Effect of sensorimotor training on morphological, neurophysiological and functional characteristics of the ankle: a critical review.

Sensorimotor training is effective in preventing ankle sprain recurrences, but the pathway through which this effect occurs is unknown. Biomechanical and neurophysiological analyses of sensorimotor training leading to functional changes of the ankle are needed to establish this pathway. This article reviews the effect of sensorimotor training on morphological, neurophysiological and functional characteristics of the ankle. A MEDLINE and CINAHL computerized literature search was conducted to search for relevant articles. A study was included if (i) the study contained research questions regarding the effect of sensorimotor training on mechanical, neurophysiological, and/or functional ankle functioning; (ii) the study dealt with subjects with a history of ankle sprain; (iii) the study contained a control group; (iv) the results contained measures of mechanical, neurophysiological or functional insufficiencies as study outcome; and (v) the study met a predefined cut-off score set for methodological quality. Results on joint position sense and muscle reaction times showed a learning effect of repeated measures and not a training effect. Decrements of postural sway after sensorimotor training were mainly attributable to a learning effect as well. Effects on muscle strength were not found. Evidence for an effect of sensorimotor training on neurophysiological, morphological and functional characteristics is limited, if present at all. Thus, the pathway of sensorimotor training remains unclear. Future studies need to focus on (i) differentiating between morphological, physiological and functional changes; (ii) larger sample sizes with a priori sample size calculations; (iii) correspondence between training and test method; (iv) using measures other than postural sway more closely linked to functional stability; and (v) using a longer follow-up period than 6 weeks.