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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

Survival curves for athletes sorted by weightbearing dorsiflexion range of motion (ROM) based on the Cox regression model. The light gray dotted line represents athletes with dorsiflexion ROM <41° (group 1), the dark gray dotted line represents athletes with dorsiflexion ROM 41° to 49.5° (group 1), and the black line represents athletes with dorsiflexion ROM >49.5° (group 3).
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fig5-2325967113518163: Survival curves for athletes sorted by weightbearing dorsiflexion range of motion (ROM) based on the Cox regression model. The light gray dotted line represents athletes with dorsiflexion ROM <41° (group 1), the dark gray dotted line represents athletes with dorsiflexion ROM 41° to 49.5° (group 1), and the black line represents athletes with dorsiflexion ROM >49.5° (group 3).

Mentions: The measurements taken from the 125 athletes with a previous ankle sprain were used in a Cox regression analysis of the injury and control groups, which demonstrated that weightbearing dorsiflexion ROM was predictive of a recurrent noncontact LAS (Table 3). The hazard ratio estimate indicated that athletes with a weightbearing dorsiflexion ROM greater than 49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS as athletes with a lower ROM (95% CI, 1.05-1.20) (Table 4). Figure 5 shows the survival curve based on the weightbearing dorsiflexion ROM. Because the cut-off value of weightbearing dorsiflexion ROM was 49.5° (sensitivity, 0.75; specificity, 0.86) by a receiver operating characteristic curve (Figure 6), and the average weightbearing dorsiflexion ROM in this study and the previous large prospective study was 45° ± 4°,27 the athletes’ outcomes were categorized into 3 groups according to their weightbearing dorsiflexion ROM: group 1, <41° (50 athletes); group 2, 41° to 49.5° (50 athletes); and group 3, >49.5° (25 athletes). Group 2 exhibited the highest survival rate (100.0%), followed by group 1 (94.0%) and group 3 (64.0%), where “survival” is defined as free from ankle sprain.


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)

Survival curves for athletes sorted by weightbearing dorsiflexion range of motion (ROM) based on the Cox regression model. The light gray dotted line represents athletes with dorsiflexion ROM <41° (group 1), the dark gray dotted line represents athletes with dorsiflexion ROM 41° to 49.5° (group 1), and the black line represents athletes with dorsiflexion ROM >49.5° (group 3).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

fig5-2325967113518163: Survival curves for athletes sorted by weightbearing dorsiflexion range of motion (ROM) based on the Cox regression model. The light gray dotted line represents athletes with dorsiflexion ROM <41° (group 1), the dark gray dotted line represents athletes with dorsiflexion ROM 41° to 49.5° (group 1), and the black line represents athletes with dorsiflexion ROM >49.5° (group 3).
Mentions: The measurements taken from the 125 athletes with a previous ankle sprain were used in a Cox regression analysis of the injury and control groups, which demonstrated that weightbearing dorsiflexion ROM was predictive of a recurrent noncontact LAS (Table 3). The hazard ratio estimate indicated that athletes with a weightbearing dorsiflexion ROM greater than 49.5° were 1.12 times as likely to suffer a recurrent noncontact LAS as athletes with a lower ROM (95% CI, 1.05-1.20) (Table 4). Figure 5 shows the survival curve based on the weightbearing dorsiflexion ROM. Because the cut-off value of weightbearing dorsiflexion ROM was 49.5° (sensitivity, 0.75; specificity, 0.86) by a receiver operating characteristic curve (Figure 6), and the average weightbearing dorsiflexion ROM in this study and the previous large prospective study was 45° ± 4°,27 the athletes’ outcomes were categorized into 3 groups according to their weightbearing dorsiflexion ROM: group 1, <41° (50 athletes); group 2, 41° to 49.5° (50 athletes); and group 3, >49.5° (25 athletes). Group 2 exhibited the highest survival rate (100.0%), followed by group 1 (94.0%) and group 3 (64.0%), where “survival” is defined as free from ankle sprain.

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