Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review
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SYSTEMATIC REVIEW
Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta‑Analyses Ingrid Barelds1,2 · Anke G. van den Broek1,3 · Bionka M. A. Huisstede3
© Springer Nature Switzerland AG 2018
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.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40279-018-0993-2) contains supplementary material, which is available to authorized users. * Ingrid Barelds [email protected] 1
Physical Therapy Science, Program in Clinical Health Sciences, Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
2
Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
3
Rudolf Magnus Institute of Neurosciences, Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
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I. Barelds et al.
Key Points Ankle bracing is effective for the prevention of acute ankle injuries in soccer, volleyball, American Football, and basketball. Athletes without a previous ankle injury who wear ankle braces have a 47% reduction in the
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