title: Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis.
abstract: BACKGROUND
  Ankle sprains are highly prevalent with high risk of recurrence. Consequently, there are a significant number of research reports examining strategies for treating and preventing acute and recurrent sprains (otherwise known as chronic ankle instability (CAI)), with a coinciding proliferation of review articles summarising these reports.
  
  
  OBJECTIVE
  To provide a systematic overview of the systematic reviews evaluating treatment strategies for acute ankle sprain and CAI.
  
  
  METHODS
  Overview of intervention systematic reviews.
  
  
  METHODS
  Individuals with acute ankle sprain/CAI.
  
  
  METHODS
  The primary outcomes were injury/reinjury incidence and function.
  
  
  RESULTS
  46 papers were included in this systematic review. The reviews had a mean score of 6.5/11 on the AMSTAR quality assessment tool. There was strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence of an ankle sprain. For the combined outcomes of pain, swelling and function after an acute sprain, there was strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques. There was conflicting evidence regarding the efficacy of surgery and acupuncture for the treatment of acute ankle sprains. There was insufficient evidence to support the use of ultrasound in the treatment of acute ankle sprains.
  
  
  CONCLUSIONS
  For the treatment of acute ankle sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques, for pain, swelling and function. Exercise therapy and bracing are supported in the prevention of CAI.
authors.affiliation: Insight Centre for Data Analytics, O'Brien Centre for Science, University College Dublin, Dublin, Ireland.
authors.forename: Cailbhe
authors.identifier: http://orcid.org/0000-0002-5284-856X
authors.initials: C
authors.lastname: Doherty
authors.affiliation: Sport and Exercise Sciences Research Institute, Ulster Sports Academy, University of Ulster, Newtownabbey, UK.
authors.forename: Chris
authors.identifier: http://orcid.org/0000-0001-9032-9691
authors.initials: C
authors.lastname: Bleakley
authors.affiliation: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.|Institute for Sport and Health, University College Dublin, Dublin, Ireland.
authors.forename: Eamonn
authors.initials: E
authors.lastname: Delahunt
authors.affiliation: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
authors.forename: Sinead
authors.initials: S
authors.lastname: Holden
mesh_terms: D016512:Ankle Injuries / Q000517:prevention & control* / Q000628:therapy*; D001915:Braces; D005081:Exercise Therapy; D006801:Humans; D012008:Recurrence; D013180:Sprains and Strains / Q000517:prevention & control* / Q000628:therapy*
keywords: Ankle; Chronic; Injury; Injury prevention; Sprain