Effects of visual distraction and dual-task load on postural control and compensation in athletes with chronic ankle instability: a narrative review

Abstract

Athletes performing in complex environments rely on multisensory integration to maintain dynamic postural stability, with visual input playing a critical role in movement regulation and environmental perception. This reliance may be particularly pronounced in athletes with chronic ankle instability (CAI), who often exhibit proprioceptive deficits, impaired neuromuscular control, and ligamentous laxity. In this narrative review, we aimed to examine how visual distraction and dual-task load influence postural control and compensatory movement strategies in athletes with CAI while discussing potential implications for assessment and rehabilitation. Relevant English-language literature was identified through searches of PubMed, Scopus, and Web of Science using keywords related to chronic ankle instability, visual disturbance, blurred vision, dual-task interference, and postural control. Evidence suggested that visual disturbance may impair environmental perception and dynamic stability, whereas uncorrected refractive errors may further exacerbate postural control deficits. Athletes with CAI frequently demonstrate compensatory neuromuscular adaptations, including increased proximal muscle activation and altered landing biomechanics, which may increase mechanical loading on the knee and hip joints. Under dual-task conditions, increased attentional and cognitive demands may further impair sensorimotor processing, reaction time, and dynamic postural regulation, leading CAI athletes to adopt hip-dominant stabilization strategies. Collectively, these findings highlight the importance of integrating visual, cognitive, and proprioceptive assessments into rehabilitation and injury prevention programs. In addition, dual-task and sport-specific training paradigms may help improve dynamic stability, neuromuscular control, and injury resilience in athletes with CAI.

Keywords

attention distraction / blurred vision / sensory integration / postural control / refractive error / neuromuscular control

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