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This systematic review with network meta-analysis examined how different physical therapy approaches affect proprioception — the body’s ability to sense joint position — in people living with chronic ankle instability, a condition that commonly follows repeated ankle sprains and significantly raises the risk of re-injury.
Researchers searched six electronic databases and identified twenty-four randomised controlled trials involving a total of 949 participants. Seven distinct physical therapy methods were evaluated. Six of these — balance training, strength training, combined balance and strength training, cognitive motor training, electroacupuncture, and whole-body vibration training — all produced statistically significant reductions in ankle joint position error, indicating improved proprioception. Electroacupuncture showed a meaningful standardised mean difference in favour of treatment. Only electrophysical agents failed to demonstrate a significant benefit. Whole-body vibration training ranked highest in the network analysis, though its advantage over other therapies, including electroacupuncture, was not statistically significant.
The authors caution that the certainty of the underlying evidence is rated as very low, which limits firm clinical recommendations. They advise that practitioners weigh individual patient circumstances when selecting an intervention, as no single approach was definitively superior.
Conclusion: Electroacupuncture, alongside five other physical therapy methods, significantly improved ankle joint position sense in people with chronic ankle instability, though the low quality of available evidence means treatment choices should be made carefully on an individual basis.
Source: Chen P, Wang L, Zhan J and colleagues. American journal of physical medicine & rehabilitation (2026). View on PubMed (PMID 41955546) · doi:10.1097/PHM.0000000000002905