Study Summary

Eight randomized controlled trials involving 216 participants with chronic ankle instability were reviewed. In these trials, participants were randomized to receive exercise therapy combined with transcranial direct current stimulation (tDCS) or exercise therapy alone or with sham stimulation. Exercise interventions included balance training, short-foot exercises, ankle strengthening, and active joint mobilization, while stimulation protocols varied in intensity and duration. The primary outcome was balance ability, assessed using dynamic balance measures (Y-Balance Test composite and directional reach scores, Dynamic Postural Stability Index) and static balance measures (center-of-pressure sway and Balance Error Scoring System). Outcomes were assessed at time points ranging from 2 to 8 weeks. Overall, the results of the study revealed no significant improvement in overall dynamic or static balance with the addition of tDCS. However, subgroup analysis demonstrated a significant improvement in dynamic balance when stimulation was combined with non-balance exercise therapy, while no additional benefit was observed when combined with balance training. These findings suggest a context-dependent effect of stimulation as an adjunct to rehabilitation.