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 lateral ankle ligament injuries.


METHODS
MEDLINE, Sportdiscus, and EMBASE were searched for papers published between 1980 and December 1998. Keywords used in the search were "prevention" in combination with "ankle," "ankle taping," "ankle bracing," "orthosis," "shoes," and "proprioception." Additional references were reviewed from the bibliographies of the retrieved articles.


METHODS
A study was included if: 1) the study contained research questions regarding the prevention of lateral ankle ligament injuries; 2) the study was a randomized controlled trial, a controlled trail, or a time intervention; 3) the results of the study contained incidence rates of lateral ankle ligament injuries as study outcome; and 4) the study met the cut-off score set for quality.


METHODS
Two reviewers reviewed relevant studies for strengths and weaknesses in design and methodology, according to a standardized set of predefined criteria. Eight relevant studies met the criteria for inclusion and were analyzed.


RESULTS
Overall, all studies reported a significant decrease in incidence of ankle sprains using the studied preventive measure. There was a great variety in methodology and study design between the eight analyzed studies, and every study had one or more drawbacks. Therefore, between studies only general results could be compared.


CONCLUSIONS
The use of either tape or braces reduces the incidence of ankle sprains. Next to this preventive effect, the use of tape or braces results in less severe ankle sprains. However, braces seem to be more effective in 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 without previous ankle sprains. The efficacy of shoes in preventing ankle sprains is unclear. It is likely the newness of the footwear plays a more important role than shoe height in preventing ankle sprains. Proprioceptive training reduces the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains.
Verhagen
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Institute for Research in Extramural Medicine, Vrije Universireit Amsterdam, The Netherlands.
van Mechelen
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de Vente
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D016512:Ankle Injuries / Q000517:prevention & control*; D001458:Bandages; D006801:Humans; D015994:Incidence; D008023:Ligaments, Articular / Q000293:injuries; D009989:Orthotic Devices; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012189:Retrospective Studies; D012775:Shoes; D013180:Sprains and Strains / Q000517:prevention & control*