Exercise-based and bracing programs to prevent ankle sprains in athletes: a systematic review

Introduction: Ankle sprains are among the most common injuries in sport and carry a high risk of recurrence and chronic instability. Exercise-based and bracing programs are the two preventive strategies most often proposed for athletes, yet their effects on first and recurrent sprains remain scattered across trials. Methods: This systematic review followed the PRISMA 2020 statement. Scopus, PubMed, OpenAlex and Crossref were searched for randomized and prospective comparative studies published between 2016 and 2025 that evaluated neuromuscular training or bracing against usual practice in athletes, with ankle sprain incidence as an outcome. Risk of bias was assessed with the Cochrane RoB 2 tool and findings were synthesized narratively. Results: Ten studies were included (10). Neuromuscular warm-up programs reduced ankle sprain incidence in most trials, with incidence rate ratios between 0.26 and 0.66, although two trials reported no statistically significant reduction. One pilot trial of a low-friction shoe patch reduced non-contact and severe lateral ankle sprains. Conclusions: Exercise-based neuromuscular programs reduce the incidence of ankle sprains in young athletes. The evidence for bracing within the review window is limited to one trial, so its preventive value in athletes remains less certain.