Physical activity levels among rural adolescents with a history of ankle sprain and chronic ankle instability.

Brittany Holland,Richard W Christiana,Rebecca A Battista,Stephanie T West,Alan R Needle,Kelly Naugle

doi:10.1371/journal.pone.0216243

Brittany Holland, Richard W Christiana + Show 4 more

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https://doi.org/10.1371/journal.pone.0216243

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Abstract

Ankle sprains and their common sequalae are thought to negatively affect physical activity levels and health-related quality of life among active populations, but limited evidence has described this among younger populations. This study aimed to determine the prevalence rate of ankle sprain and chronic ankle instability among rural adolescents and subsequently compare their physical activity levels based on ankle injury status. The study was conducted in a rural high school in North Carolina. High school students completed an online survey that assessed ankle injury history, perception of ankle instability and function, and physical activity. Respondents were categorized into one of four groups based on ankle injury history and complaints of instability: 1) uninjured (no history of injury); 2) unstable (history of injury >1 year and recurrent instability); 3) copers (history of injury >1 year and no recurrent instability); and 4) potentially unstable (injury within the past year). Frequency of physical activity was compared across groups using analysis of variance, Kruskall-Wallis test (α = 0.05), and responses to activity type were assessed using chi-square. Physical activity was found to differ significantly between the four groups with unstable respondents reporting more physical activity than uninjured respondents (unstable = 4706.05 ± 4610.56 MET-minutes/week; uninjured = 2592.93 ± 2946.02 MET-minutes/week). No differences were found between other groups. Despite injury history and sensations of instability, respondents with chronic ankle instability reported greater physical activity levels than uninjured participants. As this is contrary to pre-existing hypotheses, it is possible that continued physical activity after injury among adolescents may contribute to deleterious outcomes such as increased frequency of chronic instability.

Highlights

Physical activity (PA) behaviors develop through sports and recreation during childhood and decline with age beginning in adolescence [1, 2]
The findings of this study indicate that ankle injury rates among a rural adolescent population are similar to those reported among collegiate athletes and the general population, with nearly 60 percent of individuals having experienced an ankle sprain, and 30 percent reporting symptoms of chronic ankle instability (CAI)
And contrary to previous reports, participants with CAI had higher levels of PA, indicating that this population may have further increased exposure to subsequent injury that elucidate the symptoms of CAI

Summary

Introduction

Physical activity (PA) behaviors develop through sports and recreation during childhood and decline with age beginning in adolescence [1, 2]. Among college-aged individuals in the United States, and a large cohort of individuals in Australia, the prevalence of having had an ankle sprain at some point in their life has been reported near 60 percent [12, 13]. These values help to elucidate the economic burden of these pathologies, as ankle sprains and their sequelae have since been estimated to generate an economic burden of 4 to 6 billion dollars in the United States healthcare system [14]. Given the potential of these injuries to negatively impact PA levels, this economic value may be greater than currently reported

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