Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability

Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

doi:10.1177/0363546516628870

Cited by 294 publications

(182 citation statements)

References 46 publications

(154 reference statements)

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“…This may indicate that not all factors contributing to the success or failure of rehabilitation are known. Some of the known unfavourable prognostic factors identified for the development of CAI were an inability to complete jumping and landing within 2 weeks after a first-time LAS, deficiencies in dynamic postural control,53 altered hip joint kinematics54 and lack of mechanical stability/increased ligament laxity 8 weeks after an ankle sprain 55 56. Other factors that may influence the prognosis are sports participation at a high level,57 being a young male,52 increased BMI52 and greater body height52 (level 3).…”

Section: Resultsmentioning

confidence: 99%

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

et al. 2018

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This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury. The previous guideline provided evidence that the severity of ligament damage can be assessed most reliably by delayed physical examination (4–5 days post trauma). After correct diagnosis, it can be stated that even though a short time of immobilisation may be helpful in relieving pain and swelling, the patient with an acute lateral ankle ligament rupture benefits most from use of tape or a brace in combination with an exercise programme.New in this update: Participation in certain sports is associated with a heightened risk of sustaining a lateral ankle sprain. Care should be taken with non-steroidal anti-inflammatory drugs (NSAIDs) usage after an ankle sprain. They may be used to reduce pain and swelling, but usage is not without complications and NSAIDs may suppress the natural healing process. Concerning treatment, supervised exercise-based programmes preferred over passive modalities as it stimulates the recovery of functional joint stability. Surgery should be reserved for cases that do not respond to thorough and comprehensive exercise-based treatment. For the prevention of recurrent lateral ankle sprains, ankle braces should be considered as an efficacious option.

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Section: Resultsmentioning

confidence: 99%

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

et al. 2018

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“…Injury recurrence rates following lateral ankle sprain are high, leading to a large percentage of patients developing chronic ankle instability 31. Lingering ankle instability contributes to ongoing sensorimotor deficits and constrained functioning, which associate with decreased physical activity and quality of life.…”

Section: Summary and Recommendationsmentioning

confidence: 99%

2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains

et al. 2016

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The Executive Committee of the International Ankle Consortium presents this 2016 position paper with recommendations for information implementation and continued research based on the paradigm that lateral ankle sprain (LAS), and the development of chronic ankle instability (CAI), serve as a conduit to a significant global healthcare burden. We intend our recommendations to serve as a mechanism to promote efforts to improve prevention and early management of LAS. We believe this will reduce the prevalence of CAI and associated sequelae that have led to the broader public health burdens of decreased physical activity and early onset ankle joint post-traumatic osteoarthritis. Ultimately, this can contribute to healthier lifestyles and promotion of physical activity.

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“…Recurrent ankle sprains occur in up to 40% of individuals who have previously experienced a lateral ankle sprain [1, 2]. Individuals who report residual symptoms, which include repetitive episodes of ‘giving way’ and subjective feeling of ankle joint instability are termed as having chronic ankle instability (CAI) [3].…”

Section: Introductionmentioning

confidence: 99%

Effects of dual-task and walking speed on gait variability in people with chronic ankle instability: a cross-sectional study

Springer

Gottlieb

2017

BMC Musculoskelet Disord

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BackgroundRecent evidence suggests that impaired central sensorimotor integration may contribute to deficits in movement control experienced by people with chronic ankle instability (CAI). This study compared the effects of dual-task and walking speed on gait variability in individuals with and without CAI.MethodsSixteen subjects with CAI and 16 age- and gender-matched, able-bodied controls participated in this study. Stride time variability and stride length variability were measured on a treadmill under four different conditions: self-paced walking, self-paced walking with dual-task, fast walking, and fast walking with dual-task.ResultsUnder self-paced walking (without dual-task) there was no difference in stride time variability between CAI and control groups (P = 0.346). In the control group, compared to self-paced walking, stride time variability decreased in all conditions: self-paced walking with dual-task, fast speed, and fast speed with dual-task (P = 0.011, P = 0.016, P = 0.001, respectively). However, in the CAI group, compared to self-paced walking, decreased stride time variability was demonstrated only in the fast speed with dual-task condition (P = 1.000, P = 0.471, P = 0.008; respectively). Stride length variability did not change under any condition in either group.ConclusionsSubjects with CAI and healthy controls reduced their stride time variability in response to challenging walking conditions; however, the pattern of change was different. A higher level of gait disturbance was required to cause a change in walking in the CAI group compared to healthy individuals, which may indicate lower adaptability of the sensorimotor system. Clinicians may use this information and employ activities to enhance sensorimotor control during gait, when designing intervention programs for people with CAI.The study was registered with the Clinical Trials network (registration NCT02745834, registration date 15/3/2016).

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Recovery From a First-Time Lateral Ankle Sprain and the Predictors of Chronic Ankle Instability

Cited by 294 publications

References 46 publications

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline

2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains

Effects of dual-task and walking speed on gait variability in people with chronic ankle instability: a cross-sectional study

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