Risk of Bias Tool (RoB2).

Objective This study conducts a rigorous meta-analysis of existing literature to rigorously examine the efficacy of Proprioceptive Neuromuscular Facilitation (PNF) in ameliorating functional deficits associated with Chronic Ankle Instability (CAI). Methods Literature searches were conducted in multiple databases including China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biology Medicine disc (CBM), PubMed, EBSCO (Medline, CINAHL, SPORTDiscus, and Rehabilitation & Sports Medicine Source), Embase, ScienceDirect, ProQuest, Cochrane Library, and Web of Science for randomized controlled trials assessing the effects of Proprioceptive Neuromuscular Facilitation interventions on patients with Chronic Ankle Instability. The publication timeframe spanned from the inception of each database until April 10, 2024. Meta-analysis was performed using STATA 12 software on the included studies. Results ① A total of 12 randomized controlled trials were included, encompassing 405 patients with Chronic Ankle Instability, demonstrating a generally high methodological quality of the literature.② Meta-analysis results indicate that compared to the control group, Proprioceptive Neuromuscular Facilitation (PNF) significantly enhanced the balance ability of patients with Chronic Ankle Instability as measured by the Y Balance Test (YBT) (Weighted Mean Difference (WMD) = 3.61, 95% CI [2.65, 4.56], z = 7.42, P<0.001) and the Star Excursion Balance Test (SEBT) (WMD = 5.50, 95% CI [3.80, 7.19], z = 6.36, P<0.001), with improvement in all eight directions of SEBT balance ability surpassing that of the control group (P<0.05); muscle strength around the ankle (SMD) = 0.19, 95% CI [0.03, 0.36], z = 2.26, P = 0.024), with both Plantar flexion and Dorsal flexion muscle strength improvements exceeding those of the control group (P<0.05); Visual Analog Scale (VAS) (WMD = -1.39, 95% CI [-1.72, -1.06], z = 8.23, P<0.001); Ankle instability questionnaire (WMD = 2.91, 95% CI [1.92, 3.89], z = 5.78, P<0.001).③Descriptive analysis results showed that the differences in Inversion Joint Position Sense and Dorsiflexion range of motion between the PNF and control groups were not statistically significant (P>0.05), however, the effects of PNF training persisted for a certain period even after cessation of treatment. Conclusion Proprioceptive Neuromuscular Facilitation (PNF) can significantly improve balance, muscle strength, and pain in patients with Chronic Ankle Instability (CAI). While PNF has shown improvements in joint position sense and dorsiflexion range of motion for CAI patients, with effects that remain for a period thereafter, these improvements were not significantly different when compared to the control group. Further research is required to substantiate these specific effects.研究目的 本研究对现有文献开展严格的元分析，以严谨考察本体感觉神经肌肉促进疗法（Proprioceptive Neuromuscular Facilitation, PNF）对改善慢性踝关节不稳（Chronic Ankle Instability, CAI）相关功能缺损的疗效。 研究方法 本研究在多个数据库中进行文献检索，包括中国知网（China National Knowledge Infrastructure, CNKI）、维普（VIP）、万方（Wanfang）、中国生物医学文献数据库（China Biology Medicine disc, CBM）、PubMed、EBSCO（含Medline、CINAHL、SPORTDiscus及Rehabilitation & Sports Medicine Source）、Embase、ScienceDirect、ProQuest、考克兰图书馆（Cochrane Library）及Web of Science，检索对象为评估本体感觉神经肌肉促进疗法干预对慢性踝关节不稳患者疗效的随机对照试验。检索时限为各数据库建库至2024年4月10日。本研究采用STATA 12软件对纳入的研究进行元分析。 研究结果 ① 最终纳入12项随机对照试验，共包含405例慢性踝关节不稳患者，纳入文献的方法学质量整体较高。 ② 元分析结果显示：与对照组相比，本体感觉神经肌肉促进疗法（PNF）可显著提升慢性踝关节不稳患者的平衡能力，具体表现为Y平衡测试（Y Balance Test, YBT）的加权均数差（Weighted Mean Difference, WMD）=3.61，95%置信区间（CI）[2.65, 4.56]，z=7.42，P<0.001；星式往返平衡测试（Star Excursion Balance Test, SEBT）的WMD=5.50，95%CI[3.80, 7.19]，z=6.36，P<0.001，且SEBT8个方向的平衡能力改善均优于对照组（P<0.05）；踝关节周围肌力的标准化均数差（Standardized Mean Difference, SMD）=0.19，95%CI[0.03, 0.36]，z=2.26，P=0.024，其中跖屈与背屈肌力的改善均优于对照组（P<0.05）；视觉模拟评分法（Visual Analog Scale, VAS）的WMD=-1.39，95%CI[-1.72, -1.06]，z=8.23，P<0.001；踝关节不稳定问卷的WMD=2.91，95%CI[1.92, 3.89]，z=5.78，P<0.001。 ③ 描述性分析结果显示：本体感觉神经肌肉促进疗法组与对照组在内翻关节位置觉及背屈活动度方面的差异无统计学意义（P>0.05），但本体感觉神经肌肉促进疗法的训练效果在停止治疗后仍可维持一段时间。 研究结论 本体感觉神经肌肉促进疗法（PNF）可显著改善慢性踝关节不稳（Chronic Ankle Instability, CAI）患者的平衡能力、肌力与疼痛症状。尽管PNF可改善慢性踝关节不稳患者的关节位置觉与背屈活动度，且该改善效果可维持一段时间，但与对照组相比，此类改善差异无统计学意义，仍需开展进一步研究以验证此类特定疗效。