Background & Aims

The ankle sprain incidence is estimated in seven sprains per 1000 expositions in athletes, being higher in young women. Moreover, it is a musculoskeletal injury that causes direct (expenses with medical consultations and medicines) and indirect costs (absence from work, reducing productivity). Effective therapies to improve pain intensity, swelling, range of motion and decrease recurrence are important for this health condition. Cryotherapy has often been recommended by clinical practice guidelines and used by health professionals in acute ankle sprain management because it has low cost, easy application, and is considered potentially effective in clinical practice settings. However, current evidence supporting cryotherapy is still unclear. Our systematic review aims to investigate the effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in people with an acute episode of ankle sprain.

Methods

Methods: Searches were conducted on six databases for randomized or quasi-randomized controlled trials (RCTs) evaluating effectiveness of cryotherapy for pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain. Selection of trials, data extraction and methodological quality assessment of included trials were conducted independently by two reviewers with discrepancies resolved by a third reviewer. Estimates were presented as mean differences (MDs) with 95% confidence intervals (CIs). The quality of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach.

Results

Results: Two RCTs with high risk of bias were included. Both evaluated the additional effects of cryo- therapy, comparing cryotherapy combined with other intervention versus other intervention stand- alone. Uncertain evidence shows that cryotherapy does not enhance effects of other intervention on swelling (MD 1?4 6.0; 95%CI: 0.5 to 12.5), pain intensity (MD 1?4 0.03; 95%CI: 0.34 to 0.28) and range of motion (p > 0.05).

Conclusions

Conclusions: Current literature lacks evidence supporting the use of cryotherapy on management of acute ankle sprain. There is an urgent call for larger high-quality randomized controlled trials.

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Presenting Author

Leonardo Sette Vieira

Poster Authors

Leonardo Vieira

MSc

UFVJM

Lead Author

Júlio Miranda

Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)

Lead Author

Whesley Silva

Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)

Lead Author

Hytalo Silva

Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)

Lead Author

Rodrigo Mascarenhas

Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)

Lead Author

Vinicius Oliveira

Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM)

Lead Author

Topics

  • Systematic Reviews/Meta-Analysis