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Journal of Athletic Training Jun 2019Given the frequency of ankle sprains, especially in the athletic population, prevention is a primary task of athletic trainers and other sports health care professionals. (Review)
Review
CONTEXT
Given the frequency of ankle sprains, especially in the athletic population, prevention is a primary task of athletic trainers and other sports health care professionals.
OBJECTIVE
To discuss the current evidence as it relates to prophylactic programs for the prevention of ankle sprains and to provide critical interpretation of the evidence supporting and refuting the implementation of preventive programs.
CONCLUSIONS
External prophylactic supports and preventive exercise programs are effective for reducing the risk of ankle sprains in both uninjured and previously injured populations. Ankle bracing appears to offer the best outcomes in terms of cost and risk reduction. However, there remains a paucity of well-designed, prospective randomized controlled trials relevant to the primary prevention of lateral ankle sprains, especially across a range of sport settings.
Topics: Ankle Injuries; Athletic Injuries; Braces; Humans; Sprains and Strains
PubMed: 31116041
DOI: 10.4085/1062-6050-487-17 -
Sports Health 2015Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates.
OBJECTIVE
To analyze the effectiveness of current lower extremity injury prevention programs in basketball athletes, focusing on injury rates of (1) general lower extremity injuries, (2) ankle sprains, and (3) anterior cruciate ligament (ACL) tears.
DATA SOURCES
PubMed, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Register of Controlled Trials were searched in January 2015.
STUDY SELECTION
Studies were included if they were randomized controlled or prospective cohort trials, contained a population of competitive basketball athletes, and reported lower extremity injury incidence rates specific to basketball players. In total, 426 individual studies were identified. Of these, 9 met the inclusion criteria. One other study was found during a hand search of the literature, resulting in 10 total studies included in this meta-analysis.
STUDY DESIGN
Systematic review and meta-analysis.
LEVEL OF EVIDENCE
Level 2.
DATA EXTRACTION
Details of the intervention (eg, neuromuscular vs external support), size of control and intervention groups, and number of injuries in each group were extracted from each study. Injury data were classified into 3 groups based on the anatomic diagnosis reported (general lower extremity injury, ankle sprain, ACL rupture).
RESULTS
Meta-analyses were performed independently for each injury classification. Results indicate that prophylactic programs significantly reduced the incidence of general lower extremity injuries (odds ratio [OR], 0.69; 95% CI, 0.57-0.85; P < 0.001) and ankle sprains (OR, 0.45; 95% CI, 0.29-0.69; P < 0.001), yet not ACL ruptures (OR, 1.09; 95% CI, 0.36-3.29; P = 0.87) in basketball athletes.
CONCLUSION
In basketball players, prophylactic programs may be effective in reducing the risk of general lower extremity injuries and ankle sprains, yet not ACL injuries.
Topics: Ankle Injuries; Anterior Cruciate Ligament Injuries; Basketball; Humans; Lower Extremity; Risk Factors; Sprains and Strains
PubMed: 26502412
DOI: 10.1177/1941738115593441 -
JBJS Reviews Mar 2022Calf strain is a common condition. In high-performance athletes, calf strain contributes to a substantial absence from competition.
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Calf strain is a common condition. In high-performance athletes, calf strain contributes to a substantial absence from competition.
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Player age and history of a calf strain or other leg injury are the strongest risk factors for calf strain injury and reinjury.
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Although the diagnosis is often clinical, magnetic resonance imaging and ultrasound are valuable to confirm the location of the strain and the grade of injury.
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Nonoperative treatment is effective for most calf strain injuries. Operative management, although rarely indicated, may be appropriate for severe cases with grade-III rupture or complications.
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Further investigation is necessary to elucidate the benefits of blood flow restriction therapy, deep water running, lower-body positive pressure therapy, platelet-rich plasma, and stem cell therapy for calf strain rehabilitation.
Topics: Athletes; Humans; Leg Injuries; Magnetic Resonance Imaging; Muscle, Skeletal; Sprains and Strains
PubMed: 35316243
DOI: 10.2106/JBJS.RVW.21.00183 -
Physical Therapy in Sport : Official... Mar 2021To determine the effect of mobilization with movement (MWM) on pain, ankle mobility and function in patients with acute and sub-acute grade I and II inversion ankle... (Randomized Controlled Trial)
Randomized Controlled Trial
The effectiveness of mobilization with movement on pain, balance and function following acute and sub acute inversion ankle sprain - A randomized, placebo controlled trial.
OBJECTIVES
To determine the effect of mobilization with movement (MWM) on pain, ankle mobility and function in patients with acute and sub-acute grade I and II inversion ankle sprain.
STUDY DESIGN
Randomized placebo controlled trial.
SETTING
A general hospital.
SUBJECTS
32 adults with inversion ankle sprain.
MAIN OUTCOME MEASURES
The primary outcome was pain intensity on an 11 point Numeric Rating Scale (NRS) with higher score indicating greater pain intensity. Ankle disability identified by the Foot and Ankle Disability index (FADI) with higher score indicating lower disability, functional ankle dorsiflexion range, pressure pain threshold, and dynamic balance measured with the Y balance test were secondary outcomes.
RESULTS
Thirty participants completed the study. At each follow-up point, significant differences were found between groups favouring those receiving MWM for all variables. Pain intensity showed a mean difference of 1.7 points (95% confidence interval, 1.4 to 2.1) and 0.9 points (95% confidence interval, 0.5 to 1.3) at one and six-months follow-up respectively. Benefits were also shown for FADI, ankle mobility, pressure pain threshold and balance.
CONCLUSION
This study provides preliminary data for the benefits of MWM for acute and sub-acute ankle sprain in terms of pain, ankle mobility, disability and balance.
Topics: Adult; Ankle Injuries; Ankle Joint; Exercise Therapy; Female; Humans; Male; Movement; Musculoskeletal Manipulations; Pain Management; Postural Balance; Range of Motion, Articular; Sprains and Strains; Weight-Bearing
PubMed: 33401232
DOI: 10.1016/j.ptsp.2020.12.016 -
Sports Medicine (Auckland, N.Z.) Jul 2017Rehabilitation progression and return-to-play (RTP) decision making following hamstring strain injury (HSI) can be challenging for clinicians, owing to the competing... (Review)
Review
BACKGROUND
Rehabilitation progression and return-to-play (RTP) decision making following hamstring strain injury (HSI) can be challenging for clinicians, owing to the competing demands of reducing both convalescence and the risk of re-injury. Despite an increased focus on the RTP process following HSI, little attention has been paid to rehabilitation progression and RTP criteria, and subsequent time taken to RTP and re-injury rates.
OBJECTIVE
The aim of this systematic review is to identify rehabilitation progression and RTP criteria implemented following HSI and examine the subsequent time taken to RTP and rates of re-injury.
METHODS
A systematic literature review of databases MEDLINE, CINAHL, SPORTDiscus, Cochrane Library, Web of Science and EMBASE was conducted to identify studies of participants with acute HSI reporting time taken to RTP and rates of re-injury after a minimum 6-month follow-up. General guidelines and specific criteria for rehabilitation progression were identified for each study. In addition, RTP criteria were identified and categorised as performance tests, clinical assessments, isokinetic dynamometry or the Askling H-test.
RESULTS
Nine studies were included with a total of 601 acute HSI confirmed by clinical examination or magnetic resonance imaging within 10 days of initial injury. A feature across all nine studies was that the injured individual's perception of pain was used to guide rehabilitation progression, whilst clinical assessments and performance tests were the most frequently implemented RTP criteria. Mean RTP times were lowest in studies implementing isokinetic dynamometry as part of RTP decision making (12-25 days), whilst those implementing the Askling H-test had the lowest rates of re-injury (1.3-3.6%).
CONCLUSIONS
This systematic review highlights the strong emphasis placed on the alleviation of pain to allow HSI rehabilitation progression, and the reliance on subjective clinical assessments and performance tests as RTP criteria. These results suggest a need for more objective and clinically practical criteria, allowing a more evidence-based approach to rehabilitation progression, and potentially reducing the ambiguity involved in the RTP decision-making process.
Topics: Athletic Injuries; Decision Making; Hamstring Muscles; Humans; Leg Injuries; Magnetic Resonance Imaging; Recovery of Function; Return to Sport; Sprains and Strains; Time Factors
PubMed: 28035586
DOI: 10.1007/s40279-016-0667-x -
Foot and Ankle Clinics Jun 2023Injuries of the medial ankle ligament complex (MALC; deltoid and spring ligament) are more common following ankle sprains than expected, especially in eversion-external... (Review)
Review
Injuries of the medial ankle ligament complex (MALC; deltoid and spring ligament) are more common following ankle sprains than expected, especially in eversion-external rotation mechanisms. Often these injuries are associated with concomitant osteochondral lesions, syndesmotic lesions, or fractures of the ankle joint. The clinical assessment of the medial ankle instability together with a conventional radiological and MR imaging is the basis for the definition of the diagnosis and therefore the optimal treatment. This review aims to provide an overview as well as a basis to successfully manage MALC sprains.
Topics: Humans; Ankle Joint; Ankle; Ligaments, Articular; Sprains and Strains; Ankle Injuries; Ankle Fractures
PubMed: 37137629
DOI: 10.1016/j.fcl.2023.01.009 -
Sports Health 2016Lateral ankle ligamentous sprain (LAS) is one of the most common injuries in recreational activities and competitive sports. Many studies have attempted to determine... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Lateral ankle ligamentous sprain (LAS) is one of the most common injuries in recreational activities and competitive sports. Many studies have attempted to determine whether there are certain intrinsic factors that can predict LAS. However, no consensus has been reached on the predictive intrinsic factors.
OBJECTIVE
To identify the intrinsic risk factors of LAS by meta-analysis from data in randomized control trials and prospective cohort studies.
DATA SOURCES
A systematic computerized literature search of MEDLINE, CINAHL, ScienceDirect, SPORTDiscus, and Cochrane Register of Clinical Trials was performed.
STUDY SELECTION
A computerized literature search from inception to January 2015 resulted in 1133 studies of the LAS intrinsic risk factors written in English.
STUDY DESIGN
Systematic review.
LEVEL OF EVIDENCE
Level 4.
DATA EXTRACTION
The modified quality index was used to assess the quality of the design of the papers and the standardized mean difference was used as an index to pool included study outcomes.
RESULTS
Eight articles were included in this systematic review. Meta-analysis results showed that body mass index, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and peroneus brevis reaction time correlated with LAS.
CONCLUSION
Body mass index, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and the reaction time of the peroneus brevis were associated with significantly increased risk of LAS.
Topics: Ankle Injuries; Ankle Joint; Body Mass Index; Humans; Lateral Ligament, Ankle; Muscle Strength; Posture; Proprioception; Range of Motion, Articular; Reaction Time; Risk Factors; Sprains and Strains
PubMed: 26711693
DOI: 10.1177/1941738115623775 -
Journal of Back and Musculoskeletal... 2018Following ankle sprain, residual symptoms are often apparent, and proprioceptive training is a treatment approach. Evidence, however, is limited and the optimal program... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Following ankle sprain, residual symptoms are often apparent, and proprioceptive training is a treatment approach. Evidence, however, is limited and the optimal program has to be identified.
OBJECTIVE
To investigate the effects of two post-acute supervised proprioceptive training programs in individuals with ankle sprain.
METHODS
Participants were recruited from a physiotherapy center for ankle sprain rehabilitation. In a pre-post treatment, blinded-assessor design, 22 individuals were randomly allocated to a balance or a proprioceptive neuromuscular facilitation (PNF) group. Both groups received 10 rehabilitation sessions, within a six-week period. Dorsiflexion range of motion (ROM), pain, functional and balance performance were assessed at baseline, at the end of training and eight weeks after training.
RESULTS
Follow-up data were provided for 20 individuals. Eight weeks after training, statistically significant (p< 0.017) improvements were found in dorsiflexion ROM and most functional performance measures for both balance and PNF groups. Eight weeks after training, significant (p< 0.017) improvements in the frontal plane balance test and pain were observed for the balance group.
CONCLUSIONS
Balance and PNF programs are recommended in clinical practice for improving ankle ROM and functional performance in individuals with sprain. Balance programs are also recommended for pain relief.
Topics: Adolescent; Adult; Ankle Injuries; Ankle Joint; Arthralgia; Exercise Therapy; Female; Humans; Male; Postural Balance; Proprioception; Range of Motion, Articular; Sprains and Strains; Treatment Outcome; Young Adult
PubMed: 28946541
DOI: 10.3233/BMR-170836 -
British Journal of Sports Medicine Dec 2016Lateral ankle sprains (LASs) are the most prevalent musculoskeletal injury in physically active populations. They also have a high prevalence in the general population... (Review)
Review
Lateral ankle sprains (LASs) are the most prevalent musculoskeletal injury in physically active populations. They also have a high prevalence in the general population and pose a substantial healthcare burden. The recurrence rates of LASs are high, leading to a large percentage of patients with LAS developing chronic ankle instability. This chronicity is associated with decreased physical activity levels and quality of life and associates with increasing rates of post-traumatic ankle osteoarthritis, all of which generate financial costs that are larger than many have realised. The literature review that follows expands this paradigm and introduces emerging areas that should be prioritised for continued research, supporting a companion position statement paper that proposes recommendations for using this summary of information, and needs for specific future research.
Topics: Ankle Injuries; Athletic Injuries; Consensus; Cost of Illness; Humans; Joint Instability; Osteoarthritis; Prevalence; Quality of Life; Recurrence; Sprains and Strains
PubMed: 27259753
DOI: 10.1136/bjsports-2016-096189 -
The Physician and Sportsmedicine Nov 2020Ankle sprains are a common sports-related injury, and female athletes are more likely to sustain this injury than their male counterparts. Previous reviews have...
Ankle sprains are a common sports-related injury, and female athletes are more likely to sustain this injury than their male counterparts. Previous reviews have evaluated the efficacy of prevention programs in reducing ankle sprains in athletes, but no reviews have specifically focused on female athletes. The objective of this systematic review was to examine the sex-specific effectiveness of neuromuscular training (NMT) programs in reducing the risk of ankle sprains in female athletes. A search of PubMed, Ovid Medline, Embase, and Web of Science databases was performed using the terms: . Studies selected for inclusion were written in English, evaluated female athletes in organized athletics or reported female-specific data for mixed-sex cohorts, included a non-NMT comparison, and used ankle injury rate outcome measures. Seven articles were selected for inclusion, which evaluated a combined 5,187 female basketball, handball, volleyball, soccer, and floorball players. Two studies reported significant differences between NMT participants and controls, concluding the greatest effects were observed in preventing non-contact ankle sprains. The remaining 5 studies, although not statistically significant, revealed an evident trend toward the efficacy of ankle injury prevention with NMT programs. Current available evidence supports the efficacy of NMT in preventing ankle sprains in female athletes. When designing NMT programs, investigators should consider utilizing comprehensive approaches that incorporate strength, balance, plyometric, and agility training as the studies with significant findings created comprehensive NMT programs. Further investigations into sport- and female-specific programs are warranted.
Topics: Ankle Injuries; Athletic Injuries; Basketball; Female; Humans; Physical Conditioning, Human; Proprioception; Soccer; Sprains and Strains; Volleyball
PubMed: 32067546
DOI: 10.1080/00913847.2020.1732246