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This study investigated the effectiveness of care strategies and patient-reported outcome scores in predicting the development of chronic ankle instability (CAI) after an acute lateral ankle sprain (LAS). This study enrolled 51 community participants within 1 week of LAS (average age 21.5 yrs). Participants answered surveys about their use of assistive weight-bearing devices (crutches, walking boot) following injury and also included several PRO questionnaires: Identification of Functional Ankle Instability (IdFAI), Foot and Ankle Disability Index (FADI), Godin Leisure-Time Exercise questionnaire, and Short Form-8 (SF8).
Based on 12-month follow-up IdFAI scores, 42 (82.5%) participants were classified as having CAI and 9 (17.5%) were classified as copers (COP). Chi-square analysis revealed a higher frequency of walking boot use in COP (55%) versus CAI (21%) (χ2=4.33, P=0.04). At the 6-month interval, the CAI group displayed lower SF8 physical component (CAI: 55.7±5.6 vs COP: 59.7±2.5, P<0.01, d=0.88 [0.09,1.66]) and higher IdFAI (CAI: 21.7±6.3 vs COP: 15.9±8.2, P=0.03, d=0.76 [-0.02,1.54]) scores compared to COP. Logistic regression analysis revealed the combination of walking boot use and 6-month IdFAI and SF8 physical component scores were significant predictors of CAI classification at 12-months (χ2=13.13, P<0.01, R2=0.41). ROC curve analysis further showed the combination of these variables had strong predictive value for CAI classification at 12-months (AUROC=0.87 [0.76,0.99], P<0.01).
The findings suggest that using a walking boot immediately after an acute LAS and having favorable patient-reported outcome scores at a 6-month follow-up can reduce the likelihood of developing CAI at a 12-month follow-up. The study highlights the importance of temporary immobilization and monitoring patient perceptions beyond return-to-activity for preventing CAI.
Source: McCann RS, Kosik KB, Ohrnberger E, Gribble PA. Patient-Reported Outcomes and Walking Boot Use Following an Acute Lateral Ankle Sprain Predict Chronic Ankle Instability. J Athl Train. 2023;58(6S):112.
