THE EFFECTIVENESS OF DIFFERENT LOWERBODY PLYOMETRIC EXERCISES AND HIP STRENGTHENING EXERCISE ON IMPROVING ANKLE INSTABILITY AMONG ATHLETES- A SYSTEMATIC REVIEW WITH BAYESIAN NETWORK METANALYSIS

Abstract

Background: This study conducts a network meta-analysis to evaluate the effectiveness of lower body plyometric and hip strengthening exercises in improving ankle instability among athletes. Methodology: A systematic search followed PRISMA guidelines across databases including PEDro, ScienceDirect, PUBMED, Cochrane Central, Web of Science, Google Scholar, and MEDLINE in November 2023. Studies published between 2013 and 2024 were included. Primary outcome measures were the Cumberland Ankle Instability Tool (CAIT), Ankle Instability Instrument (AII), Foot and Ankle Ability Measure (FAAM), and Vertical Jump Test. Secondary measures included the Ankle Joint Functional Assessment Tool (AJFAT) and Foot and Ankle Disability Index (ADI). After removing duplicates and screening, nine studies were selected. The PEDro scale assessed study quality. Bayesian NMA was conducted to compare intervention effectiveness and rank them. Results: The systematic review included nine randomized controlled trials (RCTs) on ankle instability. However, only two RCTs evaluating vertical jump improvement were included in the network meta-analysis due to outcome measure heterogeneity in the other seven studies. Conclusion: The meta-analysis suggests that fastened ankle multidirectional jumping and multidirectional jumping exercises are the most effective interventions for improving vertical jump in individuals with ankle instability.