Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults.


BACKGROUND:Acute lateral ankle ligament injuries (ankle sprains) are common problems in acute medical care. The treatment variation observed for the acutely injured lateral ankle ligament complex suggests a lack of evidence-based management strategies for this problem. OBJECTIVES:The objective of this review was to assess the effectiveness of methods of immobilisation for acute lateral ankle ligament injuries and to compare immobilisation with functional treatment methods. SEARCH STRATEGY:We searched the Cochrane Musculoskeletal Injuries Group specialised register (December 2001); the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001), MEDLINE (1966-May 2000), EMBASE (1988-May 2000), reference lists of articles, and contacted organisations and researchers in the field. SELECTION CRITERIA:Randomised and quasi-randomised controlled trials comparing either different types of immobilisation or immobilisation versus functional treatments for injuries to the lateral ligament complex of the ankle in adults were included. Trials which investigated the treatment of chronic instability or post-surgical treatment were excluded. DATA COLLECTION AND ANALYSIS:Data were independently extracted by two authors. Where appropriate, results of comparable studies were pooled using fixed effects models. Individual and pooled statistics were reported as relative risks with 95% confidence intervals for dichotomous outcomes and weighted (WMD) or standardised (SMD) mean differences and 95% confidence intervals for continuous outcome measures. Heterogeneity between trials was tested using a standard chi-squared test. MAIN RESULTS:Twenty-one trials involving 2184 participants were included. The mean validity score of the included trials increased from 9.1 (SD 3.0) to 10 (SD 2.9) after retrieving further information (maximum 18 points). Statistically significant differences in favour of functional treatment when compared with immobilisation were found for seven outcome measures: more patients returned to sport in the long term (relative risk (RR) 1.86, 95% confidence interval (CI) 1.22 to 2.86); the time taken to return to sport was shorter (WMD 4.88 (days), 95% CI 1.50 to 8.25); more patients had returned to work at short term follow-up (RR 5.75, 95% CI 1.01 to 32.71); the time taken to return to work was shorter (WMD 8.23 days, 95% CI 6.31 to 10.16); fewer patients suffered from persistent swelling at short term follow-up (RR 1.74, 95% CI 1.17 to 2.59); fewer patients suffered from objective instability as tested by stress X-ray (WMD 2.60, 95% CI 1.24 to 3.96); and patients treated functionally were more satisfied with their treatment (RR 1.83, 95% CI 1.09 to 3.07). A separate analysis of trials that scored 50 per cent or more in quality assessment found a similar result for time to return to work only (WMD (days) 12.89, 95% CI 7.10 to 18.67). No significant differences between varying types of immobilisation, immobilisation and physiotherapy or no treatment were found, apart from one trial where patients returned to work sooner after treatment with a soft cast. In all analyses performed, no results were significantly in favour of immobilisation. REVIEWER'S CONCLUSIONS:Functional treatment appears to be the favourable strategy for treating acute ankle sprains when compared with immobilisation. However, these results should be interpreted with caution, as most of the differences are not significant after exclusion of the low quality trials. Many trials were poorly reported and there was variety amongst the functional treatments evaluated.


Kerkhoffs GM,Rowe BH,Assendelft WJ,Kelly K,Struijs PA,van Dijk CN





Has Abstract


2002-01-01 00:00:00










  • Decompressive surgery for treating nerve damage in leprosy.

    abstract:BACKGROUND:Leprosy causes nerve damage which may result in nerve function impairment and disability. Decompressive surgery is used for treating nerve damage, although the effect is uncertain. OBJECTIVES:To assess the effects of decompressive surgery on nerve damage in leprosy. SEARCH STRATEGY:We searched the Cochrane...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Van Veen NH,Schreuders TA,Theuvenet WJ,Agrawal A,Richardus JH

    更新日期:2009-01-21 00:00:00

  • Antibiotic lock for the prevention of catheter-related infection in neonates.

    abstract:BACKGROUND:Use of a central venous catheter (CVC) in neonates is associated with an increase in nosocomial infection. Numerous strategies exist to prevent catheter-related bloodstream infection (CRBSI); however, CRBSI continues to be a major problem. Antibiotic locking catheters is a new and promising treatment that po...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Taylor JE,Tan K,Lai NM,McDonald SJ

    更新日期:2015-06-04 00:00:00

  • Aerosolized prostacyclins for acute respiratory distress syndrome (ARDS).

    abstract:BACKGROUND:Acute respiratory distress syndrome (ARDS) is a critical condition that is associated with high mortality and morbidity. Aerosolized prostacyclin has been used to improve oxygenation despite the limited evidence available so far.This review was originally published in 2010 and updated in 2017. OBJECTIVES:To...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Afshari A,Bastholm Bille A,Allingstrup M

    更新日期:2017-07-24 00:00:00

  • Buprenorphine for the management of opioid withdrawal.

    abstract:BACKGROUND:Managed withdrawal is a necessary step prior to drug-free treatment or as the end point of substitution treatment. OBJECTIVES:To assess the effectiveness of interventions involving the use of buprenorphine to manage opioid withdrawal, for withdrawal signs and symptoms, completion of withdrawal and adverse e...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Gowing L,Ali R,White JM

    更新日期:2009-07-08 00:00:00

  • Continuous positive airways pressure for obstructive sleep apnoea in adults.

    abstract:BACKGROUND:Obstructive sleep apnoea is the periodic reduction (hypopnoea) or cessation (apnoea) of breathing due to narrowing or occlusion of the upper airway during sleep. The main symptom is daytime sleepiness and it has been suggested it is linked to premature death, hypertension, ischaemic heart disease, stroke and...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Giles TL,Lasserson TJ,Smith BH,White J,Wright J,Cates CJ

    更新日期:2006-07-19 00:00:00

  • Providing physicians with feedback on medication adherence for people with chronic diseases taking long-term medication.

    abstract:BACKGROUND:Poor medication adherence decreases treatment efficacy and worsens clinical outcomes, but average rates of adherence to long-term pharmacological treatments for chronic illnesses are only about 50%. Interventions for improving medication adherence largely focus on patients rather than on physicians; however,...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Zaugg V,Korb-Savoldelli V,Durieux P,Sabatier B

    更新日期:2018-01-10 00:00:00

  • Extracorporeal photopheresis versus standard treatment for acute graft-versus-host disease after haematopoietic stem cell transplantation in paediatric patients.

    abstract:BACKGROUND:Acute graft-versus host disease (aGvHD) is a major cause of morbidity and mortality after haematopoietic stem cell transplantation (HSCT) occurring in 8% to 59% of the recipients. Currently, the therapeutic mainstay for aGvHD is corticosteroids. However, there is no established standard treatment for steroid...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Weitz M,Strahm B,Meerpohl JJ,Bassler D

    更新日期:2014-02-25 00:00:00

  • Steroidal contraceptives: effect on carbohydrate metabolism in women without diabetes mellitus.

    abstract:BACKGROUND:Many hormonal contraceptives have been associated with changes in carbohydrate metabolism. Alterations may include decreased glucose tolerance and increased insulin resistance, which are risk factors for Type 2 diabetes mellitus and cardiovascular disease. These issues have been raised primarily with contrac...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Lopez LM,Grimes DA,Schulz KF

    更新日期:2014-04-30 00:00:00

  • Total versus subtotal hysterectomy for benign gynaecological conditions.

    abstract:BACKGROUND:Hysterectomy using an abdominal approach removes either the uterus alone (subtotal hysterectomy) or both the uterus and the cervix (total hysterectomy). The latter is more common but outcomes have not been systematically compared. OBJECTIVES:To assess and compare outcomes with subtotal hysterectomy versus t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Lethaby A,Ivanova V,Johnson NP

    更新日期:2006-04-19 00:00:00

  • WITHDRAWN: Conjugate vaccines for preventing Haemophilus influenzae type B infections.

    abstract:BACKGROUND:Haemophilus influenzae (H. influenzae) is an important cause of meningitis and pneumonia in children. Vaccine cost is a significant barrier to use in low income countries. Determining the size of the effects of the vaccine will enable cost-effectiveness comparisons with competing priorities in low income cou...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Swingler GH,Michaels D,Hussey GG

    更新日期:2009-10-07 00:00:00

  • Endovascular stents for intermittent claudication.

    abstract:BACKGROUND:Endovascular stents have been suggested as a means to improve the patency of arteries after angioplasty in patients with intermittent claudication. This is an update of a Cochrane review published in 2002. OBJECTIVES:The null hypothesis to be tested by this review is that for individuals with claudication t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Bachoo P,Thorpe PA,Maxwell H,Welch K

    更新日期:2010-01-20 00:00:00

  • Preoxygenation for tracheal suctioning in intubated, ventilated newborn infants.

    abstract:BACKGROUND:Endotracheal suctioning for mechanically ventilated infants is routine practice in neonatal intensive care. However, this practice is associated with serious complications including lobar collapse, pneumothorax, bradycardia and hypoxemia. Increasing the inspired oxygen immediately prior to suction (preoxygen...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Pritchard M,Flenady V,Woodgate P

    更新日期:2001-01-01 00:00:00

  • Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults.

    abstract:BACKGROUND:Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated w...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Derry S,Moore RA,McQuay HJ

    更新日期:2010-11-10 00:00:00

  • Moderate-term, low-dose corticosteroids for rheumatoid arthritis.

    abstract:OBJECTIVES:To perform a systematic review of low-dose corticosteroid efficacy in the moderate term for the treatment of rheumatoid arthritis (RA). SEARCH STRATEGY:We conducted a search in MEDLINE from 1966 to 1998, using the keywords "corticosteroids" and "rheumatoid arthritis". We also handsearched all issues of Arth...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Criswell LA,Saag KG,Sems KM,Welch V,Shea B,Wells G,Suarez-Almazor ME

    更新日期:2000-01-01 00:00:00

  • Interventions for rosacea.

    abstract:BACKGROUND:Rosacea is a common skin condition affecting the face, characterised by flushing, redness, pimples, pustules and dilated blood vessels. The eyes are often also involved. The cause of rosacea is unclear. It is a chronic disease, which can be controlled in most cases with appropriate treatment. Numerous treatm...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: van Zuuren EJ,Graber MA,Hollis S,Chaudhry M,Gupta AK

    更新日期:2004-01-01 00:00:00

  • Nutritional supplementation for hip fracture aftercare in the elderly.

    abstract:BACKGROUND:Fractures of the hip are an important cause of later ill health and mortality in elderly people. People with hip fractures are often malnourished at the time of fracture, and have poor food intake in hospital. OBJECTIVES:This review assesses the effects of nutritional interventions in elderly people recover...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Avenell A,Handoll HH

    更新日期:2000-01-01 00:00:00

  • Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen.

    abstract:BACKGROUND:Adjuvant tamoxifen reduces the risk of breast cancer recurrence in women with estrogen receptor-positive breast cancer. Tamoxifen also increases the risk of postmenopausal bleeding, endometrial hyperplasia, polyps, and endometrial cancer. The levonorgestrel-releasing intrauterine system (LNG-IUS) causes prof...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Chin J,Konje JC,Hickey M

    更新日期:2009-10-07 00:00:00

  • Motivational interviewing for alcohol misuse in young adults.

    abstract:BACKGROUND:Globally, harmful use of alcohol results in approximately 2.5 million deaths each year. About 9% of these deaths are young people between the ages of 15 and 29 years (WHO 2011), mainly resulting from motor vehicle accidents, homicides, suicides and drownings. Hazardous drinking levels for men (consuming over...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Foxcroft DR,Coombes L,Wood S,Allen D,Almeida Santimano NM

    更新日期:2014-08-21 00:00:00

  • Colloids versus crystalloids for fluid resuscitation in critically ill patients.

    abstract:BACKGROUND:Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids. OBJECTIVES:To assess the effects of colloids compared to crystalloids for fluid r...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Perel P,Roberts I

    更新日期:2012-06-13 00:00:00

  • Intravesical electromotive drug administration for non-muscle invasive bladder cancer.

    abstract:BACKGROUND:Electromotive drug administration (EMDA) is the use of electrical current to improve the delivery of intravesical agents to reduce the risk of recurrence in people with non-muscle invasive bladder cancer (NMIBC). It is unclear how effective this is in comparison to other forms of intravesical therapy. OBJEC...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Jung JH,Gudeloglu A,Kiziloz H,Kuntz GM,Miller A,Konety BR,Dahm P

    更新日期:2017-09-12 00:00:00

  • Plasma transfusions prior to lumbar punctures and epidural catheters for people with abnormal coagulation.

    abstract:BACKGROUND:The insertion of a lumbar puncture needle or epidural catheter may be associated with peri- and post-procedural bleeding. People who require this procedure may have disorders of coagulation as a result of their underlying illness, co-morbidities or the effects of treatment. Clinical practice in some institut...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Estcourt LJ,Desborough MJ,Doree C,Hopewell S,Stanworth SJ

    更新日期:2017-09-25 00:00:00

  • Vaccines for preventing Japanese encephalitis.

    abstract:BACKGROUND:Vaccination is recognized as the only practical measure for preventing Japanese encephalitis. Production shortage, costs, and issues of licensure impair vaccination programmes in many affected countries. Concerns over vaccine effectiveness and safety also have a negative impact on acceptance and uptake. OBJ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Schiøler KL,Samuel M,Wai KL

    更新日期:2007-07-18 00:00:00

  • Antiepileptic drugs for the treatment of infants with severe myoclonic epilepsy.

    abstract:BACKGROUND:This is an updated version of the original Cochrane review published in Issue 11, 2013.Severe myoclonic epilepsy in infants (SMEI), also known as Dravet syndrome, is a rare, refractory form of epilepsy, for which stiripentol (STP) has been recently licensed as add-on therapy. OBJECTIVES:To evaluate the effi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Brigo F,Igwe SC

    更新日期:2015-10-19 00:00:00

  • Lithium for schizophrenia.

    abstract:BACKGROUND:Many people with schizophrenia do not achieve a satisfactory treatment response with ordinary antipsychotic drug treatment. In these cases, various add-on medications are used, among them lithium. OBJECTIVES:To review the effects of lithium for the treatment of schizophrenia and schizophrenia-like psychoses...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Leucht S,McGrath J,Kissling W

    更新日期:2003-01-01 00:00:00

  • Endoscopic pneumatic dilation versus botulinum toxin injection in the management of primary achalasia.

    abstract:BACKGROUND:Achalasia is an oesophageal motility disorder, of unknown cause, which results in increased lower oesophageal sphincter (LOS) tone and symptoms of difficulty swallowing. Treatments are aimed at reducing the LOS tone. Current endoscopic therapeutic options include pneumatic dilation (PD) or botulinum toxin (B...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Leyden JE,Moss AC,MacMathuna P

    更新日期:2014-01-01 00:00:00

  • Surgical versus nonsurgical interventions for flail chest.

    abstract:BACKGROUND:Thoracic trauma (TT) is common among people with multiple traumatic injuries. One of the injuries caused by TT is the loss of thoracic stability resulting from multiple fractures of the rib cage, otherwise known as flail chest (FC). A person with FC can be treated conservatively with orotracheal intubation a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Cataneo AJ,Cataneo DC,de Oliveira FH,Arruda KA,El Dib R,de Oliveira Carvalho PE

    更新日期:2015-07-29 00:00:00

  • Environmental and behavioural interventions for reducing physical activity limitation in community-dwelling visually impaired older people.

    abstract:BACKGROUND:Impairment of vision is associated with a loss of function in activities of daily living. Avoidance of physical activity and consequent reduced functional capacity is common in older people with visual impairment and an important risk factor for falls. Indeed, the rate of falls and fractures is higher in old...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Skelton DA,Howe TE,Ballinger C,Neil F,Palmer S,Gray L

    更新日期:2013-06-05 00:00:00

  • Disposable nappies for preventing napkin dermatitis in infants.

    abstract:BACKGROUND:Napkin dermatitis is a common condition that occurs in otherwise healthy infants. It causes discomfort to infants, anxiety to parents and caregivers and contributes to the load on the health care system. A large variety of napkins, both disposable and non-disposable, are available. Evidence is required to as...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Baer EL,Davies MW,Easterbrook KJ

    更新日期:2006-07-19 00:00:00

  • Topical negative pressure for treating chronic wounds.

    abstract:BACKGROUND:Chronic wounds mainly affect the elderly and those with multiple health problems. Despite the use of modern dressings, some of these wounds take a long time to heal, fail to heal, or recur, causing significant pain and discomfort to the person and cost to health services. Topical negative pressure (TNP) is u...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Ubbink DT,Westerbos SJ,Evans D,Land L,Vermeulen H

    更新日期:2008-07-16 00:00:00

  • Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus.

    abstract:BACKGROUND:Ethnic minority groups in upper-middle-income and high-income countries tend to be socioeconomically disadvantaged and to have a higher prevalence of type 2 diabetes than is seen in the majority population. OBJECTIVES:To assess the effectiveness of culturally appropriate health education for people in ethni...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Attridge M,Creamer J,Ramsden M,Cannings-John R,Hawthorne K

    更新日期:2014-09-04 00:00:00