Tape Versus Semirigid Versus Lace-up Ankle Support in the Treatment of Acute Lateral Ankle Ligament Injury.
Condition: Grade II and III Acute Lateral Ankle Ligament Injuries
MeSH terms: Wounds and Injuries
Study type: Interventional
Phase: Phase 4

Summary: 
      The objective of this study is to compare tape versus semi rigid support versus lace up brace
      treatment for acute lateral ankle ligament injuries with regard to clinical outcome and cost
      effectiveness.

      There is a difference of 10 in functional outcome (Karlsson Score) between non-elastic
      adhesive taping and semi-rigid and lace-up ankle support, in favour of the last, for the
      treatment of acute lateral ankle ligament injury at 6 months follow-up.
    

Detailed description: 
      This study is designed as a single blind prospective randomized controlled trial to evaluate
      the difference in functional outcome after treatment with tape versus semi-rigid versus
      lace-up ankle support (brace) for grade II and III acute lateral ankle ligament injuries. The
      patients will be randomly allocated into one of the three groups. Randomization will be
      performed by computer. Blinding of patients is not possible, but the observer will be blinded
      at eight weeks and six months.
    

Intervention name(s): Tape; Semi rigid brace; Lace-up brace
Intervention type(s): Device; Device; Device
Intervention description(s): Group I will be treated with non-elastic adhesive tape (Leukotape® Classic) around the affected ankle, applied by the 'van Unen-technique'.18 This technique is an alternative for the 'Coumans- technique'.15 The rationale of taping is to take the load off the injured tissue, to correct the biomechanics, to protect the injured part and to enhance proprioception and awareness of the injured tissue. Different materials can be used alone or in combination. The bandage material must have an adhesive layer which allows it to adhere to the skin and to itself. Since the direct stabilizing effect of a bandage lasts no longer than about half an hour, the positive effect is presumed to occur primarily through traction on the skin which stimulates muscular activity.; Group II will be treated by application of a semi-rigid brace, the M-step® from Medi®. The foam gel in the pads continuously adapts to give an uninterrupted optimal fit to the constantly changing anatomical conditions, which therefore ensures a uniform compression. The ability of the foam gel pad to adapt allows one orthosis to be used for both the left and the right ankle. The pads are very light and have a soft fleecy surface. Even the edges of the outer moldings are generously padded. The M-step ankle orthosis can be quickly and securely applied by means of two Velcro fasteners; the Velcro fasteners can be detached from the outer shells and fixed individually.; Group III will be treated by application of a lace-up brace, the ASO brace. The ASO (Ankle Stabilizing Orthosis) fits into an athletic or street shoe. The ASO is made of thin, durable ballistic nylon - the same protective material used by law enforcement and military personnel. Support is achieved through exclusive non-stretch nylon stabilizing straps that mirror the stirrup technique of an athletic taping application. The calcaneus is captured, effectively locking the heel. The ASO ankle brace holds the ankle in a biomechanical neutral position, reducing either inversion or eversion type injuries or re-injuries.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Ankle; ligament injuries; non-surgical treatment; tape; brace; orthotic device; bandage; cost-effectiveness; randomized trial