Effects of footwear and insoles on balance and gait parameters in athletes with ankle injuries: protocol for a systematic review.

Abstract

Ankle injuries are highly prevalent in athletes and often lead to chronic instability, impaired postural control and altered gait mechanics that compromise performance and delay return to sport. Although specialised footwear and insoles are widely used to enhance stability and normalise gait, their true efficacy in athletic populations remains uncertain, warranting a systematic synthesis of current evidence. This protocol follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will include randomised, quasiexperimental and observational studies published up to 30 April 2025 that involve athletes with acute or chronic ankle injuries and evaluate footwear or insole interventions on balance and/or gait parameters. Five electronic databases (PubMed, Cochrane Library, Web of Science, Scopus, CINAHL) will be searched with tailored Medical Subject Headings (MeSH) terms and keywords. Two reviewers will independently screen records, extract data and assess methodological quality using the Effective Public Health Practice Project tool, which evaluates six domains: selection bias, study design, confounders, blinding, data collection methods and withdrawals/drop-outs, providing a global rating of strong, moderate or weak. Certainty of the body of evidence will be graded using the Grading of Recommendations Assessment, Development and Evaluation framework. Results will be synthesised narratively, grouping findings by intervention type, outcome measure, sport and assessment method. No ethical approval is required as the review uses previously published data. Findings will be shared via peer-reviewed publication and scientific conferences. Prospectively registered in PROSPERO under CRD420251031083.