The effect of preventive measures on the incidence of ankle sprains

Objective: To critically review the current data concerning the efficacy of preventive measures described in the literature, on the incidence of later al ankle ligament injuries. Data Sources: MEDLINE, Sportdiscus, and EMBASE were searched for papers pub lished between 1980 and December 1998. Keywords used in the search were "pr evention" in combination with "ankle," "ankle taping," "ankle bracing," "or thosis," "shoes." and "proprioception." Additional references were reviewed from the bibliographies of the retrieved articles. Study Selection: A study was included if: 1) the study contained research q uestions regarding the prevention of lateral ankle ligament injuries; 2) th e study was a randomized controlled trial. a controlled trail, or a time in tervention: 3) the results of the study contained incidence rates of latera l ankle ligament injuries as study outcome; and 4) the study met the cut-of f score set for quality. Data Extraction and Synthesis: Two reviewers reviewed relevant studies for strengths and weaknesses in design and methodology, according to a standard ized set of predefined criteria. Eight relevant studies met the criteria fo r inclusion and were analyzed. Main Results: Overall. all studies reported a significant decrease in incid ence of ankle sprains using the studied preventive measure. There was a gea r variety in methodology and study design between the eight analyzed studie s, and every study had one or more drawbacks. Therefore, between studies on ly general results could be compared. Conclusions: The use of either tape or braces reduces the incidence of ankl e sprains. Next to this preventive effect, the use of tape or braces result s in less severe ankle sprains. However, braces seem to be more effective i n preventing ankle sprains than tape. It is not clear which athletes are to benefit more from the use of preventive measures: those with or those with out previous ankle sprains. The efficacy of shoes in preventing ankle sprai ns is unclear. It is likely the newness of the footwear plays a more import ant role than shoe height in preventing ankle sprains. Proprioceptive train ing reduces the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains .