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Exercise for the Treatment of Ankle Sprain: A Review of Clinical Effectiveness and Guidelines

Last updated: April 13, 2020
Project Number: RC1261-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of exercise for the treatment of individuals with ankle sprain?
  2. What are the evidence-based guidelines regarding the use of non-pharmacological interventions for the treatment of individuals with ankle sprain?

Key Message

This review included two systematic reviews and two randomized controlled trials regarding the clinical effectiveness of exercise for the treatment of individuals with ankle sprain, and one guideline regarding the use of non-pharmacological interventions in this population.

Based on the findings of the systematic reviews that compared structured exercise-based rehabilitation plus usual care versus usual care alone, or supervised rehabilitation versus home exercise, there were no significant differences between treatment groups in terms of foot and ankle function, pain, subjective ankle instability, or subjective recovery. The results for ankle sprain recurrence were mixed. Specifically, one systematic review showed significant reduction in ankle sprain recurrence in those who received exercise-based rehabilitation plus usual care compared with usual care alone at 7 to 12 months, but not at 3 to 6 months of follow-up. In the other systematic review, one study showed that there was a significantly lower proportion of patients with recurrent ankle sprain in the supervised rehabilitation versus home exercise group, while the other study found no significant difference between groups. 

One randomized controlled trial found that compared with the traditional PRICE (protection, rest, ice, compression, and elevation) treatment, early mobilization using a stretch band ankle traction technique resulted in no significant differences in ankle strength, ankle function, pain and number of days to returning to sport in children and adolescents.

Another randomized controlled trial compared Wii Fit™ exercise therapy with conventional physical therapy and with no therapy, and found no significant differences between treatment groups for ankle function, pain, time to returning to sport, and self-reported satisfaction and effectiveness. 

The included guideline recommends the use exercise therapy in combination with functional support (i.e., ankle brace) or manual mobilization in the treatment of acute lateral ankle sprain (level 2 evidence). The guideline does not recommend the use of RICE (rest, ice, compression, and elevation) alone (level 2 evidence), or other therapies such as acupuncture, vibration therapy, laser therapy, ultrasound, electrotherapy, short wave therapy and Bioptron light therapy (level 3 evidence) in the treatment of acute lateral ankle sprain. The strength of the recommendation statements were not indicated.