Effects of Ankle Support on Lower-Extremity Functional Performance: A Meta-Analysis

Abstract

Clinicians surmise that the application of external ankle support reduces the ability to perform functional skills and movements, but the outcomes from some of these studies have been inconclusive. To meta-analyze studies regarding the effects of external ankle support on lower-extremity functional performance measures. A total of 93 effects from 17 randomized controlled trials utilizing predominantly crossover designs with recreationally active participants and competitive athletes were subjected to a random-effects meta-analysis. The treatment variable was external ankle support with three levels: adhesive tape, lace-up style, and semirigid style. Differences between mean changes in treatment and control groups were computed as standardized effect sizes for sprint, agility, and vertical jump performance with their 90% confidence intervals (CI). Effect sizes >0.20 were considered substantial. The greatest effect of ankle support on performance was a negative effect of lace-up style brace on sprint speed (effect size -0.22, 90% CI -0.47 to 0.03), equivalent to approximately 1% impairment of speed. The other effects of external ankle support on performance were insubstantial, though most were negative, and their lower confidence limits allowed for realistic chances of impaired performance. Substantial true variation between studies, although poorly defined, was also present for some effects, further increasing the likelihood of performance impairment in some settings. More research is needed to reduce the uncertainty in the effects of external ankle support on performance. In the meantime, it is our opinion that the benefit in preventing injury outweighs the possibility of substantial but small impairment of performance when athletes use external ankle support.