Treatment and
Prevention of Acute and Recurrent Ankle Sprain: An Overview of Systematic
Reviews with Meta-Analysis.

C, Bleakley C, Delahunt E, Holden S. British
Journal of Sports Medicine
. 2016;0:1-17. doi: 10.1136/bjsports-2016-096178

Take Home Message:
Exercise therapy and external supports reduce the chance of an ankle sprain;
increasing the volume of exercise further reduces the odds.

treatment options have been designed to manage persistent symptoms following an
ankle sprain and reduce the chance of a recurrent joint injury. This has led to
numerous systematic reviews to synthesize the best evidence for treatment and
prevention. However, the large number of systematic reviews has made it difficult
to understand the pros and cons of current treatment options. Therefore,
Doherty and colleagues performed a systematic review by consolidating the
systematic reviews that evaluated the treatment or prevention of acute ankle
sprain and/or chronic ankle instability. They included systematic reviews that focused
on (re-) injury incidence/prevalence or self-reported function/disability as a
primary outcome. The authors retrieved 46 systematic reviews, which included 309
individual reports. The authors performed a meta-analysis with extracted data
from the randomized clinical trials, which were included in the systematic
reviews. In summary, exercise therapy and external support improve
self-reported function and reduce the odds of sustaining an acute/recurrent
ankle sprain by 40 to 62%. There is little evidence to support the use of
ultrasound therapy, acupuncture, and manual therapy in the treatment of
recurrent ankle sprain.

conclusions from this systematic review reinforce current clinical practice by
demonstrating the efficacy of exercise therapy and external supports. Interestingly,
the authors found that when exercise therapy is performed at high doses
(>900 minutes) the odds of preventing a recurrent ankle sprain further
increase. These findings indicate that the overall amount of time performing
exercise therapy has a significant impact on improving outcomes. Therefore,
clinicians should educate their patients on the need to continue with their
exercise therapy program long after their acute symptoms have subsided. The
limited amount of time clinicians often have with patients following an ankle
sprain highlights the need for a home-exercise therapy program.

Questions for
Discussion: How much time do you spend with your athletes/patients after an
ankle sprain? What are some resources that you have given to your
athletes/patients to continue their exercises after you are finished working
with them?

by: Kyle Kosik
by: Jeffrey Driban


Fibular Taping Versus Traditional Taping in Patients With Chronic Ankle Instability

Doherty, C., Bleakley, C., Delahunt, E., & Holden, S. (2016). Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis British Journal of Sports Medicine DOI: 10.1136/bjsports-2016-096178