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Three Part Question

In [adults 2 weeks post ankle sprain] does [continual wearing of 'tubigrip'] cause [adverse outcomes such as decreased muscle strength or decrease RoM]

Clinical Scenario

A 32 year old female is receiving physiotherapy 2 weeks after her grade 2 ankle sprain. She asks if she still has to wear the Tubigrip™ bandage she was supplied with as she still has swelling but has heard from her sister that her ankle will be weaker as a result of wearing it long term. You wonder if there are any adverse long term effects of wearing Tubigrip™.

Search Strategy

MEDLINE 1966-01/05, CINAHL 1982 –01/05, AMED 1985-01/05, SPORTDiscus 1830-01/05, EMBASE 1996-01/05, via the OVID interface. In addition the Cochrane database and PEDro database were also searched
Medline, CINAHL, AMED, EMBASE, SPORTSDiscus: [{(exp bandages OR support bandages OR ankle support OR 'tubigrip' AND (ankle sprain.mp AND exp sprains and sprains OR inversion injury})] LIMIT to human AND English language.

Search Outcome

30 papers were retrieved. 29 were irrelevant to the question and the specified time scale and only 1 study using Tubigrip™ within the time scale stated in the clinical question. A Cochrane review assessed different functional strategies of which an 'elastic bandage' was one such strategy compared to semi-rigid support or ankle taping.

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses
Brooks et al 1981 UK	N = 241 10-65yrs partial tear of 'lateral ligt'. No Xray evidence of talar tilt>150. 4 treatment groups: 1. No treatment 2. physio 3. tubigrip 4. PoP	Prospective trial	Days off work at week 2	No T/T= 5.1. Physio = 6. Tubigrip 7.5. PoP = 14.	No statistical analysis. Randomisation not described. No blinding of assessors. 61% drop out rate. Uses non-validated scoring system
			Clinical scores at week 2	No T/T= 1.0. Physio = 1.2. Tubigrip = 1.0. PoP = 1.6.

Comment(s)

The 29 studies were excluded for a variety of reasons. These included: reviews without data, ankle fractures not STI, studies on children, muscle injuries, support bandage or strapping other than Tubigrip™, or a short time to follow-up (i.e. less than 2 weeks). All studies have assessed the beneficial effects of wearing Tubigrip™; there have been no studies of any adverse effects.

Clinical Bottom Line

At present there is some weak evidence that after 2 weeks of wearing Tubigrip™ post inversion sprain to the ankle patients will have the same outcome in terms of a clinical score as no treatment and are slightly better than plaster of Paris or physiotherapy. However, in terms of days off work, wearing Tubigrip™ is slightly worse than no treatment or physiotherapy treatment.

References

1. Brooks SC. Potter BT. Rainey JB. Treatment for partial tears of the lateral ligament of the ankle; a prospective trial. British Medical Journal Clinical Research Ed. 282(6264):606-7, 1981 Feb 21.