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Sports Medicine

, Volume 48, Issue 12, pp 2775–2784 | Cite as

Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses

  • Ingrid Barelds
  • Anke G. van den Broek
  • Bionka M. A. Huisstede
Systematic Review

Abstract

Background

Ankle bracing has been verified as being effective for secondary prevention of ankle injuries. However, new studies have recently been published that are not included in previous meta-analyses. Furthermore, the effects of bracing for primary prevention of ankle injuries are still unclear.

Objective

The objective of this article was to systematically review the literature about the effectiveness of ankle bracing on primary and secondary prevention of acute ankle injuries in athletes.

Methods

We searched PubMed, EMBASE, SPORTDiscus, CINAHL, and PEDro databases for eligible articles until July 2018. Randomized controlled trials that studied ankle bracing vs. no intervention for athletes were included. Risk of bias was assessed with the Cochrane Risk of Bias tool. Meta-analyses were conducted to study the effect of ankle bracing for primary and secondary prevention of ankle injuries. The Grading of Recommendation Assessment, Development, and Evaluation method was used to determine the quality of evidence.

Results

We included six randomized controlled trials. Significant risk ratios of 0.53 (95% confidence interval 0.32–0.88) and 0.37 (95% confidence interval 0.24–0.58) were found in favor of ankle bracing vs. no ankle bracing for primary (low quality of evidence, I2 = 77%) and secondary prevention (moderate quality of evidence, I2 = 0%) of acute ankle injuries. Numbers needed to treat were 26 and 12 for the primary and secondary prevention of acute ankle injuries.

Conclusions

Ankle bracing is effective for primary and secondary prevention of acute ankle injuries among athletes. However, conclusions in regard to primary prevention should be drawn cautiously because of the low quality of evidence and significant heterogeneity.

Notes

Compliance with Ethical Standards

Funding

No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Ingrid Barelds, Anke van den Broek, and Bionka Huisstede have no conflicts of interest that are directly relevant to the contents of this article.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Supplementary material

40279_2018_993_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)

References

  1. 1.
    Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014;44:123–40.CrossRefGoogle Scholar
  2. 2.
    Fong D, Hong Y, Chan L, Yung P, Chan K. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007;37(1):73–94.CrossRefGoogle Scholar
  3. 3.
    Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42(2):311–9.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Waterman CBR, Owens MBD, Davey CS, Zacchilli CMA, Belmont LC. The epidemiology of ankle sprains in the United States. J Bone Jt Surg Am. 2010;92(13):2279–84.CrossRefGoogle Scholar
  5. 5.
    Kemler E, van de Port I, Backx F, van Dijk CN. A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types. Sports Med. 2011;41(3):185–97.CrossRefGoogle Scholar
  6. 6.
    Veiligheid NL. Enkelblessures, ongevalscijfers. 2014. https://www.veiligheid.nl/sportblessures/kennis/cijfers-over-sportblessures. Accessed 1 Oct 2018.
  7. 7.
    Kemler E, Thijs KM, Badenbroek I, van de Port IGL, Hoes AW, Backx FJG. Long-term prognosis of acute lateral ankle ligamentous sprains: high incidence of recurrences and residual symptoms. Fam Pract. 2016;33(6):596–600.CrossRefGoogle Scholar
  8. 8.
    van Rijn RM, van Os AG, Bernsen RMD, Luijsterburg PA, Koes BW, Bierma-Zeinstra SMA. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. 2008;121(4):324–331.e7.CrossRefGoogle Scholar
  9. 9.
    Gross P, Marti B. Risk of degenerative ankle joint disease in volleyball players: study of former elite athletes. Int J Sports Med. 1999;20(1):58–63.CrossRefGoogle Scholar
  10. 10.
    Handoll H, Rowe BH, Quinn KM, de Bie R. Interventions for preventing ankle ligament injuries. Cochrane Database Syst Rev. 2001;3:CD000018.Google Scholar
  11. 11.
    Dizon JMR, Reyes JJB. A systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players. J Sci Med Sport. 2010;13(3):309–17.CrossRefGoogle Scholar
  12. 12.
    Yeung MS, Chan KM, So CH, Yuan WY. An epidemiological survey on ankle sprain. Br J Sports Med. 1994;28(2):112–6.CrossRefGoogle Scholar
  13. 13.
    Institute for Work and Health. What researchers mean by primary, secondary, and tertiary prevention. At Work. Issue 80, Spring 2015. https://www.iwh.on.ca/sites/iwh/files/iwh/at-work/at_work_80_0.pdf. Accessed 1 Oct 2018.
  14. 14.
    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.CrossRefGoogle Scholar
  15. 15.
    Higgins J, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0. The Cochrane Collaboration. 2011. http://www.handbook.cochrane.org. Accessed 1 Oct 2018.
  16. 16.
    Verhagen EA, Bay K. Optimising ankle sprain prevention: a critical review and practical appraisal of the literature. Br J Sports Med. 2010;44(15):1082–8.CrossRefGoogle Scholar
  17. 17.
    Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 2008;33(1):159–74.CrossRefGoogle Scholar
  18. 18.
    Surve I, Schwellnus MP, Noakes T, Lombard C. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the sport-stirrup orthosis. Am J Sports Med. 1994;22(5):601–6.CrossRefGoogle Scholar
  19. 19.
    Mohammadi F. Comparison of 3 preventive methods to reduce the recurrence of ankle inversion sprains in male soccer players. Am J Sports Med. 2007;35(6):922–6.CrossRefGoogle Scholar
  20. 20.
    Frey C, Feder KS, Sleight J. Prophylactic ankle brace use in high school volleyball players: a prospective study. Foot Ankle Int. 2010;31(4):296–300.CrossRefGoogle Scholar
  21. 21.
    McGuine T, Brooks M, Hetzel S. The effect of lace-up ankle braces on injury rates in high school basketball players. Am J Sports Med. 2011;39(9):1840–8.CrossRefGoogle Scholar
  22. 22.
    McGuine TA, Hetzel S, Wilson J, Brooks A. The effect of lace-up ankle braces on injury rates in high school football players. Am J Sports Med. 2012;40(1):49–57.CrossRefGoogle Scholar
  23. 23.
    Sitler M, Ryan J, Wheeler B, McBride J, Arciero R, Anderson J, et al. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball: a randomized clinical study at West Point. Am J Sports Med. 1994;22(4):454–61.CrossRefGoogle Scholar
  24. 24.
    Schiftan GS, Ross LA, Hahne AJ. The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: a systematic review and meta-analysis. J Sci Med Sport. 2015;18(3):238–44.CrossRefGoogle Scholar
  25. 25.
    Janssen KW, van Mechelen W, Verhagen EA. Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial. Br J Sports Med. 2014;48(16):1235–9.CrossRefGoogle Scholar
  26. 26.
    Verhagen EA, van der Beek AJ, van Mechelen W. The effect of tape, braces and shoes on ankle range of motion. Sports Med. 2001;31(9):667–77.CrossRefGoogle Scholar
  27. 27.
    Mickel TJ, Bottoni CR, Tsuji G, Chang K, Baum L, Tokushige KAS. Prophylactic bracing versus taping for the prevention of ankle sprains in high school athletes: a prospective, randomized trial. J Foot Ankle Surg. 2006;45(6):360–5.CrossRefGoogle Scholar
  28. 28.
    Kemler E, Krist MR, van de Port IGL, Hoes AW, Ardine de Wit G, Backx FJG. Economic evaluation of a soft ankle brace compared to tape in acute lateral ankle ligamentous sprains. Clin Res Foot Ankle. 2016;4:212.  https://doi.org/10.4172/2329-910X.1000212.CrossRefGoogle Scholar
  29. 29.
    Janssen K, Van Den Berg A, Van Mechelen W, Verhagen E. User survey of 3 ankle braces in soccer, volleyball, and running: which brace fits best? J Athl Train. 2017;52(8):730–7.CrossRefGoogle Scholar
  30. 30.
    Reeser JC, Gregory A, Berg RL, Comstock RD. A comparison of women’s collegiate and girls’ high school volleyball injury data collected prospectively over a 4-year period. Sports Health. 2015;7(6):504–10.CrossRefGoogle Scholar
  31. 31.
    Bahr R, Bahr IA. Incidence of acute volleyball injuries: a prospective cohort study of injury mechanisms and risk factors. Scand J Med Sci Sports. 1997;7(3):166–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Physical Therapy Science, Program in Clinical Health Sciences, Faculty of MedicineUtrecht UniversityUtrechtThe Netherlands
  2. 2.Research Group Healthy Ageing, Allied Health Care and NursingHanze University Groningen, University of Applied SciencesGroningenThe Netherlands
  3. 3.Rudolf Magnus Institute of Neurosciences, Department of Rehabilitation, Physical Therapy Science and SportsUniversity Medical Center Utrecht, University UtrechtUtrechtThe Netherlands

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