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Medicine Oct 2022The lateral sprain of the ankle is a very frequent injury in the population in general, appearing in the emergency services frequently. The general objective was to... (Review)
Review
BACKGROUND
The lateral sprain of the ankle is a very frequent injury in the population in general, appearing in the emergency services frequently. The general objective was to review the current clinical practice guidelines (CPGs) on management and treatment of ankle sprains, assess their quality, analyze the levels of evidence and summarize the grades of recommendation.
METHODS
A systematic search of the literature in relevant databases with the search terms "ankle," "sprain," "practice guideline," and "guideline" was carried out. There were included those guidelines that had the system of grades of recommendation and level of evidence concerning to management and treatment of ankle sprain. The quality of the guides was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.
RESULTS
Seven clinical practice guides were included in this review. The AGREE II scores ranged from 42% to 100%, with only six CPGs explicitly declaring the use of a systematic methodology. Seventeen recommendations were extracted and summarized.
DISCUSSION
Six of the recommendations analyzed present enough evidence to be applied in clinical practice and are highly recommended for ankle sprain management: Ottawa rules, manual therapy, cryotherapy, functional supports, early ambulation, short term NSAIDs and rehabilitation.
Topics: Humans; Ankle Injuries; Sprains and Strains; Ankle Joint; Early Ambulation; Anti-Inflammatory Agents, Non-Steroidal
PubMed: 36281183
DOI: 10.1097/MD.0000000000031087 -
Sports Medicine (Auckland, N.Z.) 2007This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting... (Review)
Review
This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports.
Topics: Ankle Injuries; Athletic Injuries; Developed Countries; Developing Countries; Humans; Sprains and Strains
PubMed: 17190537
DOI: 10.2165/00007256-200737010-00006 -
British Journal of Sports Medicine Jan 2017Ankle sprains are highly prevalent with high risk of recurrence. Consequently, there are a significant number of research reports examining strategies for treating and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ankle sprains are highly prevalent with high risk of recurrence. Consequently, there are a significant number of research reports examining strategies for treating and preventing acute and recurrent sprains (otherwise known as chronic ankle instability (CAI)), with a coinciding proliferation of review articles summarising these reports.
OBJECTIVE
To provide a systematic overview of the systematic reviews evaluating treatment strategies for acute ankle sprain and CAI.
DESIGN
Overview of intervention systematic reviews.
PARTICIPANTS
Individuals with acute ankle sprain/CAI.
MAIN OUTCOME MEASUREMENTS
The primary outcomes were injury/reinjury incidence and function.
RESULTS
46 papers were included in this systematic review. The reviews had a mean score of 6.5/11 on the AMSTAR quality assessment tool. There was strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence of an ankle sprain. For the combined outcomes of pain, swelling and function after an acute sprain, there was strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques. There was conflicting evidence regarding the efficacy of surgery and acupuncture for the treatment of acute ankle sprains. There was insufficient evidence to support the use of ultrasound in the treatment of acute ankle sprains.
CONCLUSIONS
For the treatment of acute ankle sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques, for pain, swelling and function. Exercise therapy and bracing are supported in the prevention of CAI.
Topics: Ankle Injuries; Braces; Exercise Therapy; Humans; Recurrence; Sprains and Strains
PubMed: 28053200
DOI: 10.1136/bjsports-2016-096178 -
International Orthopaedics Feb 2022Systematic review and meta-analysis to assess the effectiveness of manual therapy in improving carpal tunnel syndrome (CTS) symptoms, physical function, and nerve... (Meta-Analysis)
Meta-Analysis Review
AIM OF THE STUDY
Systematic review and meta-analysis to assess the effectiveness of manual therapy in improving carpal tunnel syndrome (CTS) symptoms, physical function, and nerve conduction studies.
METHOD
MEDLINE, Web of Science, SCOPUS, Cochrane Library, TRIP database, and PEDro databases were searched from the inception to September 2021. PICO search strategy was used to identify randomized controlled trials applying manual therapy on patients with CTS. Eligible studies and data extraction were conducted independently by two reviewers. Methodology quality and risk of bias were assessed by PEDro scale. Outcomes assessed were pain intensity, physical function, and nerve conduction studies.
RESULTS
Eighty-one potential studies were identified and six studies involving 401 patients were finally included. Pain intensity immediately after treatment showed a pooled standard mean difference (SMD) of - 2.13 with 95% confidence interval (CI) (- 2.39, - 1.86). Physical function with Boston Carpal Tunnel Syndrome Questionnaire (BCTS-Q) showed a pooled SMD of - 1.67 with 95% CI (- 1.92, - 1.43) on symptoms severity, and a SMD of - 0.89 with 95% CI (- 1.08, - 0.70) on functional status. Nerve conduction studies showed a SMD of - 0.19 with 95% CI (- 0.40, - 0.02) on motor conduction and a SMD of - 1.15 with 95% CI (- 1.36, - 0.93) on sensory conduction.
CONCLUSIONS
This study highlights the effectiveness of manual therapy techniques based on soft tissue and neurodynamic mobilizations, in isolation, on pain, physical function, and nerve conduction studies in patients with CTS.
Topics: Carpal Tunnel Syndrome; Humans; Musculoskeletal Manipulations; Neural Conduction; Pain; Pain Measurement; Treatment Outcome
PubMed: 34862562
DOI: 10.1007/s00264-021-05272-2 -
Sports Medicine (Auckland, N.Z.) Jan 2014Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist.
OBJECTIVE
Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity.
METHODS
We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields.
RESULTS
One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain.
CONCLUSIONS
Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.
Topics: Age Factors; Ankle Injuries; Athletic Injuries; Humans; Incidence; Military Personnel; Prevalence; Sex Factors; Sprains and Strains
PubMed: 24105612
DOI: 10.1007/s40279-013-0102-5 -
Schmerz (Berlin, Germany) Aug 2022The treatment of carpal tunnel syndrome (CTS) usually involves surgical decompression of the nerve or splinting and additional medication. Physiotherapy and sports... (Review)
Review
BACKGROUND
The treatment of carpal tunnel syndrome (CTS) usually involves surgical decompression of the nerve or splinting and additional medication. Physiotherapy and sports therapy could be non-invasive and alternative treatment approaches with a simultaneous low risk of side effects.
OBJECTIVE
The review systematically summarizes the current studies on the effectiveness of physiotherapy and sports therapeutic interventions for treatment of CTS and focuses on the reduction of symptoms and, as a secondary outcome, improvement of hand function.
MATERIAL AND METHODS
The systematic review includes randomized controlled trials reporting on physiotherapy or sports therapy interventions published prior to February 2021 in the electronic databases PubMed, CINAHL and Web of Science. Following the guidelines of preferred reporting items for systematic reviews and meta-analyses (PRISMA) and the Cochrane Collaboration, a systematic search of the literature, data extraction and evaluation of the risk of bias using the Cochrane risk of bias tool were conducted by two independent researchers.
RESULTS
Out of 461 identified studies 26 were included in the qualitative analysis. The risk of bias in the individual studies was graded as moderate to low. Potential bias might arise due to inadequate blinding of patients and study personnel in some cases as well as due to selective reporting of study results and procedures. Manual therapy proved to be faster and equally effective in reducing pain and improving function in the long term compared to surgery. Mobilization techniques, massage techniques, kinesiotaping and yoga as therapeutic interventions also showed positive effects on symptoms.
CONCLUSION
For the management of mild to moderate CTS, physiotherapy and sports therapeutic interventions are characterized primarily by success after as little as 2 weeks of treatment as well as comparable success to surgery and 3 months of postoperative treatment. In addition, patients are not exposed to surgical risks. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the number 42017073839.
Topics: Carpal Tunnel Syndrome; Humans; Medicine; Musculoskeletal Manipulations; Physical Therapy Modalities
PubMed: 35286465
DOI: 10.1007/s00482-022-00637-x -
Sports Health 2016Lateral ankle ligamentous sprain (LAS) is one of the most common injuries in recreational activities and competitive sports. Many studies have attempted to determine... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Lateral ankle ligamentous sprain (LAS) is one of the most common injuries in recreational activities and competitive sports. Many studies have attempted to determine whether there are certain intrinsic factors that can predict LAS. However, no consensus has been reached on the predictive intrinsic factors.
OBJECTIVE
To identify the intrinsic risk factors of LAS by meta-analysis from data in randomized control trials and prospective cohort studies.
DATA SOURCES
A systematic computerized literature search of MEDLINE, CINAHL, ScienceDirect, SPORTDiscus, and Cochrane Register of Clinical Trials was performed.
STUDY SELECTION
A computerized literature search from inception to January 2015 resulted in 1133 studies of the LAS intrinsic risk factors written in English.
STUDY DESIGN
Systematic review.
LEVEL OF EVIDENCE
Level 4.
DATA EXTRACTION
The modified quality index was used to assess the quality of the design of the papers and the standardized mean difference was used as an index to pool included study outcomes.
RESULTS
Eight articles were included in this systematic review. Meta-analysis results showed that body mass index, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and peroneus brevis reaction time correlated with LAS.
CONCLUSION
Body mass index, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and the reaction time of the peroneus brevis were associated with significantly increased risk of LAS.
Topics: Ankle Injuries; Ankle Joint; Body Mass Index; Humans; Lateral Ligament, Ankle; Muscle Strength; Posture; Proprioception; Range of Motion, Articular; Reaction Time; Risk Factors; Sprains and Strains
PubMed: 26711693
DOI: 10.1177/1941738115623775 -
British Journal of Sports Medicine Feb 2017Olympic weightlifting and powerlifting are two sports that expose the body to great forces. Injury characteristics have not been systematically reviewed for these two... (Review)
Review
BACKGROUND
Olympic weightlifting and powerlifting are two sports that expose the body to great forces. Injury characteristics have not been systematically reviewed for these two growing sports.
OBJECTIVE
The purpose of this study was to systematically review the literature regarding various definitions of injuries used, injury localisation, the prevalence and incidence of injuries and the associated risk factors for injuries in weightlifting and powerlifting.
DESIGN
Systematic review.
DATA SOURCES
Five databases, PubMed, MEDLINE, SPORTDiscus, Scopus and Web of Science, were searched between 9 March and 6 April 2015.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Studies assessing injury incidence and prevalence in Olympic weightlifting and powerlifting were included. The Quality assessment tool for observational cohort and cross-sectional studies was used to assess methodological quality.
RESULTS
9 studies were included in the review. Injury was defined fairly consistently across studies. Most studies were of low methodological quality. The spine, shoulder and the knee were the most common injury localisations in both sports. The injury incidence in weightlifting was 2.4-3.3 injuries/1000 hours of training and 1.0-4.4 injuries/1000 hours of training in powerlifting. Only one retrospective study had analysed possible risk factors.
SUMMARY/CONCLUSIONS
The risk of injury in both sports were similar to other non-contact sports also requiring strength/power, but low compared to contact sports. The severity of injuries differed in the included studies. Since little has been studied regarding possible risk factors to injuries, further research is therefore warranted to explain why athletes get injured and how to prevent injuries.
TRIAL REGISTRATION NUMBER
PROSPERO CRD42015014805.
Topics: Athletic Injuries; Back Injuries; Cumulative Trauma Disorders; Humans; Incidence; Knee Injuries; Muscle, Skeletal; Risk Factors; Shoulder Injuries; Weight Lifting
PubMed: 27707741
DOI: 10.1136/bjsports-2016-096037 -
Sports Health 2015Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates.
OBJECTIVE
To analyze the effectiveness of current lower extremity injury prevention programs in basketball athletes, focusing on injury rates of (1) general lower extremity injuries, (2) ankle sprains, and (3) anterior cruciate ligament (ACL) tears.
DATA SOURCES
PubMed, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Register of Controlled Trials were searched in January 2015.
STUDY SELECTION
Studies were included if they were randomized controlled or prospective cohort trials, contained a population of competitive basketball athletes, and reported lower extremity injury incidence rates specific to basketball players. In total, 426 individual studies were identified. Of these, 9 met the inclusion criteria. One other study was found during a hand search of the literature, resulting in 10 total studies included in this meta-analysis.
STUDY DESIGN
Systematic review and meta-analysis.
LEVEL OF EVIDENCE
Level 2.
DATA EXTRACTION
Details of the intervention (eg, neuromuscular vs external support), size of control and intervention groups, and number of injuries in each group were extracted from each study. Injury data were classified into 3 groups based on the anatomic diagnosis reported (general lower extremity injury, ankle sprain, ACL rupture).
RESULTS
Meta-analyses were performed independently for each injury classification. Results indicate that prophylactic programs significantly reduced the incidence of general lower extremity injuries (odds ratio [OR], 0.69; 95% CI, 0.57-0.85; P < 0.001) and ankle sprains (OR, 0.45; 95% CI, 0.29-0.69; P < 0.001), yet not ACL ruptures (OR, 1.09; 95% CI, 0.36-3.29; P = 0.87) in basketball athletes.
CONCLUSION
In basketball players, prophylactic programs may be effective in reducing the risk of general lower extremity injuries and ankle sprains, yet not ACL injuries.
Topics: Ankle Injuries; Anterior Cruciate Ligament Injuries; Basketball; Humans; Lower Extremity; Risk Factors; Sprains and Strains
PubMed: 26502412
DOI: 10.1177/1941738115593441 -
European Review For Medical and... Mar 2022Lateral ankle sprains are very common injuries that can be treated with different strategies. The aim of the present systematic review was to provide a comprehensive... (Review)
Review
OBJECTIVE
Lateral ankle sprains are very common injuries that can be treated with different strategies. The aim of the present systematic review was to provide a comprehensive analysis on the treatment of acute lateral ankle sprains to clarify the possible differences in outcome between surgical and conservative management, different external supports, and different rehabilitation protocols.
MATERIALS AND METHODS
A literature search on three different topics was carried out on PubMed, Scopus, and Web of Science databases on June 25th, 2021. The main objective of the literature search was to identify the randomized trials comparing: (1) surgery to conservative management, (2) different external supports, and (3) different rehabilitation protocols for the treatment of acute lateral ankle sprains. Two investigators extracted independently relevant data from each paper and assessed the quality of the trials using the Cochrane Risk of Bias Assessment.
RESULTS
A total of 12 studies for the first topic, 8 for the second one and 4 for the last one were included in this review. 8 out of 12 RCTs demonstrated a superior outcome and better socio-economic impact of conservative treatment compared to surgical management. In the other two comparisons, due to the wide variety of braces used and the different rehabilitation protocols, inconclusive results were obtained.
CONCLUSIONS
Conservative treatment should be the first choice for severe acute lateral ankle sprains, as it provides satisfactory functional outcomes without the risks and costs of surgery. It was not possible to identify the best external support, but a preference toward flexible braces emerged since they allow an earlier return to daily activities. The paucity of studies comparing different rehabilitation protocols precluded the possibility of defining the ideal one.
Topics: Ankle Injuries; Conservative Treatment; Graft vs Host Disease; Humans; Sprains and Strains
PubMed: 35363336
DOI: 10.26355/eurrev_202203_28333