Efficacy of conservative intervention for kinesiophobia in individuals with a history of ankle sprain: A systematic review.

Abstract

Objective: To determine the effect of conservative interventions on kinesiophobia, a fear-avoidance belief regarding exercise, in individuals who have had a lateral ankle sprain.

Literature survey: Systematic computerized literature search was performed using PubMed, CINAHL, Web of Sciences, and Cochrane Library databases. Randomized controlled trials investigating the effects of conservative interventions on kinesiophobia in individuals with a history of lateral ankle sprain, including chronic ankle instability, compared to those of control, sham, or different conservative interventions were included. They were written in English and published prior to December 2023.

Methodology: Two independent reviewers screened the studies using specific eligibility criteria. Study characteristics, patients, intervention and comparator, and outcome were extracted. Outcomes were defined as kinesiophobia observed using a questionnaire (eg, Tampa Scale for Kinesiophobia-11) or other means. The risk of bias was assessed using the Revised Cochrane risk of bias tool for randomized trials.

Synthesis: Five randomized controlled trials were included. These studies examined the effects of transcranial direct current stimulation, joint mobilization, balance and strength training, visual biofeedback during multimodal training, and low-friction patches attached to the outside of shoes, respectively. Limited evidence from single studies showed that the visual biofeedback during walking and low-friction patches attached on the outside of shoes were significantly more effective than the control and other treatments for kinesiophobia in individuals with a history of a lateral ankle sprain. Because the intervention and control groups differed between studies, data synthesis through meta-analysis was not performed.

Conclusions: Visual biofeedback during walking and low-friction patches attached on the outside of shoes may improve kinesiophobia in patients with a history of lateral ankle sprains. An approach to sensory-perceptual impairment in individuals with a history of lateral ankle sprains may be more effective in improving kinesiophobia. These conservative interventions may have an effect on kinesiophobia, but the evidence is limited.