The effectiveness of proprioceptive training for the prevention of ankle sprains in athletes: a systematic review and meta-analysis

This updated systematic review and meta-analysis aimed to evaluate the effectiveness of proprioceptive training in preventing ankle injuries among athletes and to explore whether preventive effects differed according to sport type and intervention composition. A systematic search was conducted in PubMed, Web of Science, Embase, the Cochrane Library, and SPORTDiscus (via EBSCOhost) from database inception to June 5, 2026. Randomized and cluster-randomized controlled trials evaluating proprioceptive training, either as a standalone intervention or as an identifiable component of a multicomponent injury-prevention programme, were included. Study-specific relative effect estimates were synthesized using a generic inverse-variance random-effects model with restricted maximum-likelihood estimation and Hartung–Knapp adjustment. Subgroup analyses were conducted according to sport type, with an additional exploratory analysis according to intervention composition. Fifteen randomized or cluster-randomized controlled trials were included. Proprioceptive training was associated with a significantly lower occurrence of ankle injury, with a pooled relative effect of 0.659 (95% CI: 0.558–0.778, p < 0.001, I² = 22.7%), corresponding to an approximately 34% lower relative occurrence compared with control conditions. No statistically detectable effect modification was observed by sport type (p for interaction = 0.299) or intervention composition (p for interaction = 0.081). Sensitivity analyses supported the robustness of the primary findings. The overall certainty of evidence was rated as moderate. Proprioceptive training was associated with an approximately 34% lower relative occurrence of ankle injury in the athletic populations represented in the included trials. These findings support the use of proprioceptive training as a component of ankle-injury prevention strategies, while the optimal training characteristics and the generalizability of the preventive effect across different sports, competition levels, and athlete populations require further investigation.