Differences in neuromuscular function of the ankle joint following lateral ankle sprain between copers and cai individuals: a systematic review and meta-analysis

Compare neuromuscular alterations of the ankle joint between individuals with chronic ankle instability (CAI) and copers who both experienced lateral ankle sprain (LAS) to examine the functional differences and guide rehabilitation strategies. Systematic review and meta-analysis. A comprehensive search of PubMed, Web of Science, Embase, SPORTDiscus, and Scopus databases from inception to 1 December, 2025. Observational studies and randomized controlled trials (RCTs) comparing neuromuscular function between copers and CAI patients were included. Fifteen studies including 627 participants were analyzed. Meta-analysis showed CAI individuals exhibited delayed peroneus longus (PL) latency (g = -1.17, 95% CI: -1.62 to -0.73), and increased tibialis anterior (TA) and medial gastrocnemius (MG) activation (g = -0.49 and g = -0.35, respectively) compared to copers. No significant differences were observed in PL activation or co-contraction indices. Muscle morphology and performance showed inconsistent outcomes across studies, preventing meta-analysis. Findings from meta-analyses indicate that copers exhibit different neuromuscular functional alterations compared to individuals with CAI. However, whether these alterations are compensations in response to LAS is still unclear. Clarifying this distinction may inform understanding of CAI development and generate hypotheses for future rehabilitation research. CRD42024623852. Date of Registration 19.12.2024. 1. Individuals with CAI exhibit distinct neuromuscular alterations compared to copers following lateral ankle sprain. 2. Individuals with CAI demonstrated delayed PL latency during displacement tasks and increased activation of the TA and MG during postural holding tasks, compared to copers. 3. Following LAS, neuromuscular function assessment may be considered to identify alterations associated with CAI. However, the predictive value and clinical utility of such assessments require prospective validation.