Collaborative Ankle Support Trial (CAST)
This randomised controlled trial assessed 584 patients with severe ankle sprain from eight emergency departments across the UK. Patients were provided with a mechanical support within the first 3 days of attendance by a trained health-care professional, and given advice on reducing swelling and pain. Functional outcome was measured over 9 months. The primary outcome was quality of ankle function at 3 months.
It was found that patients who received the below-knee cast had a more rapid recovery than those given the tubular compression bandage. Clinically important benefits were noted at 3 months in quality of ankle function with the below-knee cast compared with the bandage (mean difference 9%) as well as in pain, symptoms and activity.
The trial was led by Professor Sallie Lamb at the University of Warwick.
Read more about the trial in The Lancet.
Selected Publications
Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial.
Lamb SE. et al, (2009), Lancet, 373, 575 - 581
Treatment of severe ankle sprain: a pragmatic randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of three types of mechanical ankle support with tubular bandage. The CAST trial.
Cooke MW. et al, (2009), Health technology assessment (winchester, england), 13
Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review.
Thompson JY. et al, (2017), Bmc musculoskelet disord, 18
Clinical and cost effectiveness of mechanical support for severe ankle sprains: design of a randomised controlled trial in the emergency department [ISRCTN 37807450].
Lamb SE. et al, (2005), Bmc musculoskelet disord, 6