Table 3.
Description of Included Studies
| Study | Design | Participants | Interventions | Results | Relative Risk | Limitations |
|---|---|---|---|---|---|---|
| Verhagen et al (2005)30 | RCT Level 1b | 1127 Division III college volleyball players (643 females, 484 males). Mean age 24 years. Did not report if subjects had a history of prior sprain. |
Balance training group 36-week balance board “proprioceptive" program (n = 628) Control group (n = 494) | Incidence - 70 total sprains: Balance Training (29) vs. control (41). Incidence rate per exposure: Balance Training: 0.5/1000 hours; Control: 1.87/1000 hours. | 0.40 CI 95% 0.1-0.7 |
Reports differences between groups without providing p-value. Lacking blinding |
| McGuine et al (2006)29 | RCT Level 1b | 765 high school soccer and basketball players (523 females, 242 male). Mean age 16 years, with and without history of prior inversion sprain. |
Balance Training group 5-phase program during the pre- and sport season (n = 373) Control group (n = 392) |
Incidence - 62 total sprains: Balance Training (23) vs. Control (39). Incidence rate per exposure: Balance Training: 1.13/1000 hours; Control: 1.87/1000 hours. Intervention did not significantly reduce risk of sprain for those that did not have a prior sprain history (p = 0.059). | 0.56 CI 95% 0.33-0.95 p = 0.033 |
Recall bias, lacked blinding, ratio of females to males was 2:1 |
| Emery et al (2007)31 | RCT Level 1b | 920 high school basketball players (456 females, 464 males). Mean age 16 years, with or without history of prior ankle sprain. |
Balance Training group balance board 18-week warm-up and home program (n = 494) Control group (n = 426) | Incidence - 138 total sprains: Balance Training (62) vs. control (76). Incidence rate per exposure: Balance Training: 1.57/1000 hours; Control: 2.46/1000 hours. | 0.71 CI 95% 0.45-1.13 p = 0.15 |
Compliance, low power - to improve value would have required 980 subjects |
| Hupperets et al (2009)32 | RCT Level 1b | 522 mixed-level and sport athletes (248 females, 274 males). Mean age 28 years, with prior history of inversion sprain. |
Balance Training group unsupervised 8-week “proprioceptive” program (n = 256) Control group (n = 266) | Incidence – 145 total sprains: Balance Training (56) vs. Control (89). Incidence rate per exposure: Balance Training: 1.86/1000 hours; Controls: 2.90/1000 hours. | 0.63 CI 95% 0.45-0.88 |
Reported compliance 52%, some subjects lost to follow-up, did not specify type of sport, or hours/week of sport participation. |
| Eils et al (2010)3 | RCT Level 1b | 232 mixed-level German basketball players (all male). Mean age 25 years, did not report if subjects had a history of prior sprain. |
Balance Training group multi-station “proprioceptive” program through season (n = 96) Control group (n = 102) | Incidence – 28 total sprains: Balance Training (7) vs Control (21). Incidence rate per exposure: Balance Training: 1.53/1000 hours; 4.31/1000 hours | 0.35 CI 95% 0.15-0.84 p = 0.018 |
Lacked blinding, did not report compliance |
| Mohammadi (2007)26 | RCT Level 1b | 80 college Division I soccer players (all male). Mean age 24 years, with prior history of ankle inversion sprain |
1: Balance Training “proprioceptive” training program (n = 20) 2: Strengthening (n = 20) 3: Sports Stirrup Bracing (n = 20) 4: Control (n = 20) Performed through season. | Incidence - 15 total sprains: Balance Training (1), Strengthening (4), Bracing (2), Control (8). Balance Training reduced incidence (p = 0.02) vs. control; Bracing (p = 0.06) and Strengthening (p = 0.27) did not. Incidence rate per exposure: Balance Training: 0.0.418/1000 hours; Strengthening: 1.67/1000 hours; Bracing: 0.834/1000 hours; Controls: 3.35/1000 hours | Balance Training: 0.13 CI95% 0.003-0.93 Bracing: 0.25 CI95% 0.03-1.91 |
Small sample size, lacked blinding, lacked description of medical trainers’ experience |
| McGuine et al (2011)34 | RCT Level 1b | 1460 high school basketball players (736 females, 724 males). Mean age 16 years, with and without history of prior ankle sprain. |
Bracing group wore McDavid Ultralight lace-up orthosis for team organized conditioning, practice, and games for full season (n = 740) Control group: (n = 720) | Incidence - 265 total sprains: Bracing (117) vs. Control (148). Incidence rate per exposure: Bracing: 0.47/1000 hours; Controls: 1.41/1000 hours. | 0.32 CI 95%: 0.19-0.51 p<0.001 |
Did not account for different types of shoes, lacked blinding |
| McGuine et al (2012)35 | RCT Level 1b | 2081 high school football players (all male). Mean age 16 years, with and without history of prior ankle sprain |
Bracing group wore Don-Joy lace-up Ankle Stabilizing Orthosis, for team organized conditioning, practice, games for full season (n = 993) Control group: (n = 1088) | Incidence – 686 total sprains: Bracing (313) vs control (373). Incidence rate per exposure: Bracing: 0.48/1000 hours; Controls: 1.12/1000 hours. | 0.39 CI 95% 0.24-0.65 p<0.001 |
Did not account for different types of shoes, lacked blinding ack of subject and assessor blinding |