Restorative Physical Function and Patient-Reported Outcomes Following Acute Lateral Ankle Sprain in High School Athletes.

Abstract

Limited longitudinal data exists on patient-reported outcomes (PROs) following acute lateral ankle sprain (LAS). The impact of prospective hop testing on PROs at return to play (RTP) and 6-months post RTP is unclear. Determine if high school athletes with a LAS who return to baseline physical function as measured by a single-leg hop for distance (SLHOP) have better PROs relative to individuals who return to symmetry. Cohort Study. Ten high schools over two years. Two hundred six high school athletes who sustained a LAS were included. Baseline SLHOP testing was completed pre-injury. PROs were recorded at time of injury, RTP, and 6-months post RTP. Participants were classified as symmetry (n=134) or restorative (n=72). Symmetry was defined as achieving a SLHOP performance within 10% of the uninjured limb at RTP. Restorative was defined as achieving a SLHOP performance within 10% of pre-injury levels. FAAM-ADL, FAAM-Sport, PROMIS Anxiety, and PROMIS Depression were analyzed using a two-way non-parametric ANOVA. The interaction term of group by time was the main comparison of interest and was interpreted if significant. Post-hoc multiple comparisons were performed using the Tukey-Kramer test. The restorative group reported better FAAM scores at RTP and 6-months post RTP (p<0.05) relative to the symmetry group. There were no differences in PROMIS Anxiety scores at time of injury, RTP, or 6-months post RTP between groups (p>0.05). There were no differences in PROMIS Depression scores at time of injury between groups (p=0.34), but the restorative group had worse PROMIS Depression scores at RTP (p=0.03). The restorative group reported better FAAM-ADL and FAAM-Sport scores at RTP and 6-months post RTP relative to the symmetry group. Restoring individuals to baseline physical function rather than limb symmetry may ensure better PROs following a LAS.