Does joint mobilization effectively improve chronic ankle instability ? A systematic review and meta-analysis

Objective The aim of this study is to systematically evaluate the effectiveness of joint mobilization (JM) in improving chronic ankle instability (CAI). Methods We conducted a search in six databases—PubMed, Embase, Cochrane Library, Web of Science, Pedro, and China National Knowledge Infrastructure (CNKI)—up to March 10, 2025. We included all published randomized controlled trials (RCTs) on JM for the treatment of CAI. The primary outcome measure was ankle function (Cumberland Ankle Instability Tool, CAIT), and the secondary outcomes were pain and ankle range of motion (ROM). All outcome measures were analyzed by calculating standardized mean differences (SMDs) and 95% confidence intervals (CIs). Results We identified 237 studies across six databases and ultimately included 8 RCTs involving 318 subjects with CAI. Our findings indicate that, compared to the control group, JM effectively improves ankle function (SMD = 1.62; 95% CI = 0.29–2.94; P = 0.02, I 2 = 92%) and ROM (SMD = 1.18; 95% CI = 0.22–2.15; P < 0.0001, I 2 = 90%) in CAI subjects, but no significant difference was observed in ankle pain (SMD = –0.27; 95% CI = –0.68 to 0.13; P = 0.18, I 2 = 0%). Conclusion JM has been shown to effectively improve ankle joint function and ROM in subjects with CAI, although it does not significantly alleviate pain associated with CAI.