Recurrent Sprains Research Articles

Ankle Sprain Recurrence and Rehabilitation Among Athletes: A Case Study in the West Region of Cameroon

Ankle Sprain Recurrence and Rehabilitation Among Athletes: A Case Study in the West Region of Cameroon

Ankle sprains in male Israeli infantry soldiers during training: prevalence and risk factors

BackgroundGiven the high incidence and heavy burden of ankle sprains in recruits, large-scale, multifactorial investigations into potential risk factors are warranted. This study aimed to identify the incidence of ankle...

Is Achilles tendon structure associated with functional ability and chronic ankle instability in military recruits?

ObjectiveTo determine the relationship between Achilles tendon (AT) structure, functional ability and chronic ankle instability (CAI) in military recruits. MethodsThree hundred and sixty newly recruited infantry male soldiers recruited in April 2022 were assessed for AT structure by Ultrasound Tissue Characterization (UTC), for functional abilities (included proprioception ability, heel-raise test, dynamic postural balance, and hopping agility ability) and for CAI (recurrent sprains and a positive perceived instability). ResultsSoldiers that were identified with disorganized tendon had significantly lower heel-raise and agility scores compared to those with organized tendon structures (33.6 ± 18.1(n) vs. 49.9 ± 28.9(n), p < 0.001; and 5.39 ± 2.12(n) vs. 6.16 ± 1.90(n), p = 0.002, respectively). The best discriminator between soldiers with organized vs. disorganized structure, was heel-raise test (AUC = 0.741). Moreover, soldiers with disorganized AT structure had a higher prevalence of CAI compared with those with organized tendon structures (p < 0.05). ConclusionRecruits with disorganized tendon structures displayed reduced heel-raise score, agility ability and dynamic postural-balance and greater ankle instability. Inferior tendon quality at the onset of military service is an important physical indicator to consider when seeking to manage future injuries and potential for physical performance. Pre-recruitment screening of the AT structure, CAI, and functional abilities, especially in high-intensity infantry programs, needs to be considered.

A new patient-reported outcome measure for the evaluation of ankle instability: description of the development process and validation protocol

BackgroundAcute ankle sprains represent one of the most common traumatic injuries to the musculoskeletal system. Many individuals with these injuries experience unresolved symptoms such as instability and recurrent sprains, leading to chronic ankle instability (CAI), which affects their ability to maintain an active lifestyle. While rehabilitation programs focusing on sensorimotor, neuromuscular, strength and balance training are primary treatments, some patients require surgery when rehabilitation fails. A critical analysis of the patient-reported outcome tools (PROs) used to assess CAI surgical outcomes raises some concerns about their measurement properties in CAI patients, which may ultimately affect the quality of evidence supporting current surgical practice. The aim of this research is to develop and validate a new PRO for the assessment of ankle instability and CAI treatment outcomes, following recent methodological guidelines, with the implicit aim of contributing to the generation of scientifically meaningful evidence for clinical practice in patients with ankle instability.MethodsFollowing the COnsensus-based Standards for the selection of Health Measurement Instruments (COSMIN), an Ankle Instability Treatment Index (AITI) will be developed and validated. The process begins with qualitative research based on face‒to‒face interviews with CAI individuals to explore the subjective experience of living with ankle instability. The data from the interviews will be coded following an inductive approach and used to develop the AITI content. The preliminary version of the scale will be refined through an additional round of face‒to‒face interviews with a new set of CAI subjects to define the AITI content coverage, relevance and clarity. Once content validity has been examined, the AITI will be subjected to quantitative analysis of different measurement properties: construct validity, reliability and responsiveness.DiscussionThe development of AITI aims to address the limitations of existing instruments for evaluating surgical outcomes in patients with CAI. By incorporating patient input and adhering to contemporary standards for validity and reliability, this tool seeks to provide a reliable and meaningful assessment of treatment effects.Trial registrationNot applicable.

Magnetic Resonance Imaging Has Utility in Clinical Decision-Making for Children and Adolescents With Symptomatic Subfibular Ossicles.

We performed a retrospective study of pediatric patients with lateral ankle pain, recurrent sprains, and radiographs showing SOs who had undergone an MRI as part of their diagnostic work-up.We identified 22 patients from the senior author's registry of pediatric patients with lateral ankle injuries. Eleven were girls, and 11 were boys, ages ranging from five to 19 years.Eleven involved the left ankle; 11 involved the right. Positive MRIs showed a high-intensity signal between the SO and the distal fibular epiphysis; negative MRIs had a low-intensity signal. The main outcome measure was operative versus non-operative treatment. Sixteen of the 22 patients had positive MRIs, and six had negative MRIs. Twelve of the 16 patients with positive MRIs had undergone an operation. All six patients with negative MRIs responded to nonoperative management. MRI has utility in clinical decision-making for symptomatic patients with SOs.Patients with negative MRI sequences responded to nonoperative management.Most patients with positive MRI sequences will require surgery to alleviate their symptoms and return to full activities. IV.

Investigation of the Relationship Between Kinesiophobia, Foot and Ankle Function and Physical Activity of Athletes with Chronic Ankle Instability

Lateral ankle sprains (LAS) are common in athletes and 40% lead to chronic ankle instability (CAI). CAI is characterised by recurrent sprains and limitation of motion. Our study investigated the relationship between kinesiophobia, foot-ankle function, and physical activity in athletes with chronic ankle instability. In our study, 112 individuals with CAI who have been doing regular sports for at least 5 years were included. Tampa kinesiophobia test, Foot and Ankle Ability Measure (FAAM), and International Physical Activity Questionnaire (Short Version) were administered to the included individuals via Google form. IBM Statistical Package for Social Sciences Version 26.0 (SPSS inc, Chicago, IL, USA) was used. Pearson's test analysis was used in the study, and statistical significance was taken as p ≤ 0.05 for all measurements in two directions. 115 participants (75 males and 40 females) were included in the study. The participants were 20.43±3.921(years) years old, 176.14±9.288(cm) tall, and 67.88±11.571(kg) weight. In addition, the subjects' International Physical Activity Score (Short Version) showed that 34 were inactive, 54 were minimally active, and 27 were very active. There was a moderate negative correlation between the Tampa Kinesiophobia score and FAAM sport and DLA subscores (p&amp;lt;.001). Individuals with increased kinesiophobia scores had decreased Foot and Ankle Ability Measure scores. According to the studies, studies on foot and ankle range of motion, position perception, and balance in individuals with CAI may decrease kinesiophobia.

Both arthroscopic one-step Broström-Gould and Lasso-loop stitch techniques achieved favourable clinical outcomes for chronic lateral ankle instability.

Both the arthroscopic Broström-Gould and Lasso-loop stitch techniques are commonly used to treat chronic lateral ankle instability (CLAI). The purpose of this study is to introduce an arthroscopic one-step outside-in Broström-Gould (AOBG) technique and compare the mid-term outcomes of the AOBG technique and Lasso-loop stitch technique. All CLAI patients who underwent arthroscopic lateral ankle stabilization surgery in our department from 2018 to 2019 were retrospectively enrolled. The patients were divided into two groups according to the surgical methods employed: the AOBG technique (Group A) and the Lasso-loop technique (Group B). The visual analogue scalepain score, American Orthopaedic Foot and Ankle Societyankle hindfoot score, Tegner activity score and Karlsson-Peterson score were evaluated preoperatively and during the follow-up from June to December 2022. The surgical duration, return to sports, sprain recurrence and surgical complications were also recorded and compared. A total of 74 patients (Group A, n = 42; Group B, n = 32) were included in this study with a mean follow-up of 39 months. No statistically significant differences were observed in demographic parameters or follow-up time between the two groups. Postoperative clinical scores indicated a significant improvement (all with p < 0.001) with no significant difference between the two groups (not significant [n.s.]). There was no significant difference in the surgical duration (46.1 vs. 49.7 min, n.s.), return to sports (92.9% vs. 93.8%, n.s.), or sprain recurrence (4.8% vs. 6.3%, n.s.). Only two cases in Group A reported knot irritation (4.8% vs. 0, n.s.), and one case in Group A experienced local skin numbness (0 vs. 3.1%, n.s.), with no significant difference. Both the AOBG and Lasso-loop stitch techniques yielded comparable favourable mid-term outcomes and return to sports with a low rate of surgical complications. Both procedures could be feasible strategies for CLAI patients. Level III.

Clinical Outcomes and Return to Preinjury Sports After Anatomic Reconstruction With a Gracilis Autograft Versus the Modified Broström Procedure in Patients With Generalized Joint Laxity

Background: Generalized joint laxity (GJL) is a risk factor for inferior outcomes after the modified Broström procedure for chronic lateral ankle instability, while anatomic reconstruction with tendons is more inclined to be recommended. However, whether anatomic reconstruction could achieve better results than the modified Broström procedure in patients with GJL is unknown. Purpose: To compare clinical outcomes and return to sports between anatomic reconstruction and the modified Broström procedure in patients with GJL. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with GJL (Beighton score ≥4) who underwent either the modified Broström procedure or anatomic reconstruction with gracilis autografts between 2017 and 2020 were reviewed. Included were 19 patients who underwent anatomic reconstruction (reconstruction group) and 49 patients who underwent the modified Broström procedure (MBP group). Clinical outcomes were compared using the Foot and Ankle Outcome Score (FAOS) and the Karlsson score. The rates of return to preinjury level in high-demand sports, sprain recurrence, and range of motion between the 2 groups were also compared. Results: The mean follow-up duration was 38.3 months in the reconstruction group and 43.7 months in the MBP group. The FAOS and Karlsson scores improved significantly after surgery in both groups ( P &lt; .001 for all), with the reconstruction group having significantly higher postoperative FAOS-Sports scores (87.9 ± 8.9 vs 80.5 ± 11.6; P = .015) and Karlsson scores (86.9 ± 6.1 vs 82 ± 8.4; P = .025) than the MBP group. The rate of return to preinjury high-demand sports was higher in the reconstruction group than in the MBP group (73.3% vs 38.9%; P = .034). The MBP group had a significantly higher rate of sprain recurrence (22.4% vs 0%; P = .027). More patients reported dorsiflexion restriction in the reconstruction group (n = 4; 21.1%) than in the MBP group (n = 1; 2%) ( P = .019); nonetheless, there was no noticeable effect on daily life and sports. Conclusion: Better clinical outcomes, less sprain recurrence, and a higher rate of return to preinjury high-demand sports were found after anatomic reconstruction with free tendons compared with the modified Broström procedure in patients with GJL. Anatomic tendon reconstruction can be recommended for such patients, especially those participating in high-demand sports.

Deficits in proprioception and strength may contribute to the impaired postural stability among individuals with functional ankle instability.

Purpose: The correlations of postural stability with proprioception and strength may explain the recurrent sprains among individuals with functional ankle instability (FAI). This study aimed to compare anterior-posterior (AP) and medial-lateral (ML) postural stability, along with ankle proprioception and strength between individuals with and without FAI and investigated their correlations. Methods: Forty participants with FAI and another 40 without FAI were recruited. Their postural stability, represented by time to stabilization (TTS) in the AP (TTSAP) and ML (TTSML) directions, was calculated by the ground reaction force during jumping onto a force plate. Their ankle proprioception and strength during plantarflexion/dorsiflexion and inversion/eversion were measured using a proprioception device and a strength testing system, separately. Results: Individuals with FAI had longer TTSAP (p = 0.015) and TTSML (p = 0.006), larger ankle proprioception thresholds (p = 0.000-0.001), and less strength (p = 0.001-0.017) than those without FAI. Correlations between strength and TTSAP were detected among individuals with (ankle plantarflexion, r = -0.409, p = 0.009) and without FAI (ankle plantarflexion, r = -0.348, p = 0.028; ankle dorsiflexion, r = -0.473, p = 0.002). Correlations of proprioception (ankle inversion, r = 0.327, p = 0.040; ankle eversion, r = 0.354, p = 0.025) and strength (ankle eversion, r = -0.479, p = 0.002) with TTSML were detected among individuals without FAI but not among those with FAI. Conclusion: Individuals with FAI have worse postural stability and proprioception and less strength. Their proprioception and strength decreased to a point where they could not provide sufficient functional assistance to the ML postural stability. Improvements in proprioception and strength may be keys to prevent recurrent ankle sprains among individuals with FAI.

Effects of Balance and Strength Training for Ankle Proprioception in People with Chronic Ankle Instability: A Randomized Controlled Study.

After an ankle sprain, the ligament and joint capsule are damaged, and as a result, proprioceptive sense is damaged, causing a feeling of giving away in the ankle and resulting in recurrent sprains. Given the relevant studies, it has been seen that people with chronic ankle instability (CAI) commonly have deficits in joint position sense and reinjury risks. Joint position sense plays an important role in ankle control, thereby reducing the risk of injury. Therefore, this study aims to compare the effects of balance and strength training on ankle proprioception in people with CAI. This single-blind randomized controlled study included 29 volunteer participants (21 women and eight men) aged 18 to 30 years. Participants with a Cumberland ankle instability scale score less than or equal to 24 were randomly divided into two treatment groups: strength training (n = 14) and balance training (n = 15). Y balance test, joint position, and vibration sense were evaluated at the beginning and end of the treatment. "Hop to stabilization" exercises were applied to the balance group and resistive bands exercises to the strength group, which were performed for 6 weeks, 35 minutes per day, two times per week. There was no significant difference between the two groups in the anterior, posterolateral, and posteromedial directions of the Y balance test (P = .89, P = .50, and P = .34, respectively), but the strength training group showed significant improvement in ankle proprioception (140°) and vibration sense (fifth finger) (P < .001), and the post hoc Cohen's d effect size values were medium (.52) and small (.25), respectively. The findings of this study show that strengthening and balance exercises have similar effects on dynamic balance, but strengthening exercises are more effective in improving joint position and vibration sense. Given the positive effects of both exercise programs, it is recommended to implement the two interventions separately or together for CAI rehabilitation.

Tarsal Coalition in Children and Adolescent And Recurrent Sprain Frequency

Tarsal coalitions correspond to an abnormal fusion of one or more tarsal bones. Tarsal coalitions cause pain, stiffness, recurrent sprains, and contracted valgus flat feet in children and adolescents, detrimental to the functional prognosis. They can be difficult to diagnose on standard x-rays, so it is vital to be aware of the indirect radiological signs that may be suggestive. When in doubt, cross-sectional imaging techniques should be used. Despite the fact that it can cause radiation, CTscan is still the gold standard, providing a three-dimensional approach to the bone bridge and allowing comparative bilateral studies.&#x0D; We report the case of a 12-year-old boy with unilateral talo-calcaneal left-wing coalition, who presented with pain, a notion of repeated sprains, stiffness of the back foot with a significant limitation of daily activities and sports.

Chronic Ankle Instability and Neuromuscular Performance in Prerecruitment Infantry Soldiers.

Ankle instability can describe various impairments, including perceived instability (PI), mechanical instability (MI), and recurrent sprains (RSs), alone or combined. To examine the prevalence of 8 ankle impairment subgroups and their effect on neuromuscular performance in prerecruitment combat soldiers. Cross-sectional study. Military infantry basic training base. A total of 364 infantry male combat soldiers entering basic training (aged 18-21 years). Participants were assessed for PI (via the Cumberland Ankle Instability Tool), MI (using the Anterior Drawer Test and Medial Talar Tilt Test), and RSs (based on history) of their dominant and nondominant legs. Injuries were categorized in 8 subgroups: PI, RSs, PI + RSs, MI, PI + MI, MI + RSs, PI + MI + RSs, and none. Participants were screened for neuromuscular performance (dynamic postural balance, proprioceptive ability, hopping agility, and triceps surae muscle strength) during the first week of military basic training. For the dominant and nondominant legs, RSs were reported by 18.4% (n = 67) and 20.3% (n = 74) of the participants, respectively; PI was reported by 27.1% (n = 99) and 28.5% (n = 104) of the participants, respectively; and MI was seen in 9.9% (n = 36) and 8.5% (n = 31) of the participants, respectively. A 1-way analysis of variance showed differences in the mean proprioceptive ability scores (assessed using the Active Movement Extent Discrimination Apparatus) of all subgroups with impairments in both the dominant and nondominant legs (F = 6.943, η2 = 0.081, P < .001 and F = 7.871, η2 = 0.091, P < .001, respectively). Finally, differences were found in the mean muscle strength of subgroups with impairment in the nondominant leg (F = 4.884, η2 = 0.056, P = .001). A high prevalence of ankle impairments was identified among participants who exhibited reduced abilities in most neuromuscular assessments compared with those who did not have impairments. Moreover, participants with 1 impairment (PI, MI, or RSs) exhibited different neuromuscular performance deficits than those with >1 impairment.

Effectiveness of Platelet-Rich Plasma in Reducing Pain and Increasing Function After Acute Lateral Ankle Sprain: A Critically Appraised Topic.

Ankle sprains are one of the most common injuries in athletics, and many lead to recurrent sprains, chronic ankle instability, and persistent symptoms. Treatment improvements are needed. Platelet-rich plasma (PRP) involves formulating autologous plasma with higher platelet concentration to be injected in the desired tissue. There is currently high-quality evidence supporting the use of PRP with lateral epicondylitis and knee osteoarthritis to accelerate the healing process and decrease pain. Does the injection of PRP relieve pain faster and improve function compared with no injection or placebo in patients with a lateral ankle sprain? A computerized search yielded 191 studies; of these, 3 studies fit the inclusion and exclusion criteria. PRP injection reduces pain and increases function after lateral ankle sprain 5 to 8weeks after intervention. The use of PRP after lateral ankle sprain to decrease pain and increase function is supported with moderate evidence. Based on the Strength of Recommendation Taxonomy, evidence from the included studies is considered as level B, reflecting limited quality patient-oriented evidence.

Impact of Biodex systems equipment in prevention of ankle joint instability in junior footballers

Background: The aim of this study was to identify differences in impact in the prevention of second-degree ankle sprain recurrence, more precisely agonist-antagonist muscle rebalance, recovery of proprioception junior footballers will have a different impact on patients undergoing rehabilitation program with the help of Biodex 4 Pro and Biodex balance compared to those who perform physical therapy using classical exercise programs. (2) Methods: the study included 30 subjects divided into two equal groups according to the agreement to practice modern exercise programs and soccer-specific exercises: the experimental group which performed exercises through Biodex 4 pro and biodex balance and the control group which performed classical exercises. Part evaluations included: Biodex balance for a range of stability assessments and the PodoSmart device for running assessment. (3) Results: Analyzing the data of the present scientific research, it can be concluded that the athletes belonging to experimental group 1, for which the intervention was carried out using modern means, did not register any recurrence at the level of the ankle, compared to the athletes included in the experimental group 2 for which the intervention was carried out with the help of classic means of recovery and which recorded an average of 1.46 recurrences (sprains) at the level of the ankle.(4) Conclusion: The study has shown that the Biodex System 4 Pro and Biodex Balance (together with the other modern therapies mentioned in the current paper) are very helpful in the recovery process.

Avulsion fracture is associated with more pain after anatomic repair procedure for ATFL injury at the talar side

AbstractPurposeTo evaluate the clinical outcomes of anatomic repair procedure for chronic anterior talofibular ligament (ATFL) injury at the talar side, and to compare the outcomes between patients with and without concomitant avulsion fractures. It was hypothesized that anatomic repair procedure could produce similarly satisfactory outcomes for those two groups.MethodsThirty‐nine consecutive patients with chronic ATFL injuries at the talar side who underwent anatomic repair procedure at the department of sports medicine at Peking University Third Hospital between 2013 and 2018, were retrospectively evaluated. The pain visual analogue scale (VAS), American Orthopaedic Foot &amp; Ankle Society (AOFAS) score, Tegner score, and Foot &amp; Ankle Outcome Score (FAOS) were recorded as the primary outcomes. Time to return to sports (RTS), surgical satisfaction, deficiency of ankle range of motion (ROM), recurrent sprain, and postoperative complications were recorded as the secondary outcomes. Outcomes were compared between patients with (Group A, 16 cases) and without (Group B, 23 cases) concomitant avulsion fractures.ResultsThe mean follow‐up time was 79.4 ± 17.0 and 76.6 ± 18.5 months for Group A and B, respectively. VAS, AOFAS, Tegner, FAOS, and all subscale scores of FAOS were significantly improved in both groups at the final follow up. Patients in group A had inferior postoperative VAS, AOFAS, FAOS, and pain score of FAOS compared to group B (1.1 ± 1.1 vs. 0.4 ± 0.5, 89.1 ± 10.1 vs. 95.2 ± 5.2, 87.2 ± 7.2 vs. 91.5 ± 4.1, and 88.4 ± 11.3 vs. 96.7 ± 3.5, respectively).The mean time to RTS, rate of satisfaction and recurrent sprain had no significant differences between group A and B (6.1 ± 2.8, 93.8%, and 18.8% vs. 5.2 ± 2.2, 100.0%, and 13.0%, respectively), and the rate of ROM deficiency was significantly higher in group A (37.5 vs. 8.7%). Avulsion fracture was identified as an independent risk factor for inferior pain score of FAOS.ConclusionAnatomic repair procedure for chronic ATFL injuries at the talar side produces favourable results for patients with and without avulsion fractures at 5 to 10 years follow‐up, however, avulsion fracture is associated with more pain.Level of evidenceIII.

Chronic instability in a malformed tibiofibular syndesmosis associated with osteochondral lesion of the talus: a case report

Surgical treatment of tibiofibular syndesmosis (TFS) with chronic instability aims to obtain a solid and stable joint to avoid ankle arthritis. Osteochondral lesions of the talus (OLT) may be associated in up to 24% of cases and must be treated concomitantly. We present a 27-year-old male patient with chronic ankle pain and a history of recurrent sprains since childhood. Imaging exams showed malformation of TFS associated with an OLT. He was submitted to surgical treatment with open repair, TFS fixation with suture-button, and osteochondroplasty of the OLT with collagen membrane through arthroscopy. At 13 months follow-up, he was asymptomatic and fully active.

Dosimetry and effect of talocrural thrust manipulation on the range of motion in subjects with chronic ankle instability

Introduction: Chronic ankle instability (CAI) is described as the patient’s sense of an abnormal ankle, which is characterized by a combination of symptoms such as recurrent sprains, discomfort, edema, or activity avoidance. Talocrural thrust manipulation (TCTM) is a manual treatment technique that includes applying a manual push to a specific motion segment, often in the form of a joint glide. The study aimed to find out the dosimetry and effect of TCTM on the range of motion (ROM) and quality of life (QoL) in subjects with CAI. Materials and Methods: Forty subjects fulfilling the selection criteria were included in the study, with single group repeated measures design. A talocrural thrust is given to the ankle and outcomes were assessed during 1st week, 2nd week, and 3rd week after the intervention, and the scores were recorded. Results: The group was ranging from 13 to 22, with a mean and standard deviation (SD) of 16.15 ± 2.28. After 1 week, showed an increase in the range of 17–29, with a mean and SD of 22.40 ± 2.75. Similarly, for 2 weeks, the range increased to 24–32 with a mean and SD of 29.53 ± 1.71 after 2 weeks. However, the range was found to have increased to 31–34, with a mean and SD of 32.35 ± 0.70, and found to be statistically significant (P &lt; 0.001). Conclusion: TCTM is effective in improving ROM and QoL in people who have persistent ankle instability. Talocrural thrust manipulation technique stimulates the proprioceptive awareness which is often impaired in chronic instability subjects targeting the joints with specific thrust to treat pain and dysfunction and the consistency of the movement underlying the tissues which is more crucial in identifying the restrictions of the joint. The following core competencies are addressed in this article: Medical knowledge, Patient care, Systems-based practice

Brace for Impact: A Retrospective Analysis of the Modified Broström-Gould Procedure With and Without Internal Brace Augmentation.

Background Chronic lateral ankle instability (CLAI) is caused by lateral ankle ligament weakness or rupture secondary to recurrent sprains. The surgical management has traditionally involved a modified Broström-Gould (MBG) procedure with or without internal brace (IB) augmentation. This study aims to demonstrate the improved outcomes for patients undergoing an MBG procedure with IB augmentation for CLAI. Methodology A retrospective analysis was performed among 40 patients undergoing an MBG procedure with or without IB for CLAI at a large teaching hospital between January 2012 and June 2019. Functional outcomes were measured using the Manchester-Oxford Foot Questionnaire (MOxFQ). Clinic letters were reviewed to assess additional outcomes including postoperative complications, revision surgery rate, time in a plaster cast, and time to full weight-bearing. Results A total of 23 patients were included in the study, with seven undergoing both MBG and IB procedures and 16 undergoing MBG intervention alone. The average age was 37.1 years in the IB group and 35.7 years in the MBG group. The mean MOxFQ overall raw scores (10.9 vs. 33.6, p < 0.016), standing and walking MOxFQ subscale (4 vs. 15.2, p < 0.012), pain MOxFQ subscale (4.86 vs. 10.9, p < 0.042), and social interaction subscale (2 vs. 7.5 p < 0.023) all showed significantly better results for the IB group versus the MBG group. Patients in the IB group had significantly less number of weeks in plaster than the MBG group and were able to fully weight bear sooner (4.14 vs. 6, p < 0.01). The MBG group suffered a postoperative complication in seven patients compared to zero in the IB group (p < 0.057). There were three re-ruptures in the MBG group requiring further revision surgery compared to zero in the IB group (3 vs. 0, p < 0.53). Conclusions MBG surgery with IB augmentation for CLAI appears to have better outcomes in terms of overall function and may have fewer overall complications. The IB group displayed a lower recurrence of pain, less time in a plaster cast, and a quicker return to walking.

Using the app "Injurymap" to provide exercise rehabilitation for people with acute lateral ankle sprains seen at the Hospital Emergency Department-A mixed-method pilot study.

Acute lateral ankle sprains (LAS) account for 4-5% of all Emergency Department (ED) visits. Few patients receive the recommended care of exercise rehabilitation. A simple solution is an exercise app for mobile devices, which can deliver tailored and real-time adaptive exercise programs. The purpose of this pilot study was to investigate the use and preliminary effect of an app-based exercise program in patients with LAS seen in the Emergency Department at a public hospital. We used an app that delivers evidence-based exercise rehabilitation for LAS using algorithm-controlled progression. Participants were recruited from the ED and followed for four months. Data on app-use and preliminary effect were collected continuously through the exercise app and weekly text-messages. Baseline and follow-up data were collected though an online questionnaire. Semi-structured interviews were performed after participants stopped using the app. Results: Health care professionals provided 485 patients with study information and exercise equipment. Of those, 60 participants chose to enroll in the study and 43 became active users. The active users completed a median of 7 exercise sessions. Most of the active users were very satisfied or satisfied (79%-93%) with the app and 95.7% would recommend it to others. The interviews showed that ankle sprains were considered an innocuous injury that would recover by itself. Several app users expressed they felt insufficiently informed from the ED health care professionals. Only 39% felt recovered when they stopped exercising, and 33% experienced a recurrent sprain in the study period. Conclusion: In this study, only few patients with LAS became active app users after receiving information in the ED about a free app-based rehabilitation program. We speculate the reason for this could be the perception that LAS is an innocuous injury. Most of the patients starting training were satisfied with the app, although few completed enough exercise sessions to realistically impact clinical recovery. Interestingly more than half of the participants did not feel fully recovered when they stopped exercising and one third experienced a recurrent sprain. https://clinicaltrials.gov/ct2/show/NCT03550274, preprint (open access): https://www.medrxiv.org/content/10.1101/2022.01.31.22269313v1.

The effect of perturbation training with and without applying the dry needling on leg muscles in patients with chronic ankle sprain

IntroductionAnkle sprain is a common musculoskeletal injury that leads to recurrent instability. Repeated ankle sprain can be a mechanism for creating trigger point. Proper treatment of trigger points, in addition to preventing recurrence of sprains, may reduce pain and improve muscle function. This improvement can be the result of preserving the surrounding tissues from excessive pressure. ObjectiveInvestigate the added value of dry needling into perturbation training protocol for chronic ankle sprain. DesignRandomized clinical trial; assessor-blind; before and after comparison. SettingTreatment of patients referred to the institutional rehabilitation clinics. Main outcome measure(s)Functional assessment with FAAM questionnaire score, Pain with NPRS scale, ankle instability severity with Cumberland tool. MethodsTwenty-four patients with chronic ankle instability participated in this clinical trial and were randomly divided into two groups. Intervention was 12 sessions in which one group received only perturbation training and the other group received perturbation training along with dry needling. Repeated measures ANOVA was used to investigate the effect of treatment. ResultsData Analysis showed significant difference in NPRS and FAAM and Cumberland score before and after treatment in each group (P < 0.001). Comparison of the results between the groups did not show any significant difference (P > 0.05). ConclusionThe findings showed that adding dry needling technique to the perturbation training does not have greater effects on the pain and function of patients with chronic ankle instability.