External Supports for the Treatment of Ankle Sprain: A Review of Clinical Effectiveness

Key Message

This review included one systematic review and two primary studies (one randomized controlled trial and one cohort study) regarding the clinical effectiveness of external supports for the treatment of individuals with ankle sprain. The external supports identified in this review were stockings, elastic bandages, cohesive tape, lace-up ankle supports, semi-rigid ankle supports or posterior rigid supports, and short-leg casts. Based on the findings of the systematic review, stockings were found to be significantly more effective in improving pain, swelling, functional outcomes, and range of motion compared to bandages. However, stockings showed no significant difference in pain and swelling, but had a significantly shorter period of return to sport activities compared with placebo. The systematic review found no significant differences between taping and other external supports (such as soft braces, semi-rigid braces and lace-up braces) with regards to pain, swelling, function, range of motion, patient satisfaction, and return to sports or work. There were also no significant differences between semi-rigid or posterior rigid supports compared to tape or bandages with regards to pain, range of motion, function, or return to sports or work. There was some evidence that semi-rigid or posterior rigid supports had significantly higher patient satisfaction than tape or bandages. Reported complications associated with bandages and Air-cast brace were suspected deep vein thrombosis and suspected pulmonary embolism, with Bledsoe boots were associated with cellulitis, and taping was associated with dermatitis, skin blister, bullae formation or skin abnormalities; however, the incidence rates of these complications were unclear.The included randomized controlled trial found that the addition of kinesiotape to acupuncture did not significantly improve pain, swelling, quality of life, or number of recurrent ankle sprains. The included cohort study also found no significant differences between cohesive taping and short-leg casts in terms of swelling and function. Taken together, stockings may be a better treatment option among different external supports for functional treatment for acute ankle sprains. Treatment with bandages, tape and semi-rigid or posterior rigid supports may be associated with some complications, however the risk of these complications was unclear.