Department of Physical Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.
Department of Orthopedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Clin Rehabil. 2023 May;37(5):585-602. doi: 10.1177/02692155221137640. Epub 2023 Jan 11.
To evaluate the effect of preventive interventions for lateral ankle sprain in the general population.
A search of PubMed, EMBASE, Cochrane CENTRAL, Medline, CINAHL, and ClinicalTrials.gov was conducted up to August 2022.
Randomized controlled trials and prospective cohort studies that evaluated any interventions for preventing lateral ankle sprain were included. Two reviewers independently conducted the search, screening, and data extraction. The methodological quality of each study was assessed using the revised Cochrane risk-of-bias tool for randomized trials or using the Cochrane Risk Of Bias In Non-Randomized Studies tool for prospective cohort studies.
Seventeen studies met the inclusion criteria. Proprioceptive training exhibited better effects on preventing future lateral ankle sprain compared with the control group (risk ratio = 0.59, p < 0.001), and a stronger preventive effect was observed in participants with a history of lateral ankle sprain in the subgroup analysis (risk ratio = 0.49, p = 0.02). Compared with no bracing, ankle bracing had no significant better effect in preventing lateral ankle sprain (risk ratio = 0.43, p = 0.05). Proprioceptive training and ankle bracing had similar preventive effects (risk ratio = 0.98, p = 0.97). Limited evidence hindered the synthesis of data on pain, swelling, costs, and time loss.
Proprioceptive training is recommended for preventing lateral ankle sprain, especially for people with a history of lateral ankle sprain. Bracing seems to have an ambiguous preventive effect and requires more further investigation.
评估普通人群中预防外侧踝关节扭伤的干预措施的效果。
截至 2022 年 8 月,对 PubMed、EMBASE、Cochrane 中心、Medline、CINAHL 和 ClinicalTrials.gov 进行了检索。
纳入了评估任何预防外侧踝关节扭伤干预措施的随机对照试验和前瞻性队列研究。两位评审员独立进行了检索、筛选和数据提取。使用修订后的 Cochrane 随机试验偏倚风险工具或 Cochrane 非随机研究偏倚风险工具评估每项研究的方法学质量。
符合纳入标准的研究有 17 项。本体感觉训练在预防未来外侧踝关节扭伤方面的效果优于对照组(风险比=0.59,p<0.001),在有外侧踝关节扭伤史的亚组分析中观察到更强的预防效果(风险比=0.49,p=0.02)。与不使用支具相比,支具在预防外侧踝关节扭伤方面没有显著更好的效果(风险比=0.43,p=0.05)。本体感觉训练和支具具有相似的预防效果(风险比=0.98,p=0.97)。有限的证据阻碍了关于疼痛、肿胀、成本和时间损失的数据综合。
建议进行本体感觉训练以预防外侧踝关节扭伤,特别是对于有外侧踝关节扭伤史的人。支具似乎具有不确定的预防效果,需要进一步研究。