Comparative efficacy of conventional rehabilitation, balance acupuncture combined with conventional rehabilitation and additional unconscious proprioception training for chronic ankle instability: A randomized-controlled clinical study
In brief
Unconscious proprioception training added to balance acupuncture improves gait speed
In a 120-patient randomized trial, all chronic ankle instability groups improved with six weeks of rehab, but the group receiving conventional rehab plus balance acupuncture and unconscious proprioception training showed greater gains in gait speed, cadence and balance than acupuncture alone, which in turn outperformed rehab alone. No adverse events occurred, suggesting the combined approach may enhance functional recovery, though larger studies are needed.
- Journal
- Joint diseases and related surgery (Q2)
- Published
- 10 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Na Liu, Mi Wang, Qing Meng, Mingyu Wang, Kai Shang, Ying-Li Bi, et al.
- PMID
- 42542908
- DOI
- 10.52312/jdrs.2026.2311
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (paper of the day, 3 August 2026): Randomized controlled trial of balance acupuncture plus rehab
- Picked for Surgery (paper of the day, 3 August 2026): Rehabilitation study for ankle instability, non‑surgical
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (paper of the day, 3 August 2026): High-quality evidence in a top journal
- Picked for Rehabilitation (paper of the day, 3 August 2026).
- Picked for Orthopedics and Sports Medicine (paper of the day, 3 August 2026).
Abstract
OBJECTIVES: This study aims to compare the efficacy of conventional rehabilitation alone, conventional rehabilitation combined with balance acupuncture (BA) and conventional rehabilitation plus BA and unconscious proprioception training in chronic ankle instability (CAI) patients. PATIENTS AND METHODS: This single-center, parallel-group, assessor-blinded randomized-controlled trial included a total of 120 CAI patients between October 2022 and October 2024. The patients were randomly assigned to control (n = 40), BA (n = 40), and combination therapy (CT, (n = 40) groups. All groups received six weeks of intervention (6 days/week): the control group received conventional rehabilitation, the BA group received conventional rehabilitation + BA and the CT group received conventional rehabilitation + BA + unconscious proprioception training. Unconscious proprioception training was defined as dual-task training using the MOTOmed system with cognitive distraction to shift focus away from conscious movement control. Assessments were conducted before and after treatment using a three-dimensional gait analysis system, a balance function testing and training system, and the Star Excursion Balance Test (SEBT). RESULTS: There was no statistically significant difference in age and sex among the groups (p > 0.05). In addition, disease duration and number of previous sprains were comparable among the groups (p > 0.05). Following the six-week intervention, all three groups showed significant improvements in gait parameters, balance function and SEBT scores compared to baseline (p < 0.05). The CT group exhibited significantly greater improvements in gait speed, cadence, movement length, movement ellipse area and SEBT scores than the BA group (p < 0.05), whereas the BA group outperformed the control group in all outcome measures (p < 0.05). No adverse reactions were reported in any group. CONCLUSION: The integration of BA and unconscious proprioception training may offer additional benefits for improving gait and balance in CAI patients compared to conventional rehabilitation plus BA or conventional rehabilitation alone. Based on these preliminary findings, the combined approach shows potential clinical value for targeted populations with CAI.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.