Detailed Search Results
| Author/Association: | Janssen KW, van Mechelen W, Verhagen EALM |
| Title: | Bracing superior to neuromuscular training for the prevention of self-reported recurrent ankle sprains: a three-arm randomised controlled trial [with consumer summary] |
| Source: | British Journal of Sports Medicine 2014 Aug;48(16):1235-1239 |
| Method: | clinical trial |
| Method Score: | 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | WHAT ARE THE NEW FINDINGS: Bracing is superior to neuromuscular training for the prevention of self-reported ankle sprain recurrences. Bracing is associated with an added 47% reduction in risk of recurrence versus neuromuscular training. Full compliance to neuromuscular training and bracing as individual home-based interventions was 45% and 48%, respectively, in the first 2 months, but when the interventions were combined the compliance dropped to 28%. HOW MIGHT IT IMPACT ON CLINICAL PRACTICE IN THE NEAR FUTURE: Although the current clinical guidelines are vague on the prescription of neuromuscular training and bracing, the study results support the prescription of bracing as single secondary preventive measure for the prevention of self-reported recurrences. As in our study bracing was proven effective when prescribed during sports for 12 months, the prescription period of brace use in athletes needs to be extended, instead of being phased out. |
| Abstract: | BACKGROUND: Ankle 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. AIM: To 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. METHODS: 384 athletes, aged 18 to 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. RESULTS: During 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. CONCLUSIONS: Bracing was superior to neuromuscular training in reducing the incidence but not the severity of self-reported recurrent ankle sprains after usual care. Reproduced with permission from the BMJ Publishing Group. Full text (sometimes free) may be available at these link(s):  help |
