5):1048–62.PubMedCrossRefGoogle Scholar
  8. 8.
    Hiller CE, Nightingale EJ, Lin C-WC, et al. Characteristics of people with recurrent ankle sprains: a systematic review with metaanalysis. Br J Sports Med. 2011;45(8):660–72.PubMedCrossRefGoogle Scholar
  9. 9.
    Munn J, Sullivan SJ, Schneiders AG. Evidence of sensorimotor deficits in functional ankle instability: a systematic review with meta-analysis. J Sci Med Sport. 2010;13(1):2–12.PubMedCrossRefGoogle Scholar
  10. 10.
    McKeon JM, McKeon PO. Evaluation of joint position recognition measurement variables associated with chronic ankle instability: a meta-analysis. J Athl Train. 2012;47(4):444–56.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Wright CJ, Arnold BL. Eversion force sense characteristics in individuals with functional ankle instability: a systematic review. Athl Train Sports Health Care. 2011;3(1):33–42.CrossRefGoogle Scholar
  12. 12.
    Hoch MC, McKeon PO. Peroneal reaction time after ankle sprain: A systematic review and meta-analysis. Med Sci Sports Exerc. 2014;46(3):546–56.PubMedCrossRefGoogle Scholar
  13. 13.
    Arnold BL, Linens SW, De La Motte SJ, et al. Concentric evertor strength differences and functional ankle instability: a meta-analysis. J Athl Train. 2009;44(6):653–62.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Cordova ML, Sefton JM, Hubbard TJ. Mechanical joint laxity associated with chronic ankle instability: a systematic review. Sports Health. 2010;2(6):452–9.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Delahunt E, Coughlan GF, Caulfield B, et al. Inclusion criteria when investigating insufficiencies in chronic ankle instability. Med Sci Sports Exerc. 2010;42(11):2106–21.PubMedCrossRefGoogle Scholar
  16. 16.
    Gribble PA, Delahunt E, Bleakley C, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med. 2014;48(13):1014–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Thompson C, Schabrun S, Romero R, et al. Factors contributing to chronic ankle instability: a protocol for a systematic review of systematic reviews. Syst Rev. 2016;5(1):94.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Kung J, Chiappelli F, Cajulis OO, et al. From systematic reviews to clinical recommendations for evidence-based health care: validation of revised assessment of multiple systematic reviews (R-AMSTAR) for grading of clinical relevance. Open Dent J. 2010;4:84.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions Version 5.1.0. The Cochrane Collaboration; 2011. Available from Updated March 2011. Accessed 16 Mar 2016.
  20. 20.
    Wikstrom EA, Naik S, Lodha N, et al. Bilateral balance impairments after lateral ankle trauma: a systematic review and meta-analysis. Gait Posture. 2010;31(4):407–14.PubMedCrossRefGoogle Scholar
  21. 21.
    Wikstrom E, Naik S, Lodha N, et al. Balance capabilities after lateral ankle trauma and intervention: a meta-analysis. Med Sci Sports Exerc. 2009;41(6):1287.PubMedCrossRefGoogle Scholar
  22. 22.
    Song K, Burcal C, Hertel J, et al. Increased visual utilization in chronic ankle instability: a meta-analysis. Med Sci Sports Exerc. 2016;48(10):2046–56.PubMedCrossRefGoogle Scholar
  23. 23.
    Moisan G, Descarreaux M, Cantin V. Effects of chronic ankle instability on kinetics, kinematics and muscle activity during walking and running: a systematic review. Gait Posture. 2017;52:381–99.PubMedCrossRefGoogle Scholar
  24. 24.
    Menacho MD, Pereira HM, de Oliveira BIR, et al. The peroneus reaction time during sudden inversion test: systematic review. J Electromyogr Kinesiol. 2010;20(4):559–65.CrossRefGoogle Scholar
  25. 25.
    Pourkazemi F, Hiller CE, Raymond J, et al. Predictors of chronic ankle instability after an index lateral ankle sprain: a systematic review. J Sci Med Sport. 2014;17(6):568–73.PubMedCrossRefGoogle Scholar
  26. 26.
    Witchalls J, Blanch P, Waddington G, et al. Intrinsic functional deficits associated with increased risk of ankle injuries: a systematic review with meta-analysis. Br J Sports Med. 2012;46(7):515–23.PubMedCrossRefGoogle Scholar
  27. 27.
    McKeon PO, Hertel J. Systematic review of postural control and lateral ankle instability, part I: can deficits be detected with instrumented testing. J Athl Train. 2008;43(3):293.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    de Noronha M, Refshauge KM, Herbert RD, et al. Do voluntary strength, proprioception, range of motion, or postural sway predict occurrence of lateral ankle sprain? Br J Sports Med. 2006;40(10):824–8.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    da Silva RS, da Silva AP, Sønego DA, et al. Neuromuscular alterations on the hip associated to ankle sprains: literature review. Fisioter Mov. 2011;24(3):503–11.CrossRefGoogle Scholar
  30. 30.
    Houston MN, Hoch JM, Hoch MC. Patient-reported outcome measures in individuals with chronic ankle instability: a systematic review. J Athl Train. 2015;50(10):1019–33.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg. 2010;92(13):2279–84.PubMedCrossRefGoogle Scholar
  32. 32.
    McKeon JM, McKeon PO. Do those with chronic ankle instability have deficits in joint position recognition? A systematic review. J Orthop Sports Phys Ther. 2009;39(10):A22-A.Google Scholar
  33. 33.
    Wikstrom EA, Tillman MD, Borsa PA. Detection of dynamic stability deficits in subjects with functional ankle instability. Med Sci Sports Exerc. 2005;37(2):169–75.PubMedCrossRefGoogle Scholar
  34. 34.
    Baier M, Hopf T. Ankle orthoses effect on single-limb standing balance in athletes with functional ankle instability. Arch Phys Med Rehabil. 1998;79(8):939–44.PubMedCrossRefGoogle Scholar
  35. 35.
    Brown CN, Mynark R. Balance deficits in recreational athletes with chronic ankle instability. J Athl Train. 2007;42(3):367–74.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Gauffin H, Tropp H, Odenrick P. Effect of ankle disk training on postural control in patients with functional instability of the ankle joint. Int J Sports Med. 1988;9(2):141–4.PubMedCrossRefGoogle Scholar
  37. 37.
    Hubbard TJ. Contributing factors to chronic ankle instability. Foot Ankle Int. 2005;28(3):343–54.CrossRefGoogle Scholar
  38. 38.
    Nakagawa L, Hoffman M. Performance in static, dynamic, and clinical tests of postural control in individuals with recurrent ankle sprains. J Sport Rehabil. 2004;13(3):255–68.CrossRefGoogle Scholar
  39. 39.
    Santos M, Liu W. Possible factors related to functional ankle instability. J Orthop Sports Phys Ther. 2008;38(3):150–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Tropp H, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med. 1985;13(4):259–62.PubMedCrossRefGoogle Scholar
  41. 41.
    Tropp H. Pronator muscle weakness in functional instability of the ankle joint. Int J Sports Med. 1986;7(5):291–4.PubMedCrossRefGoogle Scholar
  42. 42.
    Tropp H, Odenrick P. Postural control in single-limb stance. J Orthop Res. 1988;6(6):833–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Perrin P, Bene M, Perrin C, et al. Ankle trauma significantly impairs posture control—a study in basketball players and controls. Int J Sports Med. 1997;18(5):387–92.PubMedCrossRefGoogle Scholar
  44. 44.
    Cornwall M, Murrell P. Postural sway following inversion sprain of the ankle. J Am Podiatr Med Assoc. 1991;81(5):243–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Fu AS, Hui-Chan CW. Ankle joint proprioception and postural control in basketball players with bilateral ankle sprains. Am J Sports Med. 2005;33(8):1174–82.PubMedCrossRefGoogle Scholar
  46. 46.
    Hiller CE, Refshauge KM, Beard DJ. Sensorimotor control is impaired in dancers with functional ankle instability. Am J Sports Med. 2004;32(1):216–23.PubMedCrossRefGoogle Scholar
  47. 47.
    Hiller CE, Refshauge KM, Herbert RD, et al. Balance and recovery from a perturbation are impaired in people with functional ankle instability. Clin J Sports Med. 2007;17(4):269–75.CrossRefGoogle Scholar
  48. 48.
    Isakov E, Mizrahi J. Is balance impaired by recurrent sprained ankle? Br J Sports Med. 1997;31(1):65–7.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Konradsen L, Ravn JB. Prolonged peroneal reaction time in ankle instability. Int J Sports Med. 1991;12(3):290–2.PubMedCrossRefGoogle Scholar
  50. 50.
    Lee AJY, Lin WH, Huang CH. Impaired proprioception and poor static postural control in subjects with functional instability of the ankle. J Exerc Sci Fitness. 2006;4(2):117–25.Google Scholar
  51. 51.
    Michell TB, Ross SE, Blackburn JT, et al. Functional balance training, with or without exercise sandals, for subjects with stable or unstable ankles. J Athl Train. 2006;41(4):393–8.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Mitchell A, Dyson R, Hale T, et al. Biomechanics of ankle instability. Part 1: Reaction time to simulated ankle sprain. Med Sci Sports Exerc. 2008;40(8):1515–21.PubMedCrossRefGoogle Scholar
  53. 53.
    Ross SE, Guskiewicz KM. Examination of static and dynamic postural stability in individuals with functionally stable and unstable ankles. Clin J Sports Med. 2004;14(6):332–8.CrossRefGoogle Scholar
  54. 54.
    Zinder SM. Influence of ankle bracing and load on factors of stability in functionally unstable and normal ankles [dissertation]. University of Virginia. 2002; p. 330.Google Scholar
  55. 55.
    Bernier JN, Perrin DH, Rijke A. Effect of unilateral functional instability of the ankle on postural sway and inversion and eversion strength. J Athl Train. 1997;32(3):226–32.PubMedPubMedCentralGoogle Scholar
  56. 56.
    You SH, Granata KP, Bunker LK. Effects of circumferential ankle pressure on ankle proprioception, stiffness, and postural stability: a preliminary investigation. J Orthop Sports Phys Ther. 2004;34(8):449–60.PubMedCrossRefGoogle Scholar
  57. 57.
    Docherty CL, McLeod TCV, Shultz SJ. Postural control deficits in participants with functional ankle instability as measured by the Balance Error Scoring System. Clin J Sports Med. 2006;16(3):203–8.CrossRefGoogle Scholar
  58. 58.
    Rozzi SL, Lephart SM, Sterner R, et al. Balance training for persons with functionally unstable ankles. J Orthop Sports Phys Ther. 1999;29(8):478–86.PubMedCrossRefGoogle Scholar
  59. 59.
    Pintsaar A, Brynhildsen J, Tropp H. Postural corrections after standardised perturbations of single limb stance: effect of training and orthotic devices in patients with ankle instability. Br J Sports Med. 1996;30(2):151–5.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Hertel J, Olmsted-Kramer LC. Deficits in time-to-boundary measures of postural control with chronic ankle instability. Gait Posture. 2007;25(1):33–9.PubMedCrossRefGoogle Scholar
  61. 61.
    Chrintz H, Falster O, Roed J. Single-leg postural equilibrium test. Scand J Med Sci Sports. 1991;1(4):244–6.CrossRefGoogle Scholar
  62. 62.
    Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4-week comprehensive rehabilitation program on postural control and lower extremity function in individuals with chronic ankle instability. J Orthop Sports Phys Ther. 2007;37(6):303–11.PubMedCrossRefGoogle Scholar
  63. 63.
    Wayne HA. A comparison of the balance error scoring system with selected forceplate measures in individuals with functionally unstable ankles [dissertation]. University of North Carolina. 2004.Google Scholar
  64. 64.
    Powell MR, Powden CJ, Houston MN, et al. Plantar cutaneous sensitivity and balance in individuals with and without chronic ankle instability. Clin J Sports Med. 2014;24(6):490–6.CrossRefGoogle Scholar
  65. 65.
    Knapp D, Lee SY, Chinn L, et al. Differential ability of selected postural-control measures in the prediction of chronic ankle instability status. J Athl Train. 2011;46(3):257–62.PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Hubbard TJ, Kramer LC, Denegar CR, et al. Correlations between multiple measures of functional and mechanical instability in those with chronic ankle instability. J Orthop Sports Phys Ther. 2006;36(11):A15-A.Google Scholar
  67. 67.
    McKeon PO, Ingersoll CD, Kerrigan DC, et al. Balance training improves function and postural control in those with chronic ankle instability. Med Sci Sports Exerc. 2008;40(10):1810–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Gribble PA, Hertel J, Denegar CR, et al. The effects of fatigue and chronic ankle instability on dynamic postural control. J Athl Train. 2004;39(4):321–9.PubMedPubMedCentralGoogle Scholar
  69. 69.
    Hertel J, Braham RA, Hale SA, et al. Simplifying the Star Excursion Balance Test: analyses of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther. 2006;36(3):131–7.PubMedCrossRefGoogle Scholar
  70. 70.
    Olmsted LC, Carciat CR, Hertel J, et al. Efficacy of the Star Excursion Balance Tests in detecting reach deficits in subjects with chronic ankle instability. J Athl Train. 2002;37(4):501–6.PubMedPubMedCentralGoogle Scholar
  71. 71.
    Ross SE, Guskiewicz KM. Effect of coordination training with and without stochastic resonance stimulation on dynamic postural stability of subjects with functional ankle instability and subjects with stable ankles. Clin J Sports Med. 2006;16(4):323–8.CrossRefGoogle Scholar
  72. 72.
    Ross SE, Guskiewicz KM, Yu B. Single-leg jump-landing stabilization times in subjects with functionally unstable ankles. J Athl Train. 2005;40(4):298.PubMedPubMedCentralGoogle Scholar
  73. 73.
    Brown C, Ross S, Mynark R, et al. Assessing functional ankle instability with joint position sense, time to stabilization, and electromyography. J Sport Rehabil. 2004;13(2):122–34.CrossRefGoogle Scholar
  74. 74.
    Boyle J, Negus V. Joint position sense in the recurrently sprained ankle. Aust J Physiother. 1998;44(3):159–63.PubMedCrossRefGoogle Scholar
  75. 75.
    Liu YW, Jeng SC, Lee AJY. The influence of ankle sprains on proprioception. J Exerc Sci Fitness. 2005;3(1):33–8.Google Scholar
  76. 76.
    Willems T, Witvrouw E, Verstuyft J, et al. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train. 2002;37(4):487–93.PubMedPubMedCentralGoogle Scholar
  77. 77.
    Gross MT. Effects of recurrent lateral ankle sprains on active and passive judgments of joint position. Phys Ther. 1987;67(10):1505–9.PubMedCrossRefGoogle Scholar
  78. 78.
    Halasi T, Kynsburg A, Tallay A, et al. Changes in joint position sense after surgically treated chronic lateral ankle instability. Br J Sports Med. 2005;39(11):818–24.PubMedPubMedCentralCrossRefGoogle Scholar
  79. 79.
    Hubbard TJ, Kaminski TW. Kinesthesia is not affected by functional ankle instability status. J Athl Train. 2002;37(4):481–6.PubMedPubMedCentralGoogle Scholar
  80. 80.
    Lentell G, Baas B, Lopez D, et al. The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. J Orthop Sports Phys Ther. 1995;21(4):206–15.PubMedCrossRefGoogle Scholar
  81. 81.
    Refshauge KM, Kilbreath SL, Raymond J. The effect of recurrent ankle inversion sprain and taping on proprioception at the ankle. Med Sci Sports Exerc. 2000;32(1):10–5.PubMedCrossRefGoogle Scholar
  82. 82.
    Refshauge KM, Kilbreath SL, Raymond J. Deficits in detection of inversion and eversion movements among subjects with recurrent ankle sprains. J Orthop Sports Phys Ther. 2003;33(4):166–76.PubMedCrossRefGoogle Scholar
  83. 83.
    Jerosch J, Hoffstetter I, Bork H, et al. The influence of orthoses on the proprioception of the ankle joint. Knee Surg Sports Traumatol Arthrosc. 1995;3(1):39–46.PubMedCrossRefGoogle Scholar
  84. 84.
    Konradsen L, Magnusson P. Increased inversion angle replication error in functional ankle instability. Knee Surg Sports Traumatol Arthrosc. 2000;8(4):246–51.PubMedCrossRefGoogle Scholar
  85. 85.
    Mitchell A, Dyson R, Hale T, et al. Biomechanics of ankle instability. Part 2: Postural sway-reaction time relationship. Med Sci Sports Exerc. 2008;40(8):1522–8.PubMedCrossRefGoogle Scholar
  86. 86.
    Ebig M, Lephart SM, Burdett RC, et al. The effect of sudden inversion stress on EMG activity of the peroneal and tibialis anterior muscles in the chronically unstable ankle. J Orthop Sports Phys Ther. 1997;26(2):73–7.PubMedCrossRefGoogle Scholar
  87. 87.
    Hopkins JT, Brown TN, Christensen L, et al. Deficits in peroneal latency and electromechanical delay in patients with functional ankle instability. J Orthop Res. 2009;27(12):1541–6.PubMedCrossRefGoogle Scholar
  88. 88.
    Javed A, Walsh HPJ, Lees A. Peroneal reaction time in treated functional instability of the ankle. Foot Ankle Surg. 1999;5(3):159–66.CrossRefGoogle Scholar
  89. 89.
    Karlsson J, Andreasson GO. The effect of external ankle support in chronic lateral ankle joint instability: an electromyographic study. Am J Sports Med. 1992;20(3):257–61.PubMedCrossRefGoogle Scholar
  90. 90.
    Khin Myo H, Ishii T, Sakane M, et al. Effect of anesthesia of the sinus tarsi on peroneal reaction time in patients with functional instability of the ankle. Foot Ankle Int. 1999;20(9):554–9.CrossRefGoogle Scholar
  91. 91.
    Konradsen L, Sommer H. Ankle instability caused by peroneal tendon rupture. A case report. Acta Orthop Scand. 1989;60(6):723–4.PubMedCrossRefGoogle Scholar
  92. 92.
    Löfvenberg R, Kärrholm J, Sundelin G, et al. Prolonged reaction time in patients with chronic lateral instability of the ankle. Am J Sports Med. 1995;23(4):414–7.PubMedCrossRefGoogle Scholar
  93. 93.
    Rosenbaum D, Becker HP, Gerngroß H, et al. Peroneal reaction times for diagnosis of functional ankle instability. Foot Ankle Surg. 2000;6(1):31–8.CrossRefGoogle Scholar
  94. 94.
    Schmidt R, Benesch S, Hald R, et al. Die Inzidenz und Wertigkeit des propriozeptiven Defizites bei Patienten mit chronischer Instabilität des oberen Sprunggelenkes. Dtsch Z Sportmed. 2005;56(11):378–82.Google Scholar
  95. 95.
    Donahue MA. The effect of tape and semi-rigid brace on peroneus longus latency. Int J Fitness. 2010;6(1):9–15.Google Scholar
  96. 96.
    Han K, Ricard MD. Effects of 4 weeks of elastic-resistance training on ankle-evertor strength and latency. J Sport Rehabil. 2011;20(2):157–73.PubMedCrossRefGoogle Scholar
  97. 97.
    Vaes P, Van Gheluwe B, Duquet W. Control of acceleration during sudden ankle supination in people with unstable ankles. J Orthop Sports Phys Ther. 2001;31(12):741–52.PubMedCrossRefGoogle Scholar
  98. 98.
    Vaes P, Duquet W, Van Gheluwe B. Peroneal reaction times and eversion motor response in healthy and unstable ankles. J Athl Train. 2002;37(4):475–80.PubMedPubMedCentralGoogle Scholar
  99. 99.
    Shima N, Maeda A, Hirohashi K. Delayed latency of peroneal reflex to sudden inversion with ankle taping or bracing. Int J Sports Med. 2005;26(06):476–80.PubMedCrossRefGoogle Scholar
  100. 100.
    Lentell GL, Katzman LL, Walters MR. The relationship between muscle function and ankle stability. J Orthop Sports Phys Ther. 1990;11(12):605–11.PubMedCrossRefGoogle Scholar
  101. 101.
    McKnight CM, Armstrong CW. The role of ankle strength in functional ankle instability. J Sport Rehabil. 1997;6(1):21–9.CrossRefGoogle Scholar
  102. 102.
    Ryan L. Mechanical stability, muscle strength and proprioception in the functionally unstable ankle. Aust J Physiother. 1994;40(1):41–7.PubMedCrossRefGoogle Scholar
  103. 103.
    Sekir U, Yildiz Y, Hazneci B, et al. Effect of isokinetic training on strength, functionality and proprioception in athletes with functional ankle instability. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):654–64.PubMedCrossRefGoogle Scholar
  104. 104.
    Yildiz Y, Aydin T, Sekir U, et al. Peak and end range eccentric evertor/concentric invertor muscle strength ratios in chronically unstable ankles: comparison with healthy individuals. J Sports Sci Med. 2003;2(3):70–6.PubMedPubMedCentralGoogle Scholar
  105. 105.
    Kaminski TW, Perrin DH, Gansneder BM. Eversion strength analysis of uninjured and functionally unstable ankles. J Athl Train. 1999;34(3):239–45.PubMedPubMedCentralGoogle Scholar
  106. 106.
    Santos MJ, Liu H, Liu W. Unloading reactions in functional ankle instability. Gait Posture. 2008;27(4):589–94.PubMedCrossRefGoogle Scholar
  107. 107.
    Pontaga I. Ankle joint evertor–invertor muscle torque ratio decrease due to recurrent lateral ligament sprains. Clin Biomech (Bristol, Avon). 2004;19(7):760–2.CrossRefGoogle Scholar
  108. 108.
    Porter GK Jr, Kaminski TW, Hatzel B, et al. An examination of the stretch-shortening cycle of the dorsiflexors and evertors in uninjured and functionally unstable ankles. J Athl Train. 2002;37(4):494–500.PubMedPubMedCentralGoogle Scholar
  109. 109.
    Hartsell H, Spaulding S. Eccentric/concentric ratios at selected velocities for the invertor and evertor muscles of the chronically unstable ankle. Br J Sports Med. 1999;33(4):255–8.PubMedPubMedCentralCrossRefGoogle Scholar
  110. 110.
    Fransz DP, Huurnink A, de Boode VA, et al. Time to stabilization in single leg drop jump landings: an examination of calculation methods and assessment of differences in sample rate, filter settings and trial length on outcome values. Gait Posture. 2015;41(1):63–9.PubMedCrossRefGoogle Scholar
  111. 111.
    Aagaard P, Simonsen EB, Andersen JL, et al. Neural adaptation to resistance training: changes in evoked V-wave and H-reflex responses. J Appl Physiol (1985). 2002;92(6):2309–18.CrossRefGoogle Scholar
  112. 112.
    Cutsem M, Duchateau J, Hainaut K. Changes in single motor unit behaviour contribute to the increase in contraction speed after dynamic training in humans. J Physiol. 1998;513(1):295–305.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Levin O, Vanwanseele B, Thijsen JRJ, et al. Proactive and reactive neuromuscular control in subjects with chronic ankle instability: evidence from a pilot study on landing. Gait Posture. 2015;41(1):106–11.PubMedCrossRefGoogle Scholar
  114. 114.
    IntHout J, Ioannidis JP, Rovers MM, et al. Plea for routinely presenting prediction intervals in meta-analysis. BMJ Open. 2016;6(7):e010247.PubMedPubMedCentralCrossRefGoogle Scholar
  115. 115.
    Guddat C, Grouven U, Bender R, et al. A note on the graphical presentation of prediction intervals in random-effects meta-analyses. Syst Rev. 2012;1(1):34.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Röijezon U, Clark NC, Treleaven J. Proprioception in musculoskeletal rehabilitation. Part 1: basic science and principles of assessment and clinical interventions. Man Ther. 2015;20(3):368–77.PubMedCrossRefGoogle Scholar
  117. 117.
    Sefton JM. Sensorimotor adaptations with chronic ankle instability [dissertation]. University of North Carolina. 2007.Google Scholar
  118. 118.
    Sefton JM, Hicks-Little CA, Hubbard TJ, et al. Sensorimotor function as a predictor of chronic ankle instability. Clin Biomech (Bristol, Avon). 2009;24(5):451–8.CrossRefGoogle Scholar
  119. 119.
    Sedory EJ, McVey ED, Cross KM, et al. Arthogenic muscle response of the quadriceps and hamstrings with chronic ankle instablity. J Athl Train. 2007;42(3):355–60.PubMedPubMedCentralGoogle Scholar
  120. 120.
    Pietrosimone BG, Gribble PA. Chronic ankle instability and corticomotor excitability of the fibularis longus muscle. J Athl Train. 2012;47(6):621–6.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.School of Science in HealthWestern Sydney UniversitySydneyAustralia
  2. 2.School of Allied Health SciencesGriffith UniversitySouthportAustralia
  3. 3.Department of Human Movement SciencesVrije Universiteit Amsterdam, Amsterdam Movement SciencesAmsterdamThe Netherlands
  4. 4.School of Science in HealthWestern Sydney UniversityPenrithAustralia

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