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Volume 16, Issue 4 ( Autumn-InPress 2026)
PTJ 2026, 16(4): 0-0 |
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Khaliliyan H, Bahramizadeh M, Ansari M, Ghaffari F, Sharafatvaziri A, Jouibari M F, et al . Effects of Virtual Reality Training on Perceived Instability, Postural Control, Gait, and Ankle Strength in Individuals with Chronic Ankle Instability: A Systematic Review and Meta-Analysis. PTJ 2026; 16 (4)
URL: http://ptj.uswr.ac.ir/article-1-952-en.html
URL: http://ptj.uswr.ac.ir/article-1-952-en.html
Hanieh Khaliliyan1 
, Mahmood Bahramizadeh *2 , Majid Ansari3 , Farhad Ghaffari4 , Arash Sharafatvaziri5 , Morteza Faghih Jouibari6 , Maria Grazia Maggio7 , Amelia Rizzo8
, Mahmood Bahramizadeh *2 , Majid Ansari3 , Farhad Ghaffari4 , Arash Sharafatvaziri5 , Morteza Faghih Jouibari6 , Maria Grazia Maggio7 , Amelia Rizzo8
1- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
2- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. & Neuromusculoskeletal Rehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
3- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
4- Orthopedic & Rehabilitation Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
5- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
6- Department of neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
7- Centro Neurolesi Bonino Pulejo: Messina, Italy
8- National Institute of Social Welfare (INPS), Medical Legal Centre of Messina, Italy.
2- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. & Neuromusculoskeletal Rehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
3- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
4- Orthopedic & Rehabilitation Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
5- Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
6- Department of neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
7- Centro Neurolesi Bonino Pulejo: Messina, Italy
8- National Institute of Social Welfare (INPS), Medical Legal Centre of Messina, Italy.
Abstract: (16 Views)
Objectives: This study evaluated the effectiveness of virtual reality (VR) approaches in comparison with traditional rehabilitation interventions or control treatments. The study also measured parameters related to balance, walking, perceived instability, and muscle strength of the ankle.
Methods: Fourteen randomized controlled trials (out of 296 initially identified records) were included in the study. The Cochrane RoB 2.0 was used to assess bias risk. The effect size for all studies was determined as the standardized mean difference (SMD) with 95% confidence interval. Relevant articles were identified by searching three health and biomedical databases, including PubMed, Web of Science, and Scopus, from inception to May 27, 2026.
Results: Fourteen studies (comprising a total of 548 participants) included in the final synthesis. VR training yielded a significant, large improvement in perceived ankle instability (SMD=0.96; 95% CI: 0.51 to 1.41; p<0.001) and moderate improvements in overall postural stability (SMD=-0.98; 95% CI: -1.93 to -0.02; p=0.04). However, effects on directional stability indices were heterogeneous. VR significantly improved plantar flexion and inversion strength (SMD=0.78-0.79; p<0.02), but effects on dorsiflexion and eversion strength were non-significant. Functional performance showed inconsistent results, with significant improvements in triple hop (SMD=2.92) but not figure-of-8 hop tests.
Conclusion: VR training demonstrates promising efficacy for enhancing perceived ankle stability and overall postural control, with moderate effects on strength parameters. However, its effectiveness varies across functional performance metrics.
Methods: Fourteen randomized controlled trials (out of 296 initially identified records) were included in the study. The Cochrane RoB 2.0 was used to assess bias risk. The effect size for all studies was determined as the standardized mean difference (SMD) with 95% confidence interval. Relevant articles were identified by searching three health and biomedical databases, including PubMed, Web of Science, and Scopus, from inception to May 27, 2026.
Results: Fourteen studies (comprising a total of 548 participants) included in the final synthesis. VR training yielded a significant, large improvement in perceived ankle instability (SMD=0.96; 95% CI: 0.51 to 1.41; p<0.001) and moderate improvements in overall postural stability (SMD=-0.98; 95% CI: -1.93 to -0.02; p=0.04). However, effects on directional stability indices were heterogeneous. VR significantly improved plantar flexion and inversion strength (SMD=0.78-0.79; p<0.02), but effects on dorsiflexion and eversion strength were non-significant. Functional performance showed inconsistent results, with significant improvements in triple hop (SMD=2.92) but not figure-of-8 hop tests.
Conclusion: VR training demonstrates promising efficacy for enhancing perceived ankle stability and overall postural control, with moderate effects on strength parameters. However, its effectiveness varies across functional performance metrics.
Type of Study: Systematic Review |
Subject:
Sport injury and corrective exercises
Received: 2026/07/27 | Accepted: 2026/09/2 | Published: 2026/08/28
Received: 2026/07/27 | Accepted: 2026/09/2 | Published: 2026/08/28
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