Ankle Bracing is Effective for Primary and Secondary Prevention of Acute Ankle Injuries in Athletes: A Systematic Review and Meta-Analyses

BackgroundAnkle bracing has been verified as being effective for secondary prevention of ankle injuries. However, new studies have recently been published that are not included in previous meta-analyses. Furthermore, the effects of bracing for primary prevention of ankle injuries are still unclear.ObjectiveThe objective of this article was to systematically review the literature about the effectiveness of ankle bracing on primary and secondary prevention of acute ankle injuries in athletes.MethodsWe searched PubMed, EMBASE, SPORTDiscus, CINAHL, and PEDro databases for eligible articles until July 2018. Randomized controlled trials that studied ankle bracing vs. no intervention for athletes were included. Risk of bias was assessed with the Cochrane Risk of Bias tool. Meta-analyses were conducted to study the effect of ankle bracing for primary and secondary prevention of ankle injuries. The Grading of Recommendation Assessment, Development, and Evaluation method was used to determine the quality of evidence.ResultsWe included six randomized controlled trials. Significant risk ratios of 0.53 (95% confidence interval 0.32-0.88) and 0.37 (95% confidence interval 0.24-0.58) were found in favor of ankle bracing vs. no ankle bracing for primary (low quality of evidence, I-2 = 77%) and secondary prevention (moderate quality of evidence, I-2 = 0%) of acute ankle injuries. Numbers needed to treat were 26 and 12 for the primary and secondary prevention of acute ankle injuries.ConclusionsAnkle bracing is effective for primary and secondary prevention of acute ankle injuries among athletes. However, conclusions in regard to primary prevention should be drawn cautiously because of the low quality of evidence and significant heterogeneity.