Materiały źródłowe

• #1 Prognostic factors in ankle sprains: a review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7336189/

  Ankle sprains are one of the most common musculoskeletal injuries, being the most frequent musculoskeletal trauma among athletes. […] Most of these injuries are successfully treated conservatively; however, up to 70% of patients can develop long-lasting symptoms. Therefore, understanding prognostic factors for an ankle sprain could help clinicians identify patients with poor prognosis and choose the right treatment. […] There are some prognostic factors linked to a better recovery and outcome; nevertheless, prognostic factors for full recovery after initial ankle sprain are not consistent. […] Understanding prognostic factors for an ankle sprain could help clinicians identify patients with a poor prognosis and choose the right treatment. Conversely, identifying patients with a good prognosis could have benefits for healthcare, health cost and resource use.

• #2 Prognostic factors in ankle sprains: a review in: EFORT Open Reviews Volume 5 Issue 6 (2020)

  https://eor.bioscientifica.com/view/journals/eor/5/6/2058-5241.5.200019.xml

  Ankle sprains are one of the most common musculoskeletal injuries, being the most frequent musculoskeletal trauma among athletes. […] Most of these injuries are successfully treated conservatively; however, up to 70% of patients can develop long-lasting symptoms. Therefore, understanding prognostic factors for an ankle sprain could help clinicians identify patients with poor prognosis and choose the right treatment. […] There are some prognostic factors linked to a better recovery and outcome; nevertheless, prognostic factors for full recovery after initial ankle sprain are not consistent. […] Understanding prognostic factors for an ankle sprain could help clinicians identify patients with a poor prognosis and choose the right treatment. Conversely, identifying patients with a good prognosis could have benefits for healthcare, health cost and resource use.

• #3 Prognostic factors in ankle sprains: a review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7336189/

  Despite insufficient evidence to recommend any factor as an independent predictor of outcome, there were some prognostic factors linked to a better recovery and outcome: young age, low activity level, low grade injury, good functional status, good neuromuscular function and no other associated injury. […] Poor outcomes may also be related to associated injuries in a stable ankle or an ankle that has healed properly, where pain is the only reported symptom osteochondral lesions are present in up to 89% of ankle sprains with chronic instability. […] Prognostic factors for full recovery after initial ankle sprain are not consistent, thus it is still unknown who benefits from acute surgical treatment. Nevertheless, many factors have been identified that increase the probability of a poor outcome.

• #4 Prognostic factors in ankle sprains: a review in: EFORT Open Reviews Volume 5 Issue 6 (2020)

  https://eor.bioscientifica.com/view/journals/eor/5/6/2058-5241.5.200019.xml

  Despite insufficient evidence to recommend any factor as an independent predictor of outcome, there were some prognostic factors linked to a better recovery and outcome: young age, low activity level, low grade injury, good functional status, good neuromuscular function and no other associated injury. […] Prognostic factors associated with a bad outcome are systemic laxity, joint geometry, re-sprain, limb/foot malalignment and multiligament injuries. […] Prognostic factors for full recovery after initial ankle sprain are not consistent, thus it is still unknown who benefits from acute surgical treatment. Nevertheless, many factors have been identified that increase the probability of a poor outcome.

• #5 Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1777-9

  One-third of individuals who sustain an acute lateral ankle ligament sprain suffer significant disability due to pain, functional instability, mechanical instability or recurrent sprain after recovery plateaus at 1 to 5 years post injury. […] The identification of early prognostic factors associated with poor recovery may provide an opportunity for early-targeted intervention and improve outcome. […] Age, female gender, swelling, restricted range of motion, limited weight bearing ability, pain (at the medial joint line and on weight-bearing dorsi-flexion at 4 weeks, and pain at rest at 3 months), higher injury severity rating, palpation/stress score, non-inversion mechanism injury, lower self-reported recovery, re-sprain within 3 months, MRI determined number of sprained ligaments, severity and bone bruise were found to be independent predictors of poor recovery.

• #6 Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1777-9

  The associations between prognostic factors and poor recovery after an acute lateral ankle sprain are largely inconclusive. […] At present, there is insufficient evidence to recommend any factor as an independent predictor of outcome. […] There is a need for well-conducted prospective cohort studies with adequate sample size and long-term follow-up to provide robust evidence on prognostic factors of recovery following an acute lateral ankle sprain. […] Factors that may be associated with poor recovery at short-term include: pain intensity, difficulties bearing weight, restricted joint motion and functional ability. […] At long-term: older age, female gender. […] There is limited evidence that re-current sprain within 3 months, predicts subjective recovery at long term. […] Overall, the existing evidence from the studies identified by this review does not allow firm conclusions to be drawn about prognostic factors of recovery from an acute ankle sprain.

• #7 Development and prospective external validation of a tool to predict poor recovery at 9 months after acute ankle sprain in UK emergency departments: the SPRAINED prognostic model – White Rose Research Online

  https://eprints.whiterose.ac.uk/id/eprint/138581/

  OBJECTIVES: To develop and externally validate a prognostic model for poor recovery after ankle sprain. […] OUTCOME AND ANALYSIS: Poor recovery was defined as presence of pain, functional difficulty or lack of confidence in the ankle at 9 months after injury. […] Age, BMI, pain when resting, pain bearing weight, ability to bear weight, days from injury until assessment and injury recurrence were the selected predictors. […] The baseline model had fair discriminatory ability (C-statistic 0.72; 95%CI 0.66 to 0.79) but poor calibration. […] The updated model presented better discrimination (C-statistic 0.78; 95%CI 0.72 to 0.84), but equivalent calibration. […] The models include predictors easy to assess clinically and show benefit when compared with not using any model.

• #8 Development and internal validation of the SPRAINED prognostic models in the CAST data set – Prognostic models for identifying risk of poor outcome in people with acute ankle sprains: the SPRAINED development and external validation study – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534075/

  This chapter describes the development and internal validation of the two prognostic models to identify people at risk of poor outcome after an acute ankle sprain. […] Ankle function at 9 months after ankle sprain was the primary outcome for CAST. For the SPRAINED study, our primary outcome was poor outcome. […] The definitions were considered and agreed by the patient and public involvement group convened for the SPRAINED study. […] The first model was developed to predict a composite outcome (hereafter referred to as outcome 1) representing the presence of at least one of the following symptoms at 9 months after injury: persistent pain, functional difficulty or lack of confidence. […] The second model was developed to predict a composite outcome (hereafter referred to as outcome 2) representing the presence of at least one of the following symptoms or clinical events at 9 months after injury: persistent pain, functional difficulty, lack of confidence or recurrence of injury.

• #9 Development and internal validation of the SPRAINED prognostic models in the CAST data set – Prognostic models for identifying risk of poor outcome in people with acute ankle sprains: the SPRAINED development and external validation study – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534075/

  The performance of the prognostic models was characterised by evaluating calibration and discrimination. […] The overall discriminatory ability was summarised by the c-statistic (or area under receiver operating characteristic curve) with 95% confidence interval (CI). […] The addition of one variable with information on pain when bearing weight on the ankle at 4 weeks after the injury improved the discriminatory ability and apparent calibration of both models. […] The estimated probability of a poor outcome developing 9 months after ankle sprain (as per the definition of outcome 1) for that patient would be 45%. […] Therefore, by adding extra information on the patient follow-up, we were able to estimate a more precise probability of presenting with poor outcome at 9 months after injury.

• #10 Ankle-GO score is associated with the probability of becoming coper after lateral ankle sprain: a 1-year prospective cohort study | British Journal of Sports Medicine

  https://bjsm.bmj.com/content/58/19/1115

  The Ankle-GO may help identify patients more likely to become copers within a year of injury. […] Those with low Ankle-GO scores and female patients should receive additional rehabilitation to increase the odds of becoming a coper. […] The total Ankle-GO score is associated with coper status 1 year after LAS. […] Patients with an Ankle-GO score above 11 points and male patients were more likely to become copers (OR=12.1; 95% CI 2.5 to 59, p=0.002 and OR=5.2; 95% CI 1.2 to 22.4, p=0.026, respectively). […] The Ankle-GO score seems to be a relevant tool to help clinician identifying patients who will become a coper 1 year after LAS. […] Patients who score 11 points is twelve times more likely to fully recover. […] In addition, males exhibit a five times higher chance of becoming copers.

• #11 Low Ankle-GO Score While Returning to Sport After Lateral Ankle Sprain Leads to a 9-fold Increased Risk of Recurrence: A Two-year Prospective Cohort Study | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-024-00693-w

  Lateral ankle sprain (LAS) is the most common sports injury, leading to a high rate of recurrence and the development of chronic ankle instability. […] The two-month Ankle-GO score was lower in patients with a recurrent LAS (5.42.8 points vs. 9.14.5, p=0.002) and predicted the risk of reinjury (AUC=0.75). […] Patients with a low score at two months have a 9-fold greater risk of recurrence within two years. […] The two-year risk of ankle sprain recurrence is nine times higher in patients with a low Ankle-GO score. […] The Ankle-GO score was the only statistically significant contribution to the model on multivariate logistic regression, with an OR of 8.6 (95% CI: 2 to 37.2, p=0.004). That is, patients who scored below 8 points on the Ankle-GO score two months after an initial LAS had a nearly 9 times greater risk of reinjury within the next two years. […] A low Ankle-GO score is associated with an increased risk of reinjury within 2 years after LAS. Patients with a score8 points two months after the initial LAS had a 9 times greater risk of reinjury.

• #12 Predictive Factors of Recovery after an Acute Lateral Ankle Sprain: A Longitudinal Study

  https://www.mdpi.com/2075-4663/9/3/41

  A prominent feature of ankle sprains is their variable clinical course. The difficulty of providing a reliable early prognosis may be responsible for the substantial rate of poor outcomes after an ankle sprain. […] Following a predictor pre-selection procedure, logistic regressions evaluated the association between the four-week predictors and the seven-month recovery status. […] The results of the logistic regressions showed that walking pain was negatively associated with the probability of recovering at seven months (odds ratio: 0.71, 95% CI: 0.53–0.95). Pain four weeks after ankle sprain had relevant predictive value for long-term recovery. Special attention should be paid to patients reporting persistent pain while walking four weeks following sprain to reduce the risk of chronicity.

• #13 Predictive Factors of Recovery after an Acute Lateral Ankle Sprain: A Longitudinal Study

  https://www.mdpi.com/2075-4663/9/3/41

  The results of the present study suggested that perceived pain during walking is associated with long-term recovery. […] The best model indicated that pain while walking was negatively associated with the probability of recovery (odd ratio: 0.71, 95% CI: 0.53–0.95). In other words, the odds of recovery seven months after the sprain decreased by 29% for each additional point on the pain scale assessed four weeks after the injury. […] These findings also highlight the importance of the assessment of pain while walking in detecting patients at risk of poor long-term prognosis. Assessing patients after the acute phase of ankle sprain recovery may help in selecting ideal rehabilitation treatments. Particular attention should be paid to patients with persistent pain in order to reduce the risk of chronicity.

• #14 Effectiveness of the SMART training intervention on ankle joint function in patients with first-time acute lateral ankle sprain: study protocol for a randomized controlled trial | Trials | Full Text

  https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-023-07195-2

  The lateral ankle sprain (LAS) is the most common injury in the field of everyday and sports-related activities. There is a high rate of patients with LAS who will develop chronic ankle instability (CAI). A possible explanation for this high rate is an insufficient rehabilitation and/or a premature return to intense exercise and workloads. […] According to a systematic review, 25% of patients with LAS will develop a chronic ankle instability (CAI). This condition is characterized by a history of one significant LAS, subsequent recurrent sprains, episodes of the ankle giving way, or self-reported deficits in ankle function. […] A possible explanation for the high rate of CAI is an insufficient rehabilitation and/or a too early return to intense sports and workloads after LAS. […] Currently, there are general guidelines for the rehabilitation after LAS but there is no standardized evidenced-based rehabilitation concept for LAS, which effectively reduces the high CAI rate.

• #15 Predicting patient-reported and objectively measured functional outcome 6 months after ankle fracture in people aged 60 years or over in the UK: prognostic model development and internal validation | BMJ Open

  https://bmjopen.bmj.com/content/9/7/e029813

  Predictive accuracy of the four models using commonly recorded clinical data to predict self-reported or objectively measured ankle function 6 months after unstable ankle fracture in adults aged over 60 years was relatively low. […] We developed and internally validated prognostic models to predict functional outcomes 6 months after unstable ankle fracture in older adults using commonly recorded clinical data. These prognostic models had relatively limited accuracy in predicting self-reported or objectively measured ankle function. Other potential predictors (eg, psychological factors such as catastrophising and fear avoidance) should be investigated.

• #16 Predicting patient-reported and objectively measured functional outcome 6 months after ankle fracture in people aged 60 years or over in the UK: prognostic model development and internal validation | BMJ Open

  https://bmjopen.bmj.com/content/9/7/e029813

  Objective To predict functional outcomes 6 months after ankle fracture in people aged 60 years using post-treatment and 6-week follow-up data to inform anticipated recovery, and identify people who may benefit from additional monitoring or rehabilitation. […] Predictive accuracy of the prognostic models using commonly recorded clinical data to predict self-reported or objectively measured ankle function was relatively low and therefore unlikely to be beneficial for clinical practice and counselling of patients. Other potential predictors (eg, psychological factors such as catastrophising and fear avoidance) should be investigated to improve predictive accuracy. […] A prognostic model has the potential to inform anticipated recovery, and identify people who may benefit from additional monitoring or rehabilitation.

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