Acute Lateral Ankle Sprain Research Articles

Effect of usual care versus accelerated rehabilitation on pain, range of motion, and function in patients with acute lateral ankle sprain: A pilot randomized clinical trial

Objective: The study's objective is to compare the effects of usual care group (UCG) versus accelerated rehabilitation group (ARG) on pain, range of motion (ROM), and function. Methods: A total of thirty participants participated in the study; they were randomly allocated to two groups. They were allocated to either the UCG or AR group, and baseline characteristics were documented. Outcome measures were measured on two occasions, before starting treatment protocol and second after completing the study's protocol. The interventions were administered for 2 weeks, with four sessions a week for eight sessions. The principal outcome measure was pain measured using the Numeric Pain Rating Scale. The secondary outcome measure was ankle ROM and function measured on the Lower Extremity Functional Scale. Results: Within-group analysis showed significant improvements in both the groups. There was no significant difference between the groups at the end of the treatment protocol. Conclusion: The groups did not differ at 2 weeks postacute inversion ankle sprains in the measured outcome measures.

Establishing return to play criteria after acute lateral ankle sprain injuries: An international Delphi study

Establishing return to play criteria after acute lateral ankle sprain injuries: An international Delphi study

Treatment of lateral ankle sprain with platelet-rich plasma: A randomized clinical study

BackgroundWe aimed to clinically evaluate the effect of platelet-rich plasma (PRP) therapy in patients with acute lateral ankle sprain treated with rigid immobilization. MethodsPatients with first-time grade II lateral ankle sprain clinically diagnosed were evaluated (n=21). A rigid immobilization was placed in all patients for ten days; previously, an application of PRP over the anterior talofibular ligament was performed in patients from the experimental group. The Visual Analogue Scale, the American Orthopedic Foot and Ankle Score, and the Foot and Ankle Disability Index were applied at 3, 5, 8 and 24 weeks of follow-up period. ResultsThe experimental group presented the highest reduction in pain and better functional scores than the control group at 8 weeks. At the end of follow-up period the results of both groups were similar. ConclusionsA similar evolution was observed in patients treated with rigid immobilization with or without PRP after 24 weeks. Trial registrationClinical Trials.gov with ID NCT02609308.

An Updated Model of Chronic Ankle Instability.

Lateral ankle sprains (LASs) are among the most common injuries incurred during participation in sport and physical activity, and it is estimated that up to 40% of individuals who experience a first-time LAS will develop chronic ankle instability (CAI). Chronic ankle instability is characterized by a patient's being more than 12 months removed from the initial LAS and exhibiting a propensity for recurrent ankle sprains, frequent episodes or perceptions of the ankle giving way, and persistent symptoms such as pain, swelling, limited motion, weakness, and diminished self-reported function. We present an updated model of CAI that aims to synthesize the current understanding of its causes and serves as a framework for the clinical assessment and rehabilitation of patients with LASs or CAI. Our goal was to describe how primary injury to the lateral ankle ligaments from an acute LAS may lead to a collection of interrelated pathomechanical, sensory-perceptual, and motor-behavioral impairments that influence a patient's clinical outcome. With an underpinning of the biopsychosocial model, the concepts of self-organization and perception-action cycles derived from dynamic systems theory and a patient-specific neurosignature, stemming from the Melzack neuromatrix of pain theory, are used to describe these interrelationships.

MANAGEMENT OF ACUTE GRADE II LATERAL ANKLE SPRAINS WITH AN EMPHASIS ON LIGAMENT PROTECTION: A DESCRIPTIVE CASE SERIES.

Lateral ankle sprain the most common injury in physically active populations. Individuals who sustain an acute lateral ankle sprain may not receive timely formal rehabilitation and are at an increased risk to have subsequent sprains which can lead to chronic pain and instability. Attention to essential factors for ligament protection and healing while preserving ankle movement, may result in a more stable yet mobile ankle offering improved outcomes. The purpose of this case series was to describe the methods and observe the outcomes associated with a comprehensive strategy for managing acute first episode grade II lateral ankle sprains. Prospective case series. Ten patients (mean age 26.7 years, range 16-51 years, mean 2.3 days from injury) with acute grade II lateral ankle sprain were treated with an approach to protect the injured ligament, prevent impairments to movement, restore strength and proprioception, and progress to full function. Patient outcomes were assessed at four, eight and 12 weeks. Follow-up interviews at six and 12 months assessed injury recurrence. Patients were treated for an average of eight sessions over a mean of seven weeks. Rapid change in self-reported function, ankle ROM, and pain were observed in the first four weeks of care. Clinically meaningful improvements in function and ankle ROM were also noted at eight weeks and maintained at 12-week follow-ups. All patients returned to desired physical activity with only a single re-sprain event within one year after injury. The results of this prospective case series suggest that a treatment approach designed to protect the injured ligament, maintain and restore normal ankle motion, and provide a tailored functional pathway to return to run and sport demonstrated resolution of symptoms and improvement in reported functional outcomes in a group of patients following grade II acute primary ankle sprain. Level IV, Case Series.

Effects of chronic ankle instability on cutaneous reflex modulation during walking.

Chronic ankle instability (CAI) is characterized by persistent giving way at the ankle following an acute lateral ankle sprain and is associated with an early onset of osteoarthritis. Researchers have reported that the cutaneous afferent pathway from certain leg muscles is modified in people with CAI while in a seated position. However, we do not know if these reflex modulations persist during functional activities. The purpose of this study was to further explore sensorimotor function in patients with CAI by analyzing cutaneous reflex modulation during gait. CAI (n = 11) and uninjured control (n = 11) subjects walked on a treadmill at 4km/h and received non-noxious sural nerve stimulations at eight different time points during the gait cycle. Net electromyographic responses from four lower leg muscles were quantified 80-120ms after stimulation for each phase of the gait cycle and compared between groups. We found that cutaneous reflex responses between groups were largely similar from the late stance to late swing phases, but uninjured control subjects, and not CAI subjects, experienced significant suppression in the medial gastrocnemius and lateral gastrocnemius muscles during the early stance phase of the gait cycle. Our results indicate that people with CAI lack a protective unloading response in the triceps surae following high-intensity sural nerve stimulation during the early stance phase of the gait cycle. Evaluating cutaneous reflex modulations may help to identify neural alterations in the reflex pathways that contribute to functional deficits in those with CAI.

Multisegmented ankle-foot kinematics during gait initiation in ankle sprains and chronic ankle instability

BackgroundIndividuals with lateral ankle sprain and chronic ankle instability have impaired postural control and altered motor strategies during walking. However, little is known regarding foot mechanics during gait. The purpose of this study was to compare three-dimensional multisegmented ankle-foot kinematics during stance phase following gait-initiation in acute lateral ankle sprain (Ankle-sprain), chronic ankle instability (Chronic-instability), Coper, and Control groups. Methods80 recreationally-active individuals (Control: n = 22, Coper: n = 21, Ankle-sprain: n = 17, Chronic-instability: n = 20) participated. Three-dimensional kinematics of the hallux, medial forefoot, lateral forefoot, medial midfoot, lateral midfoot, and rearfoot on shank were collected during the stance phase following gait initiation using an electromagnetic motion capture system. The average joint excursions of 10 steps were normalized to 101 points and analyzed using Statistical Parametric Mapping ANOVA and post hoc t-tests comparing Coper, Ankle-sprain, or Chronic-instability versus Control groups. Secondary analysis was performed comparing Chronic-instability versus Coper groups. FindingsThe Ankle-sprain group had up to 4.1° more rearfoot inversion during midstance (mean difference: 3.1°) from 42 to 49% of stance phase compared to healthy controls. The Chronic-instability group had up to 5.3° more rearfoot inversion (mean difference: 3.6°) from 34% to 91% of stance phase compared to controls. There were no further statistical differences found between Chronic-instability and Copers, other planes, or segments of the ankle-foot complex. InterpretationAnkle-sprain and Chronic-instability groups demonstrated more rearfoot inversion compared to controls with no differences in midfoot or forefoot mechanics. Clinicians and researchers should include interventions that control inversion and increase eversion following lateral ankle sprain.

The Effectiveness of Deep Oscillation Therapy on Reducing Swelling and Pain in Athletes With Acute Lateral Ankle Sprains.

Clinical Scenario: Ankle sprains are the most prevalent athletic-related musculoskeletal injury treated by athletic trainers, often affecting activities of daily living and delaying return to play. Most of these cases present with pain and swelling in the ankle, resulting in decreased range of motion and strength deficits. Due to these impairments, proper treatment is necessary to avoid additional loss of play and prevent future injuries. Recently, there has been an increased use of deep oscillation therapy by clinicians to manage pain and swelling following a variety of injuries, including ankle sprains. However, very little evidence has been produced regarding the clinical effectiveness of deep oscillation therapy, limiting its application in therapeutic rehabilitation of acute lateral ankle sprains. Clinical Question: Is deep oscillation therapy effective in reducing pain and swelling in patients with acute lateral ankle sprains compared with the current standard of care protection, rest, ice, compression, and elevation? Summary of Key Findings: The literature was searched for studies of level 2 evidence or higher that investigated deep oscillation therapy on pain and inflammation in patients with lateral ankle sprains. Three randomized control trials were located and appraised. One of the 3 studies demonstrate a reduction in pain following 6weeks of deep oscillation therapy compared with the standard of care or placebo interventions. The 2 other studies, 1 utilizing a 5-day treatment and the other a 1 time immediate application, found no differences in deep oscillation therapy compared with the standard of care. Clinical Bottom Line: There is inconclusive evidence to support the therapeutic use of deep oscillation therapy in reducing pain and swelling in patients with acute lateral ankle sprains above and beyond the current standard of care. In addition, the method of treatment application and parameters used may influence the effectiveness of deep oscillation therapy. Strength of Recommendation: Level B.

Arthroscopic Anterior Talofibular Ligament Repair with Use of a 2-Portal Technique.

Ankle sprains are common musculoskeletal injuries, with approximately 27,000 occurring every day in the U.S. alone. The anterior talofibular ligament (ATFL) is the most commonly injured ligament. Although most acute lateral ankle sprains can be treated conservatively, up to 20% of these injuries result in chronic lateral ankle instability and may require surgical stabilization. Recently, an arthroscopic lateral ankle ligament repair technique has become increasingly popular. This minimally invasive procedure is expected to reduce postoperative pain and promote faster recovery. The current article presents an ATFL repair using a 2-portal, non-distraction arthroscopic technique. Chronic lateral ankle instability refractory to physical therapy for 3 to 6 months is the main indication for surgical treatment, and sufficient quality of ligament tissue remnant is required for arthroscopic repair. Compared with an open procedure, equivalent clinical results and earlier recovery following arthroscopic ATFL repair have been reported. The major steps of the procedure, demonstrated in this video article, are (1) placement of portals for the arthroscopic procedure, (2) suture anchor insertion into the distal aspect of the fibula, (3) needle insertion into the ATFL remnant, (4) a lasso-loop stitch using a suture relay technique, (5) reattachment of the ATFL remnant, and (6) postoperative protocol. Complications are rare, and earlier return to daily activities compared with a standard open technique can be achieved.

Altered spinal-level sensorimotor control related to pain and perceived instability in people with chronic ankle instability

ObjectivesTo compare soleus spinal reflex excitability, presynaptic inhibition and recurrent inhibition between chronic ankle instability (CAI), acute Lateral Ankle Sprain coper (LAS-coper) and healthy populations. The relationship between spinal reflex excitability and pain and perceived instability in people with CAI was also examined. DesignCross-sectional laboratory experiment. MethodsTwelve individuals with CAI, twelve ‘copers’ and twelve healthy age, limb and gender-matched controls participated. Soleus H-reflex recruitment curves, pre-synaptic excitability and recurrent inhibition of the spinal-reflex pathway were examined during static double- and single-leg stance. Reporting of pain and perceived instability were used to perform a regression analysis on measures of soleus spinal excitability in people with CAI, LAS-coper and healthy controls. ResultsSoleus spinal reflex excitability was greater during single-leg stance in CAI compared to healthy and coper individuals (p=<0.001). Pre-synaptic inhibition was three-times less in CAI participants compared to both healthy controls and copers (p=<0.001). There were no differences between healthy and coper participants in spinal-level measures of sensorimotor control. Reports of pain explained 15–16% of the variance in soleus spinal reflex excitability and presynaptic inhibition during single and double-leg stance, while perceived instability explained 20% of the variance in spinal reflex during single leg stance only. ConclusionsCAI participants presented with an inability to suppress soleus spinal reflexes during tasks with increased postural threat; likely due to disinhibition of pre-synaptic mechanisms. Pain and perceived instability may contribute to changes in spinal-level sensorimotor control in CAI.

Time-to-boundary analysis of postural control following acute lateral ankle sprain

BackgroundAcute lateral ankle sprain (ALAS) impairs unipedal balance both with the injured and uninjured limb, suggesting that balance during bipedal stance may also be compromised. However, a previous study failed to find such impairment because of poorly sensitive balance outcomes. Time-to-boundary (TTB) analysis may be sensitive enough for detecting latent deficits in bipedal balance following ALAS. Research questionWe aimed to examine postural stability during bipedal stance in patients with ALAS using TTB outcomes, and to determine bilateral deficits in unipedal balance. MethodsTwenty-seven patients with ALAS and 26 persons without a history of ALAS participated. ALAS was operationally defined as a traumatic injury to the lateral ligaments of the ankle joint occurring within 24–72 h. Both limbs of the control group were side-matched to those of the patients as either injured or uninjured limbs. All participants performed 3 trials of bipedal stance with eyes open and closed. Next, they completed 3 trials of unipedal stance on both the injured and uninjured limbs in both visual conditions. Order of limb and visual condition for each limb was randomly selected. Means and standard deviations of TTB minima in the anteroposterior and mediolateral directions were computed to assess balance, with lower values indicating poorer balance. ResultsIndependent t-tests revealed significant group differences for almost all measures (p=<0.001 to 0.021), indicating that the ALAS group presented poorer bipedal balance. For unipedal balance, there were no significant group-by-limb interactions for all measures (p > 0.05), indicating no side-to-side differences in the ALAS group. However, group main effects were found for all measures (p=<0.001 to 0.048), showing poorer unipedal balance in the ALAS group. SignificanceTTB analysis revealed impaired balance during both unipedal and bipedal stance conditions following ALAS. These results support the emerging hypothesis that centrally mediated changes in postural control may occur following ALAS.

Rural Secondary School Athletic Trainers’ Recognition and Management of Acute Lateral Ankle Sprains: A Retrospective Chart Review

The management of an acute lateral ankle sprain (LAS) affects long-term outcomes, which highlights the need for assessment of practice at the point of care. The purpose of this retrospective chart review was to examine the management strategies for acute LAS as documented in a secondary school’s electronic medical records (EMR) over 2 years. Patient charts noting a LAS diagnosis (n = 107) were identified from the EMR. Most charts indicated palpation and anterior drawer test performance. Cryotherapy (82%) and compression (55%) varied in use. Therapeutic rehabilitation and return-to-activity testing were underreported. Overall, clinical management of acute LAS may not align with best available evidence.

Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium

Lateral ankle sprain injury is the most common musculoskeletal injury incurred by individuals who participate in sports and recreational physical activities. Following initial injury, a high proportion of individuals develop...

Effects of Dangguixu-san on acute lateral ankle sprain: study protocol for a randomized controlled trial

BackgroundAnkle sprain is a common musculoskeletal injury. In Korean medicine, blood stasis is thought to be the main cause of pain and swelling in patients with ankle sprain. Dangguixu-san (DS), a herbal extract, is widely used in Korean medicine for the treatment of traumatic ecchymosis and pain by promoting blood circulation and relieving blood stasis. However, the effects of DS on ankle sprain have not been evaluated in a randomized clinical trial. Here, we describe the protocol for a randomized controlled trial that will evaluate the efficacy and safety of DS for the treatment of ankle sprain.Methods/designIn this randomized, double-blinded, placebo-controlled, parallel-arm clinical trial with a 1:1 allocation ratio, participants (n = 48) with acute lateral ankle sprain (ALAS) that occurred within 72 h before enrollment will be randomly assigned to a DS (n = 24) or a placebo (n = 24) group. Both groups will receive acupuncture treatment once a day for 5 days a week (excluding Saturday and Sunday) and the trial medication (DS/placebo capsule) three times a day for seven consecutive days. The primary outcome measure will be pain relief evaluated using a Visual Analog Scale (VAS). Secondary outcome measures will include Foot and Ankle Outcome Scores (FAOS), edema, European Quality of Life Five-Dimension-Five-Level Scale (EQ-5D-5 L) scores, and the number of recurrent ankle sprains. VAS, FAOS, edema, and EQ-5D-5 L scores will be recorded before, at the end of, and at 4 weeks after treatment completion. EQ-5D-5 L scores will be additionally recorded at 26 weeks after treatment completion. The number of recurrent ankle sprains will be recorded at 4, 8, 12, and 26 weeks after treatment completion.DiscussionThis study is expected to provide evidence regarding the efficacy, safety, and usefulness of DS for the treatment of ALAS.Trial registrationcris.nih.go.kr, registration number: KCT 0002374. Registered on 11 July, 2017 and approved by the Ministry of Food and Drug Safety (registration number, 31244).

The effects of Kinesiotape on acute lateral ankle sprain: study protocol for a randomized controlled trial

BackgroundAnkle sprains are some of the most frequent injuries of the musculoskeletal system. However, there is no substantive evidence supporting which treatment strategy is superior. Taping with Kinesiotape (KT) is a new method that is used as an alternative to the more established taping and bracing techniques used for the prophylaxis and treatment of ankle sprains. The aim of this study is to examine the efficacy of KT on ankle sprain by comparing acupuncture combined with KT (AcuKT) with acupuncture alone in patients with acute lateral ankle sprains.Methods/designThis study is a prospective, multi-center (DongShin University Gwangju Oriental Hospital, DongShin University Mokpo Oriental Hospital, and KyungHee Korean Medicine Hospital), outcome assessor-blinded, randomized controlled clinical trial with a 1:1 allocation ratio. Participants (n = 60) with a lateral ankle sprain occurring within 1 week of the study will be randomly assigned to either an acupuncture group (n = 10 at each center (total n = 30)) or an AcuKT group (n = 10 at each center (total n = 30)). The acupuncture group will receive acupuncture treatment at ST36, ST41, BL60, BL62, KI3, KI6, GB39, and GB40 once per day, 5 days per week (excluding Saturday and Sunday) for 1 week. The AcuKT group will receive acupuncture treatment at ST36, ST41, BL60, BL62, KI3, KI6, GB39, and GB40 and the ankle meridian tendino-musculature and a figure-of-eight shape form of KT treatment once per day, 5 days per week (excluding Saturday and Sunday) for 1 week. The primary outcome will be pain evaluation assessed according to a Visual Analogue Scale (VAS), while Foot and Ankle Outcome Score (FAOS), edema, European Quality of Life Five Dimension-Five Level Scale (EQ-5D-5 L) score, and number of recurrent ankle sprains will be considered as secondary outcome measures. VAS, FAOS, and edema measurements will be performed at baseline (before intervention), 5 days after the first intervention (i.e., at the end of the intervention), and 4 weeks after the completion of intervention. EQ-5D-5 L measurements will be conducted at baseline, 5 days after the first intervention, 4 weeks after the completion of intervention, and 26 weeks after the completion of intervention. The number of recurrent ankle sprains will be determined at 4, 8, 12, and 26 weeks after the completion of the intervention.DiscussionThis study will provide data regarding the efficacy of KT for the treatment of acute lateral ankle sprain. The results may lead to insights into the usefulness of KT in the treatment of acute lateral ankle sprain.Trial registrationcris.nih.go.kr, ID: KCT0002257. Registered on 27 February 2017, and approved by the Ministry of Food and Drug Safety (Medical Device Clinical Trial Plan Approval #737).

Evidence-based Treatment of Acute Lateral Ankle Sprain

Evidence-based Treatment of Acute Lateral Ankle Sprain

The management of acute lateral ankle sprains: a survey of South African surgeons and best evidence available

Introduction: Ankle sprains remain the single most frequent injury in modern sports with increasing evidence that it is not as innocuous as previously thought. Conservative treatment options include various forms of immobilisation such as casts, moonboots and stirrup braces, followed by a rehabilitation period involving different modalities. Despite clinical evidence there seems to be a divergence between research and practice with an increase in acute surgical repair especially with regard to professional athletes. The aim of the study was to assess the approach on management of acute ankle sprains by orthopaedic surgeons in South Africa, by means of a descriptive cross-sectional survey analysis. Methods: This was a two-part study. First, a questionnaire was emailed to participating orthopaedic surgeons, consisting of eight treatment options for a grade three lateral ankle sprain in a non-professional athlete. Secondly, a literature review was undertaken to establish the current best practice concerning ankle sprain management. Results: A total of 129 responses was received out of the 719 that were sent out. Surgical repair was offered in 24 (19%). Conservative treatment including either cast or moonboot for a period of six weeks was chosen by 49 (38%) and two to four weeks by 55 (43%) as their preferred treatment. Only 39 (30%) of responding South African Orthopaedic Association members chose a short period of immobilisation followed by functional rehabilitation in accordance with the current best evidence available, based on the literature review done. Conclusion: Despite good clinical evidence, there seems to be a lack of consensus in the management of grade three lateral ankle sprains. Level of evidence: Level 5

Clinical Tests Have Limited Predictive Value for Chronic Ankle Instability When Conducted in the Acute Phase of a First-Time Lateral Ankle Sprain Injury

ObjectiveTo evaluate whether a battery of clinical assessments for acute lateral ankle sprain (LAS) can be used to predict long-term recovery. DesignCohort study. SettingUniversity biomechanics laboratory. ParticipantsIndividuals (N=82) were assessed using a clinical test battery within 2 weeks of incurring a first-time LAS. InterventionsNot applicable. Main Outcome MeasuresThe clinical test battery included scores on the talar glide test (degrees), the anterior drawer, talar tilt, figure of 8 for swelling (millimeters) and knee to wall (millimeters) tests, and handheld goniometric range of motion (inversion, eversion, and plantarflexion [in degrees]). Scores on the Cumberland Ankle Instability Tool taken 12 months after the clinical test battery were used to classify participants as having chronic ankle instability (CAI) or as being LAS copers. ResultsForty percent of participants were designated as having CAI, with 60% being designated as LAS copers. A logistic regression analysis revealed that a combined model using scores from the talar glide, talar tilt, and anterior drawer tests in addition to plantarflexion range of motion was statistically significant (P<.01) and correctly classified cases with moderate accuracy (68.8%). The final model had moderate sensitivity (64%) and good specificity (72%). ConclusionsThe clinical tests used in this investigation have limited predictive value for CAI when conducted in the acute phase of a first-time LAS injury.

Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review

BackgroundOne-third of individuals who sustain an acute lateral ankle ligament sprain suffer significant disability due to pain, functional instability, mechanical instability or recurrent sprain after recovery plateaus at 1 to 5 years post injury. The identification of early prognostic factors associated with poor recovery may provide an opportunity for early-targeted intervention and improve outcome.MethodsWe performed a comprehensive search of AMED, EMBASE, Psych Info, CINAHL, SportDiscus, PubMed, CENTRAL, PEDro, OpenGrey, abstracts and conference proceedings from inception to September 2016. Prospective studies investigating the association between baseline prognostic factors and recovery over time were included. Two independent assessors performed the study selection, data extraction and quality assessment of the studies. A narrative synthesis is presented due to inability to meta-analyse results due to clinical and statistical heterogeneity.ResultsThe search strategy yielded 3396 titles/abstracts after duplicates were removed. Thirty-six full text articles were then assessed, nine of which met the study inclusion criteria. Six were prospective cohorts, and three were secondary analyses of randomised controlled trials. Results are presented for nine studies that presented baseline prognostic factors for recovery after an acute ankle sprain. Age, female gender, swelling, restricted range of motion, limited weight bearing ability, pain (at the medial joint line and on weight-bearing dorsi-flexion at 4 weeks, and pain at rest at 3 months), higher injury severity rating, palpation/stress score, non-inversion mechanism injury, lower self-reported recovery, re-sprain within 3 months, MRI determined number of sprained ligaments, severity and bone bruise were found to be independent predictors of poor recovery. Age was one prognostic factor that demonstrated a consistent association with outcome in three studies, however cautious interpretation is advised.ConclusionsThe associations between prognostic factors and poor recovery after an acute lateral ankle sprain are largely inconclusive. At present, there is insufficient evidence to recommend any factor as an independent predictor of outcome. There is a need for well-conducted prospective cohort studies with adequate sample size and long-term follow-up to provide robust evidence on prognostic factors of recovery following an acute lateral ankle sprain.Trial registrationProspero registration: CRD42014014471

The preventive effect of a soccer-specific ankle brace on acute lateral ankle sprains in girls amateur soccer players: study protocol of a cluster-randomised controlled trial

BackgroundAcute lateral ankle sprains are the single most often diagnosed injury in female soccer players and often result in an inability to play. This highlights the need for effective prevention...