SLR - September 2012 - Nicole Kessel
Reference: M. de Noronha,. et al. Intrinsic Predictive Factors for Ankle Sprain in Active University Students: a Prospective Study. Scandinavian Journal of Medicine and Science in Sports 10 (1111): 1600-1606. 2012
Scientific Literature Review
Reviewed by: Nicole Kessel, DPM
Residency Program: Saint John Hospital and Medical Center
Podiatric Relevance:
Sports injuries have been shown to be second only to domestic injuries and as common as work-related injuries among European populations. Studies have further shown that 60 percent of sports injuries are sprains, subluxations and ligament tears, and that the most commonly affected joint is the ankle. Ankle sprains are also one of the most common lower extremity ER diagnoses. Therefore the significance of preventive programs for ankle injuries is clear; however, the development of these is strongly predicated on clinicians’ capacity of identifying those with a higher risk of suffering a sprain.
Methods:
One-hundred and twenty-five university students were prospectively followed for a 52 week period from 2009 to 2010. Baseline assessment was performed on each participant consistent of: foot lift test, Cumberland Ankle Instability Tool, dorsiflexion range of motion measure, Star Excursion Balance Test, and side recognition task by motor imagery. All participants were divided into two groups: 31 who suffered an inversion ankle sprain and 90 who did not; four were lost to follow-up. All patients were followed via e-mail or telephone call in regards to occurrence of ankle injury, for up to 56 weeks. A sprain was considered if there was inversion beyond physiologic limit plus more than one day of the following: pain, hematoma, absence from physical activity, or swelling.
Results:
Of the participants who completed the study, 52 (43 percent) had a history of previous ankle sprain. Thirty-one (25.6 percent) participants reported to have suffered an ankle sprain at the end of the study. Of the analyzed variables at the beginning of the study, only two remained in the model for prediction of ankle sprains: history of previous sprains and Star Excursion Balance Test (SEBT). The former group is twice as likely to suffer subsequent ankle sprain. Participants who scored higher on the SEBT were less likely to suffer a subsequent sprain
Conclusions:
Star Excursion Balance Test as well as history of previous ankle sprain are predictive factors for ankle sprain injuries. The history of previous sprain was the strongest predictive factor for subsequent ankle sprain. The participants in this study were all college students and thus these results may not necessarily be applied to other similarly active populations. Further prospective studies could focus on and further clarify the SEBT along with different variables as a predictive factor in ankle sprains.