Background
Lateral ankle sprain (LAS) is a common and burdensome injuries. However, the quality of its management is scant. Nowadays, physiotherapy management of musculoskeletal diseases seems to be generally not based on research evidence. Studies that investigated the knowledge-to-practice gap in LAS management are yet to be carried out. Therefore, this research investigated physiotherapists’ knowledge of and adherence to LAS Clinical Practice Guidelines (CPGs) and recommendations.
Methods
A cross-sectional study based on an online survey built on the LAS CPGs 2013 updated in 2018 and in 2021 and the recommendations of the 2018 Consensus Statement. The survey was structured in three sections. The first section collected demographic data. Second section showed two clinical cases (with positive and negative Ottawa Ankle Rules (OAR), respectively). The participants indicated which treatments they would adopt to manage them. Participants were classified as ‘following’, ‘partially following’, ‘partially not following’ and ‘not following’ the CPGs and recommendations. In the third section, participants expressed their agreement with different CPG and recommendation statements through a 1 (completely disagree) to 5 (completely agree) scale. We defined a ≥ 70% agreement with a statement as consensus.
Results
In total, 483 physiotherapists (age: 34 ± 10; female 38%, male 61.5%, other 0.5%) answered the survey: 85% completed the first two sections, 76% completed all three sections. In a case of acute LAS with negative OAR, 4% of the participants were considering as ‘following’ recommended treatments, 68% as ‘partially following’, 23% as ‘partially not following’, and 5% as ‘not following’. In a case of acute LAS with positive OAR, 37% were considered ‘following’ recommended treatments, 35% as ‘partially following’, and 28% as ‘not following’. In section III, the consensus was achieved for 73% of the statements. These statements dealt with assessments choices, such as the need to use the OAR, and with treatments choices.
Conclusion
This study showed that although there is a good knowledge about first-line recommended treatments, a better use of CPGs and recommendations should be fostered among physiotherapists. Our results identify an evidence-to-practice gap in LAS management, which may lead to non-evidence-based practice behaviours.