Effects of balance training with visual occlusion on postural control in individuals with chronic ankle instability: A systematic review and meta-analysis of randomized controlled trials.

Objective: Balance training with visual occlusion positively affects the improvement of proprioception and reduction of visual dependence in individuals with chronic ankle instability (CAI). However, the effect of visual occlusion balance training alone on postural control in individuals with CAI remains controversial. This review conducted a meta-analysis of existing randomized controlled trials (RCTs) to investigate the influence of balance training with visual occlusion on the postural control of individuals with CAI.

Literature survey: PubMed, Embase, The Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure (CNKI), and WanFang database were searched until July 20, 2024. RCTs were eligible if they compared the effects of balance training with visual occlusion with balance training on the postural control of individuals with CAI.

Methodology: The following information from the included articles was extracted: basic study information, interventions, and outcomes. The primary outcomes included Y-balance test (YBT) distance and center of pressure (COP) area, and the secondary outcomes were Cumberland ankle instability tool (CAIT) and Foot and Ankle Ability Measure (FAAM) scores.

Synthesis: Eight RCTs were included in this work. The results show that balance training with visual occlusion significantly improved YBT distance (standardized mean difference [SMD] = 0.40 [95% confidence interval [CI], 0.23-0.57], p < .001) and CAIT scores (mean difference [MD] = 3.03 [95% CI, 1.76-4.29], p < .001) in individuals with CAI compared with balance training alone. However, no significant difference was found between the two groups in terms of the COP area (SMD = 0.18 [95% CI, 0.51-0.86], p = .62) and FAAM scores (MD = 1.79 [95% CI, -0.03 to 3.62], p = .05).

Conclusions: Compared with balance training alone, balance training with visual occlusion may help improve the dynamic postural control ability of individuals with CAI. However, its effect on static postural control ability still needs further study.