Physical Treatments - Specific Physical Therapy

en 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 آسیب شناسی ورزشی و حرکات اصلاحی Sport injury and corrective exercises مرور سیستماتیک/ آنالیز متا Systematic Review <div style="text-align: justify;">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. </div> Ankle sprain, Balance, Muscle strength, Rehabilitation, Virtual reality, Walking 0 0 http://ptj.uswr.ac.ir/browse.php?a_code=A-10-189-2&slc_lang=en&sid=1 Hanieh Khaliliyan haniehkhaliliyan@yahoo.com 0000-0002-6400-5826 No Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Mahmood Bahramizadeh mbzoandp@gmail.com 0000-0003-4719-938x Yes Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Majid Ansari majid.ansari@gmail.com 0009-0000-4572-1141 No Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Farhad Ghaffari farhadb75@yahoo.com 0009-0006-7412-0357 No Orthopedic & Rehabilitation Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Arash Sharafatvaziri arash.sharafatvaziri@gmail.com 0000-0002-4139-0071 No Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran Morteza Faghih Jouibari mortezafaghihj@yahoo.com 0000-0001-9171-0830 No Department of neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maria Grazia Maggio hanie.khaliliyan@gmail.com 0000-0003-0757-2389 No Centro Neurolesi Bonino Pulejo: Messina, Italy Amelia Rizzo amrizzo@unime.it 0000-0002-6229-6463 No National Institute of Social Welfare (INPS), Medical Legal Centre of Messina, Italy.