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Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis
  1. Cailbhe Doherty1,
  2. Chris Bleakley2,
  3. Eamonn Delahunt3,4,
  4. Sinead Holden3
  1. 1Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland
  2. 2Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, UK
  3. 3School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
  4. 4Institute for Sport and Health, University College Dublin, Dublin, Ireland
  1. Correspondence to Cailbhe Doherty, Insight Centre for Data Analytics, University College Dublin, O'Brien Centre for Science, Belfield, Dublin 4, Ireland; cailbhe{at}insight-centre.org

Abstract

Background Ankle sprains are highly prevalent with high risk of recurrence. Consequently, there are a significant number of research reports examining strategies for treating and preventing acute and recurrent sprains (otherwise known as chronic ankle instability (CAI)), with a coinciding proliferation of review articles summarising these reports.

Objective To provide a systematic overview of the systematic reviews evaluating treatment strategies for acute ankle sprain and CAI.

Design Overview of intervention systematic reviews.

Participants Individuals with acute ankle sprain/CAI.

Main outcome measurements The primary outcomes were injury/reinjury incidence and function.

Results 46 papers were included in this systematic review. The reviews had a mean score of 6.5/11 on the AMSTAR quality assessment tool. There was strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence of an ankle sprain. For the combined outcomes of pain, swelling and function after an acute sprain, there was strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques. There was conflicting evidence regarding the efficacy of surgery and acupuncture for the treatment of acute ankle sprains. There was insufficient evidence to support the use of ultrasound in the treatment of acute ankle sprains.

Conclusions For the treatment of acute ankle sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques, for pain, swelling and function. Exercise therapy and bracing are supported in the prevention of CAI.

  • Ankle
  • Injury
  • Injury prevention
  • Chronic
  • Sprain

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Footnotes

  • Twitter Follow Sinead Holden at @Sinead_Holden, Cailbhe Doherty @DohertyCailbhe, Chris Bleakley @ChrisMBleakley, Eamonn Delahunt @EamonnDelahunt

  • Contributors CD and SH had equal contribution and act as guarantors. They conceived the study and acquired the data. CD, SH and CB analysed the data. All authors drafted the manuscript. All authors critically revised the manuscript pre- and post-peer review.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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