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
Na Liu1,2,*
, Mi Wang1,2,*, Qing Meng2, Mingyu Wang2, Kai Shang1, Ying-Li Bi2, Xiaowei Jiang1,2, Jin Li2, Jiaojiao Chen2, Shiming Feng3, Hongwei Zhai1,2
1Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
2Department of Rehabilitation Medicine,Xuzhou Rehabilitation Hospital, Xuzhou, Jiangu, China
3Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
Keywords: Analysis, balance acupuncture, chronic ankle instability, combination therapy; gait postural balance, unconscious proprioception training.
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, assessorblinded 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.
* Na Liu and Mi Wang contributed equally to this study
Citation: Liu N, Wang M, Meng Q, Wang M, Shang K, Bi YL, et al. 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. Jt Dis Relat Surg 2026;37(x):i-xii. doi: 10.52312/jdrs.2026.2311.