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

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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.

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Authors and Affiliations

  1. Physical Therapy Science, Program in Clinical Health Sciences, Faculty of Medicine, Utrecht University, Utrecht, The Netherlands

    Ingrid Barelds & Anke G. van den Broek

  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

    Ingrid Barelds

  3. Rudolf Magnus Institute of Neurosciences, Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands

    Anke G. van den Broek & Bionka M. A. Huisstede

Authors
  1. Ingrid Barelds
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  2. Anke G. van den Broek
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  3. Bionka M. A. Huisstede
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Corresponding author

Correspondence to Ingrid Barelds.

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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.

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Barelds, I., van den Broek, A.G. & Huisstede, B.M.A. Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses. Sports Med 48, 2775–2784 (2018). https://doi.org/10.1007/s40279-018-0993-2

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  • DOI: https://doi.org/10.1007/s40279-018-0993-2

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