Cailbhe Doherty1, Chris Bleakley2, Eamonn Delahunt3,4, Sinead Holden3. 1. Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland. 2. Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, UK. 3. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. 4. Institute for Sport and Health, University College Dublin, Dublin, Ireland.
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Janet E Simon; Erik A Wikstrom; Dustin R Grooms; Carrie L Docherty; Thomas P Dompier; Zachary Y Kerr Journal: J Athl Train Date: 2018-01-26 Impact factor: 2.860