Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial

Abstract

BackgroundAnkle sprain is the most common sports-related injury with a high rate of recurrence and associated costs. Recent studies have emphasised the effectiveness of both neuromuscular training and bracing for the secondary prevention of ankle sprains.AimTo evaluate the effectiveness of combined bracing and neuromuscular training, or bracing alone, against the use of neuromuscular training on recurrences of ankle sprain after usual care.Methods384 athletes, aged 18–70, who had sustained a lateral ankle sprain, were included (training group n=120; brace group n=126; combi group n=138). The training group received an 8-week home-based neuromuscular training programme, the brace group received a semirigid ankle brace to be worn during all sports activities for 12 months, and the combi group received both the training programme, as well as the ankle brace, to be worn during all sports activities for 8 weeks. The main outcome measure was self-reported recurrence of the ankle sprain.ResultsDuring the 1-year follow-up, 69 participants (20%) reported a recurrent ankle sprain: 29 (27%) in the training group, 17 (15%) in the brace group and 23 (19%) in the combi group. The relative risk for a recurrent ankle sprain in the brace group versus the training group was 0.53 (95% CI 0.29 to 0.97). No significant differences were found for time losses or costs due to ankle sprains between the intervention groups.ConclusionsBracing was superior to neuromuscular training in reducing the incidence but not the severity of self-reported recurrent ankle sprains after usual care.

Taping and bracing in the prevention of ankle sprains: current concepts

“…Taping and bracing have been shown to decrease the risk of ankle sprains by 50–70% in those with a history of ankle sprains 24. Bracing was found to be superior to neuromuscular training, reducing the incidence of ankle injuries with 47% (relative risk reduction) 21. In another systematic review on prevention of ankle sprains, taping and bracing show equal effectiveness 25…”

“…The cost over 1 season (48 exposures) for 1 ankle was ∼$40.01 for tape compared with the average cost of the AirSport ankle brace of $28.00. Additionally, applying tape is more time-consuming in comparison with a brace 11 21…”

The preventive effect of a soccer-specific ankle brace on acute lateral ankle sprains in girls amateur soccer players: study protocol of a cluster-randomised controlled trial

“…Jansen et al found that compliance was higher with an ankle brace than with neuromuscular training 9. Dutch soccer players seem to be reluctant to wear ankle braces, mainly because available braces are perceived to have a poor fit, pinching the feet in the soccer shoes due to the thickness of the braces and players are concerned about reduced ball control 16.…”

U.S. Army Medical Command Injury Summary, Active Duty Personnel, 2014

“…• Ankle braces (Janssen et al, 2014;McGuine et al, 2011;Sitler et al, 1994) • Breakaway baseball and softball bases (Pollack et al, 2005) • Mouthguards for football, basketball (Knapik et al, 2007) • Protective eyewear (Cass, 2012;Goldstein and Wee, 2011;Leivo et al, 2015 • The leading causes of injury outpatient visits with cause codes were overexertion (27.2 percent), falls (16.2 percent) and being struck by/against an object or person (14.7 percent).…”