Table 4

Overview of relevant studies, showing RR of ankle sprain (NMT vs control), intervention components, study design and quality score

ReferenceDesignQS (%)RR (95% CI)BalanceBalance board*StrengthPlyometrics†AgilityStretchingTechniqueEducation
Bahr et al74Pretest–post-test850.51 (0.32 to 0.81)++++
Cumps et al71CT810.51 (0.20 to 1.32)
Eils et al47RCT740.37 (0.17 to 0.83)+
Emery et al48RCT950.14 (0.02 to 1.13)
Emery et al49RCT1000.71 (0.52 to 0.97)++
Emery and Meeuwisse50RCT790.50 (0.26 to 0.93)+++++
Engebretsen et al51RCT580.68 (0.36 to 1.30)
Grooms et al75Pretest–post-test92#
Holme et al52RCT530.24 (0.06 to 0.99)++
Hupperets et al53RCT790.65 (0.49 to 0.87)++
LaBella et al54RCT790.42 (0.18 to 1.01)
Longo et al55RCT890.77 (0.13 to 4.42)
Malliou et al72CT690.58 (0.41 to 0.82)+
McGuine and Keene56RCT740.62 (0.38 to 1.02)
McHugh et al76Pretest–post-test540.58 (0.33 to 1.02)
Mohammadi57RCT740.13 (0.02 to 0.91)++
Olsen et al58RCT950.64 (0.40 to 1.03)
Owoeye et al59RCT840.32 (0.16 to 0.64)+++++
Parkkari et al60RCT830.43 (0.24 to 0.75)+++++
Pasanen et al61RCT950.23 (0.11 to 0.50)+++++
Petersen et al73CT690.67 (0.27 to 1.69)
Söderman et al62RCT681.17 (0.59 to 2.30)
Soligard et al63RCT840.73 (0.49 to 1.08)
Steffen et al64RCT890.94 (0.69 to 1.28)
Tropp et al65RCT580.18 (0.06 to 0.59)++
van Beijsterveldt et al66RCT741.18 (0.80 to 1.73)
van Rijn et al67RCT890.95 (0.52 to 1.73)
Verhagen et al68RCT790.54 (0.34 to 0.85)++
Wedderkopp et al69RCT680.30 (0.13 to 0.70)++++
Wester et al70RCT470.46 (0.21 to 1.01)
Total effect estimate
 RR (95% CI)0.60 (0.51 to 0.71)0.60 (0.50 to 0.72)0.54 (0.39 to 0.74)0.62 (0.46 to 0.84)0.52 (0.39 to 0.69)0.52 (0.38 to 0.72)0.57 (0.41 to 0.79)0.50 (0.36 to 0.69)
 χ2 (p value)0.0020.030.00020.0010.080.260.490.7
 I2 (%)51446966432500
Total studies (n)3021131210623
Studies preventive effect (%)4752382540505067
  • *Balance training including exercises using a balance board, wobble board, semi-globe, ankle disk, stability pad or balance mat.

  • †Jumping exercises.

  • ‡Excluded from meta-analyses.

  • §Using the ‘Biodex Stability System’ balance device, mini trampoline and balance boards.

  • +, Included intervention component (significant preventive effect of NMT on ankle sprains); −, included intervention component (no significant preventive effect of NMT on ankle sprains); #, RR could not be calculated; CT, controlled trial; NMT, neuromuscular training; QS, methodological quality score of included studies; RCT, randomised controlled trial; RR, relative risk.