OBJECTIVE: To assess the efficacy of conservative interventions and (secondary) prevention in patients with recurrent ankle sprains. METHOD: A comprehensive literature search (from 1980 to 31 January 2003) of published randomized clinical trials (RCTS) investigating the efficacy of conservative interventions in patients with recurrent ankle sprains was carried out. Studies had to include a physiotherapy intervention and at least one clinically relevant clinical outcome measure. The methodological quality of the included trials was systematically assessed by independent assessors. RESULTS: After the initial screening of 473 trials, 32 RCTS were retrieved, 9 of which were included in this review. The studies evaluated the efficacy of exercise therapy (4), tape (1), brace (1), brace and exercise therapy (1), tape and exercise therapy (1), and type of shoe (1). The methodological quality of the included studies was poor, with a mean score of 3.3 (range 1 to 6) out of a maximum of 12 points. Exercise therapy and use of braces or tape had positive effects in preventing recurrent ankle sprains (relative risk 0.32 (95% CI 0.18 to 0.59) and 0.36 (95% 0.22 to 0.59), respectively). Use of different types of shoe did not significantly influence the number of recurrences. CONCLUSION: There is evidence to suggest that exercise therapy (proprioceptive and coordination training) and use of braces are effective in reducing the recurrence of ankle sprains. The evidence is poor regarding the effectiveness of taping and wearing a specific type of shoe because of a lack of (high-quality) RCTs. No conclusions can be drawn about the efficacy of strength training, manual mobilization, gait training, and physical treatments because no trials were found. There is a need for more high-quality trials to determine the efficacy of physiotherapy interventions in patients with recurrent ankle sprains.

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