O12 Prediction of recurrent injury following return-to-play from an ankle sprain

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Study DesignProspective cohort study.ObjectivesDetermine the ability of clinical outcomes and anthropometrics to predict recurrent injuries in athletes during the same competitive season following return-to-play (RTP) from an ankle sprain.BackgroundPrediction of recurrent injury may be a valuable step towards minimising long-term consequences of ankle sprains. Limited investigation has predicted single-season recurrent ankle sprains in competitive athletes.Methods and MeasuresWe evaluated 60 high school and collegiate athletes at RTP following an ankle sprain (F:17, M:43; 17.9±3.3 years; 178.6±10.8 cm; 85.0±24.8 kg). Clinical outcomes included pain (100 mm visual analogue scale), swelling (figure-of-eight girth measurement), dorsiflexion ROM (weight-bearing lunge test), ligamentous laxity (anterior drawer and talar tilt tests), and the Foot and Ankle Ability Measure activity of daily living (FAAM-ADL) and sport (FAAM-S) subscales. Anthropometric outcomes included height, mass, and body mass index (BMI). After RTP, athletic trainers documented recurrent ankle sprains during the same competitive season.ResultsPatients with (n=8) and without (n=52) recurrent ankle sprains did not differ in involved-limb pain (12.8±16.1 vs 9.8±13.7, p=0.58), swelling (56.7±4.1 vs 54.4±5.1 cm, p=0.23), dorsiflexion ROM (7.6±4.1 vs 6.9±3.6 cm, p=0.58), FAAM-ADL (85.1±9.1 vs 86.4%±10.8%, p=0.73), and FAAM-S (70.3±10.0 vs 64.8%±19.8%, p=0.44) at RTP. Anterior drawer (p=0.64) and talar tilt (p=0.25) laxity (+/-) was not associated with recurrent injury status. Patients with recurrent ankle sprains had greater height (185.7±9.9 vs 177.5±10.6 cm, p=0.04), mass (104.7±29.7 vs 81.9±22.8 kg, p=0.01), and BMI (30.1±6.7 vs 25.7±5.5 kg/m2, p=0.05) than patients without recurrent ankle sprains. Area under receiver operating characteristic curves (AUROC) and diagnostic odds ratios (DOR) exhibited predictive value for height (AUROC=0.71, DOR=4.93), mass (AUROC=0.75, DOR=12.21) and BMI (AUROC=0.71, DOR=9.48).ConclusionsAthletic patients with greater height, mass, and BMI demonstrated greater odds of recurrent ankle sprains in the same competitive season following RTP. Taller and heavier patients may benefit from weight-management education before RTP to prevent recurrent ankle sprains.

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