Abstract
BackgroundAfter sustaining an ankle sprain, taping is often the standard treatment in primary care. Ankle braces are sometimes used as an alternative. This study aimed to compare the effects of four weeks of soft bracing or taping following acute lateral ankle ligamentous sprain (ALALS) on sprain recurrence rates and residual symptoms at one year.MethodsIn this pragmatic, non-randomised controlled trial, 157 adult participants with an ALALS caused by an inversion trauma were alternately allocated to a four week treatment with a soft brace (intervention group) or a four week treatment with ankle tape (control group) in order of presentation. The primary outcome was the 1-year incidence of the self-reported recurrence of ALALS. The secondary outcome was the occurrence of residual symptoms.ResultsBaseline characteristics did not differ appreciably between the treatment groups. Thirteen patients (17%) in the brace group reported a re-injury versus 11 patients (14%) treated with tape, corresponding to a risk difference of 3.1% (relative risk 1.2, 95% CI 0.6 to 2.6). Cox regression analysis showed a hazard ratio of self-reported ankle sprain recurrence within 52 weeks in the brace group compared to the tape group of 0.9 (95% CI 0.4 to 1.9). After one year, patients in the brace group had poorer scores on the manual anterior ankle test, corresponding to a risk difference of 15.4% (RR 2.4, 95% CI 1.1 to 5.0).ConclusionALALS recurrences and residual symptoms appear to be similar at one year when an ALALS is treated with four weeks of soft bracing or taping.Trial registrationISRCTN92030205
Highlights
After sustaining an ankle sprain, taping is often the standard treatment in primary care
The purpose of this study was to compare the effects of four weeks of soft bracing or taping following acute lateral ankle ligamentous sprain (ALALS) on sprain recurrence rates and residual symptoms at one year
One hundred (64%) of the reported ALALS occurred during sports participation
Summary
After sustaining an ankle sprain, taping is often the standard treatment in primary care. This study aimed to compare the effects of four weeks of soft bracing or taping following acute lateral ankle ligamentous sprain (ALALS) on sprain recurrence rates and residual symptoms at one year. Functional treatment including taping, bandaging and bracing of lateral ankle ligamentous sprains has been recommended instead of surgical repair and plaster cast. Several systematic reviews were unable to determine the most effective functional treatment strategy for acute lateral ankle ligamentous sprains (ALALS) [16,19]. The guidelines of the Dutch College of General Practitioners for the treatment of ALALS recommends treatment consisting of immobilisation, compression, and elevation (ICE) during the first week, followed by ankle taping for six weeks [20]
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