This study is an overview of intervention systematic reviews. The authors included 46 systematic reviews evaluating treatment and preventive strategies for acute ankle sprain and chronic ankle instability. The reviews included provided data from 309 individual studies. The primary outcomes were injury or re-injury incidence and function. The secondary outcomes were pain, strength, range of motion, proprioception and muscle activity in the ankle joint, and performance measures (i.e., biomechanical analyses of static or dynamic postural control, gait or jumping or landing tasks). The quality of the reviews was assessed using the AMSTAR tool and had a mean score of 6.5 out of 11. There is consistent evidence for exercise therapy and external supports (e.g., bracing, taping) for preventing ankle re-injury incidence (odds ratio 0.59, 95% confidence internal (CI) 0.51 to 0.68; odds ratio 0.38, 95% CI 0.30 to 0.47, respectively). For the treatment of acute ankle sprain, there is consistent evidence for non-steroidal anti-inflammatory drugs, early mobilisation, and exercise therapy for improving pain, swelling and function. There is limited evidence supporting the use of manual therapy for treating acute ankle sprain, although it does improve dorsiflexion range of motion. The efficacy of surgery and acupuncture are controversial and there is insufficient evidence to recommend ultrasound in the treatment of acute ankle sprains. There is a lack of evidence for orthotics or footwear for chronic ankle instability. The limitations of this review include the data extraction being conducted by only one reviewer and the high heterogeneity in the data presented in the included reviews.
Doherty C et al. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. Br J Sports Med 2017;51(2):113-25