Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysis
Abstract Background The lateral ankle sprain (LAS) is one of the most common injuries in everyday and sports activities. Approximately 20–40 % of patients with LAS develop a chronic ankle instability (CAI). The underlying mechanisms for CAI have not yet been clearly clarified. An inadequate rehabili...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Sports Science, Medicine and Rehabilitation |
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| Online Access: | https://doi.org/10.1186/s13102-021-00308-x |
| _version_ | 1819152048274276352 |
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| author | Christian Raeder Janina Tennler Arthur Praetorius Tobias Ohmann Christian Schoepp |
| author_facet | Christian Raeder Janina Tennler Arthur Praetorius Tobias Ohmann Christian Schoepp |
| author_sort | Christian Raeder |
| collection | DOAJ |
| description | Abstract Background The lateral ankle sprain (LAS) is one of the most common injuries in everyday and sports activities. Approximately 20–40 % of patients with LAS develop a chronic ankle instability (CAI). The underlying mechanisms for CAI have not yet been clearly clarified. An inadequate rehabilitation after LAS can be speculated, since the LAS is often handled as a minor injury demanding less treatment. Therefore, the aims of this retrospective study were to determine the CAI rate depending on age and sex and to identify possible determinants for developing CAI. Methods Between 2015 and 2018 we applied the diagnostic code “sprain of ankle” (ICD S93.4) to identify relevant cases from the database of the BG Klinikum Duisburg, Germany. Patients received a questionnaire containing the Tegner-Score, the Cumberland Ankle Instability Tool (CAIT) and the Foot and Ankle Disability Index. Additionally, there were questions about the modality and beginning of therapy following LAS and the number of recurrent sprains. There was a total of 647 completed datasets. These were divided into a CAI and non-CAI group according to a CAIT cut-off-score with CAI ≤ 24 and non-CAI > 24 points, representing one out of three criteria for having CAI based on international consensus. Results The overall CAI rate was 17.3 %. We identified a higher CAI rate in females and within the age segment of 41 to 55 years. A later start of therapy (> 4 weeks) after acute LAS significantly increases ankle instability in CAIT (p < .05). There was a significantly higher CAIT score in patients having no recurrent sprain compared to patients having 1–3 recurrent sprains or 4–5 recurrent sprains (p < .001). Conclusions Females over 41 years show a higher CAI rate which implies to perform specific prevention programs improving ankle function following acute LAS. A delayed start of therapy seems to be an important determinant associated with the development of CAI. Another contributing factor may be a frequent number of recurrent sprains that are also linked to greater levels of subjective ankle instability. Therefore, we would recommend an early start of functional therapy after acute LAS in the future to minimize the development of CAI. |
| first_indexed | 2024-12-22T14:43:06Z |
| format | Article |
| id | doaj.art-c9a03f90662f4591a8c6e672f74bb6af |
| institution | Directory Open Access Journal |
| issn | 2052-1847 |
| language | English |
| last_indexed | 2024-12-22T14:43:06Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Sports Science, Medicine and Rehabilitation |
| spelling | doaj.art-c9a03f90662f4591a8c6e672f74bb6af2022-12-21T18:22:31ZengBMCBMC Sports Science, Medicine and Rehabilitation2052-18472021-08-011311910.1186/s13102-021-00308-xDelayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysisChristian Raeder0Janina Tennler1Arthur Praetorius2Tobias Ohmann3Christian Schoepp4Clinic for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum DuisburgResearch Department, BG Klinikum DuisburgClinic for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum DuisburgResearch Department, BG Klinikum DuisburgClinic for Arthroscopic Surgery, Sports Traumatology & Sports Medicine, BG Klinikum DuisburgAbstract Background The lateral ankle sprain (LAS) is one of the most common injuries in everyday and sports activities. Approximately 20–40 % of patients with LAS develop a chronic ankle instability (CAI). The underlying mechanisms for CAI have not yet been clearly clarified. An inadequate rehabilitation after LAS can be speculated, since the LAS is often handled as a minor injury demanding less treatment. Therefore, the aims of this retrospective study were to determine the CAI rate depending on age and sex and to identify possible determinants for developing CAI. Methods Between 2015 and 2018 we applied the diagnostic code “sprain of ankle” (ICD S93.4) to identify relevant cases from the database of the BG Klinikum Duisburg, Germany. Patients received a questionnaire containing the Tegner-Score, the Cumberland Ankle Instability Tool (CAIT) and the Foot and Ankle Disability Index. Additionally, there were questions about the modality and beginning of therapy following LAS and the number of recurrent sprains. There was a total of 647 completed datasets. These were divided into a CAI and non-CAI group according to a CAIT cut-off-score with CAI ≤ 24 and non-CAI > 24 points, representing one out of three criteria for having CAI based on international consensus. Results The overall CAI rate was 17.3 %. We identified a higher CAI rate in females and within the age segment of 41 to 55 years. A later start of therapy (> 4 weeks) after acute LAS significantly increases ankle instability in CAIT (p < .05). There was a significantly higher CAIT score in patients having no recurrent sprain compared to patients having 1–3 recurrent sprains or 4–5 recurrent sprains (p < .001). Conclusions Females over 41 years show a higher CAI rate which implies to perform specific prevention programs improving ankle function following acute LAS. A delayed start of therapy seems to be an important determinant associated with the development of CAI. Another contributing factor may be a frequent number of recurrent sprains that are also linked to greater levels of subjective ankle instability. Therefore, we would recommend an early start of functional therapy after acute LAS in the future to minimize the development of CAI.https://doi.org/10.1186/s13102-021-00308-xEpidemiologyFunctional rehabilitationAnkle injuryAnkle instabilityFADI |
| spellingShingle | Christian Raeder Janina Tennler Arthur Praetorius Tobias Ohmann Christian Schoepp Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysis BMC Sports Science, Medicine and Rehabilitation Epidemiology Functional rehabilitation Ankle injury Ankle instability FADI |
| title | Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysis |
| title_full | Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysis |
| title_fullStr | Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysis |
| title_full_unstemmed | Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysis |
| title_short | Delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability – the later, the worse: a retrospective analysis |
| title_sort | delayed functional therapy after acute lateral ankle sprain increases subjective ankle instability the later the worse a retrospective analysis |
| topic | Epidemiology Functional rehabilitation Ankle injury Ankle instability FADI |
| url | https://doi.org/10.1186/s13102-021-00308-x |
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