What is the quality of clinical practice guidelines for the treatment of acute lateral ankle ligament sprains in adults? A systematic review

Table 3 Supporting evidence in each of the seven clinical practice guidelines for acute treatment of lateral ankle ligament sprains

Acute Treatment	1 [36] (2006)	2 [37] (2006)	3 [38] (2009)	4 [39] (2011)	5 [40] (2012)	6 [41] (2013)	7 [42] (2013)
Progressive weight bearing with support depending on severity (tape, brace, boot, casting)	R [43,44,45]	R [45, 46]	R	R	R [45,46,47,48]	R [45, 47, 49]	R [47, 48, 50,51,52,53,54,55,56]
Ice	R	R [57]	R	R	R [57, 58]	R [57,58,59,60,61]	R [57, 58]
Compression	R	R	R	R	R [62,63,64]	R [65]
Elevation	R	R	R	R	R	R
Progressive strengthening exercises	R	R		R	R [66,67,68,69,70,70]	R [45, 49, 66, 71]	R [66,67,68, 72, 73]
Balance exercises	R	R		R	R [66,67,68,69]	R [74,75,76]	R [74,75,76,77]
NSAIDs/paracetamol	R# [78,79,80,81,82,83]		R	R		R [69, 84, 85]
Refer on to another discipline			R	R	R
Advice DVT risk with immobilisation	R				R
Foot circle exercises	R			R
Alphabet exercises				R
Lymphatic drainage/soft tissue mobilisations							R [86]
Graded joint mobilisations or mobilisation with movement		R [73]			X [69, 73, 87]	R [88, 89]	R [44, 73, 90]
Pulsating short wave diathermy		X [91, 92]			X [91, 92]		R [92]
Electrotherapy		X			X [93,94,95,96,97]	R [98, 99]	R [97, 100]
Low-level laser		X			X [101]		R [101, 102]
Heat	X			X		X [103]
Ultrasound		X [104]			X [105]	X [104]	X [104, 105]

Key: R = CPG recommends treatment, X = CPG does not recommend treatment, # = analgesic dose. Blank = this acute treatment choice was not included in CPG.

ISSN: 1471-2474