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Intrinsic Predictive Factors of Noncontact Lateral Ankle Sprain in Collegiate Athletes: A Case-Control Study.

Kobayashi T, Yoshida M, Yoshida M, Gamada K - Orthop J Sports Med (2013)

Bottom Line: The baseline measurements included weightbearing dorsiflexion range of motion (ROM), leg-heel angle, foot internal rotation angle in plantar flexion, classification according to the mortise test, and navicular-medial malleolus (NMM) distance.The hazard ratio estimated by a Cox regression analysis showed that athletes with an NMM distance ≥4.65 cm were 4.14 times more likely to suffer an initial noncontact LAS than were athletes with a shorter NMM distance (95% confidence interval, 1.12-14.30) and that athletes with a weightbearing dorsiflexion ROM >49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS compared with athletes with a lower ROM (95% confidence interval, 1.05-1.20).NMM distance predicts initial noncontact LAS, and weightbearing dorsiflexion ROM predicts recurrent noncontact LAS.

View Article: PubMed Central - PubMed

Affiliation: Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan. ; Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan.

ABSTRACT

Background: Lateral ankle sprain (LAS) is one of the most common injuries in sports. Despite extensive research, intrinsic factors that predict initial and recurrent noncontact LAS remain undefined.

Purpose: To identify the predictive factors of initial and recurrent noncontact LAS, focusing on ankle flexibility and/or alignment in collegiate athletes.

Study design: Case-control study; Level of evidence, 3.

Methods: A total of 191 athletes were assessed during the preseason for factors predictive of noncontact LAS. The baseline measurements included weightbearing dorsiflexion range of motion (ROM), leg-heel angle, foot internal rotation angle in plantar flexion, classification according to the mortise test, and navicular-medial malleolus (NMM) distance. Occurrence of noncontact LAS and participation in practice and games were prospectively recorded for 11 months.

Results: Of the 191 athletes assessed, 169 (145 males, 24 females) completed the study; 125 athletes had a history of ankle sprain. During the observational period, 16 athletes suffered noncontact LAS (0.58 per 1000 athlete-exposures) consisting of 4 initial sprains and 12 recurrences. The hazard ratio estimated by a Cox regression analysis showed that athletes with an NMM distance ≥4.65 cm were 4.14 times more likely to suffer an initial noncontact LAS than were athletes with a shorter NMM distance (95% confidence interval, 1.12-14.30) and that athletes with a weightbearing dorsiflexion ROM >49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS compared with athletes with a lower ROM (95% confidence interval, 1.05-1.20).

Conclusion: NMM distance predicts initial noncontact LAS, and weightbearing dorsiflexion ROM predicts recurrent noncontact LAS.

No MeSH data available.


Related in: MedlinePlus

Flowchart of the study protocol. LAS, lateral ankle sprain; ROM, range of motion.
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fig1-2325967113518163: Flowchart of the study protocol. LAS, lateral ankle sprain; ROM, range of motion.

Mentions: During the preseason period, all athletes underwent baseline measurements and completed a questionnaire regarding history of previous LAS. The athletes were followed for 11 months (48 weeks) to monitor the occurrence of ankle sprain and participation in practice or games. At the end of the follow-up period, analyses were performed to calculate the risk of injury and define the risk factors for both initial and recurrent noncontact LAS (Figure 1). All injured athletes reported their injury mechanisms (ie, contact/noncontact or inversion/eversion) and the severity of the sprain along with all necessary details. If necessary, they visited a medical institution to rule out fractures. Athletes who suffered contact ankle sprains, defined as an injury involving physical contact at any body part during the injurious action, were not included in the analyses. LAS was defined as an ankle injury with an inversion mechanism that caused the player to miss at least 1 game or practice. Hours participating in practice or games were recorded by a club manager and were reported to the researchers monthly.


Intrinsic Predictive Factors of Noncontact Lateral Ankle Sprain in Collegiate Athletes: A Case-Control Study.

Kobayashi T, Yoshida M, Yoshida M, Gamada K - Orthop J Sports Med (2013)

Flowchart of the study protocol. LAS, lateral ankle sprain; ROM, range of motion.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555518&req=5

fig1-2325967113518163: Flowchart of the study protocol. LAS, lateral ankle sprain; ROM, range of motion.
Mentions: During the preseason period, all athletes underwent baseline measurements and completed a questionnaire regarding history of previous LAS. The athletes were followed for 11 months (48 weeks) to monitor the occurrence of ankle sprain and participation in practice or games. At the end of the follow-up period, analyses were performed to calculate the risk of injury and define the risk factors for both initial and recurrent noncontact LAS (Figure 1). All injured athletes reported their injury mechanisms (ie, contact/noncontact or inversion/eversion) and the severity of the sprain along with all necessary details. If necessary, they visited a medical institution to rule out fractures. Athletes who suffered contact ankle sprains, defined as an injury involving physical contact at any body part during the injurious action, were not included in the analyses. LAS was defined as an ankle injury with an inversion mechanism that caused the player to miss at least 1 game or practice. Hours participating in practice or games were recorded by a club manager and were reported to the researchers monthly.

Bottom Line: The baseline measurements included weightbearing dorsiflexion range of motion (ROM), leg-heel angle, foot internal rotation angle in plantar flexion, classification according to the mortise test, and navicular-medial malleolus (NMM) distance.The hazard ratio estimated by a Cox regression analysis showed that athletes with an NMM distance ≥4.65 cm were 4.14 times more likely to suffer an initial noncontact LAS than were athletes with a shorter NMM distance (95% confidence interval, 1.12-14.30) and that athletes with a weightbearing dorsiflexion ROM >49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS compared with athletes with a lower ROM (95% confidence interval, 1.05-1.20).NMM distance predicts initial noncontact LAS, and weightbearing dorsiflexion ROM predicts recurrent noncontact LAS.

View Article: PubMed Central - PubMed

Affiliation: Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan. ; Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Hokkaido, Japan.

ABSTRACT

Background: Lateral ankle sprain (LAS) is one of the most common injuries in sports. Despite extensive research, intrinsic factors that predict initial and recurrent noncontact LAS remain undefined.

Purpose: To identify the predictive factors of initial and recurrent noncontact LAS, focusing on ankle flexibility and/or alignment in collegiate athletes.

Study design: Case-control study; Level of evidence, 3.

Methods: A total of 191 athletes were assessed during the preseason for factors predictive of noncontact LAS. The baseline measurements included weightbearing dorsiflexion range of motion (ROM), leg-heel angle, foot internal rotation angle in plantar flexion, classification according to the mortise test, and navicular-medial malleolus (NMM) distance. Occurrence of noncontact LAS and participation in practice and games were prospectively recorded for 11 months.

Results: Of the 191 athletes assessed, 169 (145 males, 24 females) completed the study; 125 athletes had a history of ankle sprain. During the observational period, 16 athletes suffered noncontact LAS (0.58 per 1000 athlete-exposures) consisting of 4 initial sprains and 12 recurrences. The hazard ratio estimated by a Cox regression analysis showed that athletes with an NMM distance ≥4.65 cm were 4.14 times more likely to suffer an initial noncontact LAS than were athletes with a shorter NMM distance (95% confidence interval, 1.12-14.30) and that athletes with a weightbearing dorsiflexion ROM >49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS compared with athletes with a lower ROM (95% confidence interval, 1.05-1.20).

Conclusion: NMM distance predicts initial noncontact LAS, and weightbearing dorsiflexion ROM predicts recurrent noncontact LAS.

No MeSH data available.


Related in: MedlinePlus