May 2014

Cost-effectiveness data favor bracing alone to prevent recurrent ankle sprain

In the moment: O&P

By Emily Delzell

Bracing costs less and prevents recurrent ankle sprain more effectively than bracing plus neuromuscular training (NMT), according to a cost-effectiveness analysis of injury prevention methods.

Dutch investigators at the VU University Medical Center in Amsterdam randomized 340 active teen and adult athletes who had sprained an ankle up to two months before the study’s start to eight weeks of home NMT (30 mins/day), 12 months of semirigid ankle brace wear for sports, or both interventions.

Using an incremental cost-analysis ratio that accounted for costs of patient time, interventions, healthcare, and lost productivity, investigators found the brace group had significantly lower mean costs and a nonsignificant favorable effect on ankle sprain incidence while the NMT group had nonsignificant lower costs and a nonsignificant higher reinjury rate compared with the combination group. The cost effects remained to a lesser extent when investigators subtracted patient time from the analysis. During the one-year follow-up 27%, 19%, and 15% of individuals in the NMT, combination, and brace groups, respectively, experienced an ankle sprain.

The American Journal of Sports Medicine epublished the results on April 21.


Janssen KW, Hendriks MR, van Mechelen W, Verhagen E. The cost effectiveness of measures to prevent recurrent ankle sprains: results of a 3-arm randomized controlled trial. Am J Sports Med 2014 Apr 21. [Epub ahead of print]

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