Article type
Year
Abstract
Introduction/Objective: To assess the effectiveness of interventions used to prevent ankle ligament injuries or sprains in physically active individuals from adolescence to middle age.
Methods: A systematic review of the evidence of effectiveness from randomised controlled trials (RCTs) which compared interventions to reduce ankle injuries for the targeted population was undertaken. Trials were mainly identified via electronic databases, journal searching and bibliographic review of relevant articles. No language restriction was applied. Those trials which did not record ankle injuries were excluded. All trials fitting pre-specified selection criteria were independently scrutinised by at least four researchers for methodological quality, and data extracted for ankle sprains, lower-limb injuries and complications using piloted forms. Wherever possible, results of outcome measures were pooled and sub-grouped by history of previous sprain.
Results: Five RCTs with data for 3954 young, active, mostly male adults participating in high-risk, usually sporting, activities, were included. A further six were excluded. Ankle disc training excepted, all prophylactic interventions entailed the application of an external ankle support. There was a significant reduction in the number of ankle sprains in people allocated external ankle supports in the form of a semi-rigid orthosis or air-cast brace (odds ratio 0.49: 95% confidence interval 0.37-0.66). This reduction was greater for those with a previous history of ankle sprain, but still evident for those without prior sprain. For ankle disc training, there was limited evidence for reduction in ankle sprain for those with previous ankle sprains.
Discussion: This review provides good evidence for the beneficial effect in the form of semi-rigid orthoses or air-cast braces for the prevention of ankle ligament injury during high-risk sporting activities. Participants both with and without a history of previous sprain should be advised that wearing such supports may reduce the risk of incurring a future sprain. However, any potential prophylactic effect should be balanced against the baseline risk of the activity, the supply and cost of the particular device, and for some, the possible or perceived loss of performance. Further research is required.
Methods: A systematic review of the evidence of effectiveness from randomised controlled trials (RCTs) which compared interventions to reduce ankle injuries for the targeted population was undertaken. Trials were mainly identified via electronic databases, journal searching and bibliographic review of relevant articles. No language restriction was applied. Those trials which did not record ankle injuries were excluded. All trials fitting pre-specified selection criteria were independently scrutinised by at least four researchers for methodological quality, and data extracted for ankle sprains, lower-limb injuries and complications using piloted forms. Wherever possible, results of outcome measures were pooled and sub-grouped by history of previous sprain.
Results: Five RCTs with data for 3954 young, active, mostly male adults participating in high-risk, usually sporting, activities, were included. A further six were excluded. Ankle disc training excepted, all prophylactic interventions entailed the application of an external ankle support. There was a significant reduction in the number of ankle sprains in people allocated external ankle supports in the form of a semi-rigid orthosis or air-cast brace (odds ratio 0.49: 95% confidence interval 0.37-0.66). This reduction was greater for those with a previous history of ankle sprain, but still evident for those without prior sprain. For ankle disc training, there was limited evidence for reduction in ankle sprain for those with previous ankle sprains.
Discussion: This review provides good evidence for the beneficial effect in the form of semi-rigid orthoses or air-cast braces for the prevention of ankle ligament injury during high-risk sporting activities. Participants both with and without a history of previous sprain should be advised that wearing such supports may reduce the risk of incurring a future sprain. However, any potential prophylactic effect should be balanced against the baseline risk of the activity, the supply and cost of the particular device, and for some, the possible or perceived loss of performance. Further research is required.