Prediction of Recurrent Lateral Ankle Sprain and Ankle Pain Using Applied Care Strategies and Patient-Reported Outcomes

Abstract

Context: Patients with lateral ankle sprains (LASs) often have deficient patient-reported outcomes (PROs) at return to activity (RTA), potentially increasing risk for recurrent LAS and ankle pain. Additionally, applied care strategies are known to correct impairments, but their ability to mitigate risk for long-term consequences remains unknown.

Objective: To determine if applied care strategies and PRO scores at RTA and 6 months after RTA predict recurrent LAS and ankle pain 12 months after an acute LAS.

Design: Prospective cohort study.

Setting: Online survey.

Patients or other participants: We enrolled 63 individuals within 1 week of sustaining an acute LAS.

Main outcome measure(s): Participants completed online surveys about their health history and recent LAS. At RTA and 6 months after RTA, participants completed online surveys regarding demographics, applied care strategies, and PROs, including the Foot and Ankle Disability Index (FADI), Identification of Functional Ankle Instability, Godin Leisure-Time Exercise Questionnaire, and Short Form-8 (SF8). At 12 months post-RTA, we asked participants if they sustained recurrent LASs. Chi-square analyses determined if recurrent LAS and ankle pain at 12 months were related to applied care strategies or ankle pain at RTA. Independent t tests compared demographics and PROs at RTA and 6 months between participants with and without a recurrent LAS or ankle pain at 12 months. Logistic regression and area under the receiver operating characteristic analyses determined if demographics, applied care strategies, ankle pain at RTA, and PRO scores at RTA and 6 months predicted recurrent LAS and ankle pain at 12 months.

Results: Participants with a recurrent LAS had a lower walking boot use (P = .05) and were taller than those without (P = .03). Increased height and lack of walking boot use were predictive of recurrent LAS (P < .01, R2 = 0.33, area under the receiver operating characteristic = 0.81 [0.68, 0.95]).

Conclusions: Individuals with LAS who are taller and do not use a walking boot might have greater risk for a recurrent LAS withing 12 months of RTA.

Keywords: health-related quality of life; perceived instability; rehabilitation; return to activity; self-reported function; walking boot.